PPG Meeting Minutes

Should you require access to copies of older documentation, please contact the practice

November 2021

Meeting Date:	Tuesday 2nd November 2021	Start Time:	12.30 pm
Location:	The Peter Hall, Budleigh Salterton	End Time:	1.30pm

Present:	David Forward (DF); Sue Lake (SL); Mike Rice (MR); Brian Taylor (BJT) Peter Frean (PF); Chris Kitson (CK); Jacqui Ruhlig (JR); Richard Waller (RW); Mark McGlade (MM); Judy Wright (JW); Deborah Mitchell (DM); Ellie Rejzl (ER)
Absent:	Tania Davis (TD); Lynette Oram (LO); Richard Waller (RW)

Previous Minutes

The minutes of the previous meeting dated 7th September 2021 were agreed previously to be a true account and have been published on the practice website.

Welcome and Apologies

Tania Davis and Richard Waller sent their apologies.

Practice Update

Dr Ellie Rejzl joined the meeting and introduced herself to the members. She has been a salaried GP at Budleigh since November 2020 having grown up in Topsham and completing her GP training in Exeter. Ellie has clinics Tuesday, Thursday and Friday.

SL mentioned that in the media patients were still not being seen face to face. This is not the case in Budleigh and patients have a choice where clinically appropriate.

PF asked why the waiting room was empty whereas pre pandemic it was full. This can be attributed to a number of reasons including that patients are asked to arrive on time and not early to avoid waiting; patients are asked to come alone where possible; patients no longer make appointments or collect prescriptions from the front desk. DM confirmed that there were the same number of appointments available as pre pandemic and clinics were full to capacity.

RH asked why patients were no longer able to have an appointment on the day of phoning. DM confirmed this was not the case and that there was a daily duty doctor for urgent on the day appointments. It was reiterated that the duty doctor was not there for non-urgent needs – these patients would be offered a pre bookable appointment or asked to phone at 8.00am for an on the day appointment.

ER advised that on her last duty list patients were actually booked in at 1 minute intervals due to the volume of patients requesting urgent attention.

Covid

DF advised there was general confusion with patients about who to contact regarding vaccines.

1st and 2nd Vaccines: Patients can be book appointments through the National Booking Service online or 119.

3rd Vaccines: A number of patients on certain medications or with blood disorders will be recommended to have a 3rd vaccine. This can be booked through their consultant or they can use the “drop-in” service at Greendale if they have a consultant letter. Alternatively patients can contact the Devon Vaccine Centre on 01752 398836.

Boosters: Patients can have a booster vaccine 6 months following their 2nd vaccine. This can be booked through the National Booking Service online, 119 or through the medical centre. There has been a duplication invitations, but patients can be advised that they can book their vaccine through any of the aforementioned methods.

NHS Covid Pass: This is available online through the government website or if you do not have access to the internet you can request a letter through 119 and this will arrive within 5 working days. Booster vaccines do not show on these passes. The surgery is unable to help with this.

Devon Vaccine Centre: For any queries relating to the vaccine that 119 is unable to help then please call 01752 398836.

Volunteers: The Local Vaccine Centre at the Exmouth LED has asked for weekend volunteers aged 18 plus. There is no upper age limit.

Lloyds Pharmacy

Concerns have been raised about Lloyds Pharmacy.

DM spoke with Amy, manager at Little Lloyds for an update. Evelyn is back from maternity leave and is the pharmacist at Large Lloyds. She works 5 days per week with either a Monday or Saturday day off. Geoff is the pharmacist for Little Lloyds. He works 5 days per week and has Mondays off.

Every week locum pharmacists are required to cover one day at each pharmacy additional to annual leave and sickness and there are very few locum pharmacists living in the South West. Lloyds paid a relocation fee for Evelyn to move to Devon. It is a legal requirement to have a pharmacist on the site prior to opening the front doors and therefore Lloyds are unable to open without a pharmacist.

Patients can request prescriptions are “released” from Lloyds so they can go to another pharmacy. They will be given a code which can be given to any other pharmacy in order to receive their medication.

CK and MM advised that there were only 2 pharmacy licences in Budleigh and these were both held by Lloyds Pharmacy who had previously advised they were trading as 2 independent businesses.

Action: SL to write to Lloyds Pharmacy Head Office

Friends and Family Test

Currently suspended by NHS England until at least 31/12/20221.

On 02/09/2021 the practice sent 250 randomised mobile invitations to complete an online Friends and Family Test to patients who had received either a face to face appointment or a telephone consultation in August 20221. I has been agreed that this will continue on a monthly basis and the results will be reviewed by the PPG. MR has collated the most recent results and this has been distributed to the PPG members.

