PPG Minutes

Minutes of The Meeting 8th July 2024

Present

• Alan Breadmore (Chairman)
• Karen Sperrey (Minute taker)
• Claire Hill
• Mary Wilson
• Ian Wootton
• Lucy Hall
• Dr Sarah Stallabrass (Surgery)
• Lousie Murray-Clarke (Surgery)
• Bridget Jones (Lambourn PC)

1. Apologies

Peter & Liz Cox, Geoff Fowler & Graham Jones.

The sad passing of Gillian Greenham had been noted on the agenda. Alan stated that the subsequent vacancy will be dealt with at another meeting, and he welcomed Ian Wootton to his first meeting as a full member of the PPG.

2. Minutes of the meeting

These had previously been circulated via email and were accepted as a true record. 

3. Matters Arising

a) NHS App training/awareness

Marta from NHS Training will be carrying out awareness training on 31st July in Lambourn Library on a turn up and chat basis with no appointments being necessary. Two staff from the surgery will be on hand to assist. It will be publicised electronically via FaceBook & displaying physical posters wherever possible. The PPG were asked to help publicise the event as much as possible to encourage people to attend. 

Action: Alan to include in the next newsletter & Lousie to create a poster for Alan to circulate to everyone. 

4. Discussion Topics

a) Surgery

(i) DNA appointments

Louise reported that the DNA numbers were static, with more on the nurse appointments than doctors and that Saturday is particularly bad. She explained that staff are now phoning in advance and sometimes on the day to make sure that attendees are coming where there are long appointments booked for Saturdays.

(ii) New website

The privacy notice has been updated otherwise no other changes were noted.

(iii) Communicating Surgery hours/closures

This was raised following the recent staff training closure. There was concern that there had not been enough prior communication about this, and several patients had made wasted journeys to the surgery. Louise reported that it had been detailed on the Surgery Face Book and pinned to the top to prevent the message being lost, the surgery phones had a message explaining closure due to training and a notice pinned on the main door. However, patients thought the pharmacy side was closed & had not entered. Alan was curious why the door had not opened automatically as usual.

Learning for the future: It was agreed that any future closure notice will state that the pharmacy side is open as usual when the surgery is closed for training, which is usually only twice a year. 

Travel Clinic: Alan asked if the surgery was still a designated travel clinic and was told no, due to lack of capacity. Patients are referred to Boots. 

b) Lambourn Surgery Amenities Fund (LSAF)

A member of staff is looking at dementia friendly initiatives & neuro diverse options so there could be a funding request in the future Mary asked if the PPC would accept a donation for a specific item from the Sackler Foundation and a decision was taken not to proceed.

c) Patient Panel & related discussion

Alan is due to attend a meeting soon discussing how surgeries are getting on with their e-triage systems. He asked for feedback on E-Consult.

From non-surgery staff:

• Form too lengthy & often repetitive questions.
• Continuity of care is not catered for so easily with E-Consult.
• Complicated when there are several symptoms.
• Care navigators offer a good service.

From Lousie & Sarah:

• The vast majority of patients are still calling in rather than using it, which is ok.
• E-Consult works well for specifying help for new conditions. The doctors like it as they have more information to go on.
• Staffing and waiting time.
• Acute / pain conditions seen the same day.
• Amber level seen within 3 days.
• Routine appointments 3 weeks average
• There are no current vacancies, but they are struggling with funding. The BMA has launched a campaign to tackle the issue of there having been a real term cut. Staff are overworked & GPs working above & beyond contracted hours with a lot of goodwill. 

d) Healthwatch

• Alan explained that Healthwatch is an independent Statutory Organisation which monitors health care services in each ICB, and they are represented at Patient Panel Meetings. More information can be found at www.healthwatch.co.uk Our local body is Healthwatch West Berkshire. Alan & Louise have met the newest member, Simon Shaw. He has responsibility for encouraging co-operation between surgeries and PPGs, and is following up on the report of the outcomes of the Focus Group discussions.

