1. WELCOME & APOLOGIES

PRESENT

Patients: Dobrila Nincic, Mimi Colahan, Gill Walt, Jonny Bucknell, María Constantinidou, Isky Gordon, Kathy Graham Harrison, Donatella Soldi, Nori Graham, Nancy Hogg, Kirsten de Keyser, Veronica BrintonJill Fraser (QC), Patricia Langton (QC), Adriana Santos(QC), Susanne Korda (QC)

Staff: Sarah Warboys (Link GP), Neeshma Shah (Clinical Pharmacist), Olivia Twose, (GP) Stephen Yaxley (GP)

APOLOGIES

Adriana Santos, Susanne Korda, Judy Sands, Tony Gardner-Medwin, Penny Gamez.

 

  1. POLICY ON ASTHMA MEDICATION

Neeshma Shah briefly explained the policy of the Practice in relation to asthma medication.  Aerosol inhalers will gradually be replaced with environmentally more ‘green’ inhalers, using dry powder, once the policy has been approved by the NCL CCG, so that all hospitals and GPs in the five boroughs are following the same pathway.   Patients will be introduced to the different types of inhaler, some of whom may continue to use the aerosol inhalers if necessary.  The change is being introduced because asthma affects more than 300 million people worldwide and aerosols release large amounts of Co2. There is also wastage as people continue to get repeat doses and not use them.

 

  1. FEEDBACK FROM PRACTICE

Staffing:  a number of new appointments have been made and will be joining the practice between now and August. They include a returning GP, three new GPs, a healthcare assistant working across both QC and JW and a number of physician associates and paramedics.

Pilots: Sarah Worboys described a number of pilot projects the practice is involved in, with others such as UCLH, including a nationwide prescribing project, in which people with minor ailments can be referred by their GP to the community pharmacist and a lifestyle scheme supporting people back into exercise and diet.

New appointment system:   The new system was introduced in February, as Olivia Twose reported. She proposed a project to get patient feedback on the appointment system, and it was agreed that the current volunteers would meet with her and others to finalize a plan on what questions should be asked, and the process for doing so. Members of the PPG were invited to join if they wished to take part in this project, by indicating their interest to Gill or Mimi.

 Complaints:  Sarah Worboys provided data collected by Sammy Benfares, covering the period November 2021 to April 2022. Data was collected from the practices (email and telephone), including social media.

From JW : there were 97 complaints, and from QC: 47 complaints.  They fell into the following categories:

Clinical (largely about prescriptions) 29%

Communication 23%

Appointments 16%

Attitude of staff 3.2%

Waiting time on the phone 8%

The above is data from JW, but similar results were obtained from QC.  Complaints are dealt with by Sammy Benfares (digital and communications manager) who then sends a holding letter to complainants. It was agreed that there would be a regular report on complaints and how the practice responded to them.

 

  1. REPORT FROM VOLUNTEER GROUP

A short report on the first 6 weeks was circulated, and will be available on the website, PPG page. As previously, this has been a positive experience for both volunteers and patients. Since many of those visiting the KTHC are attending a variety of services, not just JW, volunteers guide people to where they need to go. This relieves the queues for reception. A record kept on Tuesdays between 10 and 12 am showed:

50% of visitors are for In Health (scans, ultrasound, breast screening)

23% for the phlebotomy (blood) clinic

15% for the diabetic eye clinic

The rest cover a variety of questions, including doctor and nurse appointments

Issues that were reported to the KTHC management included empty hand sanitisers, lift out of order, and for the JW patients, the need for a change in the text message sent to those going to phlebotomy.

 

  1. MENTAL HEALTH SERVICES:

PPG members had asked for a briefing on how the homeless and mentally ill patients are treated at both practices.  Sarah Worboys pointed out that JW and QC practices are in Camden, which has the highest level of severe mental illness (SMI) in the UK.  Homeless people are registered under the JW practice address in order to be able to treat them. A nurse-led pilot, which will run until January 2023, proactively facilitates nurses to go into Camden hostels to help with both physical and mental health issues. Many refugees stay in hostels, but as they are constantly being moved on, follow up is difficult.  QC works with young people in Oak House which offers supported accommodation for unaccompanied refugee minors. However more funding is needed for working with Bengali and Somali refugees, identifying issues and problems, and dealing with the sense of taboo associated with SMI, which is expressed very differently according to ethnicity. The practices are also involved in the

Primrose Project, a centrally funded project looking at the significant gap in health and well-being between those who do and who don’t have SMI.