MR advises that there were 95% positive responses which is the same as pre pandemic in spite of the media. On comparison with other surgeries Budleigh is excellent.

PPG congratulated the practice on excellently managed Flu and Covid Vaccination clinincs.

Correspondence

• A visiting PPG Chairperson contacted SL with positive feedback regarding the newsletter.

Next Newsletter (Winter 2021)

This will be ready for Tuesday 7th December. Topics agreed to be included:

• ER will ask GPs for a topical medical issue
• Appointments
• Family and Friends Test – MR

Any Other Business

• Ways2Wellbeing: The contact for this enablement service ends 02/12/2021. There is no further information available at the current time.
• Mental Health Ambassadors: ECC has restarted this programme and there are 40 youngsters now able to support their peers with mental health.
• CAMHS: There is now a mental health worked based at ECC 5 days per week.
• HeadsUp: A project commissioned by the WEB PCN for raising mental health awareness in primary schools. SL advised this had not progressed in Budleigh.
• PPG Members: SL advised that there were 2 young students from ECC who would like to become members of the PPG.
• Staff Shortages: MM discussed that there was a massive shortage of care providers across all sectors.

Next meeting

Tuesday 11th January 2022, 12.30pm – 1.30pm.

September 2021

Meeting Date:	Tuesday 7th September 2021	Start Time:	12.30 pm
Location:	The Peter Hall, Budleigh Salterton	End Time:	1.30pm

Present:	Kathryn Blurton (KB); David Forward (DF); Sue Lake (SL); Tracey Poole (TP); Mike Rice (MR); Brian Taylor (BJT) Peter Frean (PF); Chris Kitson (CK); Lynette Oram (LO); Jacqui Ruhlig (JR); Richard Waller (RW)
Absent:	Tania Davis (TD); Robert Harland (RH); Mark McGlade (MM); Deborah Mitchell (DM); Judy Wright (JW)

Previous Minutes

The minutes of the previous meeting dated 7 th July 2021 were agreed previously to be a true account and have been published on the practice website

Welcome and Apologies

Tania Davis and Deborah Mitchell sent their apologies.

Practice Update

Urgent blood tests will be maintained during the bottle shortage but patients for routine tests will experience delays. The PPG said they were very concerned but it is acknowledged that this is a short term situation, the PPG asked that their concerns be raised with appropriate bodies when this situation is discussed.

Flu vaccinations will be delayed for a further two weeks. Patients may be able to receive both flu and covid vaccinations at the same time but this is yet to be confirmed and is dependent upon vaccine delivery. The current plan is to deliver flu vaccinations at the surgery and Covid vaccinations from a centralised service in Exmouth.

Dr Taylor asked the PPG for their views on a proposed initiative. The intention is to offer patients an appointment with the GP with whom they are registered and try to establish improved continuity of care. This might occasionally mean a delay to appointment times but would patients prefer this option? The PPG supported this initiative. The Medical Centre will provide information for patients on the website and SL suggested there should be a piece in the Winter edition of the PPG Newsletter.

KB reported that there are no longer any staff shortages at the Medical Centre. PPG expressed concerns at the rise in verbal abuse to GP staff as reported in the media. KB advised that staff are fully supported when they incidents of verbal abuse are identified.

Community Pharmacy Consultation Service (CPCS)

It is being used by the practice but too early for the PPG to judge.

Leg Ulcer Service

KB reported that work continues to provide a more local service for patients who currently have to travel to Exmouth Hospital. RD&E will continue to hold the contract for the service.

Electronic Dispensing Service

SL reported that a few people have complained about the electronic dispensing service for repeat medication. The date given to patients by Lloyd’s on which to collect their next prescription has proved on occasion to be inaccurate. Confusion seems to arise between the 3 month “repeat” date on the system and the 12 week period date given to patients by Lloyd’s staff. It appears the Lloyds staff are not looking on the shared IT system to confirm the date on which the surgery will issue the prescription. KB will arrange a meeting with Lloyds to discuss the problem and ensure that staff are familiar with how the system should operate.

Friends and Family Test

Currently on hold by NHS England.

Correspondence

None received

Next Newsletter (Winter 2021)

To be discussed at the next meeting

Next meeting

2nd November 2021, 12.30pm

July 2021

Meeting Date:	Wednesday 7th July 2021	Start Time:	12.30 pm
Location:	Town Hall, Budleigh Salterton	End Time:	1.30pm

Present:	David Forward (DF); Robert Harland (RH); Sue Lake (SL); Debbie Mitchell (DM); Mike Rice (MR); Richard Waller (RW); Judy Wright (JW); Kathryn Blurton (KB); Ben Hallmark (BH); Karen Heaney (KH); Rebecca Roach (RR)
Absent:	Peter Frean (PF); Chris Kitson (CK); Mark McGlade (MM); Lynette Oram (LO); Jacqui Ruhlig (JR)

Previous Minutes

The minutes of the previous meeting dated 4 th May 2021 were agreed to be a true account and have been published on the practice website.

