Minchinhampton Surgery Patient Participation Group (PPG)

Minutes of Committee Meeting on Wednesday 7th

February 2018

AT 7 PM AT HORSFALL HOUSE, WINDMILL ROAD.

A1: Welcome, Attendance and Apologies: John Harrop welcomed all those attending.

Present by invitation: Anne Neal (Chair Minchinhampton Surgery Charitable Trust), Emily Lewis

(PPG member, Archway School Sixth Form).

Committee members present: John Harrop (Chair), Graham Spencer (Vice-Chair), Ian McPherson

(Secretary), Colin McCleery (Treasurer), John Cleever (Pharmacy Liaison), Gerald Ford (Transport

Officer), Rosemary Boon (Transport Officer) Wendy Gordon (Practice Manager), Dr. Pippa Xerri

(Partner, Surgery), David Nurden (Driver). (10 members present: quorate).

Apologies: Claire Feehily (MSCT Liaison), Alison Gray (Driver & Driver Compliance), Margaret

Haines, Anne-Marie Marlow (President).

A2: Minutes of meeting on 12 October 2017 (D2): Approved without amendment.

A3: Matters Arising:

A3a: Speakers at future meetings (John Harrop): John Harrop was reviewing previous suggestions.

John Cleever suggested that the manager of Boots (Minchinhampton) could be considered.

A3b: PPG Action Plan 2017: Target 2 (‘ ... more representative of all patients’) New PPG leaflet for

patients’ pack. Virtual PPG. Use of Surgery website. (Graham Spencer, Ian McPherson). See D3.

Copies of the new PPG leaflet were distributed and discussed. The leaflet was approved by the

Surgery and by the Committee. (Post-meeting note: Copies of the leaflet are now available at the

Surgery Reception or online http://www.minchsurgery.nhs.uk/files/2018/02/PatientPaticipation-

Group-Leaflet.pdf ). Following discussion, the meeting agreed to investigate, with the help of Gerald

Ford, whether copies of the leaflet could be distributed more widely by inclusion in copies of Tom

Long’s Post – the news leaflet of Minchinhampton Parish Council. Gerald would seek permission for

this from the Parish Council. Graham Spencer agreed to assist with this project.

Additionally, PPG officers proposed to give priority to making better use of the PPG page on the

Surgery website, and then reviewing this, before committing to the possible alternative of developing

an independent website for the PPG. This could be more effective for dissemination and

sustainability, as well as saving some effort and expenditure. Revision of the PPG page was in

preparation.

Furthermore, the meeting was delighted to welcome Emily Lewis, not least as in effect representing

much younger patients registered with the Surgery. Emily spoke about her commitment to training for

NHS Midwifery. John Harrop stressed that Emily would be welcome at future meetings and welcome,

if she wished, to bring with her friends who were also registered with the Surgery.

The meeting discussed further possible ways of distributing the new PPG leaflet more widely. These

included Boots, local churches, schools, the library, and golf clubhouses. The total number of patients

registered with the Surgery had increased from about 7200 to over 7500. Patient turn-over amounted

to about 20 to 30 patients per month. New patients would receive the PPG leaflet in their pack from

the Surgery for new patients.

A3c: National Association for Patient Participation: NAPP 100. NAPP Newsletters (Ian

McPherson). So far the proposed NAPP 100 surveys had not started. (Post-meeting note: the first

such survey took place shortly after the meeting and Minchinhampton PPG contributed). NAPP

newsletters had been forwarded to PPG Committee members. The NAPP AGM would be held on

Saturday 9th June in Nottingham. The programme for this would be circulated to Committee members,

as soon as available, so that those interested in attending could then confirm their interest.

A3d: Parking Passports, Carers Gloucestershire: letter from Tim Poole. See D4 (Wendy Gordon).

This new scheme (“Carer’s passport”) would mainly benefit recognised carers of patients, rather than

PPG drivers, unless carers accompany patients being driven. Wendy would draw attention to the

scheme in the Surgery Newsletter. Families may not be aware that if they are going into hospital to

help care for a patient who has been admitted for 12 days or more they may be eligible for a “carer’s

passport” for free parking. Carers should approach the ward sister at the hospital in order to request

this. Alternatively, if (or when) disabled parking spaces are not an available option for PPG drivers,

sometimes appropriate parking is available at Gloucester Royal near the Tower entrance, towards the

rear of the main block; failing which it may be possible for drivers to keep revisiting different 20-

minute dropping-off areas.

A3e: New Telephone System: update (Wendy). Various comments on patients’ experience in using

the system had been passed to the Surgery. In response, improvements had been made. The system

was becoming more familiar and currently working well. The more refined the system, the greater the

expense. More statistics on use of the system, although not always easy to interpret, could assist in

meetings needs of patients. There were now more phones in the Surgery office and more people

answering these phones. The PPG Committee would be interested to learn of any problem with the

phone system that might be appropriately addressed with assistance from PPG funding, subject to

sustainability.

A3f: Flu prevention: update (Wendy). Following extensive discussion at the previous Committee

(see previous minutes: 12 October 2017), Wendy gave news of more recent developments.