Future ideas might include:

• Type-2 Diabetes Awareness.
• Engaging with sixth formers who might aspire to become medics working alongside the surgery although this could have privacy issues.

e. Community Wellness/Solutions4Health

• Alan reported that this company are offering mini health checks which are paid for by West Berkshire Public Health. They have been once in Lambourn promoting a smoke-free life initiative. They operate from a small minibus size vehicle as a drop-in centre with information leaflets. They may come again and also visit some of the training yards.

f. Pharmacy

• Graham was not present, but Alan updated that he is very busy coping with staff shortages due to sickness. 

AOB

a. General ‘Wellman/woman’ clinics

Bridget asked for clarification why men are being invited for general checks but not women. Louise clarified that there is no general policy to invite men for general wellman checks-ups. Those being invited in are those with chronic issues that need managing.

b. Flu Vaccination

The program will start in October this year as a later vaccination is viewed as offering better efficacy. It will be an appointment clinic rather than walk-in. Covid will be offered at the same time. The flu vaccine will be offered to patients only, the COVID vaccine to anyone so the logistics with need some coordination.

c. Period Poverty initiative

Dr Wanless has introduced a Period Poverty Initiative through the Charity ‘All Yours’ www.allyoursbox.co.uk/our-boxes Free packs of period products are being left in the surgery toilet and several have been taken already. She is also working on establishing the surgery as a ‘Breast-feeding friendly practice’. The consideration of which space is being discussed. 

Next Meeting

Monday 14th October 2024 at 6.30 p.m. 

Minutes of The Meeting 15th April 2024

Present

• Alan Breadmore (Chairman)
• Peter Cox (Secretary)
• Liz Cox
• Mary Wilson
• Geoff Fowler
• Karen Sperrey
• Claire Hill
• Graham Jones (Lambourn Pharmacy)
• Dr Sarah Stallabrass (Surgery)
• Sarah Rowell (Surgery)
• Ian Wootton (potential member of PPG)

Apologies

• Louise Murray-Clarke (Surgery)
• Julie Mintern
• Gillian Greenham
• Bridget Jones (Lambourn PC)
• Lucy Hall 

Chairman's Report

The Chairman welcomed Ian Wootton to the meeting. He had spent many years working within the NHS and local government and was asked to observe the meeting.

(post meeting, he agreed to be a full time member of the Lambourn surgery PPG) 

Minutes of the meeting

The minutes were approved

Matters Arising

a) NHS App training/awareness

Sarah Rowell reported that Marta Fischer, Digital Access lead from BOBICB, was due to visit the Surgery on Thursday to train all the staff on how to impart the knowledge, and use of the NHS App
 to others. Alan suggested that SystemOnline should be included as this was a useful addition which had features not included in the NHS App. Following the presentation from Marta the Surgery will discuss the possible plan to use the Library for a teaching venue to encourage patients to use the digital systems. Alan commented that at the recent Patient Panel meeting Strawberry Hill reported that they held a similar type of meeting where, after an invite via a text to patient’s smart phones, 50 people turned up.

Action: Follow up on training for digital use by patients

5. Discussion Topic

a) Surgery

(i) Update on new website and appointments

Sarah Rowell reported that pictures and profiles for all the staff were now on the website. Recently there had been an update to the “Friends and Family” comments form which meant that they could now be quoted on the website. DNA figures were not quoted for every month. During March the numbers of appointments missed, and time lost, were; 33 for GPs (8.75h), 52 for Nurses (13.75h), 12 for Clinical Pharmacist (3.75h), 5 for MSK Practitioner (1.5h), 2 for GP Assistant (1.5h) and 1 for Mental Health (0.75h). When asked if there could be any sanctions against persistent offenders Sarah Stallabrass said that there were none available on the NHS system.

(ii) Procedures for Long Term Condition and Medical Reviews

Alan had received many comments on the current procedures and requested the background to them. Sarah Stallabrass said that almost half of the practice patients, approx. 3,000, needed one of the reviews at least once per year. The aim was to link the longterm condition and medication reviews with the blood tests, if needed, in the patient’s birth month. The process for the medication review was currently different as the practice clinical pharmacist was on maternity leave and the service was being carried out by an outside agency. This had led to
some concerns from patients when they received a call from an 0333 number and were worried that it was a spam call. Sarah Stallabrass reported that this problem was being resolved by using one of the practice 01488 numbers to call from. Alan said that it was difficult for a patient to find a request for a medicine review via the NHS App. Sarah Rowell said that they could be requested via the patient’s information records on SystemOnline.

