What is the PPG?
The Ryalls Park Patient Participation Group (PPG) is a partnership between us the patients, the medical practitioners, pharmacy management and practice management of the Ryalls Park Medical Centre.
What is the PPG for?
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.
What can we, the patients, do?
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
Great ideas come when we all work together.
Chairman Ryalls Park PPG
Yeovil PPGs meet with Commissioners to discuss problems with primary care
A number PPGs from Yeovil and the surrounding villages met with the Somerset Clinical Commissioning Group (CCG) to discuss issues of real concern to patients. The CCG is the body which distributes the money from the NHS nationally to all health providers in Somerset. This includes GP practices, acute hospitals like YDH and Musgrove Park, community hospitals like South Petherton, maternity provision and mental health services. So the CCG is a vital organisation. The decisions it makes affects us all in the county.
See below the notes of the meeting.
Approved Notes of meeting between the Somerset Clinical Commissioning Group (CCG) and the Yeovil Patient Participation Groups (PPGs)
Date of meeting: 11 January 2019
Present: from the CCG, Tanya Whittle Deputy Director Contracts, Michael Bainbridge Assoc. Director Primary Care, from the PPGs, John Falconer Chair Ryalls Park, Darryl Stimpson Vice Chair Ryalls Park, Ray Croissant Chair Penn Hill, David March Chair Preston Grove, Malcolm Jefferies Vice Chair Preston Grove, David Staddon Acting Chair Hendford lodge, Lesley Morris Vice Chair Martock and South Petherton.
Agenda Item 1 – The Future of Primary Care
The PPGs began by pointing out that for at least two years they have been campaigning for the CCG to set out how GP practices should develop to meet increased demand and crucially to clarify the level of increased funding to be made available to meet patient needs now and in the future.
The PPGs feel that no clear plan has yet been published and the PPGs require the CCG to urgently set-out its intentions with particular regard to:
Securing a GP appointment within one or two days has become increasingly difficult in recent years. Waiting times are now typically two to three weeks.
Primary Care Strategy
The CCG was unable to commit to a date when the revised primary care strategy will be published. There is a process, mandated by NHS England relating to public engagement and consultation, which has to be followed for major service change proposals. The CCG intended to have a clear plan in place for primary care although this might or might not be a formal strategy document.
The CCG agreed that increased funding for practices may be necessary, especially in urban areas, but no data had been presented by practices which positively supported the case. The CCG point to significant variation in the performance of GP practices despite similar levels of funding. Practices should therefore concentrate on improving the efficiency of their internal procedures.
There has been a change of emphasis in national policy. Previously, the term ‘primary care at scale’ suggested that larger practices provided a better service. Recent evidence however, suggests that smaller, independent practices are equally cost-effective and can provide a more patient-centred service. The CCG predicted that both Symphony Healthcare and independent practices would continue to exist but that a greater degree of working together was required.
The PPGs welcomed the statement regarding large-scale providers and requested that the CCG make this known to all the practices in Yeovil.
But the PPGs were dismayed about the response on funding. The PPGs firmly take the view that GP practices do not have adequate resources, particularly of health professionals, to meet current patient demand. Whilst efficiency improvements are necessary and welcome, the supply/demand imbalance in Yeovil can only be brought into equilibrium by increasing the funds available to practices.
The PPGs were also disappointed with the progress on strategy and felt that clearer plans to improve quality in primary care services were needed.
Agenda Item 2 – Online Consulting
The PPG described a number of online initiatives which are already available to patients. Some are fairly mature systems, for example My Diabetes My Way. Others are not yet available to all but are being tested in a pilot study. Still more are available as apps to be selected from the library of NHS Digital.
But in all cases practices are receiving little or no guidance or communication from the CCG regarding which systems to use or whether additional resource may be available to assist practices in getting online consulting up and running. Some practice managers feel considerably less well informed about OC than their PPG.
The CCG accepted it needed to do more in this area and announced that Allison Nation had recently been appointed as the Assoc. Director of Digital IT. The CCG suggested that the PPGs may wish to meet with Allison directly to discuss this matter further.
Agenda Item 3 – How to Assess Practices
The CCG accept that the performance of GP practices vary considerably. PPGs are aware of the performance variability, particularly in terms of delays in getting a GP appointment, long waiting times on the telephone, repeat prescription delays and difficulties with reception staff.
But in discussing these issues with practices, PPGs cannot refer to a standard or expected performance against which the practice may be falling short.
PPGs accept that detailed service levels are not part of the nationally negotiated contract with practices and so cannot be made mandatory. Nevertheless, PPGs request a simple set of non-binding service indicators which patients can reasonably expect their practice to conform to.
