James Wigg and Queens Crescent Practice (PPG) Kentish Town Health Centre Sun Room Meeting Thursday 19th September 2024

1. Welcome, Apologies and Matters Arising.

Present: Pat Banks, Veronica Brinton, Mimi Colahan, Tony Gardner-Medwin, Danya Glaser, Isky Gordon, Kathy Graham-Harrison, Nori Graham, Patricia Langton, Eddie Malfiggiami, Jane Mays, Ruthine Newton, Tamar Posner, Judy Sands, Gill Scott, Manor Wong, Gill Walt.

Practice: Pal Bhambra, Manisha Kaur, Steve Yaxley.

Apologies: Jonny Bucknell, Liz Sturgeon, Kirsten de Keyser, Hilary Calvert, Nancy Hogg, Amanda Williams, Donatella Soldi.

The Chair welcomed everyone and observed that the July event in the KTHC garden had been a good opportunity for socialising as well as asking questions about primary care and the practice.  The chair apologised for the slow progress on the newsletter.

2. Brief Reports on Dementia Awareness.

1) The Dementia support group is growing progressively, meets on the first Tuesday of every month. It is only for JW/QC patients.  The practice will implement a pop-up on EMS system when a dementia patient has an appointment, informing the doctor about the support group. The practice will also inform the Camden Memory Service of this support group.

2) Dementia Week. Organised by Lucy Legg, this initiative aimed to raise awareness about dementia in the community.  The Health Hub at KTHC had pamphlets and flyers, which were also handed out by the volunteers in Reception. Other activities took place in the community: at Camden School for Girls, and a local care home. For a full description of the week, see the Camden New Journal, 19 September 2024.

3. Signage in KTHC.

Community Health Partnership has been in contact with the PPG through Gill Scott. A face to face, on site meeting is planned for 3rd October. A proforma of the signs envisaged was presented for all to view. Thanks were warmly expressed to Gill Scott for all her work and perseverance.

One of the new tenancies at the KTHC is the East Integrated Neighbourhood Team, a new initiative. From the end of September they will occupy the top floor of the KTHC. Among their staff will be social and care services and district nurses. The aim is to have an integrated approach all under one roof with multi-disciplinary experts available. Many details are still to be decided.

4. Treatment of Long-Term Conditions and Preventive Screening.

Follow up on patients with long term conditions was presented. Data on a few specific conditions (eg diabetes) Illustrated how the practice had improved. e.g. the percentage of diabetic patients seen had improved from 41% in the previous 12 months to 62% in just the first 4 months of the current year. This trend was seen in all conditions. There is a team dedicated to the recall of these patients. Health checks for cervical smears were going well in the age range 50 – 64 with a 74% uptake, although progress among 25 – 49 year olds was not as good. However, it is improving, going from 40% last year to 62% currently.

Routine health checks on patients between 40 and 70 years of age with no underlying condition are also going well. This age range is determined by NHS England. It was suggested that a useful research project could explore whether this health check should be expanded to patients 70 – 80 years of age who do not have a long term condition, to see if important health conditions were being missed in this age group.

Pal Bhambra made the point that GP practices in England tend to fall into two groups: either very good at follow up but having difficulty with providing sufficient appointments on demand. Or practices with providing sufficient appointments on demand but which are unable to carry out long term follow-up or screening as required.  The statistics suggest that both the JW and QC practices are providing good follow up for patients with long term conditions. This reduces the number of acute appointments and also reduces A&E visits.

5. Test Results.

It is not always clear to patients how to get results from tests carried out. The doctor who ordered the test has the responsibility to check the results and act accordingly.  However, it was suggested that patients should check with the practice if they have not heard anything after 10 days to be sure results had been received.

6. NHS England Demonstration Site Programme.

A new initiative invited all 1250 Primary Care Networks (PCNs) in England to be part of a demonstration project where significant extra resources will be provided for at least 2 years. The JW/QC forms its own PCN and was one of the 22 selected for this demonstration project.  The PCNs can spend the extra money as they like, and the JW/QC PCN is hoping to employ new staff, including another GP, pharmacists and others. Reports of workload will need to be fed back to NHS England monthly.  The aim is to see how much extra funding PCNs require to provide a service that meets the needs of the population.

7. AOB.

Website – No further progress to date.

A pilot was suggested to use WhatsApp as a method of communicating with patients – providing information, but with no ability to reply or comment. A few members of the PPG were keen to join the trial.

8. Next meeting.

21st November at 2pm.

