Castle Place Practice
PATIENT PARTICIPATION GROUP
NOTES OF MEETING HELD ON Friday 15th August 2014
Helen Kingdon (Practice Manager) welcomed everyone to the meeting and introduced Tim Davies
(Deputy Practice Manager) and Dr David Lonsdale-Eccles (GP Partner).
Matters Arising from Previous Meeting (Feb 2014)
Prescription Line Closure (Tim Davies)
The telephone repeat prescription service was ceased on 31st March. Very few negative comments
have been received about this. Our reasons for closing the telephone service were focused around
patient safety and controlling the processing of prescription requests in order to reduce errors.
The use of the Electronic Prescription service has risen from 11% to 41% of prescriptions being
electronically signed off by the GP and transmitted to the Pharmacy. Additionally 2000 patients are
now ordering their prescriptions on-line.
The next project on the horizon is the implementation of Batch Prescribing.
For stable patients, GPs would sign a prescription for a six month supply. Patients will only be
dispensed their medication on a monthly basis but they wouldn’t have to contact the Practice every
month; the Pharmacy would manage the process. This will reduce workload at the practice for our
reception team as well as for the GPs.
It’s not a system that is suitable for all patients and we’ll probably start by targeting stable patients
on one or two medications at most, who receive free prescriptions.
The computer system would alert the GP to a patient’s suitability for a six month prescription and
would prompt a discussion between the patient and GP.
Some concerns were noted from those present namely:
 Will this reduce over-ordering?
 What about the outstanding prescriptions of deceased patients?
 Frequency of supply – set dates or four weekly?
These are all queries that are still to be resolved.
Mrs Lumb reported that the Clinical Commissioning Group are working with local Pharmacies to
review the different quantities of medication supplied and the use of blister packs. The aim of
which is to reduce waste.
Timing of Meeting (Helen Kingdon)
As suggested at the February meeting, this meeting was held on a week day.
Castle Place Practice
With 22 in attendance including some new faces, all present felt it was a very good idea.
Update from Dr Lonsdale-Eccles
Minor Injuries Unit
The minor injuries service was put out to tender and bids were submitted by North Devon
Healthcare Trust, Devon Doctors on Call (DDOC) and the South West Ambulance Service Trust
(SWAST).
SWAST won the contract and have upgraded the unit to an Urgent Care Centre.
SWAST also run the 111 service and are able to direct ambulances to attend Tiverton Hospital.
At the moment no tangible difference has been felt but the aspiration is to have a GP on site at all
times when the unit is open. SWAST are also keen to offer more services on site but they have to
ensure that support services are available e.g. x-ray.
SWAST plan to introduce new ambulatory care pathways, an example of which would be the on-site
treatment of cellulitis, rather than sending patients down to Exeter.
GP Changes
Whilst we as a Practice are keen to maintain personalised lists, there is a need to balance this with
some GP’s desire to reduce their hours and work part-time.
To this end:

Dr Alex Werhun has been employed to work with Dr Ali Round and cover her patient list on a
Friday. Dr Round regularly attends committee meetings at the Clinical Commissioning Group as
well as sitting on the Exceptional Treatments Panel.

Dr Declerck will be reducing his hours in October in order to work in the A&E unit in Exeter. Dr
Laura Taylor will be joining the practice in October and will see Dr Declerck’s patients on a
Wednesday.