(iii) April booster vaccinations for Covid for those aged over 75 or vulnerable

There will be just one day allocated for the Surgery to provide this appointment only provision for patients which will be Saturday, 27th April. 402 appointments were available but only via the central NHS vaccination service which would also check on the persons eligibility. Patients eligible were to be informed by letter. Graham will also be providing the service over the next few weeks.

The PPG had offered to assist the Surgery in car park duty and provide a meet and greet service. Sarah Rowell reported that the latter task was being covered by Linda inside the building. Karen had previously offered to organise the rota but with doubts raised by Alan as to whether he was allowed to pass on the list of volunteers to Karen due to GDPR he offered to find the 4 people required. Peter and Liz offered to assist on the day. The presence of the Breast Screening unit in the car park was not considered to be an issue on the day as the unit will not
be operation at that time.

Graham reported that the Pharmacy would also be providing the vaccination service
throughout the next few weeks with bookings being taken online from the 22nd April.

b) Lambourn Surgery Amenities Fund (LSAF)

Liz reported that she now had online access to the bank figures. £47 had been received from the Amazon Smile fund which is no longer active. Other money has been received from donations and legacies.
As regards the possible funding from the Greenham Trust Mary thought that there was a deadline of the 23rd March for applications. This will be checked on for the next LASF meeting on the 19th April.

c) Patient Panel

Alan reported that there has been just one meeting since the last PPG meeting and this had focused on newsletters. None of those present reported on issuing one per month. Alan was about to issue one and will try in future to do one every other month. There had been no sight of the report of the Healthwatch Focus group, which Peter and Liz had attended last year, on the needs of patients. Alan thought that there is a new local PPG contact for Healthwatch West Berkshire.

d) Pharmacy

Graham reported that Pharmacy First had started on the 1st February and to date there had been 14 referrals. There is a new service for those who don’t stay compliant with their medication. The general workload has ramped up because of the shutting of the local Boots and Lloyd’s services. There is still also time lost in sourcing medicines.

d) Report on GWH “The Way Forward Programme” presentation

Peter had distributed an image of the current developments for emergency treatment at the GHW which was due to open in June (The image was from a GWH webinar on the 20th April and is attached as an Appendix to the minutes). There will be an Integrated Front Door (IFD) policy where all walking entries will enter via the Urgent Treatment Centre (UTC) to be triaged and directed to the appropriate section in the unit. There will be a new expanded unit for children (CEU) with 13 bays and a resuscitation unit. Patients arriving by ambulances will enter via the rebuilt Emergency Department unit at the south of the GWH which will now have 22 bays, an increase of 45% over the current 15. It was stated that no additional staff were required for the main units due to improved efficiency of the IFD process but there will be an increase in staff for the CEU due to the higher capacity.

The GWH base Brighter Futures charity reported that it had been difficult to raise funds for the special touches needed for the new emergency units compared to the easier raising of £2M for the radiology cancer unit. However, a sky ceiling in the waiting area, a mobile X-ray unit and a relative’s room had already been provided. The GWH had purchased 5.5 hectares to the west of the main site a few years ago for potential development but there were no plans/money at present for new hospital units. There were thoughts that the site could be used for;

• Staff and students’ accommodation
• Sterile Services unit
• A private hospital facility (it was reported that the Shalbourne suite in the main hospital had been closed since the Covid outbreak when it had been used to accommodate Covid patients).
• All the above could be privately funded. 

AOB

On behalf of Bridget, Alan asked if there was any evidence of public health issues as a result of the sewage flow from various manhole covers in the area and covering pedestrian pathways. Sarah replied that there had not been any change from the last PPG meeting and that none had been evident at the Surgery.

Next Meeting

It was proposed that the next meetings will be F2F on Mondays, 8th July and 14th October. 