James Wigg/Queens Crescent PPG Annual Report 2021 – 2023

Gill Walt, Chair

It is ten years since this PPG was formed, according to the terms of reference drawn up in early 2014, when the chair and vice-chair agreed to take on the roles. Reports on the activities of the PPG have been produced since that time and are available on the James Wigg (www.jameswigg.co.uk) and Queens Crescent websites (www.queenscrescent.co.uk) under Minutes of meetings or Activities and studies.

This report covers the activities of the last three years.

The last meeting before the coronavirus pandemic was in February 2020. However, the PPG continued to meet on-line: 3 times in 2020, 4 times in 2021, 5 in 2022 and 5 in 2023. In addition, an informal evening meeting was held in 2021,2022 and 2023 in the Kentish Town Health Centre (KTHC) garden in July. When we returned to face-to-face meetings in June 2022, it was clear that a number of major factors had affected general practice generally in the UK, but also the JW/QC practice:

The Coronavirus Pandemic

During the lock down stages of the pandemic, patients were seen only under strict conditions, to keep everyone safe. Members of the PPG worked with a local residents’ association to make masks and scrubs for JW/QC staff (and others); they assisted in clearing out books and other material from the KTHC and undertook a small study to ask patients about their experiences during the pandemic (available on website). PPG feedback on a website message about attending the Practice or making appointments led to a change in wording.

Structural and Administrative NHS Changes

Major changes in NHS structures occurred between 2020 and 2023. The Camden Commissioning Group (CCG) was incorporated into the North Central London (NCL) CCG, along with Barnet, Islington, Haringey and Enfield, and in July 2022 NCL CCG became the NCL Integrated Care Board (NCL ICB). All these administrative changes were time-consuming and costly to staff, although most patients were probably not initially affected. They have been since, as NCL has moved services around the five boroughs to provide integrated care.

As a result of these structural changes, the Queens Crescent, James Wigg and Philip Matthewman Practice were merged to form one group practice (JW/QC) as a Primary Care Network (PCN). Patients were consulted through the PPG but the amalgamation had a relatively small impact on patients. As a result, the existing PPGs from QC and JW were joined into one, with continuity provided by the JW chair and vice-chair.

All these changes were reported at PPG meetings, and PPG members attending Camden wide patient and public engagement meetings (CPPEG) provided feedback on the changes and how they were likely to affect services in the borough.

Changing Profiles of General Practice

Primary health has had little financial support during this period, affecting general practices. During 2021, 2022 and 2023 the JW/QC PPG has discussed at most meetings the impact on patients. As a result of patient concerns, several presentations on changes in general and in the Practice were made by Practice staff. These have led to discussions of the difficulties faced by the Practice and its patients and potential solutions. Most exchanges were focused on issues to do with access: telephone waiting times, appointment availability, continuity of care, using e-consult on-line forms, face-to-face versus telephone appointments, among other things.

Attempts to meet demand have led to the introduction of a much wider range of allied health professionals to general practices. Patients today may be seen by nurses, ambulance staff, pharmacists, as well as by doctors. Pharmacies have been given prescribing powers for certain conditions, so patients can go directly to those so designated. As a training practice, JW/QC have large numbers of doctors passing through the Practice, something which patients do not always appreciate. All of these factors have had an impact on patient access to primary care.

Administrative staff have increased in general practice too, as part of the growth in digital systems and Government monitoring policies. In 2023 the JW/QC practice appointed a partner with a particular responsibility in operational matters to deal with an increasingly complex environment.

Activities by the PPG

Volunteers in Reception

A group of volunteers has been working in the Reception area of KTHC since 2022. They assist patients negotiate the building and help to manage the queue which sometimes builds up at busy times. By 2024 every morning of the week was covered by at least one volunteer. One of the volunteers also helps with the Food Bank provided by Creative Health Camden. Through their observations several suggestions have been made to, and taken up by, the Practice regarding other services such as Phlebotomy and In Health, management of the queue, working and positioning of self check-in kiosks, messages on overhead screens, among many other things. Many expressions of appreciation for the work the volunteers do have been received by both patients and reception staff. A number of reports from the volunteers are on the PPG page on the websites.

Volunteers in the Garden

The garden at KTHC is much appreciated by both staff and patients. A few PPG volunteers kept the garden going through the Pandemic and after. In mid 2023 FreeSpace (now Creative Health Camden) arranged for a professional gardener to provide regular input to the garden. Patients are welcome to join the gardener on Thursdays. Contact: [email protected]

End of Life Clinic

One of the PPG volunteers with special interest in end of life issues sees patients referred by GPs to discuss issues of concern towards the end of life. The service was short-listed for a British Medical Association General Practice Award in 2023.

