PPG Minutes - 28th April 2025

• Location: Bridport Medical Centre (BMC)
• Time: 2.30pm to 3.30pm
• Ammonite Reps: AF, AMa, AM, MM
• PPG Reps: PE (Chair), PM (Notes), AW, BB, RC, SS
• Apologies: JG (emailed), BH (emailed), BP (emailed), GP (emailed), JS (emailed), JPT (apologies with Reception), JP, LD
• Room Booking: AMa

Agenda Items

1. Welcome, Introductions and Apologies
2. Social Prescribing presentation
3. Notes of last meeting
4. Clinical update
5. Patient Services update
6. Staffing update
7. Practice website
8. Newsletter
9. 2024 GP Patient Survey
10. Practice priorities for the PP
11. AOB. Jim Gammans Update from NSH Dorset - to be emailed with minutes
12. PPG Chair
13. Date for next meeting

Notes and Action Points

2. Social Prescribing Presentation

Explanation of the team and the activities undertaken by Social Prescribing occurred. There are currently 6 people within the team, soon increasing to 7. Area covered: Bridport, Lyme Regis, Charmouth, Beaminster, Maiden Newton. This is a non-clinical team who work closely with the clinicians in the practice. 

• Objective: The objective is to look at people as a whole and what is going on in their life. They do not prescribe medication, but look at activities or services for the persons overall wellbeing and health - their physical, mental and emotional wellbeing. 
• Types of referrals: Social isolation, loneliness, living with a long-term condition, mild to moderate mental health conditions (such as anxiety and depression), emotional wellbeing, loss of confidence and purpose, socialisation, carers, support through life changing events (such as births, deaths, aftermath of bereavement), making healthy lifestyle choices, work, housing or money worries. 
• Process (1-to-1 support): Referral to team, talk to uncover issue, the underlying cause to get to the root cause. Person centred conversation. What is happening to them decides what happens next. Meet for approximately 6 sessions, support to access other services and information pertinent to them.
• Three sectors: Adult Support, Children and Young Persons Support, and Care Coordinators who support people with long-term conditions.
• Community Support: As well as direct 1-2-1 work, work with the community in various ways. Such as identifying gaps in provision, where they initiate support groups (for example, recently set up Diabetes Support Group). If support is not out there, the prescribing team set up provision (for example, worked with Leisure Centre and others, to help with activities and support for Chronic Pain Management). This not only serves patients, but free’s up the clinician’s time as the patient has other more relevant avenues of support.
• Children and Young Peoples Service: referrals often differ, including home visits and community groups, making the patient as comfortable as possible. Primarily work with schools. Mainly dealing at secondary school age and above, this is due to their age allowing them autonomy. With the younger children, the team will see the child and signpost the parent to relevant support and relevant services for the child’s needs.
• Type of referrals: relationship worries, support for young carers, anxiety, self-esteem, body issues, low moods, self-harm, vaping cessation, helping them get more active, sexual health advice, school-based anxiety and refusal, and school transition, future life planning, loneliness and isolation. 
• Benefits: Improved mental, physical and emotional wellbeing, becoming involved in community, increase in confidence and self-esteem, reducing feelings of isolation and enabling them to feel more in control, giving confidence to self-manage. 
• Outcome: help individual and takes pressure off clinical teams

There followed a Q&A:

• Question concerning Cancer and MND: There is a Care Coordinator experienced in these types of conditions, well versed in supporting people in challenging conditions. 
• What connects with The Family Hub: unable to answer during this meeting, there are connections, unable to go into detail. 

