Patient Participation Group

• Date: 6th November 2024
• Meeting held at: Strawberry Hill Medical Centre
• Present: Sabrina Mann (SM), Karen Swaffield (KS), Maggie Bates (MB), Jane Belcher(JB), Dr Imogen Caffrey (IC), Janice Cook (JC), David Stock (DS), Jane-Marie Stock (JS), Ros Quinn (RQ,) Joan Blore (JoB), Simon Shaw (SS) - HealthWatch Simon explained that his role was to
  support PPG’s in any way he can.
• Apologies for the absence: Mike Fereday (MF), Elizabeth O’Keeffe (EO), Ramesh Kommi (RK)

Voting and introduction of committee members

Mike Fereday, vice chair, chaired the meeting.

All self-nominated members were invited to the meeting and accepted onto the organising committee. Everyone introduced themselves.

The following appointments were made for 2024-25:

• Karen Swaffield – chair
• Mike Fereday – vice-chair
• Maggie Bates and Jane-Marie Stock joint secretary

Conflict of interests

None.

Minutes of the last meeting

The minutes for the last meeting were accepted and signed by KS.

Matters arising

New website

MB was concerned that the personal details held do not include which Covid vaccination was administered. SM explained that the information from the surgery about vaccinations feeds into “Outcomes4Health”* which feeds into EMIS* which feeds into Patient Access. The surgery cannot alter the information held by EMIS.
*see Appendix 1

It was suggested that patients should be made aware of which vaccine is being given beforehand. IC said it would be possible to put up a sign. The surgery is only able to offer one type of vaccine.

Blood tests

These can now be booked via the SHMC website for every other Saturday morning. It was reported that the system for blood tests at West Berkshire Community Hospital (WBCH) was working well.

Staff roles

IC will ask Olga, the pharmacist, to write about her role for the newsletter.

PPG forms

The old forms have now been sorted. Forms will be needed for nominations for the PPG for the AGM in February.

Patient access sign in

This has been found to be a lengthy process but the practice is unable to change it. It was suggested that patients use the NHS app as this is easier to use and Patient Access will soon be obsolete.

New appointments

Deputy Practice Manager, Christy, is due to start the role on the 18th November, 2024. A second Phlebotomist has been appointed. The surgery is looking to appoint a Pharmacy Technician.

Council waste policy

JMS reported that that there are no plans for West Berkshire Council to collect empty blister packs or inhalers in kerbside collections.** The only places that we know of in the area are GKG vets (empty blister packs) and Halo Pharmacy in Thatcham (used inhalers and blister packs).
**see Appendix 2

JMS will now write to Lee Dillon, MP for Newbury, regarding this issue.

Self-referral for physio – how?

There are forms available at reception and on the NHS website. A Patient Care Adviser (PCA) can text a link to patients for self-referral. SM will add the link on to the SHMC website.

U3A

KS has booked a speaker from the U3A to speak at the AGM.

Updates from the practice

SM Report

As well as informing us of new appointments (see 4, f) above), SM reported that the last weekend of flu and Covid vaccinations will be Saturday 9th November and that 3,500 patients have been vaccinated at SHMC.

Support for surgery – Workshop?

Autumn workshop – 30th November, at SHMC, 8.30am-11.30am. Graham Stiff will attend this meeting to talk about IT. PPG members and members of non-clinical staff will support this meeting.

SS was invited to attend.

Newsletter

KS was not happy that Newsletters were not being given out at the reception desk and wondered if the Newsletter was worth doing. IC and SM agreed that paper copies of the newsletter were not easy to manage in the practice. MB emails it out to the virtual group. It is not an easy task to email to all 22,000 patients.

