The Ryalls Park Patient Participation Group (PPG) is a partnership between us the patients, the medical practitioners, and practice management of the Ryalls Park Medical Centre.
The PPG ensures the voice of the patient is heard when decisions are made about how the Practice is run, how current services are provided and what new or additional services should be provided in the future.
The PPG is concerned not just with medical treatments and the provision of medicines, essential though they are. We are also concerned about the whole patient experience from making the appointment, arrival and check-in at reception, waiting times and receiving your treatment and medicine.
As patients, it’s obviously in our interests that Ryalls Park becomes the best medical centre it can be. The PPG provides a route for patients to inform and advise the Practice on what matters most to patients and to help identify solutions to problems. In short, we need to contribute to the continuous improvement of the practice.
The management of the Practice want to hear from us. We need to say what is most important to us, what problems there may be and to help identify solutions.
If you are interested in joining the PPG, wish to make a comment or suggestion or would simply like some more information please call the practice or email us on email@example.com
Chairman Ryalls Park PPG
PPG Meeting Dates: PPG meetings are held approximately monthly. If you wish to attend please email the PPG at firstname.lastname@example.org. See below the minutes of the three most recent meetings.
Please note that due to the coronavirus restrictions PPG meetings (beyond February 2020) have been suspended until further notice.
Notes of meeting held Wednesday 26 February 2020 at 5.30pm
Present: Daniel Vincent, Jan Yates, Catherine Wilson, Darryl Stimpson, Erica Woolmington, Steph Puddy, Roger Brown, Brenda Axe, Joanne Childs, Mike Freestone, Julia Reynolds, Rom Muryn, John Falconer.
Apologies: Karina Parsons, Lesley Hudd, Claire Mallinson
The committee was delighted to see the return of Joanne after a long period of absence due to serious illness. Welcome back Jo!
Joanne was pleased to be able to return and emphasised that although her illness had been very difficult for her she said the care and treatment she received at Ryalls was exemplary and asked Dan to pass on her thanks to all the staff.
A new member, Rom Muryn, attended the meeting and said he wanted to understand what the role of PPG was and may want to join the committee. The Chair welcomed Rom to the meeting.
1. Approval of the notes of previous meeting.
The notes of the January meeting were approved.
Roger distributed the Opinionater reports and although on some days no results had been recorded the general trend of overall patient experience per visit to the practice remains unchanged.
Over the period from September 2019 to January 2020 the results are as follows:
Average number of patient votes per month – 370
Average proportion of patients voting “Happy” – 83%
Average proportion of patients voting “Okay” – 5%
Average proportion of patients voting “Not Happy” – 10%
The remaining 2% are unreliable results due to evidence of improper use of the Opinionater.
The committee agreed that these results are satisfactory and represent the settled view of patients over the five month period. It was therefore further agreed that it was now time to change the question posed by the Opinionater to a more specific issue. Questions related to prescriptions or the appointment system are potential candidates and it was agreed to defer the decision until the March meeting.
Post meeting note: Due to the Covid19 precautions PPG meetings are postponed until further notice.
3. Managing Partners Report
Daniel reported that Zoe had been recruited to communicate with and welcome patients as they arrive at the practice and to ensure patients can take a seat in the waiting room without losing their place in the queue to see a receptionist. The committee had been requesting such a role be established for some time and wholly approved of Zoe’s appointment.
But the main part of Daniel’s report dealt with preparations for the forthcoming full inspection by the CQC. This inspection is a repeat of the summer 2019 inspection which resulted in a rating of Inadequate across the board. The inspection will take place on 3 March and a new rating will be declared when the CQC issues its report. The report is not expected until late spring or early summer 2020.
Daniel said all clinical staff and administrative staff had been through a number of practice inspections. The Chair of the practice, Dr Richard More, had been particularly active in this regard. On a number of occasions Richard acted as the CQC inspector to put Daniel and the staff through a realistic, albeit simulated, inspection.
One of the CQC inspectors had made contact with the PPG Chair. John reported that he had been contacted two days prior to the meeting and had been asked a number of questions related to patient’s opinion of the practice. The inspector asked if two or three PPG committee members would attend a meeting on the day of the inspection. Darryl and Joanne kindly agreed to be available. Steph and Jan agreed to attend if either Joanne or Darryl were unavailable on the day.
Post meeting note:
The CQC duly arrived yesterday to conduct the formal re-inspection of the practice. Darryl, Joanne and I met with one of the inspectors, Ian Fraser-Roe for over 90 minutes. He asked us very searching questions on topics including what we think of the practice, what patient’s main concerns are, how we run the PPG, how are complaints handled and what we have achieved in recent years? I think we gave a good account of ourselves and the three of us felt that the inspector was professional, thorough and fair.At the end of the day Daniel messaged me to say…the practice has had a very positive day. The new inspection team had a different approach. The feedback session at the end of the day was overwhelmingly positive with a strong implication that there is a future!