Vaccinations were currently being given to further patients at risk, in total several hundred more than

in previous years. Fewer school children were being vaccinated for flu by the Surgery, as more pupil

vaccinations were now being done in school, independently of the Surgery. The quadrivalent vaccine

purchased (which protects against two types of influenza A and two types of influenza B strains)

provided the best affordable protection for eligible adults. While this was more expensive to purchase,

there were savings from benefits to patients and staff. The NHS had recently approved new guidance

for 2019 which might require revised arrangements for the coming autumn. It was recognised, from

recent research, that vaccinations, especially for older patients, tended to be more effective in the

morning, due to daily variation in the immune system.

The meeting then discussed (again) patients’ experience and views on the process. Some suggested

the Porch Room of Holy Trinity parish church might be used for vaccinations, making the process

more of a social event, including refreshments and conversation, with benefits especially for some

patients. However, as Wendy reminded the Committee, there would be risks in doing this, as patient

records would not be at hand for checking as needed, and as any reaction to vaccination could not be

treated as well as it would be in the Surgery. Nevertheless, if the PPG wished, it could organise

concurrent refreshments beyond the Surgery, perhaps in the Porch Room or Library, if available and

affordable. Costs of hiring might be offset by charging or requesting donations for refreshments. It

was agreed to give these issues further consideration. John Cleever was willing to approach the

Library for information about availability and cost.

A3g: Letter to Colin McCleery for PPG Committee (Ian). The secretary had written to Colin as

requested by the Committee. Colin responded expressing appreciation for the concern expressed for

Marjorie and himself.

A3h: Any other matters arising. None.

A4: News from the Practice (Wendy Gordon and colleagues).

Registrars: In addition to Dr White, a new Registrar - Dr Rasaiya - would be with the Practice until

August 2018. In January Dr Michelle Doidge successfully completed her year with the Practice. Dr

Cooper was preparing to become a recognised trainer for medical students undertaking placements in

the Practice.

Wendy and Dr. Pippa Xerri explained that the Practice needed specialised equipment for measuring

blood-pressure in patients’ legs (sphygmomanometer) in line with current requirements for complying

with recognised standards. This could also be made available for other practices in our area. The

Committee agreed, subject to consideration of costs, to fund the purchase of this equipment by and for

the Practice. The suggestion about sharing this equipment with other Practices in our area was

acceptable to the Committee in principle. Dr Xerri would take the matter of purchase forward, in

consultation with the Committee.

Wendy outlined the work being done to provide improved access to local appointments with GPs, in

line with government requirements. A pilot for new arrangements would start in February, with full

implementation of the Improved Access Scheme from the start of April 2018. This would provide

extra evening GP appointments at GP Surgeries across the Stroud area: in Minchinhampton alternate

Tuesdays and every Wednesday. Extended hours at Minchinhampton will continue on Monday

mornings and Wednesday evenings. Appointments for Improved Access could be made in advance

through a Minchinhampton Receptionist, who would also request patients’ consent for sharing their

records, needed when patients would attend appointments at other surgeries. More information would

be issued by Minchinhampton Surgery when available. These new local arrangements would be

independent of the current national “111” service and would not be for emergencies. The new Scheme

would mean that the current local Choice Plus arrangements would finish (at the end of March).

Minchinhampton Surgery was being proactive in these matters. Drs. Cooper and Simpson are to be

congratulated for volunteering to work additionally for the new Scheme, meaning that no locum

doctor service would need to be bought in for this purpose. If patients believe they need longer than

standard appointments, it would be helpful if this could be mentioned to the Receptionist when

booking an appointment.

A5: Feedback on patients’ compliments, comments and concerns (Wendy and colleagues).

Wendy tabled a summary of anonymous data on patient feedback, mainly from the Family and

Friends form, received since the last PPG Committee meeting. Wendy interpreted the data helpfully

for the meeting, preserving strict anonymity. In general, patient feedback was good or excellent. If

patient responses give rise to concern or are recognised as challenging they are always circulated

promptly to the Partners. Wendy explained the difficulty occasionally caused by anonymous

comments, as well as comments coming from patients who withheld consent for sharing or details

needed for further responses. Partners continued to receive cards and letters expressing appreciation.

The PPG had given Surgery staff a Christmas present and card, to thank everyone on behalf of

patients.

Patients who have requested a prescription, or a repeat prescription, and need to collect their

medication urgently are advised to ring to check with the commercial pharmacy before calling to

collect, in case of any delay due to the pharmacy’s delivery or processing time.

Dr Cooper had recently undertaken a survey of his patients as part of his revalidation process. About

50 questionnaires had been given out at the Surgery for this purpose. John Harrop mentioned that the

NHS England annual GP Patient Survey was about to happen and reminded those patients who

received a questionnaire of the importance of responding to this. The GP Patient Survey assesses

patients’ experience of healthcare services provided by GP surgeries, including experience of access

to GP surgeries, making appointments, the quality of care received from GPs and practice nurses,

satisfaction with opening hours and experience of out-of-hours NHS services. The survey now also

includes a number of questions assessing patients’ experience of NHS dental services. The results of

the survey are published annually by Ipsos MORI on behalf of NHS England on the GP Patient

Survey publication website.

