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Patient Participation Group- a representative group of patients who suggest possible changes in the health system to improve patient care

PPG MEETING – OCTOBER 17th 2013

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The Patient Participation Group held a meeting at the surgery on October 17th 2013 in the surgery . The full minutes are on the surgery website:-
http://www.102theavenue.co.uk/files/download/5843a082abe3f19

We reported on outcomes of planned achievements from last year – 2012/13

  • Passing on of information
    We have managed to obtain 500 patient email addresses to be able to inform patients of current changes in the NHS. Following last years meeting I started this blog in an attempt to let patients and others know about national changes aswell as local events and changes. It has also been an attempt to educate readers about medical topics aswell as some stories relating to my life as a doctor and tying it in to more recent advances in medicine.
  • Clinical Systems We have been in negotiation most of the year with other doctors in our network and having agreed on a system which would be more patient friendly it has been decided to Ho over to this system after April when the busy winter months are over.
  • Patient education Arranging events in the form of talks has been difficult due to patient’s availability but by continuing with posters , providing links on our website, patient leaflets and now deciding to focus on particular at risk groups such as the mentally ill we hope this will be an ongoing
    provision.PLANS FOR 2013/14

    We have brought up 3 subjects to consider and will sending out a survey completed anonymously to gather information from a wider section of patients

    PREMISES AND MERGER
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    With reference to a paper brought out earlier in the year in the magazine Commissioning Success a bi-monthly magazine from the team behind Practice Business, aimed at helping clinical commissioners get the best outcomes from clinically-led commissioning.
    Collaborative healthcare ‘groups’ and informal alliances can work better than formal mergers, says NHS Confederation.
    Published: MAY 1, 2013

    “The new options for governing through healthcare groups set out in this paper can strengthen rather than reduce the connections to local people, and help maintain safe local services. They could also mean less upheaval for staff and for patients, many of whom worry that they will lose a valued service or even their job.”

    We discussed the present situation of general Practise and how small practises are becoming less viable and ways in which we could consider keeping the personal touch we have created in a small practise. However, being realistic we must now consider sharing facilities with other nearby practises and with a new computer system where access to notes would be more obtainable by other doctors we could reduce waiting times and share resources.
    We have already begun to collaborate with other practises in our network (about 10 practises) in Commissioning services such as anticoagulation and community run musculoskeletal-skeletal services but we need to think of ways to facilitate services at a practise level for more everyday services and how we can satisfy CQC inspectors with regard to standard of premises.
    The survey will provide more feedback from our patients on this topic.

    OUT OF HOURS and A&E
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    This has been an ongoing topic in the national news for some time and recently I have been asking patients what they would do if they needed a doctor out of hours and was surprised at the lack of knowledge. This prompted me to write the blog on 111 and please read this if you haven’t already done so. The NHS is wasting phenomenal amount of money asking highly qualified health professionals to deal with health problems which could be dealt with in the home or visiting a local pharmacy. Splinters, common cold, flu, simple cuts, bruises and sprains and domestic worries are not reasons for attending A&E or calling an ambulance. Believe it or not that is what I see every time I do an Out of Hours session at one of our local hospitals. Again refer to this blog which outlines what to do if you have a medical problem out of hours.

    https://102theavenue.wordpress.com/wp-admin/post.php?post=1109&action=edit

    PRESCRIBING AND MEDICINES WASTAGE
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    Another topical cause of concern has been medicine wastage and we need to educate patients how to avoid this. We as doctors meet regularly with a prescribing advisor and we work closely with a prescribing pharmacist to find ways in which we as doctors avoid waste and to consider cost-effective prescribing. By doing this there is more chance that there will be money in the pot for expensive medication for conditions such as cancer. It is also helpful if patients buy over the counter products such as paracetamol when appropriate.
    See blog:- Do you use your inhaler as an air spray? https://102theavenue.wordpress.com/wp-admin/post.php?post=381&action=edit

The next step is to send out our survey both by hand in surgery and online and then analyse the results and meet again to discuss.
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Posted by on October 26, 2013 in Training and Advice

