In a drive to enagage with as many patients as possible, Mountwood Patient Participation Group (PPG) held its first virtual meeting on Thursday. Patients who wished to participate logged in via a link sent to them and discussed a variety of questions that had been sent in prior to the meeting. These questions were varied and relevant to all of our patients so please take the time to read through them below.
Dr Liz Hermaszewska and Mrs Shannon Hanbury (the new Practice Manager) answered all the questions and dealt with the follow-up questions that were posed by the patients. The meeting lasted for an hour and was felt to be extremely useful for all concerned. The questions and responses from the meeting are shown below
The plan is to hold more of these type of meetings every few months with as many patients as possible who wish to engage. To join the list of patients who get sent the link to the meeting, please email firstname.lastname@example.org and make your request. If you have a question for future meetings, again send it to the email address above.
Questions for the PPG Zoom meeting
It still seems extremely difficult to see our GP at the practice when we feel we really need to do so. The Government is openly encouraging GPs to see patients again.
- In common with most other GP practices nationally, we have experienced a huge increase in requests for GP appointments . The number of appointments has risen by approx. 30% since 2019, without an increase in resources.
- There are also staffing issues- the government has reduced direct income into GP practices in favour of investing in primary care networks, and clinicians are also hard to recruit. GPs and other clinicians can earn substantially more working for other NHS and private services where the work is less demanding , so there is less incentive for clinicians to stay in general practice.
- These issues mean that our capacity is also limited. We are not a bottomless service. Our clinical and admin staff are working much harder than ever before and this is unsustainable for a safe service. Please be assured that we are doing our best.
- Currently the ratio between face-to-face and telephone triage at Mountwood is 50:50 for our clinicians
- Telephone appointments allow us to manage the car park better
- Telephone appointments reduce the number of people passing through the waiting room, reducing COVID risks for our vulnerable patients.
- A national study reporting this year has shown that only 10% of patients would prefer a face-to-face appointment.
The current system of filling a form for an appointment does not seem to be appropriate. Patients need to talk to GP over the phone or be seen at the surgery, whatever the GP thinks is appropriate
- Form filling should be more straightforward with the new online form system, PATCHS (patchs.ai/practice/mountwoodsurgery)
- PATCHS will be introduced to all patients in Summer 2022. It has been commissioned by the whole of NW London and we hope that it lives up to expectations.
- The forms are always triaged by a GP, as are the minitexts, to ensure that they go to the most appropriate person. Many forms do not need a GP appointment, and it is appropriate to direct the form to a different route. The Government is investing heavily in community pharmacy services (see below, GP CPCS) to be able to help people with a wide range of minor health issues, and to manage some long term conditions. We must make use of this , as well as encouraging self help, and directing suitable patients to other support services such as H4ALL (https://www.h4all.org.uk/)
- The Government is imposing online consultation in Primary Care, and we have no choice but to work with it.
- Currently we receive around 100 forms in a day, and 230 phone calls to reception.
- GO CPCS - General Practice Community Pharmacist Consultation Service. This is a digital GP referral method that offers patients the option of having a face-to-face appointment or remote consultation with a pharmacist (usually the same day) following an initial triage by a practice care navigator for a range of minor illnesses. Should the patient need to be escalated or referred to an alternative service, the pharmacist can arrange this and will also share a summary with the GP practice of the consultation for the patient’s medical record.
Is there a reason why a chair could not be placed in the reception area for when people with mobility issues are queuing to see receptionists?
- Fewer people are coming to reception so there is little or no queue. If there is a problem they can ask reception to sit somewhere nearby while they wait.
Some people often find making unanticipated phone calls of any kind stressful. This can be compounded by other factors such as illness or knowing the person they're calling is under pressure of time. Is there any way of making this easier?
- The new contact system, PATCHS, should remove this problem for all patients, as there is a link to complete the form directly from the website.
Would it be possible to change the 'hold' music on the phone line as it has extremely piercing tones that reach excruciatingly high notes.
- There will be a new phone system installed soon and hopefully we will be able to select different music when “on hold” . The phone system has been commissioned by Hillingdon Primary Care so we hope it will also live up to expectations.
