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 firstname.lastname@example.org
Chairman Ryalls Park PPG
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:
Increased funding to enable practices to provide a greater number of GP appointments to patients.
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.
Will independent GP practices continue to be supported or does the CCG predict a transition to large-scale primary care providers?
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.
PPG Meeting Dates: PPG meetings are held approximately monthly. If you wish to attend please email the PPG at email@example.com. See below the minutes of the three most recent meetings.
Notes of Ryalls Park PPG Meeting held on Wednesday 11 September 2019 at 5.30pm in the Meeting Room at Ryalls Park Medical Centre
Present: Roger Brown, Joanne Childs, Daniel Vincent, Darryl Stimpson, Julia Reynolds, Karina Parsons, Brenda Axe, Jan Yates, John Falconer.
Apologies: Mike Freestone, Erica Woolmington, Claire Mallinson, Catherine Wilson, Lesley Hudd.
1. Apologies and approval of the notes of previous meeting.
The notes of the previous meeting held on 2 July 2019 were approved.
2. Matters Arising from previous meeting
There were no matters arising but JF confirmed that regrettably Claire Mallinson has had to resign her position on the committee due to difficulties obtaining reliable childcare cover. The committee wished to send sincere thanks to Claire for her contribution, particularly as secretary, and hoped she may be able to return to the PPG in future.
3. The Opinionater
RB presented the data collected and collated to date. (summary circulated with these notes). 114 patients had recorded their opinion since 29 August of which 65.5%) said very good, 14 (12.4%) said okay and 25 (22.1%) were not happy.
The committee thanked Roger and felt this was a very good start. It was suggested the Opinionater could be repositioned slightly to become more noticeable to patients as they leave the practice.
A fuller picture of patient opinion should be available at the next meeting.
4. Managing Partners Report
DV reported the distressing news that the CQC had given Ryalls Park a rating of Inadequate in its recent report. Dan explained that the partners and staff were particularly puzzled with the report because many of the alleged deficiencies reported were in fact not true. As a result the practice sent a rebuttal document to the CQC pointing out 76 factual errors. The CQC considered the rebuttal but did not change any of its findings.
(CQC reports circulated with these notes)
The committee had several questions and comments arising from this report. KP, JY, DS, BA, JC, RB all said they did not recognise the practice from the description made by the CQC. There had been problems in 2018 with prescriptions and GP access but 2019 had seen a considerable improvement. JR, SP and JF, who met the CQC leader, Ruth Lough, on the day of the inspection, said that Ms Lough gave no indication that she was about to give such a damning report.
Overall the committee concluded that the report did not fairly describe the practice and wished to confirm its full support to all the staff. There will be a repeat inspection later in the year and it is hoped a fairer result will emerge.
By agreement, there was extended discussion of the CQC report which meant there was no time for the remaining agenda items. It was agreed that the 2019/2020 objectives would be debated at the next meeting.
Post meeting note:
JF gave the following quote to Somerset Live following publication of the report.
The Patient Participation Group (PPG) was disappointed to read the July 2019 CQC inspection report of Ryalls Park Medical Centre. Having been through a difficult period in 2018, mainly due to a shortage of GPs at the time, the practice has made significant improvements to its performance this year. Although there is much still to be done, these improvements were generally not recognised in the report and the PPG views the CQC rating of Inadequate as a harsh verdict which does not fairly describe the current performance of the practice.
That said, Ryalls Park has accepted the report and has implemented a comprehensive action plan to address the issues identified by the CQC. The PPG fully supports the action plan and all the staff at Ryalls Park. It looks forward to a much improved rating when the CQC conducts a repeat inspection later this year.
JF thanked everyone for attending and closed the meeting.
Date of next meeting: 16 October 2019 at 5.30.
Minutes of the Ryalls Park PPG Meeting held on Wednesday 3 July 2019 at 5.30pm in the Meeting Room at Ryalls Park
Present: Roger Brown, Daniel Vincent, Darryl Stimpson, Steph Puddy, Julia Reynolds Karina Parsons, Joanne Childs, Lesley Hudd, Brenda Axe, John Falconer.
Apologies: Mike Freestone, Erica Woolmington, Claire Mallinson, Jan Yates, Catherine Wilson.
Minutes of the previous meeting
The minutes of the meeting held on 22 May 2019 were approved.
Matters Arising from previous meeting
EMIS – DV reported that he had not yet had chance to run the latest statistics but would do so for the next meeting.