A6: Patients’ Transport Service (Rosemary Boon and Gerald Ford). Gerald presented a summary

of vital statistics for the service, confirming the extensive support that the volunteer drivers provide

for patients throughout each year, including time-consuming visits to hospitals, as well as the Surgery

and other medical, dental and physiotherapy services. The Transport Coordinators proposed that the

drivers should be thanked for this service by provision of a modest funded lunch for them and their

partners (in view of practical support), perhaps at Egypt Mill, Nailsworth, if feasible. The Committee

discussed this proposal and stressed that such an event, while commendable, must not be seen as a

precedent for repeated events, but as something exceptional. Subject to this proviso, and to a limit of

40 places, both the Treasurer and the Committee gave their consent in principle and asked Gerald to

investigate possibilities.

A7: Treasurer’s Report (Colin McCleery). As the last instalment of the Elizabeth Kirby bequest to

the PPG had now been paid, Colin reminded the Committee of the sums involved. The Committee

confirmed its appreciation of this generous bequest. Running costs of the PPG could be estimated at

approximately £1500 per year, so that several years of such running costs were currently sustainable.

Recent commitments include funding the water-cooler in the Surgery (in liaison with Wendy),

commercial copying of the new PPG leaflet, and new equipment for measuring blood pressure in legs.

The Committee then discussed current options for PPG investment policy, in the context of current

very low interest rates and our policy needs. A PPG small group meeting with the Treasurer of

Minchinhampton Surgery Charitable Trust, to discuss such problems, had been helpful. John Harrop

tabled comparative figures for possible saving accounts with the United Trust and with Lloyds Bank.

For the percentage of PPG funds that would be better invested, a term of three years was suggested.

However, the Committee agreed it would be better to leave such decisions to the Treasurer, taking

account of the meeting’s discussion.

Colin announced that for personal reasons he would be stepping down as PPG Treasurer at the AGM

this year. He undertook to deal with this year’s audit. John Harrop assured Colin that his decision was

understood. Gerald Ford expressed the PPG’s appreciation of the sound work Colin had done as

Treasurer.

A8: Draft report: patient feedback on proposed new surgery building (John Harrop). See D5 - D8.

John thanked those who attended the public meeting on 29 November 2017 at which the Practice

shared their proposal for a new GP surgery building in Minchinhampton. There had been an

impressive turnout and people engaged well with the plans and their advocates. Staff at Horsfall

House were thanked for providing tea, coffee and other light refreshments. 177 feedback forms were

received during and after the event, up to the end of December. The PPG collected and collated all the

written responses: see papers D5-D8, issued for this meeting.

In summary the feedback showed overwhelming support for a new surgery in Minchinhampton, with

a clear preference for the chemist to remain in the centre of town. This feedback, an important part of

the business case for a new surgery, will be presented to Gloucestershire CCG (Clinical

Commissioning Group: the NHS funding managers) by Drs. Pouncey and Cooper in May 2018. The

PPG Committee, for its part, approved this draft report, noting that it would be scrutinised in detail

with a view to approval by the Practice. It would then be forwarded by the PPG to the steering group

for the Minchinhampton Neighbourhood Development Plan (NDP).

Wendy and Pippa expressed appreciation, on behalf of the Surgery, for this helpful contribution by the

PPG to the business case for the new Surgery building. Gerald Ford noted that the Parish Council,

recognising the documented opposition to any relocation of the dispensing and retail chemist from the

town centre, would be likely, for its part, to decide against any such relocation. Wendy added that the

rules on the location of pharmacies, of whatever kind, were complicated and took account of a range

of factors, including distances and areas. Accordingly, it was unlikely that any relocation of the

pharmacy would be allowed by the other authorities with a stake in the matter.

A9: Minchinhampton Surgery Charitable Trust - News (Claire Feehily and Anne Neal). Anne

Neal, Chair Minchinhampton Surgery Charitable Trust (MSCT), was welcomed to the meeting and

invited to share news from the Trust. Anne summarised activities supported by the Trust and

possibilities for future support explored by the Trust. Increasing numbers of lonely people are living

on their own and in need of appropriate support. Possible approaches under consideration include

home visiting, similar to a feature of the extended role that was once more commonly taken by

District Nurses. David Forbes, the Secretary of MSCT, had announced that he would be standing

down this year.

A10: Any other business. None.

A11: Date of next meeting, etc. (See D 9). Wednesday 11th April, 2018 was confirmed for the next

Committee meeting, as was Wednesday 9th May 2018 for the AGM.

Documents (D):

D1. Agenda for PPG Committee, Wednesday 7th February, 2018.

D2: Minutes of previous PPG Committee meeting (12 October 2017).

D3: New PPG leaflet for patients’ pack, etc.

D4: Parking Passport (“Carer’s Passport”) letter (T. Poole).

D5 – D8: Draft report: patient feedback on proposed new surgery building.

D9: Proposed dates for PPG meetings in 2018.