 

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Aside

imageNEXT PATIENT PARTICIPATION GROUP MEETING
WILL BE HELD  ON THURSDAY  OCTOBER  17th

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AT
11.00am

IN THE SURGERY

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NEXT PATIENT PARTICIPATION GROUP MEETING

 

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PATIENT PARTICIPATION GROUP

If you read the main website on the following link http://www.102theavenue.co.uk/patient_group/ you will be able to view the practise profile and what actions have been taken following previous PPG meetings.
Last year was directed at health education and a major reason for starting this blog.
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THE PURPOSE OF PATIENT PARTICIPATION GROUPS

• To give Practice staff and patients the opportunity to discuss topics of mutual interest in the Practice.
• To provide the means for patients to make positive suggestions about the Practice and their own healthcare.
• To encourage health education activities within the Practice.
• To develop self-help projects to meet the needs of fellow patients.
• To act as a representative group that can be called upon to influence the local provision of health and social care.
• To involve further patients from the wider population.

imageAs I am sure you are all aware the NHS has become NHS ENGLAND and has reinvented itself with the prime aim to improve the health outcomes for people in England.
http://www.england.nhs.uk/

STATED AIMS OF NHS ENGLAND

We believe the new approach we are taking will really make a difference and deliver the improved health outcomes we all want to see.

Central to our ambition is to place the patients and the public at the heart of everything we do. We are what we want the NHS to be – open, evidence-based and inclusive, to be transparent about the decisions we make, the way we operate and the impact wehave.

We encourage patient and public participation in the NHS, treat them respectfully and put their interests first. This allows us to develop the insight to help us improve outcomes and guarantee no community is left behind or disadvantaged.

We empower and support clinical leaders at every level of the NHS through clinical commissioning groups (CCGs), networks and senates, in NHS England itself and in providers, helping them to make genuinely informed decisions, spend the taxpayers’ money wisely and provide high quality services.

Engaging with our staff is equally important to us too. Our staff are what makes NHS England an excellent organisation: an exemplar in customer focus, professionalism, rigour and creativity.

Grounded by the values and principles of the NHS Constitution, we are an organisation who shares ideas and knowledge, successes and failures, and listens to each other carefully and thoughtfully.

At NHS England, we practice what we preach. By working collaboratively and building coalitions with partners everywhere means we can achieve greater things together and deliver the best patient service not only in England but in the world.

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It is with this in mind that we are continuing to develop our PPG and your views as patients will be important when we have our CQC inspection.
We need your support during the changes that are anticipated and feedback from you to establish what is going well and we need your positive suggestions as to how we can make improvements to the practise and your healthcare.

Small practises such as ours are under threat and we are finding ways as to how we can work more closely with other local practises and have started to share resources such as anticoagulant management,lung function measurement,children’s phlebotomy and nursing home patient care as well as training our staff. We recently held our cardio-pulmonary support training session with staff from other practises and patients were also invited.

We have joined a network with other local practises to meet to discuss care pathways for patients with complex medico-social problems as well as finding learning needs and addressing them.
Doctors and/or practise manager always attend CCG meetings so that we keep up to date with local and national changes and a chance to meet doctors from other networks to formulate ways of improving health care by commissioning.
The 2013/14 prosectus and links can be found on the following website http://www.ealingccg.nhs.uk/media/3881/ealing_prospectus_-_final_310513.pdf

Following the CQC inspection there will inevitably be suggestions of actions that need to be actioned. You may have noticed certain changes such as all staff wear name badges including me when I remember! Also there are EXIT signs and all staff are being trained in more advanced health and safety including fire safety. All staff are trained regularly in first aid and life support and awareness of patients with particular needs.
We have all been alerted to the special needs of patients with learning disability and sensory impairment and are attempting to find ways of accommodating them sensitively as advised by healthcare professionals who are expert in this field.

