Patient Group Meeting Minutes July 2023

Swanton Morley patient participation group

Minutes of the meeting held on Wednesday 19th July, 2023

  • Present: Secretary -Simon Brock (SB), Ruth Hannent (RH), Nancy Briggs (NB), Gerry Pamer (GP), Joyce Middleditch (JM), Ken Walton (KW), John Mallen (JM), Robert Richmond (RR), Brenda O’Dowd (BO’D), Alive Verlander (AV), Roger Thorneley (RT), Alison Walker-Fraser (AW), Angela Shannon (AS), Dianne Crossgower – Peebly (DC) and Jane Keidan.
  • From the Practice: Dr Abigail Brun (Dr. B) and Lian Tan (LT), Practice Manager
  • Apologies for absence: Jenny Cunningham, Jane Richmond, Phil Bulman-Page and Pat BulmanPage. Phil and Pat also have resigned from the committee. SB welcomed Dianne Crossgower-Peebly and Jane Keidan (Gressenhall Councillor) as new members.

Election of Officers

After the resignation of RT as Chair at the last meeting the committee re-elected new officers.

  • Chair, Brenda O’Dowd -  Proposed Nacy Briggs
  • Vice Chair, Alison Walker-Fraser -  Proposed Simon Brock
  • Secretary, Simon Brock -  Proposed by Alison Walker-Fraser

No other members stood for the positions, and all were voted in unanimously.

Brenda chaired the rest of the meeting and proposed a vote of thanks to Roger for his many years as chair.

Minutes of the Previous Meeting

RH proposed that the minutes represented a true record of the meeting, which was agreed by all present.

Matters arising: (discussed before practice staff arrived)

JM questioned what was happening with refreshing the terms of reference of the group. It was agreed that a separate meeting would be arranged to do this.

RT suggested an update from the surgery on waiting times for appointments. JK suggested that the surgery should be able to share data on waiting times produced by their telephone appointment software.

GP said there were still issues with long phone waiting times and sometimes being cut off altogether.

NB thought the new system was working very well.

RH said that the online booking service also seems to be up and running and is working well.

There was a lot of discussion about planning for new housing developments whilst not taking into account the impact on local surgeries. There were even thoughts that in the past, housing developments in Dereham had overstretched their surgeries leading to more patients applying to Elmham. There was also concern that Elmham surgery diluted its staff with Toftwood surgery. JK suggested one solution would be to write to Breckland District Council to encourage them to address the problem. NB would like to know from the surgery how do they plan to cope with the addition of the barracks as well as a possible 400 new houses and carrying out Covid vaccinations? How much more can they absorb?

NB shared an article that appeared in 22nd July’s EDP which mentioned the ten best surgeries in the county. Elmham doesn’t appear in the list so would it good to hear the surgery’s comment.

NB thought the recent local magazine articles from the surgery were excellent and hopes the surgery are going to do more.

RT questioned how the surgery performs in general. JM thought that a survey had shown 70% of patients though that surgery performed above there expectation. AV thought that it was not so much about the service received it had been more problematic contacting the service.

Practice Items

Dr Brun (Dr. B) and Lian Tan (LT) arrived, and BO’D briefed them on the new officers that had previously been elected.

BO’D reported back on the engagement workshop she attended following the link LT had sent to the PPG. She summaries that it was the South Norfolk region (Norfolk and Waveney) and they wanted to know how they could better engage with the local community and hence the engagement of the PPGs. They wanted to review how the NHS could work better in the community with Community Heath, Social Services, Primary Care and the voluntary sector. They were looking at different care levels in the region – particularly in more rural areas. Once they have met all the regions, they will produce a plan for the future and their objectives.

LT said how they were looking at all areas, as well as patients and surgeries. They are also focussing on bringing care out into the community through secondary care. It is preparing for the future when a higher proportion of the population will be elderly. Rather than the traditional way where some elderly people end up in care homes they will look at ways that they can stay in the own environment for longer; hopefully leading to a better quality of life and wellbeing. JM stated that he had received very positive feedback from the surgery’s local magazine article and congratulated the surgery.