Raising Awareness of Dementia

One PPG member has run a few sessions with reception staff to raise awareness of dementia, especially among patients coming to KTHC. A session was held in April this year and more are planned. PPG members are also exploring the extent to which patients who are carers of people with dementia would like to establish a support group.

Signage at Kentish Town Health Centre

Studies undertaken by the volunteers established that patients coming to the Kentish Town Health Centre were from all over London, and only about 40 percent had appointments with the James Wigg Practice. It also became apparent to the volunteers that the signage in the KTHC was very poor, and that this led to considerable stress among some patients, already anxious about their health and impacted on reception staff.

A PPG member undertook to do a survey of the signage system in the KTHC and in early 2024 produced a report outlining the problems and potential solutions for improving waymarking. It is available on www.jameswigg.co.uk and www.queenscrescent.co.uk websites, under Studies and Activities. The report was presented to Community Health Partnerships Ltd who run the building in February 2024 and they are due to report back to the PPG in July.

Communication Between PPG and Practice Staff

The volunteers have met on a few occasions with reception staff to discuss issues pertaining to patients’ experiences as well as to learn from staff. The meetings have been useful exchanges, providing insight into the work of the reception staff, who do much more than front-of-desk tasks. They have also provided an opportunity to present problems that patients face when coming to Reception.

The PPG runs an email list and sends out messages to patients about meetings, including agendas and minutes, as well as informing patients of Camden wide health issues which may be of interest. The email list is independent of the Practice and managed through [email protected] which can be used by patients to raise issues important to them. A new initiative has been suggested to produce a biannual newsletter for patients, the first issue of which should be available in July 2024, in both paper form and on the website.

Open face- to- face meetings are held every two months, with a more social meeting in the garden in the summer. All these meetings are attended by and are open to JW/QC doctors and other staff as well as all patients. Agendas and minutes are uploaded on to the website under the Participation site.

The volunteers meet separately every two to three months, and report to the PPG meetings. Two representatives from both JW and QC meet with the link doctors from each Practice (JW and QC) as well as the partner in charge of operations. Three PPG members who regularly attend PPG meetings also attend CPPEG (Camden Patient and Public Engagement Group) meetings and feedback to the JW/QC PPG any items of broader health interest.

Broader Health Activities

The PPG has supported the Caversham Practice PPG in its 2024 campaign to retain the Peckwater Centre for primary health services.

The PPG also signed a letter from Camden PPGs to the Secretary of State for Health and Social Care in 2021, expressing concern about the commercialization of primary health care and the lack of transparency of NCL CCG (now NCL ICB) in the transfer of AT Medics to Operose, a company owned by US group, Centene.

Dr Jacky Davis attended a PPG on-line meeting in 2021 to give a talk on assisted dying, and a bill which was then getting its second reading in Parliament. The PPG has also circulated information about health activities at the NCL level, some of which have invited patient participation in specific policy exchanges or have sought experience for particular conditions.

Summary

The PPG has been very active as ‘a critical friend’ to the Practice, particularly through its volunteers in Reception. More broadly it has also disseminated information from NCL or NHS England, as well as acted as a conduit for such bodies seeking patient experience. While there is much to commend the level of participation, PPG members recognize that they are a small group, not representative, either ethnically or demographically, of the very diverse set of patients registered at JW/QC – a common failing of many PPGs across the country. Two challenges for 2024 are to recruit a new Chair and Vice-chair during the year and to broaden participation of patients in the PPG.

Annual Report 2020

The PPG met in the Gym at the Kentish Town Health Centre 5 times in 2019, and once in February 2020, before the coronavirus lockdown. In July 2020 the PPG meeting was held on-line, using Zoom, and this remained the case until February 2021 (4 meetings). Each meeting was attended by Gill Walt (chair), Mimi Colahan (Vice-chair), between 10 – 16 patients, the practice manager and the link GP.

During 2019 a number of changes of staff took place: Loni Booker and Siobhan Moriarty, practice managers, both left, and the management structure of the practice changed. When Natasha Smeaton left to go to Queens Crescent practice, the GP link relationship with the PPG went first to Dilini Kalupahana and then to Sarah Worboys.

The PPG was active in a number of areas during the period, summarised below. Details are in the Minutes of each meeting, on the participation page of the James Wigg website.