Daniel went on to say that the devil is in the detail and we won’t get the report from the CQC for perhaps two months.
The inspector began his session with us by saying that the practice leadership greatly values us as a PPG. We can also say we greatly support the practice, its leaders and indeed all the staff. So thank you all for the support you have given the practice and the PPG as a committee member. Without you we would not have a PPG. And special thanks to Joanne and Darryl for answering the questions yesterday so expertly.
4. Report from Somerset Chairs’ Network
John and Darryl attended the Somerset CN. The main subject for discussion was the recently published Primary Care Strategy. Michael Bainbridge, Assoc. Director of Primary Care at the CCG, was due to present the strategy to the meeting. Unfortunately Michael could not attend so a member of his team, Jess ?, presented the paper on his behalf.
The criticism of the PCS from all PPGs was brutal. Every element of the strategy was justifiably slammed. Jess took the battering stoically and tried, with little success, to provide answers and explanations.
The CCG recognise that the PCS will need a major re-write before it can be reissued.
1. Daniel thanked all who filled out CQC survey cards. The CQC did not give any indication regarding the comments on the cards but were satisfied with the number of cards posted in the box.
2. It was pointed out that Yeovil District Hospital has declared it has reached Operational Pressures Level (OPEL) 4.
OPEL 4 is the highest distress level and is defined as:
“There is increased potential for patient care and safety to be compromised. Decisive action must be taken by the local A&E Delivery Board to recover capacity and ensure patient safety. All available local escalation actions taken, external extensive support and intervention required. Regional teams in NHS E and NHS I will be aware of rising system pressure, providing additional support as deemed appropriate and agreed locally, and will be actively involved in conversations with the system. Where multiple systems in different parts of the country are declaring OPEL Four for sustained periods of time and there is an impact across local and regional boundaries, national action may be considered.”
There being no other business, John thanked all for attending and closed the meeting.
Next meeting: TBA.
Notes of meeting held Wednesday 22 January 2020 at 5.30pm
Present: Daniel Vincent, Jan Yates, Catherine Wilson, Lesley Hudd, Darryl Stimpson, Erica Woolmington, Steph Puddy, Roger Brown, John Falconer.
Apologies: Brenda Axe, Joanne Childs, Julia Reynolds, Karina Parsons, Mike Freestone.
1. Approval of the notes of previous meeting.
The notes of the December meeting were approved.
The meeting discussed the issue encountered by Roger regarding death certificates. Roger’s Mother sadly died after a long illness in early January. The GP who had last attended Roger’s Mum was unavailable so another GP would have to authorise the death certificate. This caused some delay but Roger was assured the certificate would be issued in the following day or two. However it turned out that, despite her being seen by District Nurses the day before her death, CHC funded carers twice daily and a Doctor at RPMC had been spoken to the day before her death, that because she had not been physically seen by a Doctor within 14 days of her death the matter had to be referred to the Coroner.
Some confusion at the practice led to the time limit being exceeded which caused additional delay and anguish to Roger and his family. Daniel agreed this was a failure on the part of the practice and apologised to Roger. The referral to coroner rule was known about but it was not expressly written into practice procedures at the time.
Once it was realised this problem had occurred, the practice acted swiftly to resolve the matter.
Daniel assured the meeting that the correct procedure was now written into practice rules to ensure no re-occurrence in the future.
The meeting unanimously wished to record its sincere condolences to Roger.
Roger distributed the Opinionater reports but it was clear a problem had arisen. On certain days no results had been recorded. This may have been because the machine was not switched on or it may be that no patient clicked the machine. After some discussion it was felt to more likely that there was a fault in the machine.
Roger will investigate the matter and report at the next meeting.
3. Managing Partners Report
Daniel reported some personnel changes. Dr Leather has left the practice to take up a position in Bridport. Dr Regan returns from maternity leave in March. Dr Smith is retiring in October and Dr Becky Sales has joined the practice.
Vacancies have been posted for a respiratory nurse and for an apprentice in the admin team.
As a follow-up to the CQC inspection, the CCG has issued contract breach notices to the practice. To avoid closure the practice must submit an action plan to the CCG setting out how and when the deficiencies stated in the CQC report will be resolved.
The action plan must be submitted by end January and Daniel reported that the deadline will be met.
It should also be noted that the CQC is due at any time soon to conduct the formal re-inspection.
