Castle Place Practice
PATIENT PARTICIPATION GROUP
NOTES OF MEETING HELD ON Friday 13th March 2015
Helen Kingdon (Practice Manager) welcomed everyone to the meeting and introduced Tim Davies
(Deputy Practice Manager). Apologies were offered for the short notice.
Matters Arising from Previous Meeting (Aug 2014) (Tim Davies)
EPS (Electronic Prescribing Service) Update
61% of prescriptions are now being transmitted to pharmacies electronically. The system helps
with tracking a prescription on its journey from request, to electronic signature to eventually being
dispensed.
Some items still need to be printed on to a paper prescription; namely controlled drugs. This has
caused some delays in the process as some repeat items have gone electronically but the controlled
drugs have been sent to the pharmacy on paper.
We’re endeavouring to change this so that all items go together on paper.
Any problems, do please let us know.
Batch Prescribing
Batch prescribing would enable us to reduce the number of prescriptions that require signing as the
GP effectively signs a prescription for six months and the items are issued every 28 days by the
pharmacy.
Unfortunately trials of the system have found that the management of the process is quite
complicated and time consuming. We’ve experimented with the contraceptive pill and are not
ready to expand it as yet.
The hope is that the process will become more efficient eventually.
Appointment System Changes
Changes discussed at the last meeting have been implemented. The system overall is under
frequent review and improvement. Everyone that calls and requests a same day appointment
receives a call back from their own GP, the Duty Doctor or one of our Practice Nurses.
If you call when your GP is on a day off, you will be offered a call back from them the following day.
One attendee had experienced the system and said that for him it worked well.
Building Decoration
Castle Place Practice
The whole interior was re-painted in December.
The question was raised as to whether the Practice was built under a PFI project. Helen confirmed
that the whole site was built as a PFI project and that the Practice has a 30 year lease. It is
therefore crucial that the hospital is used efficiently and fully in order to meet the payment
requirements. The Practice however, as tenants, is restricted in its ability to sub-let any of the
consulting rooms.
GP Changes (Helen Kingdon)
Helen outlined forthcoming changes:
Dr Savill retires this month. His last day is 25th. Dr Savill’s patient list is being taken over by Dr
Charles Ristic. He may be known to some patients locally as he used to be a Partner at the
Sampford Peverell Practice.
Dr Ali Round is retiring from the Partnership in April. Her patient list will be shared between Dr
Megan Parkin and Dr Rachel Lucey. Letters will be going out to her patients shortly.
Salaried GPs – Dr Alex Werhun has left and Dr Lynne Anderson is also leaving.
Practice Nurse Services (Helen Kingdon)
We have recently lost two of our Practice Nurses with a third due to leave us at the end of March.
We are having difficulty finding replacements and this will obviously have an impact on the range of
services that we will be able to provide in the interim.
Millie White has left to farm livestock. Sarah Godeck has joined the Occupational Health Service
and Jayne Lacey will be working in the Sexual Health Service in North Devon.
The requirements of our core contract will continue to be met but we may have to temporarily
suspend some of the work that we are doing and not getting paid for e.g. leg ulcer dressings and
ear syringing.
As explained in previous meetings we hold a Contract to provide core services to patients and
chronic disease management as well as enhanced services e.g. INR monitoring. Any work not
currently covered by a contract or enhanced service is currently being reviewed and may be
temporarily suspended until we're able to recruit new Nurses.
The question was raised as to whether the American system of wound management was going to
be adopted here. The Practice isn’t aware that this is a priority for investment here. However, the
current methods are very time consuming for the nurses.
Castle Place Practice
The question was raised about nurse prescribing and why our nurses don’t do it. The Partners and
Nurses prefer for the patient’s GP to be involved in their on-going care so always check with the GP
and get them to sign off the suggested prescriptions.
On-Line Access (Tim Davies)
On-line access requirements are changing from 1st April 2015. All patients registered with the
Patient Access system will now be able to view a summary of the medical record as well as their
medications, allergies and any adverse reactions.
Allergies will be listed – please let us know if these are incorrect or missing.
An attendee asked who else has access to this information. Nationally, as well as basic
demographic information, medication and allergies are visible in healthcare environments via the
Summary Care Record. Access is restricted to those with a Smartcard and who have a need to use
the information in the provision of healthcare.
As far as we’re aware the RD&E Hospital are not yet accessing summary care records routinely.
Please let us know if you spot any errors on your records.
One attendee frequently uses the on-line service and gave good feedback.
Friends and Family Test (Tim Davies)
As discussed at the previous meeting, the friends and family test is now compulsory for general
practices. It’s been live since December.
Unfortunately we weren’t allowed to use the token system as previously discussed. However, we
have postcards in the waiting room and the questionnaire is available on our website.
This is now part of our core contract and although completion rates have been low so far, we aim to
target specific patient groups, Nurse and GP appointments.
One attendee asked if the Practice is at full capacity and how we were going to cater for the
expanding population, with new housing developments planned. Although the turnover of patients
is quite high, the total practice list size increases quite slowly. However, we may need to expand
the number of GPs and/or Nurses in order to meet the increase in population.
The Future of the Patient Group (Helen Kingdon)
As discussed in previous meetings, the formation and function of the patient group has been
governed by an enhanced service.
This is changing and it will become part of our core contract from April 2015. The only detail from
the BMA so far is as follows:
Castle Place Practice

The patient participation enhanced service will end. From 1 April 2015, it will be a contractual
requirement for all practices to have a patient participation group (PPG) and to make
reasonable efforts for this to be representative of the practice population. Funding associated
with this ES will be reinvested in global sum.
We currently have approx. 150 members and certainly don’t want to lose the connection that
we’ve had with the group as the feedback has been invaluable.
It was suggested and agreed therefore that once more detail is known, this will be shared with the
group and future meetings arranged as required.
It was suggested that the minutes of the meetings be added to the Patient Group section of the
website so that those interested could see what has been discussed in the past.
It was also suggested that more information about the requirements (once known) be displayed in
the waiting room.
Any Other Business
Waiting Room Screens
Several attendees reported that the screens change too quickly. Tim to slow them down.
Routine Screening for Men
At the moment the only system in place is for Abdominal Aorta Aneurysm screening. Several men
in the room queried why PSA/Prostate checking is not yet routine.
Ex-Service Personnel
Do they receive preferential treatment? Not in primary care but referral to specific services are
given priority.
Parking Permits
Not all GPs are displaying their permits. Helen to check.
Thank You and Farewell
One of the group members gave his apologies for future meetings due a change in his personal
circumstances. He’s enjoyed being part of the group and wished us all well for the future.
Post Meeting Notes/Comments
Timing of the Meetings
It was suggested that we rotate the days the meetings are held, and not always hold them on a
Friday.