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Dear Patient,

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 medical staff and 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.

Yours sincerely

John Falconer

Chairman Ryalls Park PPG


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 perhaps you could email the PPG at  See below the minutes of the three most recent meetings. 


Minutes of the Ryalls Park PPG Meeting held on Wednesday 24 October 2018 at 5.30pm in the Meeting Room at Ryalls Park Medical Centre


Present: Steph Puddy, Mike Freestone, Christine Hunt, Daniel Vincent, Darryl Stimpson, Joanne Childs, Jan Yates, Roger Brown, John Falconer (Chair). 


Apologies: Claire Mallinson, Brenda Axe, Lesley Hudd.


Two new patients joined the committee this evening.  Christine Hunt and Roger Brown were introduced and welcomed by the Chair.   


The Chair informed the committee that regrettably Karina was unable to attend due to a serious ill-health condition and for the time being would step down from attending meetings.   The committee expressed their distress at the news and unanimously sent their best wishes to Karina for a complete and rapid recovery.    


Online Consultations

This is an additional item which Mike Freestone asked to be added to the agenda and agreed to by the Chair.

Online consultations provide a potential means to increase patient access to GPs and other health professionals.  However, as Mike pointed out, it is not necessarily appropriate for all patients.  Some do not have a computer or tablet and in any event may not be confident when using digital equipment.  Mike was concerned that online consulting might replace face-to-face consulting in future – a backward step. (See attached note)

The committee discussed the issue and agreed that although there were potential problems online consulting should be explored further.    



  1. Minutes of the previous meeting


The minutes of the meeting held on 26/09/18 were approved as a correct record except as follows:  Lesley Hudd was recorded as present in error.  She was unable to attend and had submitted her apologies. 


  1. Matters Arising from previous meeting


VolunteersRegrettably, Jan and Karina were unable to continue as volunteers, at least in the short term.  It is intended that the remaining volunteers should begin in the 2nd week of January 2019. 


  1. Managing Partner’s Report

Daniel began by announcing that new starters, Rose and Hannah have joined the Patient Liaison Team and Sian has joined the Nursing Team.

Also, as mentioned last month, Dr Helen Day has joined the practice.  Taken together, this gives the practice a full complement of staff - not seen for a very long time. 


Daniel read the main points raised in a letter received from Marcus Fysh MP. The letter was well balanced with a request to understand what we are doing to improve access, that the government is looking at further funding and that the patient who had raised the concern had said how excellent both the GPs and reception team were.



The prescription process was again discussed.  Many patients continue to experience problems and improvements to the process are still being considered.  A further meeting is planned to take place on 20 November to review progress to date and to discuss next steps.  


  1. Somerset Chairs’ Network – Report


John and Darryl attended the October meeting of the Somerset Chair’s Network. 


Items of note for discussion:


The SIDeR Programme

The Somerset Integrated Digital e-Record is intended to improve end of life care by giving hospices and other care organisations access to patient records.  Unfortunately it is a stand-alone initiative and is not integrated with other NHS platforms, for example EMIS. 

Not sure who came up with the silly title.  Cider is not the first thing that springs to mind for health or memory!  JF


Winter Planning for Community Hospitals

Last year the number of staff available in some community hospitals fell below the minimum safe level which resulted in the hospitals having to unexpectedly close for a period.  To avoid this happening in the coming winter, Lucy Nicholls, of Somerset Partnership NHS Trust has decided to close some hospitals early!

The obvious idea of getting more staff on stand-by seems not to have been considered.


Health and Care Stategy

Michael Bainbridge (Head of Primary Care at the CCG) explained that the ‘Health and Care Strategy’ had been superseded by the ‘Fit for my Future’ Strategy.  Michael made it clear that the FfmF strategy is no different from the HaC strategy.  (no different from the STP strategy before that either!)

Essentially, the CCG will be conducting a number of ‘road-shows’ around the county to gather views from people as to how the CCG should proceed.  In the meantime the number of GPs in Somerset continues to reduce making it ever more difficult to get an appointment.


The Genome Project

Darryl explained this important development which is gradually being made available to doctors.  Occasionally, clinicians are unable to diagnose certain conditions which do not respond to treatment.  In these circumstances it may be that the patient in question has a genetic defect which is the cause.  In future it will be possible for GPs to check if that is the case.  Darryl will circulate separately the presentation material given at the CN meeting)  


Executive Committee

As it is not practical for the entire Chair’s Network to engage in detailed discussion with the CCG, the idea of forming an executive committee of five or six people to represent the CN was approved in principle.

John Falconer has been invited to join the executive committee.


  1. AOB


No progress regarding to Mens Shed.  A suitable location is being sought.