What are our priorities and vision for the future?
Ealing CCG has seven overarching priority areas of work, as follows:
*A better start in life – increasing breastfeeding initiation, reducing avoidable childhood injuries, and increasing childhood immunisations.
*Increasing life expectancy – reducing cardiovascular disease deaths, reducing cancer deaths; and reducing alcohol-related hospital admissions.
*Shifting unplanned care towards planned care – increasing the amount of services delivered in a community setting, improving unplanned care services in Ealing, and reducing the delays in hospital discharges.
*Reducing variations in primary care – better early diagnosis and treatment, and reducing variations in hospital referral patterns by GPs.
*Improving recovery – increasing the range and access to rehabilitation services.
* Enhanced mental health services – increasing the provision of community services.
* Improving care at the end of life – increasing the proportion of deaths in preferred places.

These are the areas of work which we are discussing in our CCG meetings and implementing in our networks and in the practise.

The main areas a PPG can help are:-
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*Improving services provided by the surgery
Carrying out surveys into a whole variety of subjects eg health needs/expectations and major cause of ill-health in a particular area.
• To explore the changing needs of patients.
• Measure patient satisfaction.
• Gather ideas for improvements or modifications needed for the delivery of services.
• Discussions at meetings.

*Offering support to other patients
e.g Befriending service, Carers Group

*Improving facilities at the surgery
• Fundraising for new furniture, toys or decorating.
• Keeping the plants or gardens of the surgery maintained.
• General environmental improvements.
A BIG THANK YOU TO THOSE WHO HAVE CONTRIBUTED IN THIS WAY

*Providing health promotion and education
e.g diabetes awareness day,contributions to the blog and notices added to our notice board.

* Supporting voluntary organisations in the area
e.g Age UK, MIND, Heart Foundation, Cancer UK, Dementia Concern
We have several patients who make contributions to these and other organisations

This year the CCG want to particularly want to focus on Carers
CARERS
Many people who are caring for someone do not necessarily see themselves as a ‘carer’. Rather they are mothers, fathers, daughters, sons, partners, husbands, wives or neighbours. However, being identified as a carer by the council can help you get the right support you need to look after the person you care for.
To understand what support can be given to Carers the following website is helpful
imagehttp://www.ealing.gov.uk/info/200379/carers/851/useful_links_carers

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Patient’s role in NHS England

As we all read the papers or listen to the news it is now blatantly obvious the NHS on its 65th birthday is in serious trouble.
The NHS is “about to run out of cash” – and faces a £30 billion funding gap by 2020, senior health service officials have warned.
It is down to NHS England to advise sweeping changes – a call to action……

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Formally established as the NHS Commissioning Board on 1 October 2012, NHS England is an independent body at arm’s length to the Government.
NHS England   will play a key role in the Government’s vision to modernise the health service with the key aim of securing the best possible health outcomes for patients by prioritising them in every decision it makes.
The main aim of NHS England is to improve the health outcomes for people in England.
    • We believe the new approach we are taking will really make a difference and deliver the improved health outcomes we all want to see.

      The new health and care system becomes fully operational from 1 April to deliver the ambitions set out in the Health and Social Care Act. NHS England, Public Health England, the NHS Trust Development Authority and Health Education England will take on their full range of responsibilities.

    • Locally, clinical commissioning groups – made up of doctors, nurses and other professionals – will buy services for patients, while local councils formally take on their new roles in promoting public health. Health and wellbeing boards will bring together local organisations to work in partnership and Healthwatch will provide a powerful voice for patients and local communities.
    • Central to our ambition is to place the patients and the public at the heart of everything we do. We are what we want the NHS to be – open, evidence-based and inclusive, to be transparent about the decisions we make, the way we operate and the impact we have
    • We encourage patient and public participation in the NHS, treat them respectfully and put their interests first. This allows us to develop the insight to help us improve outcomes and guarantee no community is left behind or disadvantage
    • We empower and support clinical leaders at every level of the NHS through clinical commissioning groups (CCGs), networks and senates, in NHS England itself and in providers, helping them to make genuinely informed decisions, spend the taxpayers’ money wisely and provide high quality services.
    • Engaging with our staff is equally important to us too. Our staff is what makes the NHS England an excellent organisation: an exemplar in customer focus, professionalism, rigour and creativity
    • Grounded by the values and principles of the NHS Constitution, we are an organisation who shares ideas and knowledge, successes and failures, and listens to each other carefully and thoughtfully.
    • At NHS England, we practice what we preach. By working collaboratively and building coalitions with partners everywhere means we can achieve greater things together and deliver the best patient service not only in England but in the world.