Welcome and Apologies

No further apologies received. Rebecca Roach was welcomed to the meeting.

Community Pharmacy Consultation Service (CPCS)

Rebecca Roach is a PCN Pharmacist who has been qualified as a pharmacist for over 25 years. Her main role is to support the Care Homes and she is also the lead on the CPCS.

This nationwide scheme was started in other parts of the county in October 2019 and currently there are over 10,500 referrals into this service across England.

All 11 pharmacies and 7 practices in WEB will be taking part in this pilot. Money has been allocated locallay for training. Existing pharmacists have had consultation training skills and new pharmacists now have this included in their training as well as prescribing. GP staff are also being trained in how to make referrals to pharmacists.

All pharmacies have private consultation rooms which are cleaned to the same standards are GP practices.

NHSE are promoting self-care and encouraging people to take responsibility for their own health. The conditions have been selected and agreed by the 7 practices. These conditions would not initially require a doctor and patients can self-care.

It is acknowledged that 10% of patients will be referred back to the GP.

Referrals are made only with the agreement of the patient and once made the pharmacy will phone the patient back within 4 hours and offer them an appointment of their choice (eg face-to-face; telephone; video). If the pharmacist deems the patient needs an appointment with the doctor then this will be made for the patient.

Two Exmouth practices started this project on 01/07/2021 and the outcome measures will be reviewed at the end of September and shared with WEB practices.

Practice News

The practice has 22 staff and 5 partners. Over the last 12 months the practice has had 9 staff leave which included 3 retirements.

This year there have been 4 new administrators – so please bear with us whilst they are training. If you experience problems or hear of problems, please let DM know so she can review what went wrong as it may be a training issue.

Following discussion about the concerns raised by patients to the PPG, KH and BH both advised that they will welcome the move back to face-to-face consultations. Telephone consultations has in fact doubled the workload of doctors, as often you will speak with a patient on the phone and then need to bring them down for an appointment on clinical grounds. They both would like to see a move to asking patient’s if they would prefer a telephone consultation or a face-2-face over the coming weeks.

On 17/07/2021 there is a political drive to normalise life. However, as a practice we will need to adhere to medical guidelines. Safety must continue to be our priority and it may be that the wearing of masks and the use of hand santiser will continue.

Covid cases continue to rise in England and fully vaccinated people are getting infections, although the severity has reduced as have the number of deaths.

KB has advised that the practice is on standby for more information the third booster. It is felt that this may run alongside the annual flu programme for those over 70 years, the immunosuppressed and shielded patients. There is also some speculation regarding the efficacy of giving a third vaccine when many parts of the world have not received their first. KB will advise the PPG when more information is received.

eConsult

PPG have reported that older patients in particular are finding the system onerous and often have given up using it in favour of a ‘phone call. Younger patients find e-Consult very helpful, especially when they are of working age

eConsult is an additional service and patients can choose whether or not they would like to use this service.

In June 2021 there were 475 eConsult users, 214 of whom submitted an eConsult to the practice

PPG Member Feedback

SL has heard from a voluntary driver regarding a Budleigh patient who attends the surgery twice weeks for leg care. She has been quite distressed by the move of this service to Exmouth Hospital. KB does know this patient and has spoken with her.

KB explained that the leg ulcer service has been commissioned to the RD&E from 01/07/2021. All 7 practices in WEB had wanted to remain involved in the delivery of this service but currently this is not the case. RD&E will be holding clinics twice weekly at the Exmouth Hospital. There are currently 50 patients within WEB (11 from Budleigh) who have been referred to this clinic. KB and the practice manager from Rolle Medical Centre are liaising with the hospital over future delivery of the service through WEB.

Correspondence

None received.

Any other Business

DM to contact the Exeter Nuffield regarding a patient online education session on asthma and how to manage this. SL advised that the Woodbury, Exmouth and Budleigh (WEB) Primary Care Network (PCN), in conjunction with local mental health support services, are working towards providing extended Mental Health services and peer support for children at Exmouth College and 14 Primary schools in WEB.