It was pointed out that there are similarities between the Mens Shed idea and the UTA, the University of the Third Age.


Jan pointed out that messages left online were not always followed up.  Daniel replied that the situation should improve now we have additional staff.


Mike confirmed that men aged between 65 and 70 were being invited for a scan to check for aortic aneurism.   However, men over 70 must request a scan via the practice.


John thanked everyone for their attendance and closed the meeting.


Next meetings:


Wednesday 21 November at 5.30

Wednesday 19 December at 5.30




 Online Consultations

I have received an email concerning the use of online video consultations.

I feel the PPG need to discuss this. Apparently it is in trial operation in some parts of the country and could be rolled out nationwide.

1st.  My first feeling is what about the elderly and frail persons who may not have access to a PC.

2nd presumably there would be no extra doctors, so whilst a doctor is spending time answering a video call what happens to his patients personal visit.

3rd Somehow it seems to be a method of shifting appointments from the patient visiting the surgery to the patient sitting at home on a PC, the same thing applies to telephone appointments. A doctor cannot be having a video consultation and a normal visit of a patient at the same time.

Is this the thin edge of the wedge to completely do away with a surgery (building) much the same way as retailers are shutting shops due to online sales. Food for thought.  

Mike Freestone



Minutes of the Ryalls Park PPG Meeting held on Wednesday 26th September 2018 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), Lesley Hudd (LH), Jan Yates (JY), Steph Puddy (SP), Karina Parsons (KP), Richard More (RM), Joanne Childs(JC)


Apologies:   Linda Bacon (LB), Diane Paris-Hunter (DPH), Mike Freestone (MF).  For the purpose of the minutes JF advised that both LB and DPH had given their resignations from the PPG due to not having the time to commit at present.  However JF also reported he had been contacted by two additional people interested in becoming members and he would follow these up.


  1. Minutes of the previous meeting

The minutes of the meeting held on 25/07/18 were approved as a correct record.


  1. Matters Arising from previous meeting


Volunteers – DV advised that the three PPG volunteer members had completed the relevant DBS checks but only one as, yet, had received their full clearance back. KP raised concerns in view of recent issues within the practice regarding volunteers being front line and having to deal with irate patients.  It was hoped the volunteer role would start ASAP however it was felt that with one volunteer now resigned from the PPG and one expressing concern that thought should be given about redefining the roles and expectations of the volunteers.  DV also advised that he had been approached by a non-PPG patient who was interested in being a volunteer however it was agreed to pilot with the PPG volunteers initially.


Man Shed – JF updated that this was still ongoing.


Updated Prescription Process – This would be covered by RM/DV later in the meeting.


Staffing Issues– This would be covered by RM/DV later in the meeting.


Meeting of PPG Chairs – JF reported that he and DS had met with the Chairs/Vice Chairs of local PPGs and all were seemingly in a similar position regarding pressures of staffing, availability etc.


  1. Managing Partners/Practice Chairman’s Report

DV/RM presented their update as follows


National statistics show a drop in full time practitioners with another 275 having been lost in the first quarter and 25% of the remaining GPS being over the age of 55.  However despite these figures Ryalls Park continues to thrive.


Historical issues identified within the practice are being looked at as part of the Xytal processes and RM was pleased to report that the end is in sight.


With regards to the Leadership team RM and DV remain as Practice Chairman and Managing Partner respectively whilst Dr Smith has stepped into the role of Clinical Lead and these positions are being supported by Dr Regan and Dr Leather.


RM reported a clear divide between what patients want and what the government will fund however it is hoped that by working on efficiency to free up GP time and reduce waiting times that this can be addressed.  Trained GPs are providing acute clinical care whilst being supported by other health professionals such as Nurse Practitioners, Health Coaches and Physiotherapists to try to maintain a balance.


RM extended thanks to DS on behalf of Sue McGuinness (Xytal) for his input and ongoing assistance with streamlining the prescribing process currently in place at the Practice.


It was hoped that objectives could be worked through but this would be on the basis of a 2/3 year plan.  And experienced Practice Manager from Taunton had been invited to come into the Practice to give advice and feedback.


DV reported that a new GP had been appointed – Ryalls Park is delighted to welcome Dr Helen Day onto the GP team.  Dr Day has worked at many other practices and is a very experienced GP specialising in Women’s Health, Contraception and MSK.  She has also been through the Xytal process at previous practices.


JF raised the issue of patient complaints seeming to be on the increase at the Practice however DV reported that in a local patient survey Ryalls Park were joint 1st of all the Yeovil Practices. 