The CCG made it clear once more that the national contract does not contain compulsory service levels but recognised the problem the PPGs raise. In internal discussions the CCG are considering making available a ‘dashboard’ which may satisfy the requirement but emphasised this was not yet agreed.
Agenda Item 4 – Practices not Cooperating with PPGs
The PPGs reported that in most cases the relationship between the practices and the PPGs is very good indeed. Unfortunately, there are some practices where this is not the case. An example was given where a practice almost entirely controls the activities of the PPG, including limiting the number of meetings, approving the agenda and minutes of the meetings before circulation and requiring to vet applicants for Chair, Vice Chair etc. of the PPG some weeks in advance of the elections. In another example a practice had proceeded to merge with another primary care provider without seeking the agreement of, or explaining the implications to, the PPG.
The PPGs requested the help of the CCG to discuss these matters with practices. The PPGs pointed out that the NAPP require practices to support their PPGs “without seeking to direct or control their activities”. Furthermore, the CQC consults with the PPG during assessment visits.
The CCG agreed to mention this matter to the relevant practices and would reply in due course.
Agenda Item 5 - AOB
The PPGs requested the assistance of the CCG regarding the lack of disabled access at the Martock and South Petherton practice. Funding for a ‘press-button’ door is needed.
The CCG said they would consider the matter and were hopeful that the funds will be made available.
Finally, the PPGs thanked Tanya and Michael for the meeting and the cooperative spirit in which it was conducted.
Ryalls Park practice under pressure from patients - access to GP appointments becomes increasingly difficult
During the autumn and winter of 2017/18 many patients found the process of booking an appointment to see a GP almost impossible. Call waiting times were far too long and even when patients got through to the reception staff the day's appointments were often fully booked. The practice admitted it was unable to keep up with patient-demand and, encouraged by the PPG, issued a public statement on Facebook setting out the problems and requesting the understanding of patients.
The response was very positive. Most patients appreciated being told about the difficulties the practice was experiencing and did their best to seek an appointment only when absolutely necessary. Whilst the PPG fully supports the practice being candid with patients it is clear that the underlying problems must be fixed. Essentially this means making available more appointments. The practice maintains it requires more funding to offer additional appointments. NHS Somerset acknowledge that budgets are under pressure but believe that by being more efficient the practice can do better with existing funds.
The PPG's view is that increased funding for Ryalls Park (and the other Yeovil practices) is necessary in order to bring about a balance between the supply of appointments and patient demand. That said we strongly encourage the practice to continually seek to improve its processes under a general policy of continual improvement.
Over many months the practice has considered how best to respond to these challenges. Among those considerations was the possibility of joining other primary care organisations in the hope that improvements can be made through 'economies of scale'. The PPG were not able to support such a move unless it was clear it would benefit patients. The practice has now confirmed it will remain independent, and the PPG are delighted to support the decision.
The issue of funding in the GP sector remains a key issue. The PPG has held discussions with NHS Somerset in recent weeks and we hope to hear some positive news in the near future.
See below the confirmation from the practice.
To all patients, their families and friends of Ryalls Park Medical Centre (RPMC)
You may have seen the recent statement we made via social media, followed up by press reports, regarding the difficulty to access GP appointments at RPMC. We are determined to improve the service we offer to our patients and have been considering how best we can achieve it. Various options have been considered including the proposal to seek a merger with other practices or to join a large-scale primary care provider. After careful consideration we are pleased to announce that we will remain an independent practice. We firmly believe this is in the best interests of both the practice and its patients. We are also pleased to announce that Dr Richard More has agreed to join us. Dr More has many years’ experience both as a GP and in Chairing and managing a wide range of businesses and will be the Chairman at RPMC. Daniel Vincent remains as Managing Partner focussing on strategic improvements to the practice. In conjunction with NHS commissioners Daniel has been examining how to improve working arrangements in order to best serve our patients. Funding, of course remains a crucial issue. Our PPG (Patient Participation Group) has been pressing Somerset NHS to increase funding for GP practices. We hope to say more about this in the coming months.
Our doctors, nurses and admin team are committed to improving access to the excellent patient-care at RPMC.
We will be setting out further changes and additions to our team in the near future to improve our performance. We know it has been a very difficult winter period for all and we wish to thank you for your understanding and forbearance during often challenging days.
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.