BO’D asked about the new telephone reception system and was LT able to interrogate data from the system to see how well it is performing? LT explained that statistics are available, and they can show such things as how long callers are waiting on the phone line. She said that overall, waiting times have dropped, but it can be very much dependent on a number of factors; what time of day they call, weather conditions, holiday related, how many clinicians are available, staff numbers etc. So, it is difficult to monitor but overall, phone calls and waiting times are down.

Br B added that the pre bookable appointments have helped a lot and reduced the morning rush. Patients are texting more and using the surgery’s website. LT added that the NHS is also carrying out a recovery access plan where they are looking to improve access to surgeries. They are looking at telephone systems, bookable appointments etc but LT was please to say that the surgery is already carrying out a lot of the NHS’s suggestions.

BO’D asked how transparent the surgery’s data is, and is it available for the PPG to see? LT said that would carry out a presentation at a future meeting to show the performance through the previous months.

LT presented some of the recent survey results. There was a very recent national GP survey sent to 222 patients which only half responded and so it only represents about 1% of the surgery’s patients. Some of the feed back was good and some not so good. The surgery will investigate the areas for improvement. The surgery also has results from the Friends and Families survey (available on the website). There has been some very good feed back which has been reported back to the staff and proved very useful for staff moral. Also, Healthwatch (part of the CQC) have visited. They interview patients (outside the surgery so that they feel they can speak freely) to get their opinions of the surgery. They were very impressed with the staff, whom they described as very helpful and welcoming. They felt there was a real team feeling about the surgery. LT said that this was a great compliment and said how important teamwork is.

AW fed back from the group that the general feeling was that staff training had worked very well and reception service was very much improved. LT said she would gratefully feed this back to the staff. RT wanted to know how the surgery coped with the turnover off staff. LT explained that staff roles are much more fluid these days. The receptionist duties are now defined as ‘care navigators’. If someone leaves, it is a good opportunity to re-evaluate skills and to decide if they need replacing with the same role or whether it is it updated? Dr. B added that the NHS are currently putting a lot of funds into the PCN. So, for example if a surgery employed pharmacist was to leave, then they would be replaced by a PCN funded pharmacist. As technology improves, certain roles become redundant and this leads to fresh opportunities for staff. A few years ago, the surgery was struggling to find GP’s so the model of care was changed completely and a team of nurse practitioners were employed together with clinical pharmacists and a mental health nurse. RT wanted to know how the surgery would cope if an extra 2-300 houses were be built. LT explained that it was up to the local council to decide on planning. Dr. B explained that surgeries are paid per patient, so if more patients are in the locality, then the surgery will have more money to increase the surgery and staff available.

KW was concerned that elderly patients are less capable of using technology and may have disabilities that lead to them being unable to contact the surgery. Dr. B pointed out that vulnerable people in isolated situations are normally looked after by social services. If elderly patients are struggling with technology, then the surgery reverts to more traditional methods such as writing or phone calls. Also, visiting nurses and community nurses are usually aware, and will help with any problems.

BO’D asked if there has been any impact on the surgery from taking on the Toftwood surgery? LT and Dr.B said it has had a positive impact as they have learnt form each other and swap ideas. Their site manager is excellent, and staff are rotated between the sites. Toftwood has not diluted the number of staff available and so all in all, it is very positive. Toftwood surgery very much feels part of Elmham.

GP was concerned that Swanton Morley surgery has been neglected. It is a nurse practitioner led practice and a Covid vaccination centre. He thinks it should have its own doctors to reduce the difficult travel of elderly patients to Elmham.

LT explained that it is a nurse practitioner led practice and now has taken on clinics such as Covid. Now the landscape is changing, the surgery needs to be reconsidering how the location is used and is it efficient and serving the local community. Dr. B said that a GP or Nurse Practitioner is usually always present every working day. It is possible, when making your appointment, to request to visit Swanton Morley rather than Elmham. GP thought it would be good idea to make this clear in the local magazines.

BO’D offered a vote of thanks to the surgery staff for attending. NB asked if there could publish a local magazine update after each meeting. LT thought that would be a good idea.


(PPG engaging was covered earlier in the meeting.)

The Terms of Reference for the group needs updating. A meeting to discuss was arranged for 6th September at 7.00 at Swanton Morley Village Hall. SB to book hall and circulate ToR before the meeting.

Date of Next PPG Meeting

Wednesday 18th October at 19.00 at Swanton Morley Village Hall