Raising Awareness About Dementia

Nori Graham, a retired psychiatrist specialising in old age, introduced the notion of raising awareness about dementia among James Wigg patients. A training session was held in November 2019 for reception staff and PPG members, and a meeting planned for the following March, for a wider community of patients. Because of the pandemic, that meeting did not take place.

Volunteer Support

PPG members were involved in a number of different activities:

  • Between 3-5 members helped to manage the reception queue 3 mornings a week, advising and answering queries of patients and other visitors to the Kentish Town Health Centre. Through their feedback, a number of improvements were suggested and changes to reception processes were made. The PPG drew up an information sheet for new volunteers and new reception staff. Both patients and practice staff expressed great appreciation for the work of the volunteers.
  • A small team of volunteers restored the garden outside reception, which had become neglected, with the support of FreeSpace, a charity funded by Kentish Town Improvement Fund. The garden now flourishes and small changes have made it a haven for patients and staff.
  • PPG members also helped deliver and collect art boxes and weekly creative activities arranged for shielding patients by FreeSpace.
  • At the beginning of lockdown, when GP practices, hospitals and care homes were acutely short of PPE (personal protective equipment) the PPG worked with BARA, a local residents’ association, and a local laundry, Universal Dry Cleaners, to make and provide masks and scrubs for health staff. The local community donated fabric, found patterns, and sewed hundreds of pairs of scrubs and masks, some of which were delivered to the James Wigg practice, among others.
  • A small study was undertaken by the PPG to try to capture the experience of a few James Wigg patients during lockdown. Twenty patients who had been in touch with the practice were interviewed by 5 PPG members. The overall conclusion was that for this very small group of patients, the practice had met their needs, although not always as smoothly as they would have liked. Telephone consultations were found acceptable, and the great majority of patients found the consultation with the doctor highly satisfactory.

Communication

The on-line Zoom meetings focused on a number of different subjects that patients identified (see Minutes of meetings for details):

  • Questions around coronavirus, which shifted over time, and ranged from concerns about transmission, testing, PPE, vaccinations among many other issues.
  • Issues around access to the practice, waiting times, the telephone system, the introduction of the e-consult form, telephone consultations and rules around face-to-face consultations, repeat prescriptions on-line, and the website.
  • Broader concerns about the impact of the pandemic lockdown on staff wellbeing, on patients with other conditions such as cancer, and on patients with long covid.

General Feedback

Looking beyond the practice itself, representatives from the PPG who sit on CPPEG (Camden Patient and Public Engagement Group) were able to inform PPG members about the establishment of the North Central London CCG, incorporating 5 London boroughs, as well as the NCL experience of, and response to, coronavirus and the vaccination programme, among other things.  The PPG was also informed about HealthWatch surveys and question and answer zooms about the pandemic.

Annual Report 2019

The PPG met five times during 2018, welcomed new patients to the Thursday meetings and the email list, and undertook a number of different activities. Dr Natasha Smeaton, the link doctor between the Practice and the PPG, attended all meetings, and at the September meeting, when she handed over the role to Dr Dilini Kalupuhana, she was warmly thanked by PPG members for her support and interest in the PPG over the past three years.

During the year the Practice Manager, Loni Booker and the Associate Practice Manager, Siobhan Moriarty, also joined PPG meetings regularly. Between 10 – 15 patients participated in meetings, with agendas and minutes going out to an email list of about 100.

In July the PPG held its ‘Meet Your Practice’ evening in the gym. Dr Jonathan Levy, senior partner, made a short presentation of what the Practice had been doing over the past year, and people present asked a number of questions related to activities and events in the Practice, and also raised concerns over specific issues such as appointments. After the meeting refreshments were served in the garden.

PPG activities during 2018

  • Meetings were held between the PPG and Reception staff. A new telephone system was introduced early in the year, which included, among other things, a message which told patients where they were in the waiting queue. Several patients expressed appreciation of this improvement.
  • The new PPG at Queens Crescent Practice joined a James Wigg PPG meeting, and discussed the role of the PPG.
  • Another focus of interest for the PPG was supporting carers in the practice. A number of discussions were held and a letter was sent out to the practice’s 80 registered carers, to see what sort of support might be helpful. Representatives from both Camden Carers and Age UK met with PPG members. Response from carers to the letter sent out was limited, but three carers attended one PPG meeting, and led a lively discussion on their different needs.
  • Self help week 12-18 November. PPG members helped the Practice with this national initiative on self-care. They
    • attended one of the sessions devoted to diabetes.
    • set up a stand in the reception area, to answer any queries about the role of living wills.
    • worked the reception queue. As a result of this action, one PPG member JudyHildebrand, volunteered to help with the reception queue on a regular basis.
  • The PPG wrote two letters to the manager of the Kentish Town Health Centre, pointing out continuing patient confusion around signage, check-in, and where to go in the building. The matter remains to be satisfactorily addressed.   The PPG also helped the Practice change the wording of letters going to patients who are registered at the Practice but who move or live outside the catchment area.