The meeting closed at 7:55pm

Peter Cox
Secretary Lambourn PPG
15th May 2024

Minutes of The Meeting 15th January 2024

• Date: 15th January 2024 at 6:30pm
• Location: Lambourn Surgery

Present

• Alan Breadmore (Chairman)
• Peter Cox (Secretary)
• Liz Cox
• Mary Wilson
• Geoff Fowler
• Karen Sperrey
• Claire Hill
• Bridget Jones (Lambourn PC)
• Louise Murray-Clarke (Surgery)
• Graham Jones (Lambourn Pharmacy)
• Dr Sarah Stallabrass (Surgery)

Apologies

• Julie Mintern
• Gillian Greenham
• Lucy Hall

A letter of resignation had been received from Jane Turton and the Chairman had responded thanking her for her years of service representing the people of Great Shefford.

Chairmans Report

The Chairman opened his report by thanking the members of the PPG for their support and to the partners for their trust in the PPG. The good working relationship with the Surgery was a feature which was not observed by all members of the Patient Panel at meetings he had attended.

As regards membership, the PPG currently has 13 active members (now 12 with Jane’s resignation), up from last year which had been boosted by a recruitment campaign earlier in the year. Particular thanks go to Mary who drove this and of course to our new members. Thanks were made to the ex officio members, Liz and Geoff as members of the Amenities Fund and to Peter as Secretary. The Virtual PG has 13 members, static (plus one) whilst the Volunteer bank has 23 members, static, although there is a core of about 6 who are most active.

The activities of the PPG have been traditional quarterly meetings, to discuss the matters of the day which have now returned to being face to face. The PPG have supported two series of Vaccination Clinics in the Spring and Autumn along with members of our volunteer group. We provided support to the Surgery during the transition to the new triage and appointments service, including a series of communications entitled “The Future of Primary Care in the Lambourn Valley”, which was well received. We have published six newsletters this year, down on last year perhaps due to not so much news but also resources.

As Chairman Alan has; generally liaised with the Surgery, edited the newsletters, managed the provision of volunteers for the Vaccination Clinics and attended eight Patient Panel and other Berkshire West meetings on behalf of the PPG. In the latter meetings there has been a focus on the BOB (Buckinghamshire, Oxfordshire and West Berkshire) ICB (Integrated Care Board) where there are 150 GP surgeries providing Primary Care. It was noted that Berkshire West were well ahead on the national “Recovery Plan” for Primary Care especially regarding digital telephony and using digital tools for patient access.

Alan encouraged PPG members to continue to support our surgery in every way possible, similarly Alan urged the surgery to ask for more so that we can broaden our activities to support both the surgery and our community.

The new digital telephony seems to work well, but once again this perhaps needs explaining more, so that we can instil trust.

e-consult works but in Alan’s opinion is very clunky (and perhaps this is also reflected in the telephone service). On behalf of the PPG, Alan would welcome the opportunity for us to help the surgery fine tune it, in particular in the areas of routine appointments, follow up appointments and general follow up communication.

As Alan had now resolved some of his constraints on local activities, he would be prepared to stand again as Chairman provided that there was help to share the load. He asked for members to consider taking a specific role within the PPG either as an officer or with a particular task.

AGM

Election of officers to serve a 2 year period 

• Chairperson – Alan Breadmore proposed by Peter and seconded by Bridget
• Vice Chairperson – there were no nominations
• Secretary – Peter Cox nominated by Alan and seconded by Mary.

The above posts were accepted and passed unanimously.

Review the membership in order to maintain and active and representative group.

The constitution allowed for up to 15 members and at present there are 12 with 2 expressions of interest. There may be a case to have a specific representative for young families.

Appoint/reappoint Ex Officio members

The following were approved;

• Representative of Lambourn Parish Council – Bridget Jones
• Representative of the Benefice of Lambourn Valley – Julie Mintern
• Representative of Lambourn Pharmacy – Graham Jones

There was no active representative of the Racing Industry and Bridget will enquire amongst the parish councillors if there was a suitable person to take on the role.

Appoint/reappoint Patient Trustees to Lambourn Surgery Amenities Fund

Agreed as; Geoff Fowler as Chair and Liz Cox as Treasurer.

(Post meeting, Louise had corrected this by reporting the Dr Stallabrass was the Chair as appointed by the Surgery whilst Geoff was a Trustee)

Minutes of The Meeting 9th October 2023

The minutes were approved.

Matters Arising

There were none which were not covered by the Agenda.

Discussion Topic

Surgery

i) Update on new website and appointments

Louise reported on the reduction in waiting times for appointments as a result of the new e-consult and digital phone processes. What was a 3 to 4 weeks wait was down to 1 week.