DS felt that the prescription process was still a big issue and the NHS systems seemed to be where this was failing.  With a move to encourage patients to use the electronic EMIS system to request prescriptions, appointments etc it was felt that this would resolve many of the current issues providing that the system worked effectively.


JF queried how the administration staff were coping with the change in process and DV reported that the team members were all responding well and contributing positively to the process change and were being kept informed every step of the way.


DV confirmed that a new receptionist had been appointed and another receptionist was being sought to join the team. Current minimum staffing numbers were 2 GPS per day supporting the NP team.



JF raised the ongoing issue of funding from the CCG/NHS England.  Despite statements earlier in the year that significant additional funding would be forthcoming; it is yet to be confirmed.  RM felt that this issue would never be resolved and it was a case of working with what we had to ensure that the patients needing appointments were seen when needed.  To this end communication would be essential between the Practice and its patients.


RM stated that the objectives set by the PPG for the coming year were very doable.


BA raised a concern regarding the shortage of Health Professionals to carry out specific procedure especially in view of the fact that some staff changes were afoot in terms of maternity leave etc.  Discussion ensued and DV stated that he hoped to be able to cover all specialist procedures currently carried out by staff that were leaving temporarily and hoped that existing staff would be trained to ensure continuity of specialist services currently offered.


JF queried whether RM thought it would be possible for Primary Care to obtain more funding and it was advised that NHS England rejected a plan put forward by the CCG for more funding in Primary Care.


JF thanked RM for attending and it was agreed that he would attend the meeting in December to update on Xytal progress.


  1. Any Other Business




Date of next meetings

Future meeting dates were discussed and the following agreed :


Wednesday 24th October 2018 – 5.30pm

Wednesday 21st November 2018 – 5.30pm

Wednesday 19th December 2018 – 5.30pm


JF thanked all for their attendance and closed the meeting.


Minutes of the Ryalls Park PPG Meeting held on Wednesday 25th July 2018 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), Lesley Hudd (LH), Jan Yates (JY), Mike Freestone (MF)


Apologies :  Karina Parsons (KP), Linda Bacon (LB), Jane Perry (JP), Steph Puddy (SP), Mike Norman (MN)


  1. Minutes of the previous meeting

The minutes of the meeting held on 27/06/18 were approved as a correct record.


  1. Matters Arising from previous meeting


Volunteers – CM updated that the DBS forms had now been received and a meeting was set up with prospective PPG volunteers and DV for 03/08 for completion prior to volunteers starting.


Man Shed – JF updated that this was ongoing as had been unable to arrange suitable appointment with MF.


Sputum Sample - DV had resolved this issue with the member concerned.


Updated Prescription Process – DS and DV reported that the consultation process with Xytel regarding this had started and a productive meeting was held on 24/07. It was hoped that a simpler process would be identified.


  1. Managing Partners Report

DV presented his report on the following :


Staffing/Capacity Issues – Dr Moorhouse was leaving the practice on 12/09/18 due to moving out of the area.  A new GP is being interviewed on 01/08.


A Nurse Practitioner has been booked for September to November but will not be qualified to inject joints at present.  The plan is to train 1 GP and 2 Nurse Practitioners to do contraceptive implants as they already administer the depo injection.   New staff will all be salaried.  A new NP Leigh will be joining the practice on 03/09. Within the nursing team Emma starts on Monday 23/09 to replace Holly.  Lauren P will be joining the HCA team to replace Jay however Maternity Cover is still sought for Anna’s Maternity Leave.  Melinda joined from Castle Cary surgery to cover the Health Coach team and it is planned that she will support respiratory and diabetic patients in Anna’s absence.


Two admin apprentices, Lucy and Aleysha  have joined for one year.


There is currently a vacancy on reception as Tracey decided to leave and this has been advertised with a good response so far of 25 applicants.  Beth who is currently on maternity leave will not be coming back.


If unable to recruit a GP long term they will look at using other team members to cover this work within the practice.


Prescription Process - DV/DS fed back from the prescription process meeting held on 24/07.  They are very much at the early stages of data capture and understanding the current process and a follow up meeting has been arranged in two weeks to look at this in further detail.  The aim is to reduce current prescription time to 3 days but too early to say whether this will be possible.  It is hoped an update will be given by Dr Richard More at the September meeting.


DV reported that there had been a positive response from staff regarding the implementation plans with Xytel and they were feeling invigorated and re energised.




  1. Report from Somerset PPG Chairs Meeting


DS and JF attended the meeting on Monday 17/07 where Nick Robinson was present.  Updated that a 3 year plan had been started but that things had not moved much further forward than last time.  There was a clear lack of consultation at grass roots level and whilst a greater investment in Primary Care was needed this was still on the table and no further decisions has been made.