Phil Tilson – Chair Martock and South Petherton PPG
Phil kindly agreed to explain the ‘Opinionater’ to the meeting. It is a device to simply record patient’s views by the press of a button and has been in use at the Martock practice for several weeks. The data collected, which is entirely anonymous, has been very useful.
DV agreed to purchase an Opinionater for Ryalls Park which Phil delivered at the meeting.
The committee unanimously agreed that the device should be installed in the waiting room so that patients can express their view immediately after their appointment prior to leaving the practice.
JF thanked Phil Tilson for his excellent presentation.
The Opinionater will require setting up properly and the raw data will have to be collected and collated into useful information. A sub-committee was appointed sort out the detail with DS as Chair, JC and RB.
Managing Partners Report
The CQC has conducted an inspection of the practice. The previous inspection in 2016 gave a rating of ‘Good’ but recent problems at the practice may result in the practice receiving a lower rating of ‘Needs Improvement’.
The CQC report should be available in 8 weeks, at around the end of August.
Dr Regan has left on maternity leave. Drs Day and Leather are covering together with a locum.
An additional Nurse Practitioner has been selected and is expected to start soon.
Engage Consult has had a slow start but is working satisfactorily.
There is an increasing need to collate and monitor the large volume of data being generated by the practice. As a result, a new position for a document work-flow clerk has been agreed.
More 4 Star reports have been received via NHS Choices. Ryalls Park now has the highest average rating in the PCN.
This subject was briefly considered but it was agreed that it should be more fully discussed at the next meeting. The committee asked JF if some examples of objectives could be circulated before the next meeting. JF agreed.
Any Other Business
Date of next meeting
Wednesday 11 September at 5.30pm.
JF thanked all for attending and closed the meeting.
Minutes of the Ryalls Park PPG Meeting held on Wednesday 22nd May 2019 at 5.30pm in the Meeting Room at Ryalls Park Medical Centre
Present: Claire Mallinson (CM), Roger Brown (RB), Daniel Vincent (DV), Darryl Stimpson (DS), Catherine Wilson (CW), Erica Wilmington (EW), Steph Puddy (SP), Karina Parsons (KP), Joanne Childs (JC)
Apologies: John Falconer (JF), Jan Yates (JY), Lesley Hudd (LH)
Minutes of the previous meeting
The minutes of the meeting held on 24/04/2019 were approved as a correct record.
Matters Arising from previous meeting
EMIS – DV reported that he had not yet had chance to run the statistics for usage and advised that he would update these via portal.
Personal Success and change
DV updated on a series of sessions funded externally for local people offering help with coping strategies and mindfulness in everyday life. It was proposed that 10 people are recruited for the first set of sessions to see how successful it will be. DV asked for PPG approval and input as to whether it was felt to be a good idea. There was unanimous agreement to run these sessions at the practice. DV also reported that he could apply for lottery funding of up to £10k and it was agreed that DV would take this forward.
Managing Partners Report
DV presented the information used at the ops meeting and the following was reported:
The appointment audit showed that the number of people unable to be offered an appointment had increased slightly however that has had a positive impact in the rolling appointments which are released at 8am each morning
The E-Consult document is not yet ready to use and needs adjustments made to make it more user friendly
DV reported ongoing issues with rejected prescriptions not being notified to patients so patients are unaware the prescription will not be there to collect. Overall however the system is working well.
DV updated on the new proposed Primary Care Networks which would involve the Practice being tied in with the other Yeovil practices to provide one overall practice area for patients. There will be no immediate impact with the focus being mainly on District Nurses, Health Visitors etc
EMIS now has a proxy function available enabling those patients with children or those who are a registered career for a relative to be able to request prescriptions, book appointments etc in their behalf. DV advised that there were a few legal process to verify before launching this but it was hoped to be able to offer this to all patients soon. A tick box will be added to the application form in order for patients to give consent to their carers to access this service in their behalf.
Overall the practice is thriving with patients moving across from other Yeovil surgeries. The data is being collected by the new Performance Manager, Kim, who will be leading this process.
Online Consulting Update
It was reported that this was ongoing with the next stage being a letter to the CCG from the Yeovil PPGs outlining their reasons for wishing to implement this. Discussion ensued regarding the new hospital passport, EMIS access etc and how this would potentially affect the online consultation process.
Any Other Business
Date of next meeting
Wednesday 25thJune 2019 at 5.30pm at Ryalls Park
NB This meeting date was subsequently changed to Wednesday 3rd July 2019 due to the Managing Partner DV being unable to make the original date.
DS thanked all for their attendance and closed the meeting.
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