Dr Hugh Savill will be retiring at the end of March 2015.
Enhanced Service Summary (Helen Kingdon)
As in previous meetings, the requirements of the Patient Participation Enhanced Service were
summarised.
1. Maintain and improve our existing PPG
2. Review patient feedback from multiple sources
3. Develop and agree an action plan (three priority areas)
Castle Place Practice
4. Publicise actions taken and benefits gained
5. End of Year Report
Profile of Current Group
Current members = 161
Gender split: Female = 77
Male = 84
Age Ranges:
20-29 yrs
30-39
40-49
50-59
60-69
70-79
80-89
90-99
3
2
10
19
44
52
29
2
The question was asked:
How can we increase our patient group and encourage wider/better engagement?
There was general discussion around trying to encourage younger people to get involved, as at
present they are unable/unwilling to join and attend meetings.
Focus groups were suggested in order to make direct contact and gain feedback and opinions on
the services provided by the Practice.
It was also suggested that we target families with children.
Reviewing Patient Feedback – the Friends and Family Test (Helen Kingdon)
We’re required by many monitoring agencies to review patient feedback from a variety of sources;
the National Survey, complaints, CQC reports, comments made on the website etc.
A new vehicle for collecting this information is being introduced to general practice from December
2014.
If you’ve attended hospital recently you may have seen the signage and been asked to complete a
Friends and Family test. A standard question is asked about how likely you are to recommend the
service/ward/department to friends and family.
Collecting this data has been a requirement for hospitals for a few years now and will soon be a
compulsory requirement for general practice.
Castle Place Practice
We included the Friends and Family test in our last patient survey in order to obtain a baseline of
results for comparison when the official test became obligatory.
Our results were extremely encouraging.
In response to the standard question – How likely are you to recommend Castle Place to friends
and family if they needed similar care or treatment:
Response
Total
Percentage
Very Likely
73
68%
Likely
31
29%
Either / Or
0
0%
Unlikely
2
2%
Very Unlikely
2
2%
Total Responses:
108
In order to capture a range of data and to enable the maximum number of patients to access and
complete the test, it was felt that a variety of approaches were required. The following three
suggestions were put to the group and discussed:



A simple token system with a suggestions box in the waiting room
Paper questionnaires
Electronic Questionnaires (on our website)
It was felt by those present that the token system would be an effective visual motivator for people
to take part and could be done on the way out of the Practice.
However, it was felt that the other options also offered greater control so that we could trust the
data collection.
Those present were very generous in their praise of the practice with lots of very positive
statements being made, favourably comparing the service offered by Castle Place to that offered in
other areas.
Those present were happy for the Practice to proceed with the variety of options presented.
Castle Place Practice
Appointment System Review (Dr Lonsdale-Eccles)
The Practice is undertaking a review of how the on-the-day appointment demand is managed.
Our aim is to ensure equity of access for all patients as well as strengthening continuity of care.
Generally our current system works very well with problems only being experienced when the usual
GP is away or on a day off.
In these circumstances, patients calling at 8.30am are subject to a lottery as to whether they’ll
achieve an appointment that day or not and no prioritisation of patient need is taking place.
The hope is that by changing how calls are handled a fair system will be introduced which will give
priority to vulnerable patients e.g. those with mental health issues, depression, chronic illness.
The proposal is that all patients calling on the day will be called back by the Duty Doctor. They will
discuss and assess the patient’s needs. Patients will then be redirected as appropriate; telephone
advice may be given, an appointment may be made with the GP or Practice Nurse, a prescription
may be issued, a message may be left for their own GP to contact them the following day etc.
Additionally we will make available to the Duty Doctor some appointment slots with our Salaried
GPs and Locums. They will still have pre-bookable appointments but will also have a few
appointments set aside specifically for the Duty Doctor to use.
An on-going process of review will take place to discuss the success or otherwise of these changes.
Action Plan (Helen Kingdon)
The three areas proposed for action were agreed as follows:
1.
2.
3.
Patient Group membership/engagement
Friends and Family Test implementation
Appointment System Changes
It was further agreed that these actions would be reviewed at our next meeting in February 2015.
Any Other Business
1.
Is it possible to provide WIFI in the waiting room?
Tim confirmed that unfortunately this was not possible due to concerns around security and being
unable to share access with the public.
2.
Waiting Room and Signage – all looking a bit tired, could the pictures be changed?
We’ll consider this!
Castle Place Practice
3.
Routine Care of Older Men – what is out policy re offering routine examination to older
men?
To be confirmed.