  1. Letter from PPG Member


JF read out a letter from MN in which he tendered his resignation.  Issues had arisen where he felt the practice was failing to get things organised properly and he had lost confidence in the management of Ryalls Park.  As a result he felt he could no longer serve on the PPG committee and offered his resigation.  MN's resignation from the PPG committee was accepted. 


  1. PPG Objectives


There are a number of key issues which the committee have identified as in urgent need of improvement.  They are :


  • The number of appointments available, especially with GPS
  • The time patients spend trying to get through to the practice on the telephone
  • The layout of the waiting room and staff attendance at the reception desk


The committee also wishes the practice to consider expanding its services by introducing online consultations with GPS and other health professionals using Skype or similar apps.


  1. Any Other Business


Regarding the Man Shed MF said he had enquirer of SSDC if there was any funding planned.  To date he had not received a reply.


Date of next meetings

Future meeting dates were discussed and the following agreed :


No meeting in August

Wednesday 26th September 2018 – 5.30pm


JF thanked all for their attendance and closed the meeting.




Minutes of the Ryalls Park PPG Meeting held on Wednesday 27th June 2018 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), Lesley Hudd (LH), Linda Bacon (LB), Diane Paris-Hunter (DPH), Steph Puddy (SP), Joanne Childs (JC)


Apologies:  Karina Parsons (KP), Jan Yates (JY), Jane Perry (JP), Mike Freestone (MF), Mike Norman (MN)


  1. Minutes of the previous meeting

The minutes of the meeting held on 23/05/18 were approved as a correct record.


  1. Matters Arising from previous meeting

Volunteers – CM and DV updated that several meetings had been held with the three PPG volunteers.  A role description of duties was discussed and agreed and confidentiality declarations had been signed by all.  DV was awaiting DBS process completion before volunteers can begin.


Man Shed – JF updated that a potential location had been found for Man Shed.  He would liaise with MF to take this forward.


Sputum Sample - DV had missed the issue with the sputum sample from the last meeting but would now follow this up with relevant staff.


Updated Prescription Process – DS had sent updated prescription process to DV for approval but had not yet heard anything.  DV apologised that this had not yet been done but it was agreed that a meeting with DS and DV would take place to complete this.


  1. Managing Partners Report

DV presented his report on the following:


Leaflet – A new leaflet had been produced giving details of Medical staff at the Surgery, extended hours, waiting times, updates and signposting to other personnel such as Health Coaches, Pharmacy etc. for various medical issues.  This was tabled for review and would be made available in the waiting area and online.


NHS Choices – DV reported that RPMC was rated first, equal with Penn Hill, as best practice in the area.


Staffing/Capacity Issues – A new Nurse Practitioner (Leigh) would be joining the practice on 03/09/18 bringing the NP staff back up to two on most days.  A locum NP was also in place.  This means that there are currently 2 GP’s and 1 Nurse Practitioner working each day with the NPs offering on-the-day appointments meaning the GPs are released for pre-booked appointments, prescription signing and other necessary admin work.


From the HCA Team Holly has left to take up a position at YDH.  Anna is due to commence her Maternity Leave in November and Jay’s apprenticeship is coming to an end and he is leaving in September to pursue a nursing career.  In order to backfill this Emma will be joining the HCA team on 23/07/18 from Oaklands surgery where she is currently working.  Three candidates have been interviewed for the apprenticeship post and there is somebody interested in covering Anna’s maternity leave.


LB joined the meeting at this stage.


DV reported that this year’s patient survey results were due out on 09/08/18.


DS raised the issue of prescription backlogs and DV reported that all GPs now have half an hour per day allocated to sign these.  Discussion ensued regarding staff knowledge of the different processes for obtaining prescriptions and it was felt that staff needed to be reminded about the different types of prescriptions and the processes for obtaining them.  DV reported that Xytal were due to come in on 23/07/18 to implement programme to help with this.  DPH suggested that it may be prudent for a member of the PPG to attend this also to better understand the implementation process.  It was agreed this would be a good idea and DS agreed to be part of this process to walk through resource implementation.


Repeat dispensing has been discontinued as it was not working well from a patient perspective.


  1. PPG Objectives


  • Availability of appointments/GP capacity
  • Phone system appointments System
  • Potential diagnostic services at surgery
  • Online facilities/Skype appointments with doctor
  • Improvements to Reception Area.  Training standardised for all PLT members
  • Parking


  1. Any Other Business




Date of next meetings:

Wednesday 25 July at 5.30pm.

             No meeting in August

Wednesday 26th September 2018 – 5.30pm


JF thanked all for their attendance and closed the meeting.




Planning Ahead – A guide for patients and carers.


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