The volume and nature of the TV adverts/infomercials in the waiting room can be distressingly loud for some patients. Can the volume be altered at times?
- Simply ask the reception staff to turn the volume down or off if it is a nuisance, or request to move to a quieter area
Are any letters issued by the hospital consultants actually seen by the GP first for any action or do they just go on to the file without reviewing?
- If the letter is flagged as important and urgent, the duty GP will review it that day.
- Most letters are scanned into patient records first.
- Anything needing action will be seen by a GP.
- Some letters will go straight to file .
If I have to report a medical problem the website is only open from 8.00 until 11.30am. Why can I not report outside of this morning window? I could report it in the evening and quite happily get a response next morning.
- Initially, forms were open all day and the surgery was overwhelmed. The demand exceeded capacity and it became unsafe.
- This is why a window was created for forms, which should be for non-urgent issues
- This is a very common set up in most GP surgeries.
- The plan for Mountwood is that our clinicians will manage the forms and have routine and urgent appointments in the mornings, and the afternoons will be for us to concentrate on managing our patients with complex needs and long term conditions, as well as urgent problems arising in the day.
There is no (obvious) shortcut on the website to ask a follow-up question without ploughing through several screens, repeating previous information.
- We hope PATCHS will be more user friendly.
I have had several texts from the surgery where it has not been possible to reply or ask a follow-up question.
- We cannot accept replies for most texts because it then becomes a dialogue which prevents the GP from managing other patients’ queries.
Online booking form - passwords are not easy to remember, especially when ill. Also the use of tracking on the form prevents it working for anyone using security that blocks tracking.
- Passwords are a fact of life - your account needs to be kept secure.
- Once you have registered with PATCHS you should be able to enable your phone or computer to allow automatic log in as with any other app.
- Some cookies are essential for an app to function properly - they are not there to track you
- If you have an urgent problem then please call the surgery. Please understand that our reception staff are trained to direct patients to wait till the following day if the problem is not urgent, or to direct them to alternative services, including 111, minor injuries (Minor Injuries)and A+E.
Patient access app. The practice should take the lead in setting up appointment booking for all patients to use. The app also is only able to cancel appointments and not reschedule.
- All our appointment requests need to be triaged by a GP to ensure the patient is handled by the correct person and so our capacity is not exceeded so we manage our patients safely.
- We hope that in the future we can enable appointment booking for patients for some services such as blood tests as long as the form has been provided already.
I had to cancel a telephone consultation a few weeks ago because as a teacher, there was nowhere private I could take the call. Actually seeing a doctor face to face would have been far easier as I could have taken time off but that is not possible with a telephone consultation. I feel the surgery needs to be more flexible for people like me - other key workers - who cannot at certain times take telephone consultations because we have no privacy or cannot just 'pop in' to do things.
- Time off work for a f2f appointment is no different to time off work for a telephone appointment, so your workplace should not need to know whether you are having time off for a telephone or f2f appointment. You should still have time away from work for it.
- On your on-line form, you can specify the hours which you work and can request to be phoned outside those hours. If you end up with a call booked for a difficult time, please call us to rearrange it .
How does the use of smart phones and apps affect patients who either do not have smart phones or who are not technologically competent. This affects issues such as having to use the NHS app to request repeat prescriptions.
- The Government is demanding GP surgeries to offer online consultations.
- For most this is OK but there are a small number of people for whom this is challenging.
- For those who can’t use the system they can have a proxy to do it on their behalf.
- Most of our elderly and dependent patients have a relative, friend or Carer who can access the online service for non urgent problems on their behalf, and request prescriptions for them by proxy. and this works very well.
- If there is no option. These patients can phone the surgery but it is important to keep the phone line for emergencies and urgent issues.
- It is much quicker and safer to request a repeat prescription through the NHS app or Patient access as it goes directly into the prescribing system here.
- You can still hand in written repeat prescription requests to the surgery - these are handed out with each issue of medication from the Pharmacy. This is a slower process and requires more investment in admin for the surgery.