 

  1. AOB

After very full discussions, a number of issues were touched on briefly, and will be brought back to the next meeting in May.

  • Integrated Care Systems to be discussed at the next PPG meeting
  • Website Tony Gardner Medwin has volunteered to work with Sammy Benfares to make the website more user friendly.
  • Poor signage within the KTHC, a matter which has been discussed often, and which the administration of KTHC have been made aware of.
  • Childhood routine vaccinations: these are declining in Camden, and the NCLCCG is working on ways of improving vaccination rates. What is happening at JW and QC will be discussed next meeting.
  • Garden development. Ian Critchley has signed up to a nationwide project with the Royal Horticultural Society.  Called the Grow Well Initiative, a pack of seeds ad activity ideas will be sent to Ian, to use in the KTHC garden.  Grow Well sowing week will be 2-8th May, and all PPG members are invited to join Ian and others. Email Gill or Mimi, or [email protected]

 

Report on Volunteer project                                                                    31 January – 18 March 2022

Five PPG volunteers have been at the Kentish Town Health Centre since the beginning of the year, assisting patients who come to the James Wigg/Queens Crescent practices, as well patients attending other provider services.  They have been present from 10 – 12 on Mondays, Tuesdays and Fridays during this period.

Here is a brief summary of experience during this period:

  1. All agreed that patients find the help given useful, and most express appreciation, some going out of their way to thank the volunteers. The volunteers felt patients liked the eye-to-eye interaction and in a few cases, being ‘heard’, especially where they were feeling aggrieved.

When volunteers are present there is no doubt that the queue at the Reception desk is smaller, and reception staff are often available quite quickly.  It was noticeable that the queue seldom had more than about 6 people waiting at any one time, and often it was fewer.

The volunteers themselves found the experience made them empathize with reception staff and the sometimes difficult situations they face. They also found volunteering both interesting and enjoyable, and found themselves doing a variety of things beyond directing patients, eg looking after a baby while Mum went to the toilet; playing with a small child for a few moments, among other things.

 

  1. In terms of demand for services, the most visible are those provided by In-Health, for scans (ultrasound, echo-cardiograms) and mammography. The Diabetes Eye-clinic also has a large through put of patients (seen by JW/QC nurses) as does the UCLH phlebotomy service. Other services such as Midwifery, Podiatry, Dental and Mosaic also have a regular flow of patients.

Volunteers found that even if the letter or text received by the patient stated where they should go, patients often did not take note of the details.

 

  1. A number of services were rare, and volunteers did not know always about them: eg acupuncture, the existence of interpreters, the removal and placement of contraceptives, and there is some confusion around the relationship between physiotherapy and the steroid clinic. Volunteers to follow these up for clarity.

 

  1. A large number of patients have mobility difficulties and the lift on the south side has been out of order for at least 4 weeks. The administrator of KTHC said they were waiting for a part. Volunteers felt that a number of items that take up space in reception, but that are not working or being used, should be removed. This includes the self-check-in machines, one weighing machine. Also some of the TV screens are not working, and the door stop to the back offices on the south side of the building is not working. Volunteers felt these faults detract from what is otherwise a pleasant reception area, and irritate patients (eg when the self check-in machines do not work).

Transport is also an issue. There is not always space in the official spaces in Bartholomew Villas and Bartholomew Road for paid parking,  and it is not always clear to patients where taxis will come to, to fetch them.

 

  1. It was noted that the text message from the Practice to JW/QC patients who need to have a blood test is incorrect and should be changed. Currently it tells patients they do not need a form, and should go directly to room 22. However, in most cases those patients are sent back to reception to get a form. The message needs to change for JW/QC patients to say ‘pick up a form at reception before going to room 22’.
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