PPG Minutes March 2024

We are currently in the process of changing our current analogue telephone system to a Cloud Based Telephony (CBT) system. This is so that we can comply with NHSE regulations. The new CBT system will have enhanced features, enabling us to direct calls better and will also include call recording.

We are in the early stages of implementing the new system and envisage that this should be in place by June.

The new system will require a change to our current telephone number. The practice has previously changed its telephone number and we found this did not cause any significant issues. Patients will be informed of the new telephone number as soon as possible. All patients will be informed via text or letter. Posters will be displayed in the surgery and updates will be posted on both our practice website and social media platform (Facebook).

Once the new telephone number is in place, a message will be placed on the old number advising patients of the new number to contact. It has not yet been confirmed how long the message will stay on our old number for.

PPG Member enquiry as to what options would be available on the new telephone system.

Mary advised that at present we are proposing the following options:

1. Appointments.
2. Test Results.
3. Prescriptions.
4. Referrals.
5. Insurance or medical report requests.
6. Other / general enquiries.
7. The options have not yet been confirmed and the practice are open to any suggestions.

We no longer have a 24hr voicemail available and medication requests are no longer taken via telephone. If patients select this option on the new system, they will receive an automated message advising them to order their medication via the NHS App or Patient Online Access Account, email the surgery, submit an eConsult, ask their nominated pharmacy to order on their behalf or complete a slip and post in the box outside of the reception doors.

The 24hr voicemail service was withdrawn to prevent any prescribing errors. Quite often messages were left for requests with no patient name stated. Messages were left for medication stated as the “blue inhaler or pink tablet”. Message were muffled and not always clear.

PPG Member has had a previous issue in ordering medication and found ringing the practice easier than contacting their pharmacy. However, this issue was more related to the timeframe that the pharmacy took to obtain a particular item.

There were no concerns raised by any PPG Members regarding the implementation of a new telephone system.

Mary discussed the reason as to why our reception staff ask patients the nature of their problem when requesting an appointment. All reception staff are bound by confidentiality and are trained Care Navigators.

Extended Access is a service offered across South Tyneside where patients can book into an appointment at our surgery or at another GP surgery within South Tyneside. GP, Practice Nurse and Advanced Nurse Practitioners appointments are available. We also work alongside various other healthcare professionals who are based either in the practice or at another practice within South Tyneside. These practitioners include Musculoskeletal Practitioners / Physiotherapists, Podiatrists and Mental Health Practitioners. We can book patients directly in with these practitioners, should it be appropriate. We can also refer patients direct to pharmacies via the GP2Pharmacy scheme for many common conditions.

Patients can contact NHS 111 and if appropriate, following triage, they can be booked into an appointment within South Tyneside. This can be either a telephone or face to face appointment.

To try and educate patients regarding the above services available, the possible barriers mentioned by PPG Members today were:

• Patients are used to seeing a GP first for a diagnosis and then referred elsewhere.
  • Mary discussed that now we have many more practitioners available, it is a better patient outcome if they are booked with the most appropriate practitioner first. For example, if a patient contacts the surgery with hip pain, rather than waiting to see a GP, our reception staff can arrange an appointment with an MSK/physiotherapy practitioner. This would ensure that the patient is seeing the most appropriate partitioner first time and prevent delays to advice and/or treatment.
• Male patients not wanting to disclose personal problems to a female receptionist.
  • Dr Zaidi confirmed that all staff are bound by confidentiality. If a patient did not want to disclose the nature of their problem, this would be respected by the receptionist. However, this may delay the advice or treatment needed by the patient as the GP may not be the most appropriate person to deal with their issue.
• Reception area is not very private when discussing issues with the reception staff.
  • Mary discussed the reasoning behind the screens which are now in place in our reception area. If a patient wants to discuss their issue in private, they can inform the receptionist of this, and they will be offered a private consultation room to talk with one of our reception team.

Mary discussed our current appointment system. Appointments are available to book on the day, 24hours in advanced or 48hours in advance. The appointments we offer are often utilised before 9am.

We are looking at changing our appointment system to a Modern General Practice system. This would involve the implementation of eConsult for all appointments requests. We currently have patients using eConsult, however the new Modern General Practice System would be for all appointments to be requested using eConsult.

The proposed system would work by an Oncall GP and receptionist working together to review all eConsult requests submitted on a daily basis. Patients would then be offered an appointment most appropriate for their need. As previously discussed, this could be an appointment with a GP, Advanced Nurse Practitioner, referred via GP2Pharmacy or booked with another healthcare practitioner.

We understand that not all patients will have access to a smart phone or digital device to submit an eConsult, therefore patients attending in person to request an appointment or contacting the surgery via telephone, the receptionist would complete an eConsult Lite template. This would be a shorter version of the form available online. This would then await review by the GP as stated above.

As reception staff are Care Navigation trained, any eConsult received, which could be directly referred to another service would be done so without the need for the Oncall GP to review. This is what our reception staff do currently, where appropriate to do so.

All PPG Members agreed that going forward with eConsult seemed a good approach if this would enable patients to receive an appointment with the most appropriate practitioner within the most appropriate timeframe.

We currently have an Advanced Nurse Practitioner, Andrea working in the surgery and appointments are offered one day per week. The PPG members who have had a consultation with Andrea, have had a very positive experience and found her to be very thorough and helpful.

When contacting the surgery, it was suggested that it would be nice to know which staff member the patient was speaking to. This was a welcome suggestion, and it would be implemented by the surgery.