Other ideas to increase meaningful circulation were to:

• add it as a ‘pop up’ on the SHMC website
• put it on social media sites e.g. Facebook group
• copies to be available for attendees at the workshop on 30th November

Matters for discussion (IC)

1. NHS app and Royal Berkshire Hospital (RBH) portal. There was nothing to report on these.
2. U3A see 4 i) above.
3. Telephone / messaging. This is a useful tool and has been used successfully by MB.
4. Skin clinic – KS brought up that Falkland surgery have a Skin Clinic and asked if that would be possible at SHMC. IC will investigate.

Patient Panel Report

No report available. JB informed us that the AGM for the Patient Panel will be held at Shaw House, 21st November 2024, 3pm to 5pm.

Virtual List

There are 168 members on the virtual list.

AOB

• Primary Care Course. MB emailed the details in September, passed on from MF. SS told us it was a free course, aimed at PPG’s about how Primary Care works. MB will email the details to the PPG again.
• Secure data environment. KS showed the PPG a video about how de-identified data collected from the Thames Valley and Surrey area can be used, from March 2025, for research purposes. The data stays in the secure environment, but the results of the analysis can be published to help with, for example, prediction and diagnosis of illness and addressing health inequalities which will improve healthcare.
• Website information. KS and SM will meet to look at a list of items of interest to go on the website.
• JoB informed us that Falkland Surgery offer an annual health checkup and asked if SHMC could offer the same. IC will investigate. IC told us that people with chronic conditions are seen annually to review meds, etc. DS told us that he requested and received a ‘well man’ review with SHMC.
• JC informed us that there was no driver available to deliver drugs from the Day-Lewis (Strawberry Hill) pharmacy.
• MB told us that the nomination forms for the AGM need to be sent out 21 days beforehand. The AGM will be promoted at the workshop on the 30th November, and also via the Virtual Group, the website, social media sites, posters in the practice, on the screens in the waiting room, etc. to help improve attendance on last year’s numbers.
• RQ asked for updates on the RBH new hospital project but there was no news on this. A meeting was due to be held on 6th November but this had to be cancelled. Details of the new meeting are below:

Join us for our monthly Building Berkshire Together Zoom update by Programme Director, Alison Foster.

Building Berkshire Together Online Update

• Join Zoom Meeting – Tuesday 3 December – 6.30pm to 7.30pm
• Meeting link

All welcome – We look forward to seeing you

• SS told us about the “GP Access Report”. SS will pass details to MB who will put the details on the website.

Future Meeting Updates

• The meeting finished at 6.50 pm.
• AGM Wednesday 12th February at 7 pm (time tbc)
• Wednesday 26th February at 5.15 pm

• Date: 21st February 2024
• Meeting held at: Strawberry Hill Medical Centre and on MS Teams and via phone conference (audio only)
• Present: Karen Swaffield (KS), Louisa Walker (LW), Maggie Bates (MB), Jane Belcher (JB), Dr Imogen Caffrey (IC), Janice Cook (JC), David Stock (DS), Jane-Marie Stock (JS), Ros Quinn (RQ), Joan Blore (JoB), Cath Walsh (CW), Christine Wolstenholme (ChW), Nalini Mistry (NM), Mike Fereday (MF)
• Apologies for the absence: No apologies received.

Chair's Report

KS opened her report by explaining that the Patient Participation Group (PPG) was formed 7 years ago, a year after the opening of SHMC, and that any registered patient of the practice was eligible to be a part of the group. This can be as a member of the 12 strong organising committee or as a member of the virtual group. The virtual group is for patients who may not want/are not able to attend meetings in person. They receive newsletters and invitations to contribute to group activities online. The PPG would like to recruit members from a cross section of our community to take part but this has proved difficult to achieve.

The PPG is a voice for patients and it is an opportunity to feedback to the surgery. KS updated surgery developments. There have been some challenges this year with staff recruitment, staffing at the pharmacy and supply of medications. The PPG have produced 3 informative newsletters and the latest one was dropped off to the new estates at Shaw/Donnington as SHMC is their local surgery.