Next Newsletter

PPG members to send DM suggestions for the next newsletter. Currently topics:

• Blood pressure
• Pharmacy Triage/Treatment service

Next meeting

7th September 2021 at 12.30pm

May 2021 - AGM

Meeting Date:	Tuesday 4th May 2021	Start Time:	12.00 noon
Location:	Zoom Meeting	End Time:	12.29 pm

Present:	Tania Davis (TD); David Forward (DF); Peter Frean (PF); Robert Harland (RH); Chris Kitson (CK); Sue Lake (SL); Mark McGlade (MM); Debbie Mitchell (DM); Jacqui Ruhlig (JR); Judy Wright (JW); Lynette Oram (LO);Mike Rice (MR); Richard Waller (RW)
Absent:	None

Welcome and Apologies

Approval of the Previous AGM minutes

No AGM was held in 2020 due to Covid pandemic

Chairperson’s Report 2020/2021

See Appendix 1. All members thanks SL for her publications and the sharing of information through emails over the previous year.

Election and Re-Election of Committee Members for 2021/2021

To continue for a further year in view of the current pandemic and the associated restrictions upon open public meetings.

Appointment of Chairman, Vice Chairman and Secretary for 2021/2022

To continue for a further year in view of the current pandemic and the associated restrictions upon open public meetings.

Any other business

Younger PPG members to be encouraged to join the PPG. Agreed a change in time to accommodate school time-tables may be required.

PPG recruitment in autumn 2021 if possible.

CK reports that in general terms patients are pleased and grateful that the medical centre is functioning as “normal”

TD has advised the workload is increased and that the practice has returned to “business as usual” albeit a slightly different one to pre Covid. The practice does still need to adhere to social distancing for the safety of our patients and staff. Support for patients who had had the Covid vaccine and are still experiencing symptoms has increased. Sadly, mental health issues amongst the younger population is more apparent – youngsters having dealt with home schooling and isolation from friends for so long are now struggling considerably. Older folk have struggled with isolation and loneliness during the pandemic.

SL spoke about the developing Local Care Partnership across Eastern Devon – Please contact the surgery if you would like a copy of the report

SL spoke about the Eastern Locality Form – Please contact the surgery if you would like a copy of the report

Meeting Closure

The meeting closed at 12.29pm.

Appendix 1:

• Budleigh Salterton GP Practice
• Patient Participation Group
• Chairpersons report AGM May 2021

Well, the past year really has been unique with challenges never faced before! However, in spite of that our Budleigh Salterton Medical Centre has worked hard to rise to those challenges and supported an amazing local Covid vaccination programme. It has been a very difficult time for all at the Medical Centre but they have made the necessary changes to working practice in order to keep both staff and patients safe and we know this is much appreciated.

During the pandemic the Patient Participation Group (PPG) meetings have continued with the aid of “Zoom” and “Teams,” and whilst meetings on screen are not the same as meeting in the same room we continue to work together very well. Through these regular meetings with members of the Medical Centre the PPG continues to actively represent patients in the Budleigh area. Although restrictions mean we cannot communicate so easily with those we represent we have received very positive feedback regarding the vaccination clinics and the care provided from the Medical Centre. It is acknowledged that, whilst the service is not the same as usual, face to face consultations are still available. It would be fair to say that e-Consult receives mixed reviews with several people reporting that they find it lengthy and cumbersome to use but many have found it useful.

Dr. Richard Mejzner retired last Autumn but is still to be seen out and about as he helps with the vaccination programme! The PPG are very grateful to Dr Mejzner for his many years of proactive support for the PPG. Dr Tania Davies now regularly joins our meetings and keeps us up to date with the activities of the Medical Centre as well as giving careful thought and response to any concerns we raise.

Our PPG Newsletter is posted online at the Medical Centre website and in addition many people receive it electronically. Please let the Medical Centre know if you would like to be on the list to receive it this way. We hope it will not be too long now before we can place hard copies of the Newsletter at local venues again, such as the Library.

Recently we have taken the decision to withdraw our membership of the National Association for Patient Participation (NAPP). We have found that NAPP has little or no value for the PPG. We have good working relationships with the Primary Care Network, the Clinical Commissioning Group, RD&E plus the Woodbury, Exmouth and Budleigh (WEB) Community Health & Wellbeing Board and so consider that we are sufficiently well armed with up-to-date information which is pertinent to the patients of the Medical Centre.

Looking to the future there are changes ahead in the way that the NHS interacts with local communities and we will keep abreast of that; in particular the organisations that are being established in support of the programme known as the Integrated Care System. This aims to establish closer working between the NHS, local councils together with the private and voluntary sectors.

We would love to have the younger community in the area represented on the PPG so if you know of anyone who might be interested in joining us please let us know. I am aware that membership of such organisations is well received on University applications!

Please don’t forget that the Medical Centre website holds lots of useful information as well as details of the PPG. We plan to hold health information sessions again as soon as Covid restrictions permit and look forward to seeing you then.