ACTION: Prescribing Team to provide information

• What type of support for the Elderly: They do liaise with AGE UK and work with Carers. 
• Asked to quantify number of people helped annually (upward trend):

3. Notes of last meeting (Request for updates and chase for any outstanding actions)

• Names changed to initials for GDP
• Campaigns – updates in Clinical Update
• New Patient Questionnaire – ongoing and when ready awaiting PPG review
• eConsult – still in process
• New video – waiting for mutual dates
• Newsletter – on this agenda
• PPG Suggestions – on this agenda

4. Clinical Update

• Nursing team: new practice nurse started. Few vacancies looking to fill. Maternity cover just started. Successful in recruiting a Healthcare Assistant who will be starting shortly.
• Campaigns: Covid Spring Booster Campaign – for those aged 75yrs and older, and those with eligible chronic conditions – up until 17th June. Catch up program for men ACWY HPV for younger men who missed school vaccinations.

Question: Why is there continuous covid text messaging to remind of booster, these are consistent even after booked an appointment. Practice explained that these come from national NHS and different bodies. Ammonite Practice remove off the recall system to remove reminders when there is a booking, but will recheck system, but unable to amend any national notifications. The national messaging will probably not stop until the NHS registers the vaccination has occurred.

ACTION: Ammonite to check their removal off the recall system is active

5. Patient Services Update

New Patient Services Lead has started one day a week. One member of reception has left to go on maternity leave. There are various job roles looking to fill.

Carers leader is pushing for Carers to be recognised, with focus on front desk to make sure people know how to register as a carer.

Few issues with JHoots pharmacy, where the reception receive complaints, Ammonite are meeting with JHoots area manager to try and resolve the issue. There is no direct connection with Ammonite, but is causing frustrations with patients. 

Concerns (Complaints) received: only 4 received which are to do with discrepancies in appointment bookings. 

Reception have answered 6089 calls in the period 1st to 25th April – which is average.

Questions: availability of some medications. 

Dr Finucane explained how the clinical team are updated by the clinical pharmacy team. Individual issues must be referred to the practice as these can be investigated for a successful outcome. 

Clinical pharmacy issue notifications to the clinical team regarding low stocks, alternative medications and updates.

Most ‘out of stocks’ tend to be individual pharmacy having supply chain issues.

Clinical pharmacy team provide proactive information, to prevent GPs prescribing medication which is nationally unavailable. Currently, medication is secure and it is only individual pharmacy supply chain issues. 

Dr Finucane discussed BMA dispute with the Government over GP contracts. Problem is that the awarded increase has been swallowed up with the recent changes in increases in Employment costs. BMA advised that they can no longer be in dispute with Central Government, but they can be in dispute with locally commissioned services. General Practice are being requested to undertake more services, which takes away from the secondary level (hospitals/Consultants/Specialists). This increases GP costs. For example, phlebotomy services are being pushed to first level primary care (GP), other parts of country are reimbursed, but Dorset is different. GPs are refunded £2.10 to take blood, where the actual cost to break even is £5.50, the ICB, have increased the reimbursement to £2.40 as they state they cannot afford any more. Ammonite delivers services at a loss to provide a local phlebotomy service to help patients rather than they travel all the way to Dorchester for a blood test. These issues are brewing in the background, the hope is for a revised offer which closer meets the provision. Locality has an effect, where larger conurbations in the east (Weymouth onwards), have their own hospital and/or blood community clinics. 

Question: Explanation and thoughts about Govt proposing hospital services should be dealt with initially by GPs. Dr Finucane explained that the media misrepresents with statements such as “GPs paid to keep people out of hospital” in reality, past high level medical issues would be referred by GP to specialist, who then managed the patient. Now proposing, due to large waiting lists, GPs are requested to submit pre-referral questionnaire (Advice & Guidance) which they will be paid for.

Positive: for example, a complex problem with an initial prognosis of a life-long debilitating condition would be forwarded to a Specialist with a year waiting list. With the pre-referral questionnaire, Dr Finucane received a reply same day, with a response regarding the initial prognosis and information for the patient. This was useful and comforting whilst waiting for the Specialist appointment. This is similar to the triage which Ammonite apply to filter patients to the fastest and most appropriate service.