      *****************************************************************************

      At the same time this potential crisis reaches the headlines we as GP’s are asked to choose whether to liaise with the Patient Reference Group(PRG) to get ideas of how we can improve our services by increasing efficiency and cost effective commissioning. We as a practise have opted to participate in this Direct Enhanced Service (DES) and work with the PRG.

      Patient Reference Group
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      The purpose of the patient participation DES is to ensure that patients are involved in decisions about the range and quality of services provided and over time, commissioned by their practice. It aims to encourage and reward practices for routinely asking and acting on the views of their patients. This includes the patients being involved in decisions that lead to changes to the services their practice provides or commissions, either directly or in its capacity as gatekeeper to other services.It aims to promote the proactive engagement of patients through the use of effective Patient Reference Groups (PRGs) and to seek views from practice patients through the use of a local practice survey. The outcomes of the engagement and the views of patients are to be published on the practice’s website.

      Suggestions of aspects which may be discussed – NHS England
      One aspect that practices may wish to focus on is ensuring convenient access to the practice and also from the practice to other services in its role as coordinator of care, facilitating access to other health and social care providers.
      Access has many dimensions; the relative importance of these will vary according to the specific needs of the registered population. These dimensions include:
       lists being open to all
       hours of opening with the ability to be seen urgently when clinically necessary, as well as
      the ability to book ahead
       continuity of care
       range of skills available – access to different professionals
       a choice of modes of contact which currently includes face-to-face, telephone and electronic contact, but can be developed further as technology allows
       geographical access, enabling care as close to home as possible.
      Access must be flexible enough to meet the varying needs of individualsand requires sufficient capacity to meet the population’s needs. Details of access arrangements (including opening hours) should be made widely available to the patient population to enable patients to exercise choice.

      Patient Reference Group (PRG) may be an existing formal patient participation group or a similar group that is representative of the practice population, which would feed in its views alongside the findings from the surveys and agree with the practice priority areas for possible change. This would result in an action plan to be agreed between the practice and the PRG.
      Practices taking part in this DES will also carry out a properly constituted survey of a sample of the practice’s patients looking at a broad range of areas which could include convenience of access (opening times, ability to book ahead, ability to be seen quickly, telephone answering), patients’ experience of the treatment and service they receive, the physical environment in the practice and other issues specific to individual practices.
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      As I am sure some of you are aware we have already participated in having meetings with a cross section of patients during the past few years to discuss results of patients surveys addressing issues such as access to doctors, telephone access, car parking,email prescription requests, children in surgery and more recently patient education and we have attempted to improve our service and act on points raised in the survey. The minutes of these meetings are published on our website. This was formerly called the Patient Participation Group but will know be known as the Patient Reference Group.
      We have tried to make our meetings representative of the patient population but along with our GP colleagues we have found the numbers participating are small and some types of patients are not represented. Nevertheless, we are persevering to reach our patients by our website,written newsletters and survey sheets distributed over a period of time to a wide cross section of patients.

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      We will be announcing a PRG meeting in the next few weeks and conducting a survey with patients attending the surgery and strongly encourage as many people as possible to participate. Although it is good to hear favourable comments on things we are doing well it would be extremely useful and perhaps more so if we could have constructive criticism of things we are NOT doing well,and even better if we can have ideas of how we can provide a better service.
      When we obtain the results of the survey we will hold a further meeting to discuss the findings and hopefully come to an agreement as to how we can implement plans for changes to the services provided.
      If you have suggestions please contact the practise Manager,Sangeeta Kathuria by email(sangeeta.kathuria@nhs.net), appointment or by letter.
      We need everyone to pull together to keep our NHS continuing to provide a service to all who need it.
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