Annual Report 2018

The PPG met five times during 2017, welcomed new patients to the Thursday meetings and the email list, and undertook a number of different activities.

Thursday meetings were attended by the link doctor, Natasha Smeaton, and the practice manager, Loni Booker. Other doctors and staff members also attended some meetings. Between 10 – 15 patients participated in meetings, with agendas and minutes going out to an email list of about 70.

In July at a ‘Meet Your Practice’ evening 130 people squeezed into the gym, but in spite of the crowd, patients expressed appreciation for being able to voice their concerns, and an interest in hearing more about how the practice is run. Issues raised by patients included waiting times for appointments, not seeing the same doctor each visit, and outsourced services, among other things. Patients were introduced to the neighbourhood structure for NW5 GP practices and to the new clinical pharmacist. This was the first time that an invitation to a PPG meeting had been texted to patients with a mobile phone.

Activities

Reception staff invited PPG members to one of their regular lunch-time meetings, and a full discussion took place. PPG members learned about the different roles reception staff play, and some of the issues that arise for them in communicating and dealing with patients. PPG members were able to voice concerns about the way patients are greeted and the system to deal with long queues, among other things.

Another focus of interest for the PPG was supporting carers in the practice. A number of discussions were held and a letter was sent out to the practice’s 80 registered carers, to see what sort of support might be helpful. Representatives from both Camden Carers and Age UK met with PPG members, and attended PPG meetings to talk about what services are available. It was noted that one care navigator is attached to the practice, and the support she offers to patients is highly valued.

Response from carers to the letter sent out was limited, but three carers attended one PPG meeting, and led a lively discussion on their different needs. Part of ongoing activities for the PPG will explore whether there is any wish for a carer support group, run by and for carers.

Communication: presentations

Several presentations were made at PPG meetings during the year initiating discussion:

  • Daniel Davis, geriatrician and epidemiologist from UCL explained to PPG members the aims of the NHS linkage research study, which was recruiting patients from the practice. The study focuses on the impact of hospital admittance and discharge on elderly people.
  • Anna Wright, Deputy Director of Healthwatch, Camden provided a brief overview of the aims and objectives of the organization, and went on to talk about a couple of Healthwatch studies which had been completed during the past few months, including one on care homes.
  • Asif Dewan described the newly instituted clinical pharmacist scheme, whereby a clinical pharmacist would see patients taking multiple medicines in the practice on referral from their GP. The first clinical pharmacist was introduced at the PPG meeting in July.
  • Another new scheme – Physician Associates – was initiated in the practice during the year, and a new recruit explained the role of PA’s in the practice.
  • The Care Navigation Manager from Age UK spoke to the PPG about the work of Care navigators and described services available for carers in Camden.
  • The Wellbeing Hub Manager presented what services the hub in reception offers to patients.
  • PPG members were asked to comment on the design of the new website.
  • The PPG chair gave a brief talk about the PPG to the regular James Wigg staff meeting.

Communication: information exchange

Several newsletters were produced by the Practice Manager during the year, with inputs from the PPG, and distributed in reception and through the PPG email list.

NAPP (National Association on Patients Participation) produces a number of regular e-bulletins, and these were disseminated through the email list. They also occasionally conduct surveys which the PPG or Chair respond to, or distribute to the email list for PPG members to act on.

A survey run by the Practice (on knowledge of patients about access to their records) was disseminated through the email list, as was a letter to patients explaining the new extended hours service.

A number of consultations initiated by NHS England to hear patients’ views (on changes in prescription medicines, long term conditions services, the future of mental health acute day units) were shared with the PPG or disseminated through the email list.

Camden Patients Participation and Engagement Group (CPPEG)

CPPEG is part of the Camden Clinical Commissioning Group (CCG). Two PPG members (Gill Walt and Kathy Graham-Harrison) were elected to CPPEG in 2016 and 2017, and attended monthly meetings during the year, half of which were open meetings, which all PPG members are welcome to attend. The PPG representatives serve on a number of different CCG committees.