Negative: where pre-referral is made, and the specialist replies back to the GP with requests for multiple tests which then the GP practice have to fund as they are the requestors.

Dr Finucane and the BMA are watching and waiting to see how this primary care /secondary care triage system pans out. This pre-referral system applies to all clinical issues, except the cancer fast-track. 

6. 2024 GP Patient Survey

Small sample size, it does not tally with Friends and Family feedback received – which is a disconnect. 26,000 patients, only 50% responded. 

Negative feedback on telephony system. This can depend on day and the time of call, some days can be very busy and some quieter. Invested extensively in a high-level telephony system.  Callback system only activated after 10 calls, which has been reduced now to the time, rather than, position in queue. Ammonite have discussed with other neighbouring practices to see how they work their systems, others offered callback after a 5-minute wait. Ammonite are continuously testing against others and improving the service based on best practice. 

Congratulations were given on the good results.

7. Practice Website

Still working on the website, this will be a continuous with frequent updates. Advertising online processes and latest campaigns. Newsletter will go on the website (already on Facebook page), this was sent to the team, but it is probably in the background, and needs to be pulled through to the live pages.

ACTION: Ammonite to send to Jo Hughes for inclusion in the Parish bulletin. Bridport local area bulletin goes out every 2 weeks.

ACTION: Ammonite to send copy of newsletter to go to PPG participants. 

ACTION: Send other info to J such as banners from the website (campaign notices, vaccination info etc)

8. Practice Priorities for PPG

Priorities advised by Ammonite:

• Positive PR communications to patients
• Help to recruit Advocates
• Supporting non IT literate patients
• Practical support – ie vaccinations, marshalling 
• Regular help and assistance
• Ammonite Digital coordinators can show patients how to use web based, but need a method of communicating this support is available. 

ACTION: Ammonite to come up a proposal, for example a workshop

ACTION: Ammonite to speak to Social Prescribing team as they are good at setting up regular programs (one-off training can be easily forgotten)

Potential new PPG members have been submitted to Chairman to be included in circulations and meetings. Larger virtual list has been cleaned up and contacted, there are no new members to be advised.

Suggested that at the next vaccination clinic, that volunteers or information for the PPG is available. 

ACTION: Ammonite to advise regarding next vaccination clinic

9. AOB

Asked why Ammonite is not participating in the Charter Fair, as this would be a good vehicle for PR. Queried why GP response was that they do not wish to invite feedback at a stand at the community fair – it was explained that this was not the intent of the response, but that it is difficult to deal with complaints in that type of setting. Investigations cannot be undertaken and so this was why they have multiple ways of gathering feedback, where the background and full details can be assessed for understanding and continual improvement.

Chair advised that the stand/stall at the Charter Fair would a good way of getting patients to talk to the PPG to advise how they see the practice working as a whole, and what changes they would like to see, rather than complaints. 

The charter fair is the main event for Bridport, but there are more events for networking for PR for the practice. Lessons learned that the next opportunity needs more participation from the practice.

Jim Gammans NHS Community Engagement Officer was unable to attend and has send an update by email. This will be issued to all PPG along with the minutes.

ACTION: Notetaker to issue emails with the Minutes

10. PPG Chair

Chair asked if his activities are acceptable, and if anyone with more time or energy would like to take over the roll. It was unanimous that the Chair was carrying out activities as expected and was doing a good job.

At the same time the Notetaker advised that she would need to step away for a while, as having an operation on her wrist and therefore out of action for a few months. Plus, at the same time work demands were increasing so she could not actively participate. Her participation would need to be frozen, but would like to be included in information so when she is able to rejoin, she is up to date.

ACTION: Chair to issue request for replacement NoteTaker

11. Date for next meeting

Proposal Monday 21st July (depending on room availability) with proposal that the AGM is held in October (AGM date to be agreed at the next meeting).

ACTION: Chair to issue agenda for next meeting nearer the date