The criticisms from the CQC and CCG relate mainly to the process of managing the practice rather than the quality of care given. To strengthen managerial oversight of the practice processes, a Governance Board (GB) has been established. The members of the GB include the Managing Partner, the Clinical Lead Partner, the Senior Nurse and the heads of the admin functions.
The Chair of the PPG has also been invited to join the GB. The meeting thanked Daniel for recognising the importance of PPG involvement in governance issues and agreed the Chair should join the GB subject to the following:
1. The Chair will not take part in adjudicating individual patient complaints.
2. The day-to-day running of the practice is solely a matter for the staff at the practice.
Daniel reported that he is conducting a patient survey in the waiting room. Survey forms are on each seat and patients are invited to respond while they wait or to take away the form and respond later.
Daniel will give an update at the next meeting.
It was also reported that the practice intends to review its appointments system.
4. The CCG Primary Care Strategy
The recently circulated Primary Care Strategy paper was briefly discussed. It was generally agreed there was much that was good in the paper but a great deal of it is unclear, confusing or even incomprehensible.
There is a meeting tomorrow of all the Somerset PPGs at the CCG offices. The Head of Primary Care at the CCG, Michael Bainbridge, is due to present the paper at the meeting.
Darryl made the point that occasionally he and other PPG members receive complaints from patients about the practice. In these circumstances the complaint is passed to the practice by the PPG member or the patient is advised to make the complaint directly to the practice (normally Daniel). Understandably, Daniel deals with the matter and responds to the patient. This leaves the PPG member unaware if the complaint has been satisfied or not. It would helpful if the PPG member received feedback when the matter is resolved. Such feedback would report only that the matter was closed. No detail need be given.
Daniel agreed to do this in future.
Erica commented on Engage Consult. She said the system was working well but that very few people were using it or even knew about it. The meeting agreed it was difficult to persuade patients to take up new online facilities and that the whole subject of communication should be discussed at a future meeting.
The condition of the waiting room was briefly mentioned. Erica pointed out some of the walls were grubby and Jan said she had recently sorted out the magazines racks. Perhaps the cleaners could have these issues included in their nightly schedule?
John thanked everyone for attending and closed the meeting.
Next meeting: Wednesday 26 February at 5.30.
Notes of meeting on Wednesday 18 December 2019 at 5.30pm
Present: Richard More, Daniel Vincent, Jan Yates, Mike Freestone, Catherine Wilson, Lesley Hudd, John Falconer.
Apologies: Brenda Axe, Joanne Childs, Julia Reynolds, Erica Woolmington, Steph Puddy, Darryl Stimpson, Roger Brown, Karina Parsons.
1. Approval of the notes of previous meeting.
The notes of the November meeting were approved but it was agreed the following should be added to the December notes:
In circumstances where a patient presents at the reception desk or on the phone and reports that a medical practitioner or a pharmacist (not necessarily connected to Ryalls Park) has told the patient to urgently seek medical advice from the practice, then the reception staff must inform either a GP or a NP as soon as possible. The patient must be given advice or treatment immediately or at the latest by the end of the working day.
2. A Review of 2019
Richard and Daniel gave the meeting their perspective of the events at the practice during the year to date.
Although the overall situation at the practice has improved during the year, the very negative CQC report following the inspection in the summer has overshadowed all other events.
All the staff at the practice are very distressed by the report but have responded with energy to resolve the criticisms and shortcomings highlighted by the CQC.
A further blow to the practice came in early December when the CCG served notice that a breach of contract had occurred. The alleged breach relates to the criticisms levelled by the CQC.
A wide ranging discussion took place with a number of views being expressed. Although the practice accepts it must improve those issues identified by the QCQ, it remains concerned that the degree of criticism is disproportionate. In its report, the CQC states that it received negative comments from third parties who would remain anonymous. The practice has repeatedly asked for more information to better understand what these negative comments may be whist respecting the anonymity of the complainant. The CQC has refused.
At a meeting to serve the breach of contact notices, the CCG said it was principally concerned with the poor opinions expressed by patients in the NHS survey of January 2019. The PPG suggested that in light of the latest data from the Opinionater, it may be worthwhile writing to the CCG to inform it of the most up to date views from patients.
The meeting approved the idea and John agreed to write to the CCG directors dealing with the matter.
The meeting ended on a rather more upbeat note. Both Richard and Daniel insisted the practice would get through this difficulty and reassured the meeting they had rejected any thoughts of closing the practice.
The PPG in turn repeated its support for the practice, its partners and staff.
John thanked everyone for attending and wished all a very happy Christmas.
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