The surgery has regular inspections form the Care Quality Commission (CQC), the last full inspection was in May 2019. They judged SHMC to be ‘Good’ overall, with ‘Outstanding’ for being ‘well led’.

The surgery has over 22,000 patients registered. The make-up of this number is mainly white British with a small percentage of other minorities.

The biggest change at the surgery is the change in systems from ‘Total Triage’ to ‘Care Navigation System’. This means that patients can have same day appointments for urgent needs and within 2 weeks for a non—urgent appointment. The appointment can be a phone call, a video call or a face-toface. There were problems at the beginning but patients are finding it a better system as it means you get an appointment more easily. Currently, the surgery is fully staffed with 25 clinical staff.

SHMC is part of the A34 Primary Care Network (PCN) along with Eastfield House and the Downland Practice. The 3 surgeries are able to share some services.

Saturday 10th February. NHS app workshop. The practice held a successful workshop to assist patients who own mobile phones but who have not yet downloaded the NHS app. There was a very good response to the workshop. The PPG assisted with refreshments and were on hand to assist with the workshop and to chat about our role at the practice

Speaker – Steve McManus CEO of the Royal Berkshire NHS Foundation Trust

Steve McManus, CEO of Royal Berkshire Hospital (RBH) NHS Foundation Trust was our guest speaker and he gave us a comprehensive and very informative update on the hospitals.

Steve has been CEO since 2017; between then and now he was seconded to the Test and Trace Service and in October 2022 to July 2023 as CEO of Oxon, Bucks and Berkshire West NHS trust; he is now back in place as CEO of RBH.

The RBH is a community based trust covering Berkshire West and South Oxfordshire hospitals: West Berkshire Community Hospital, RBH, Windsor, University of Reading, Whiteknights, Bracknell and Henley. This is an area of approximately 600,000 people who have had over a million interactions during the year across the range of services within the trust. The budget for the trust is £0.5 billion of public funds which includes spending on education, training and research.

He outlined the 5 long term objectives of the trust:

• High quality care
• Deliver in Partnership
• Investment in staff and live out the values
• Cultivate innovation and improvement
• Achieve long term sustainability

The trust’s partnership with the University of Reading provides post graduate medical training with 2 nursing schools and Physician Associate training being delivered there. The university’s Health Innovation Partnership has led to improved patient care and accreditation for services for quality, education and research.

Recent achievements:

• A £6 million Rapid Response lab
• Well-being of the 5600 staff – RBH was in the top 5 organisations voted for by staff
• Martha’s Rule was launched today (21st Feb)
• De-carbonisation on site

Challenges and opportunities faced by the Trust:

• A huge increase for emergency and urgent demand services in the last 2-3 years
• Waiting lists – examples of reasons for this: 20% increase in cancer referrals since the pandemic, disruption caused by the industrial action. He also noted areas of progress where there was evidence of reduction in wait time
• Health inequalities. Steve talked about “Meet PEET” (Patient Experience Engagement Team) whose focus was on engaging and listening to seldom heard groups in our community
• Retention and recruitment. There has been a focus on staff well-being which has led to staff stability and national recognition of this

Strategic Partners:

• Digital records will replace paper records and this will help services to interact with each other
• Public Health for Berkshire
• University of Reading

Integrated Care System BOB ICB:

• This stands for Buckinghamshire, Oxfordshire & West Berkshire (BOB) Integrated Care Board (ICB)
• The 3 ‘acute’ hospitals work together as health and social care partners to reduce waiting lists and economise by buying goods for all 3 hospitals

Building Berkshire Together:

• 2019 RBH was adopted on to the New Hospital Programme
• 2020 The Strategic Outline Case was put forward and options for on and off the current site were considered. The most favourable
• outcome - a new hospital on a new site
• 2031 funding available for construction to start onsite
• Currently the funding is not enough to cover cost either onsite or offsite
• Current site has limitations due to being ‘land locked’

To summarise:

• Funding allocation has not yet been finalised
• 2 viable sites at Wokingham are being investigated for ‘due diligence’
• Patient requirements are still being explored. There is a “have your say survey” on the Building Berkshire Together website.

