What is the PPG?
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.
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.
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.
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.
The minutes of the meeting held on 22 May 2019 were approved.
EMIS – DV reported that he had not yet had chance to run the latest statistics but would do so for the next meeting.
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.
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.
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)
The minutes of the meeting held on 24/04/2019 were approved as a correct record.
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.
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.
DV presented the information used at the ops meeting and the following was reported:
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.
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.
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.
Notes of the Ryalls Park PPG Meeting held on Wednesday 24 April 2019 at 5.30pm in the Meeting Room at Ryalls Park Medical Centre
Present: Darryl Stimpson, Steph Puddy, Joanne Childs, Roger Brown, Catherine Wilson, Lesley Hudd, Erica Woolmington, Jan Yates, John Falconer, Claire Mallinson, Julia Reynolds, Daniel Vincent.
Apologies: Karina Parsons, Mike Freestone, Brenda Axe.
The Chairman welcomed a new member, Julia Reynolds, to the committee.
The minutes of the meeting held on 27/02/19 were approved as a correct record.
After a steady increase in registrations in recent months, the numbers now appear to be flat lining. Seeking ways to encourage patients to register for EMIS will be an agenda item at future meetings.
Appointments: Booking face-to-face or telephone appointments online has now been restored. During the hiatus in April appointments could only be booked by calling the practice. The data collected during April has been used to determine the proportion of appointments available to book online in May and beyond.
Approximately one third of appointments will be by telephone and two thirds face-to-face.
In addition the practice has resolved a minor problem which had caused difficulties in the past. When a GP asks a patient to see the him/her again in, say, three weeks, it had been the responsibility of the patient to book the appointment. Often it was not possible to book an appointment in the required timescale which understandably caused exasperation.
In future it will be the responsibility of the practice to make the appropriate appointment and call the patient to confirm.
An analysis of the call data shows a wide variation in the ‘time to zero’. This is the time each day for the call queue to fall to zero patients waiting. Not surprisingly, if fewer receptionists are deployed answering the phones the ‘time to zero’ is greater!
In further efforts to improve productivity, an analysis of document work flow has shown that admin staff can take responsibility for the disposition of many documents which formerly required the attention of GPs.
The number of patients on the list has fallen from 6173 to 5949. DV to investigate why patients have left I.e moved away etc. He reported that frequent flyers were still problematic but the number of these had reduced considerably so there were now very few.
GP recruitment update – advert currently out for a GP and had one person interested, DV reported that he and Dr Helen Day were attending a GP recruitment event in Taunton on 01/05/19 and would take part in a webinar. He confirmed that no additional GP needed urgently at present but they were looking ahead to Dr Smith’s retirement next year and cover of annual leave.
DV also reported that a lady called Kim would be joining the practice on 29/04/19 as a performance manager as there had been nobody in place since Amy started her maternity leave and no data had therefore been analysed.
DV updated that an NHS app for requesting repeat medications had been launched and no ID was required to set this up.
DV reported that this new system has been initially launched and trialled by a few PPG members and that all enquiries received had been responded to quickly after initial teething problems. It was hoped to roll this out further after a few more trial requests had been dealt with. JF to test system out also.
JF updated on his attendance at this meeting last week. Unfortunately there were no further answers given regarding the NHS 10 year plan and the investment required within Primary Care going forward. An update was expected in autumn 2019 but this is now likely to happen in spring 2020. JF was considering press involvement as the current delays were unacceptable and needed highlighting on a wider scale.
Wednesday 22nd May 2019 at 5.30pm
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