At each PPG meeting there was feedback from CPPEG, so that members were kept informed about wider changes affecting Health services in Camden. Examples include the introduction of GP neighbourhoods and the GP Federation, new commissions for outsourced services, such as Muscular Skeletal services being taken over by UCL, and the extended hours’ service run by AT Medics.

Annual Report 2017

The PPG met regularly in 2016, with members participating in a number of different activities internal to the Practice as well as in Camden-wide events.

External participation in activities

A presentation on the newly launched Camden Integrated Digital Records (CIDR) was provided by Nigel Slator from the Camden CCG in February, to bring members up to date on how access to records is being shared and protected within Camden health and care services.

A member of the PPG, Kathy Graham-Harrison, was elected to join CPPEG – Camden Patient Public Engagement Group – and the PPG received regular and valuable feedback from her on CPPEG discussions and health policy issues in Camden. CPPEG open meetings were held regularly during the year, and were attended by several members of the PPG. At the last one in November, Loni Booker (Associate Practice Manager) and Gill Walt (Chair) did a short presentation on how the PPG and the Practice work together.

The Care Quality Commission inspected the James Wigg Practice on 22 September. Two members of the PPG attended the presentation made by Philip Posner to the members of the CQC team, and were later interviewed by the head of the CQC team. One of the CQC team talked to patients in the reception area. The results were published in January, and are available on the CQC website. The Practice did very well, was judged to be good, and the only area ‘needing improvement’ was in relation to patient access to appointments and telephone services. This was not unknown, and is probably common to every GP Practice in London.

The PPG is also a member of the National Association of Patients Participation (N.A.P.P), whose newsletters are uploaded on the PPG page of the James Wigg Practice website, and are also sent to the PPG email list.

Internal participation activities

In March PPG members designed and carried out a small study on nursing in the Practice, to ascertain whether these had improved after some changes had been made in services. Six questions were asked of patients exiting from nurse appointments, regarding their satisfaction with the service. The results were reassuring and demonstrated a high degree of satisfaction.

From late September to October a PPG-initiated Advance Care Planning month took place during the period devoted especially to Flu Clinics. Leaflets about advance care planning were printed and distributed to patients; information was made available on the TV screens in reception; and posters were put in the corridor. Lessons were learned from the experience – eg the need to make front-line staff more aware about what advance care planning is – so that they would be more pro-active in their interactions with patients. The PPG and Practice will work together to repeat the experience in 2017 in order to raise consciousness among patients about advance care planning.

In October PPG members met staff from Reception, and a very lively meeting resulted in a number of proposals for improving patients’ experience in queuing for Reception, among other things. PPG members found it useful to learn of the different tasks undertaken by Reception staff, and it was agreed to hold another meeting in six months’ time.

A number of activities were undertaken to try to widen participation in the PPG. The PPG leaflet (explaining what the PPG is and does and how to participate in it) was redesigned and made simpler. In June – during National PPG week – PPG members handed out the leaflets to patients entering or leaving the Kentish Town Health Centre – and spoke to those interested. It was felt afterwards that this was not a particularly helpful way to reach patients or encourage participation.

PPG meetings have led to information exchanges between the Practice and patients on a number of different issues (prescriptions, telephone service, patient on-line services, out of hour services, new appointments among many other things). PPG meetings have also raised wider issues, such as concerns over the Sustainability and Transformation Plans (STPs). From some of these discussions actions have been taken, in the form of writing letters (eg to ensure the phlebotomy service was not moved from KTHC) to changes in letters going from the Practice to patients who failed to turn up to appointments. The PPG also worked with the Practice on the production of a newsletter which is informative for both patients and staff.

In summary, the year was a positive one for the relationship between the PPG and the Practice. The Chair and Vice-Chair met regularly – before each PPG meeting – with the Lead GP link, Natasha Smeaton, and the Associate Practice Manager, Loni Booker, who both attended all PPG meetings. Other GPs from the Practice also attended some PPG meetings. The meeting between Reception staff and PPG members was perceived by all to have been a valuable exchange. From these on-going discussions issues have been identified and acted on where possible, to facilitate and improve the relationship between patients and the Practice.

Annual Report 2015

In January 2014 the PPG (consisting of patient members and practice representatives) developed and adopted new terms of reference, which outlined the objectives of the PPG, membership, and general rules about the running of meetings.  A new chair and deputy chair were proposed from among the patient members.