There were 3 levels of appointments where 1 was acute and seen the same day, 2 was can’t wait for 3 weeks and 3 was awaiting the availability of documents. There was now an option of asking for a F2F meeting and for a specific Doctor of preference.

Routine prescriptions were best done via the NHS App but were still available via Airmid and/or the Surgery website. It was agreed that maybe there could be an opportunity to have an open session in the Lambourn Library to explain to patients how Information Technology can be best used.

Action: Louise and Alan to consider the possibility of holding an information session in the Lambourn library

ii) Update on vaccinations

The second session of combined flu/covid vaccinations resulted in a final total for the under 65s of 666 flu and 60 Covid. The figures over the two sessions (and including those done at the Pharmacy and elsewhere) equate to 86% having the flu vaccination and 83% for Covid vaccinations.

Karen asked about the shingles vaccination. Louise replied that the requirement is slightly complicated and that the request is raised by the Surgery. For the pneumonia vaccination this is a one off and offered after the patient is aged 65.

iii) Public Health Issues

Alan asked if there was any evidence of public health issues as a result of the sewage flow from various manhole covers in the area and covering pedestrian pathways. Sarah replied that none had been evident at the Surgery. 

Lambourn Surgery Amenities Fund (LSAF)

The Feno machine for checking a patient for asthma was being used with good results.

The Surgery have a dermatoscope machine for checking moles but is not so reliable and it would be desirable to have a second machine which will cost around £300.

A suggestion was made regarding having the water machine in the waiting room re-installed.

Louise replied that it had been a problem with the misuse of the previous unit by children and she would not be in favour of it being reinstated.

A question was asked as to whether there could be a note on the blood pressure measuring machine to say it was funded by the LSAF?

Action: Surgery to attach a notice noting the LSAF funding for the machine with possibly a QR link for optional funding.

Pharmacy

Graham had booked for a Covid vaccine session on the meeting night but it had been cancelled due to a lack of clients. He had submitted a report which is provided below in italics. Additional information was given as shown.

Pharmacy First

Late last year the NHS announced that the Pharmacy First scheme would be starting in this year. This has been a very compressed timescale as we endeavour to be ready before February.

Pharmacy First will allow community pharmacy to treat certain conditions to reduce pressures on urgent care and GPs. The conditions are:

1. Urinary tract infections in women
2. Impetigo
3. Infected insect bites
4. Sinusitis
5. Sore Throats
6. Acute Otitis media

We are currently implementing the treatment pathways and PGDs to offer the service. Referral to the service can be from the 111 service, 999 service, GP and self referral.

The service is due to start on the 1st February. He noted that all those seen who are patients of the Surgery will have a report on their issues and treatment sent back to the Surgery.

Flu and Covid Clinics

We are continuing to act as a covid vaccination centre until the end of January. We understand we are now the only service still offering covid jabs in West Berks. We will be running a couple of evening walk in clinics which I will advertise through social media.

The next vaccination session will be at the end of April with the service ending at the end of June. Graham reminded the PPG that the Covid vaccination is only for those aged 75 and over or who have a weakened immune system.

Pressures

Due to a number of reasons (mostly financial) Community Pharmacy is in a state of flux. Boots has significantly reduced its estate with a number of sales and closures across the country. Lloyds no longer exists with all pharmacies either closed or sold. This inevitably has a big impact on other pharmacies with extra workload being absorbed. We are confident we can handle the local pressures and have been able to adapt to the new environment.

Harv

Harv is currently off on paternity leave. He became a dad for the second time just before Christmas.

Peter asked for his comments on the TV programme on Pharmacy provision where it was illustrated that at times Pharmacies have to dispense drugs at a loss. Graham explained that the drug tariffs supplied through the NHS vary monthly and at times it can create difficulties. 

AOB

Louise informed the meeting that the Surgery had received “Veteran friendly” accreditation which can be used by anybody who has served in the armed forces. The extra service provided by the Surgery includes family members.

Next Meeting

It was proposed that the next meetings will be F2F on Mondays, 15th April, 8th July and 14th October.

The meeting closed at 7:50pm

Peter Cox
Secretary Lambourn PPG
19th February 2024