West Berkshire Community Hospital:

• New services have been developed – cancer care, renal and endoscopy
• Long term ambition is for all services to be delivered at WBCH

Q & A

1. A question was raised about the role of Physician Associates (PA) and whether more PA’s will be employed in the NHS in the future.

Steve explained what the training was for PA’s: a 2 year post graduate programme (available at University of Reading/RBH). In situ, PA’s are part of a multi-disciplinary team they work with supervision from doctors and play an important part in sharing the workload. Steve felt that the media and social media had an unhealthy and unhelpful campaign against PA’s. He went on to say there are not enough doctors and training and employing PA’s was a way to deal with the increased workload.

2. Is there a valid career pathway for PA’s?

Steve told us that the first cohort of PA’s was trained 2015-2017, at RBH. There is continual training and for the more experienced PA’s there are opportunities to take a pathway to medical training and qualifications. Dr Imogen Caffrey explained that there are 5 PA’s at SHMC. They were very useful and were definitely not a cheaper option. She explained the protocols in place at SHMC; a senior doctor goes through what the PA has done. Steve added that at the RBH the PA works in a supervised environment within their scope of practice. They are supervised by consultants and line managers.

There is a procedure in place should a patient be unhappy with the PA and a consultant is always involved in every case.

3. A third question was about the communication, or rather, lack of it, between hospitals e.g. results of blood tests and x-rays that cannot be shared.

Steve agreed that unfortunately, this was the case; it was as a result of different trusts using non-compatible electronic systems and some paper systems still being in place. It takes time for information to be digitalised. Although it is presently throwing up challenges, it was hoped that this could be something that could change by using a ‘Connected Care Platform’ in the future.

Dr Caffrey said that individuals can access their own test results via the NHS app. Another member of the audience told us of her recent experience of lack of communication between hospitals. Steve reiterated the use of the NHS app and agreed that there was still work to be done on improving communication. He explained that the NHS had been allowed to develop their own system which has ended up with a ‘patchwork’ effect.

4. Why has the main ENT department being moved to Henley? This makes attendance from Newbury difficult.

Steve said that, unfortunately, the RBH accommodation for ENT was substandard and could no longer be used. Henley Townlands hospital had space available and was therefore the best option.

5. Why do Specsavers no longer offer NHS audiology? WBCH is unable to cope with the larger numbers.

Dr Caffrey explained that Specsavers had ended the contract.

6. How will the new hospital meet the needs of the population in the future?

Steve explained that there are surveys in place about this and that younger people, in particular, were being asked about what they may want in the future. He agreed it was very difficult to project about future needs. He told us there are 3 hospitals in the area being re-developed – Frimley (which has become an urgent project because of RAAC), Basingstoke and RBH.

7. Is Steve confident that work will start in 2031? (Audience laughter!)

Steve’s answer was that the project team was being as prepared as possible but with a general election on the horizon, things might change. He assured us that whatever could be controlled was being controlled in order to keep informed and moving forward. He said that more information about the viability of the new site or re-development of the old site over the next 5-10 years will be available when a geo survey is carried out later this year.

8. What about the impact for patients from Newbury if the RBH moves out of Reading?

Steve said that looking at transport links would be part of the process. Also, looking at how WBCH could be developed to offer an all-encompassing range of services.

9. A member mentioned that ‘Building Berkshire Together’ had a stand at WBCH on Monday 26th February 9pm to 2pm for anyone interested.

Steve was thanked for his attendance at the meeting and for such an informative and interesting talk.

Nominations received

All nominations received will be part of the next PPG organising committee.

Election of the organising committee

Nominees will be invited to the next meeting of the PPG.

Date of the first PPG organising committee meeting

Thursday 28th February 2024, 5pm at SHMC