Notes of the Ryalls Park PPG Meeting held on Wednesday 27th February 2019 at 5.30pm in the Meeting Room at Ryalls Park Medical Centre
Present: Claire Mallinson (CM), Daniel Vincent (DV), Darryl Stimpson (DS), John Falconer (JF), L Steph Puddy (SP), Joanne Childs (JC), Mike Freestone (MF), Roger Brown (RB), Erica Woolmington (EW), Catherine Wilson (CW)
Apologies: Karina Parsons (KP), Lesley Hudd (LH), Jan Yates (JY)
The minutes of the meeting held on 23/01/19 were approved as a correct record.
Volunteers – DV and CM confirmed that the Volunteer pilot will be out on hold until April.
EMIS – DV confirmed that 101 replies were received to a text message asking if they would like electronic access.
Prescription Process – JF confirmed that a letter had been sent to Dr Day thanking her for her efforts in streamlining the prescription process.
DV presented his report as follows:
The call waiting time during the morning session from 8.30am was being monitored and lowest was 9 minutes with the highest being 11.5 minutes. This was felt to be largely due to the resolution of the prescription process meaning fewer calls in the morning. Call time varied daily from 15 minutes to 2 hours.
Prescription turnaround times were now same day 42.75%, 1 day 39.91%
GP time was being freed up by choosing which letters/documents needed to be seen by the doctors. New protocols in place so some items, forexample Radiology reports from A&E can be filed directly into patient notes without the need to be seen first by a GP
DV reported that on 26/02 and 27/02 the Patient Liaison Team managed to get their daily tasks down to zero
DV also reported that RPMC was now the top rated practice in Yeovil town (excluding West Coker) on the NHS choices website. JF applauded DV for his efforts.
4. Ear Wax Removal
The CCG has announced that it will be funding practices to provide an ear wax removal service. Normally the irrigation procedure proves effective but in cases of impacted ear wax it will be necessary to use vacuum removal. The latter method uses special equipment which practices will have to share. The CCG are encouraging practices to work together to provide this service.
5. Online Consulting
A system called ‘Engage Consult’ has been selected by the CCG as the preferred online consulting system for Somerset. Ryalls Park is one of a number of practices piloting the system which gives patients a new means of contacting the practice and getting medical advice. Unfortunately a legal issue has emerged elsewhere in the country concerning miss diagnoses and Daniel has suspended OC activity until advice is received from the CCG.
Post meeting note: the suspension has been lifted following advice from Annie Paddock of the CCG. Also Engage Consult is not to be confused with E Consult which is a different product marketed by a different company.
Catherine made the point that additional resources were required at the practice to improve the service offered to patients. This is particularly true of resources relating to mental health.
Catherine also asked if PPG committee meetings were the appropriate forum to bring up new ideas. She was assured that it is. In recent times many improvements to the practice have resulted from ideas first discussed at PPG meetings.
The Chairman thanked everyone for attending and closed the meeting.
Wednesday 27 March at 5.30
Wednesday 24 April at 5.30
Minutes of the Ryalls Park PPG Meeting held on Wednesday 23rd January 2019 at 5.30pm in the Meeting Room at Ryalls Park Medical Centre
Present: Claire Mallinson (CM), Daniel Vincent (DV), Darryl Stimpson (DS), John Falconer (JF), Brenda Axe (BA), Jan Yates (JY), Steph Puddy (SP), Joanne Childs (JC), Mike Freestone (MF), Roger Brown (RB)
Apologies: Karina Parsons (KP), Lesley Hudd (LH)
The minutes of the meeting held on 19/12/18 were approved as a correct record.
Volunteers – DV suggested that the pilot be out on hold until due as the three PPG members cleared could now no longer offer their services due to ill health. It was suggested that during this year the PPG repeat the Patient Survey that was carried out successfully last year. This was agreed as a good idea and JF asked for any suitable questions for the new survey to be passed to DS for collating. BA and JF said they would be able to offer some time to carry out this survey.
EMIS – RB suggested that some kind of email survey for current EMIS users regarding ease of use of system may be prudent to gauge how well this is working. JF suggested compiling a simple questionnaire regarding EMIS be put together and DS agreed to facilitate this.
Prescription Process – This would be covered by DV later in the meeting as part of his report however early indications are that the system is working much better, largely due to the input of Dr Helen Day. JF will write letter to Dr Day on behalf of the PPG thanking her for this.
Online Consultation – DS and DV updated on a meeting on how to approach launching this initiative. This was also attended by SP and JC. It was agreed that DS would resend the information to MF as he had not received this initially and had misunderstood the concept of Online Consultations and what they were to be used for.
DV reported that Dr More had given positive feedback about his first six months with the Practice which was encouraging.