The Terms of Reference appear on the PPG page of the James Wigg practice website: Terms of Reference

PPG activities

Setting up an email account

One of the first activities of 2014 was to try to extend representation of patients on the PPG, and to provide a forum for feedback and information exchange through a dedicated email address. Two sub-groups were established: one to look at initiating a specific email address for the PPG, which was separate from the Practice, and two, to discuss ways of enlarging the membership of the PPG and PPG email list, to include younger patients and those from different ethnic groups.

The email was set up at [email protected] and is now used as one of the main ways the PPG communicates with members.  Agendas and minutes are circulated to the PPG email list from this address, and members can raise issues through the email which can be brought to meetings for discussion.  The email address is managed by the Deputy Chair.

Widening representation

Widening representation was a more difficult task, and the PPG started by designing and then printing a leaflet about the PPG and what it does, and giving the new email contact.  During a week in October, several members of the PPG attended Reception, the Mother and Baby and Flu clinics to hand out the leaflet, to talk to patients about the PPG and to add names and email addresses to the PPG email list.  Several other initiatives were undertaken to talk to others about widening participation.  As a result of the exercise 20 names were added to the email list, and a poster, similar to the leaflet, was designed and is now posted in the glass noticeboards at either end of the corridor in Reception.

Improving the website

The PPG has been active in trying to get improvements to the website, both generally and to the PPG page.  It has been a frustrating year in this regard, and only small changes have been made to basic design flaws, uploading of new material, updating and maintaining the website, and creating a section on feedback.  Efforts to improve the situation are continuing, but the Practice has been hampered by poor service from Boilerhouse, the original designers who retain control, and insufficient dedicated personnel.

Feedback on appointments and complaints

The appointment system continued to be a factor of some concern to some patients. In the week long survey conducted by the PPG (see above) getting appointments with named doctors, in a timely manner, and waiting times, were common sources of expressed dissatisfaction.  These are complex issues for the Practice, not helped by a GP practice in Camden Road being closed and the resulting inflow of new registrations, demands from NHS England and general reforms and budget cuts introduced through the Health and Social Care Act.

The PPG asked the Practice for more information on complaints and how they were dealt with, and also observed that the website did not make clear how patients could give feedback – whether negative or positive.

Details of complaints logged at the Practice as well as those posted on the NHS website were tabled at the November meeting. Results from NHS showed that there had been an increase in complaints but PPG members were sceptical about how to interpret these, as they are anonymous. The Practice does ask those who complain anonymously to get in touch.

The Practice produced a summary of complaints made to the Practice. This summary – from both Queens Crescent (approx. 3300 patients) and James Wigg (approx. 20,500 patients) practices was welcomed by the PPG, and members noted that the total number of complaints was lower in 2014 than in 2013 although they did not cover the whole of the year.  This information will be available for all meetings.

Information and Communication

During the year, a number of initiatives which affected the Practice were outlined to the PPG members, and noted in minutes.  These included, for example, the Friends and Family test (FFT)  which sent texts to 10% of patients (ie about 100 patients of the 1000 seen at the Wigg Practice every week) to rank their experience by answering a question such as: ‘How likely are you to recommend our GP practice to friends and family if they require similar treatment’.  The FFT is currently being run by the Practice.

Other information regarding data sharing was discussed.  For example, the PPG was informed about the proposal Camden Integrated Digital Record (CIDR) which will go live in 2015.  This is a local initiative which will allow individual health and social care information to be accessed by health professionals in Camden in order to provide better, integrated care.

Support group initiated

Two PPG members initiated a support group for Cancer patients and carers, which meets on the first Tuesday of every month, at the Kentish Town health Centre, and provides an opportunity to exchange and learn from others’ experiences around issues to do with cancer.  A Diabetes Support Group also meets regularly at KTHC, on the first Monday of every month.

External to the Practice

A PPG member volunteered to become a member of the Camden Public Participation and Engagement group, (CPPEG), from early 2015, and will report back on CPPEG meetings. CPPEG is part of the CCG (Clinical Commissioning Group). The chair and deputy attended a number of open meetings run by CPPEG on aspects on health in Camden. These meetings are open to anyone interested, and cover a wide variety of areas, such as 111 and Out of Hours Services, Care for the elderly in Camden, and the results of a survey of the Somali community in Camden, and their experience of health care.   PPG members are welcome to attend these open meetings, and information about them is circulated to the email list.

The PPG is a member of the National Association for Patient Participation, and any patient can access information on their website: www.napp.org.uk to help improve GP services. An electronic newsletter is available through the website.

