PPG meeting Wednesday 10th October 12:30 to 14:00

Present: Paul and Betty Young Suzi Colley Marilyn Miles Sally Millett Laura Smith (Community Well Being Agent).

1) Apologies for absence: Richard Easthope, Norman Kay, Clare Janik.

2) Minutes of last meeting. Wednesday 18th June 2018 – These were accepted as correct.

3) Matters arising not covered by the agenda: from AOB Clare and Suzie to discuss possible talks about setting up Healthy Lifestyle events similar to those being run at Frithwood. This has not happened – Suzi will contact Clare to see if these can be activated at Prices Mill.

4) Recent PPG County meeting. MM shared handouts and leaflets on the following:

a) community defibrillators
b) the merger of the 2gether trust and the care services trust
c) urinary tract infections – leaflet for older adults and carers
d) 15 steps challenge for mental health primary care practice
e) dementia friendly Forest of Dean

All of the leaflets contained valuable information and will be available in the waiting room and referred to on the Prices Mill website. With reference to the community defibrillator It has been proven that availability of these is significant in the prevention of death through heart attack. There is good news on the one proposed for Forest Green installation of this is well on the way.

5) National GP patient survey. Suzie handed out some results from the 2018 national survey with particular reference to Price’s Mill. For the 2017 survey the surgery exceeded the local and national average on all questions.

For this year there were three areas where it was thought the practice could improve:

a) 51% of respondents usually get to see or speak to their preferred GP when they would like to. Local average 57% national average 50%. Suzie said that although there is no one GP who is “unpopular” there was at least one GP who patients find it very difficult to make an appointment. She works part time two days a week. The surgery has more GPs per 1000 patients compared to other surgeries but none of them work five days a week. This it is a common trend in GP practices for doctors to work part time. Because of this it is very difficult to know whether there can be much improvement in this figure and it was noted that the 100% of patients accepted the appointments they were offered.

b) 86% of respondents felt that the healthcare professional recognised and understood any mental health needs during the last general practice appointment. Local average 90% national average 87%. It is difficult to know whether this question related to diagnosed mental illness in patients or mental well-being in general.

c) Dr Yerburgh is the mental health champion in the surgery and she works two sessions a week. Most of the doctors are champions/specialists to whom other doctors can refer if needs be. E.g. Dr Meikle is children’s and young people specialist, Dr Malins specialises in the elderly and dementia and other specialisms are noted on the PM website.

d) 81% of respondents say they have had enough support from local services or organisations in the last 12 months to help manage their long-term conditions (local average 84%, national average 79%).

e) Of the 251 surveys sent out 131 were returned which is a 52% completion rate. The company doing these attitude surveys have no access to the medical records and the random sample is chosen on grounds of gender and age. So, it is not known how many of those who responded had a long-term condition or mental health difficulties.

Sections of the survey where the practice did particularly well were:

f) 93% of respondents find it easy to get through to the practice by phone (local average 30s 83% national average 70%).

g) 77% of respondents were offered a choice of appointment when they last tried to make a GP appointment (local average 68% national average 62%.)

h) 77% of respondents are satisfied with the general practice appointment times available (local average 70%, national average 66%).

i) The surgery also did its own in-house survey earlier this year and it was reassuring to know that the results of that survey reflected similar degrees of satisfaction/concerns to national survey.

6) Suicide: Paul Young brought up his concern about suicide and we had quite a  wide-ranging discussion about this issue and the resources that might or might not be available within the surgery and the community. The recent suicide of a 19-year-old patient indicated that he had not been in touch with the surgery in the weeks before his death. All deaths of patients within the surgery are looked at by the clinical team. Laura Smith made reference to the mental health and well-being team in Stroud which is run by the Independence Trust which has a number of facilities and resources. Reference was also made to the Open Door resource. We noted that the new suicide czar has been appointed by the government – Jackie Doyle-Price a junior health minister. The general feeling of the group was the doctors at Prices Mill are very aware of the problems caused by depression and very willing to offer support but one of the problems experienced is getting those who are struggling to ask for help.

7) Roll out of National Diabetes Prevention Programme. Dr Tom Malins is the main contact for this. The county wide programme has been expected since mid-2017 and is thought to be coming to the Stroud area in the near future. Marilyn it is putting something into the Nailsworth News for November and it needs a bit of tweaking. At the moment patients who have been diagnosed from a blood test as being at risk of developing type 2 diabetes are sent a letter with advice as to how to deal with it. The new programme offers more than this with the opportunity for some group sessions followed by some individual structured help to support the patient. Price’s Mill invite pre-diabetic patients back for a check-up every year and this is likely to happen also with the national program when it is rolled out.

8) Dementia Friendly GP practice. The practice is signed up to the DAA. Marilyn has still to add some information on to the DAA website. Dr. Malins will be the point of contact for this group. 2 recent members of staff attended the dementia awareness session in July and the leaflet was left for the next session due on November 13 for any new staff. The practice has done a survey of patients with a diagnosis of dementia and their carers and the feedback is positive. Permission is sought from patients with dementia to allow discussion with their carers. In particular the receptionists are more aware and are better able to communicate with such patients. Signage has been improved.

9) Closure of Lloyds pharmacy in Mill Yard. Marilyn has been in touch with other PPGs in the Stroud & Berkeley Vale cluster and it would appear that similar problems to the ones we have been having have been noticed another Lloyds pharmacist. However, it is thought that there has been some improvement in the Old Market branch. The surgery is considering whether to site a second pharmacy in Nailsworth next to Prices Mill Surgery. The PPG is asked to canvass views from the local community about whether they consider this to be a good idea or not. It was agreed that Marilyn would draft something to go into a future Nailsworth News for Suzie to peruse and comment.

10) Other changes in the practice. There is a new nurse Melissa Freeman who has recently started. She comes from a hospital background.

11) Any other business. Betty Young asked about communal consultations and whether this is likely to happen. The group work that is proposed with the pre-diabetes patients would be a good example of such an approach and the surgery is using this as an example to see whether it is successful. Even with group consultations it may be necessary to have a one-to-one discussion with the GP e.g. to modify particular medications. The general thrust within the NHS is to encourage greater self-care and this is one way of promoting it.

12) Date of next meeting. Wednesday, February 11th, 2019 at 12:30 to 14:00.