DV presented his report as follows:
DV reported that another visit from the CCG and NHS England had occurred and they gave positive feedback on the improvements already made within the Practice.
A QI team had been formed made up of various practice members to involve them in new processes and also task them with making daily improvements to benefit the patients and staff and discuss next steps. This group meets weekly each Tuesday. The outcomes of these meetings are shared with the whole team and are on display in the meeting room for team to review.
JF queried how mental health provision at the Practice was being met. DV updated that it was still a grey area with access to CBT etc still being very limited. It was confirmed by DV that the Practice does have access to an allocated Clinical Practice Nurse for mental health patients if needed.
DV confirmed that by June the Practice would be part of a Primary Care Network to decide how Care is delivered in the local area. All Yeovil core practices will be part of this group. It was hoped that this would help to access central funding as a result if collaboration between the Yeovil core practices and Somerset Partnership took place.
JF reported on a meeting recently attend with Yeovil Chairs and Vice Chairs of PPGs. It became apparent that communication between some PPGs and their relevant practices was problematic.
He also met with Michael Bainbridge from the CCG and it would seem that no further progress has been made with regards to funding etc. JF would forward full meeting notes to all PPG members for a full and complete update.
Date of next meetings
Future meeting dates were discussed and the following agreed :
Wednesday 27th February 2019 – 5.30pm (Apologies from CM)
JF thanked all for their attendance and closed the meeting.
Notes of the Ryalls Park PPG Meeting held on Wednesday 19 December 2018
Present: Daniel Vincent, Darryl Stimpson, Karina Parsons, Lesley Hudd, Jan Yates, Steph Puddy, Roger Brown, Joanne Childs, Mike Freestone, Richard More, John Falconer.
Apologies: Claire Mallinson, Brenda Axe.
The minutes of the meeting held 21 November were approved as a correct record.
Volunteers – There remains some uncertainty about who may be available to begin the volunteering pilot. DBS checks are largely complete so it is dependent on who is available in January. The PPG prefers that the pilot uses members of the PPG committee only. This is an important means of communication with patients and the committee should receive valuable feedback from the volunteers.
No team changes since the last meeting and the practice remains at full staff capacity.
EMIS registration continues grow steadily. The number now using EMIS has risen to 33%, about 2000 patients. This is an excellent improvement since the summer of 2018 when only 5% of patients were registered.
The prescription process continues to improve. The average time from prescription request to medication dispensed is now approximately two days, down from five days in June this year. It should be noted that the improvement mainly relates to standard repeats or run-of-the-mill requests. When a patient’s medication is due for reassessment, a change of dose or other complication, delays still occur. About 5% of prescriptions fall into this category. Daniel reported that a member of staff will be appointed as liaison officer to deal specifically with these irregular problems.
Darryl has been closely involved with practice staff in bringing about the recent improvement, especially in understanding and mapping the process. But a GP must still review and authorise every prescription request. In this regard Dr Helen Day has greatly improved the approval rate of prescriptions.
In approximately six months the management of prescriptions has been transformed for the better. The committee wished to record their appreciation of all the staff who have contributed to this improvement.
There are now a number of initiatives considered as online consulting. Darryl is leading for the PPG on this issue and stressed that although OC provides a great opportunity to improve the service to patients, it must be managed carefully by the practice.
It was noted that the practice has made more appointments available to book online. Joanne has monitored the situation in recent months and she confirmed the position is noe greatly improved.
There was a short break in proceedings at this point and the staff were invited to join the PPG members for a festive mince pie, a coffee and to distribute the ‘Secret Santa’ gifts.
The Chair of the practice, Dr Richard More, joined the practice in summer 2018. Having now been with us for six months he gave the committee his views and observations to date.
He said the first few weeks were spent firefighting a number of problems, some relating to training and some to shortage of resources and he confirmed that performance was improving. The CCG is giving support during the transition and the practice is financially stable.
A staff away-day took place where everyone was given the opportunity to contribute. There was excellent feedback and many good points for improvement were made.
The plan in the immediate future is to make quick-hits for improvement where possible and in addition to formulate a long-term plan for improvement.
However, he remains concerned about the future of primary care in general. There is no clear strategy coming from commissioners regarding long-term funding or how GP practices should be organised.
Finally, he thanked the PPG for their continued support.
The Chair of the PPG thanked Richard for attending and giving his candid assessment. The committee is delighted that he chose to join the practice and is confident that Ryalls Park is on a positive path to continuous improvement under his leadership.
Next meetings: 23 January at 5.30
20 February at 5.30
The Chair wished everyone a happy Christmas and adjourned the meeting.
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