Annual Report 2013/2014

The PPG currently consists of 34 active patient members of the practice plus at least 2 practice members which includes one of the partners and the Deputy Practice Manager.

Profile of the PPG by age and sex:

10-19 20-29 30-39 40-49 50-59 60-69 70-79 80-89 90-99
Male 0 0 1 0 0 2 4 1 0
Female 0 0 0 2 6 9 5 2 1

 Profile of the PPG by ethnicicty:

Profile of registered patients by age and sex:

0-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80-89 90-99 100+
Male 1287 1017 1661 2017 1513 1058 651 360 148 16 0
Female 1191 1097 2162 2136 1511 1070 731 469 197 30 1

Profile of registered patients by recorded ethnicity:

The PPG and the practice acknowledge the difficulty in try to ensure that such a large and diverse population as seen at the James Wigg Practice has representation and a consensus was agreed that, while it may be difficult to ensure that there is an active PPG member from each demographic, that increased effort should be made in making the PPG as accessible as possible and these initial efforts are described later in this report.

In May 2013 the PPG discussed areas of concern and decided to conduct a patient survey to assess opinion on the external services that patients were referred to such as physiotherapy, podiatry etc.

The surveys were distributed to doctors to hand to patients at the point of contact and also left in the waiting room for patients to complete.

Despite over 60 forms being distributed only 3 were returned, one commented on the difficulty obtaining an appointment, one indicated that the physiotherapy service had been good and the other on the advantage of having a phlebotomy service in the practice.

Feedback from clinicians felt that there may have been a delay between the referral to the service and the appointment possibly leading to the patient forgetting about the survey and lack of time to explain the form during the consultation and also the fact that the survey was carried out over the summer when many of the usual clinicians were on leave. Overall it was felt to be a very disappointing response.

The issue around appointments was discussed in detail at the PPG meeting in July as this had been the subject of a number of administrative complaints received by the practice. Key action points were identified as follows:

1) Lack of information regarding the new appointment system

2) To consistently be able to book appointments at least 4 weeks in advance

3)Address concerns about the apparent reduced availability of on-the-day appointments.

The practice responded by acknowledging that there had been a problem with the introduction of a new appointment system and that some of the key issues were around lack of information available for patients and has subsequently produced an information leaflet for patients which is readily available at the reception desk and also around training for reception staff – this has resulted in any ongoing training programme for reception staff.The practice acknowledges that while some of the problem had been due to the reorganisation of Health Education England and a delay in information regarding staff on the Foundation year programme being given to practices in a timely fashion, there was also a local problem around staff requesting leave once the rota had been finalised which caused unacceptable delays. The practice has now a strict policy of a minimum of 6 weeks’ notice for leave.The practice also agreed to address concerns about the availability of on-the-day appointments.Further research done within the practice showed peak demands for these appointments on Mondays and the appointment system has been adjusted further to accommodate this demand.Core opening hours of the practice are 8.30am – 6.30pm Monday-Friday with extended hours appointments being available from 7.30-8.00am on Monday, Wednesday and Thursday mornings and from 6.30-8.00pm on Tuesday and Thursday evenings. During core hours patients can access services either by presenting to the reception desk, telephoning or, for non-urgent requests sending an e-mail to the practice e-mail address which is [email protected] further concern, throughout the year attendance at the PPG had been falling and in Autumn the practice took the decision to suspend the PPG in order to look at ways of improving representation and direction.This resulted in several positive outcomes.The existing members of the PPG met independently of the practice and identified the following key areas for the PPG to act on:

1) Terms of reference for the PPG

2) Appointing a patient chair to run the meetings

3) A subgroup to look at increasing representation on the PPG

4) A subgroup to look at setting up a “virtual” PPG in order to improve communication between meetings and improve the profile of the PPG within the practice.

This was fed back to the practice in January 2014 and to date the terms of reference have been agreed and the members of the subgroup have been appointed.The practice and the PPG are continuing to work to ensure that as many patients as possible can access the PPG and that the PPG can continue to work with the practice in what has historically been a very positive and productive way.A cancer support group with the aim of providing a network of support for patients and carers who have been affected by a diagnosis of cancer has also been set up by some members of the PPG and the inaugural meeting took place recently and was extremely well attended and received. The idea for this came from members of the PPG and has been resourced and developed purely by them with some administrative support from the practice in order to publicise the group.

This report was discussed at the most recent PPG meeting held on 20th March 2014.

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