Patient Participation Group

Welcome to the Stamford Surgery PPG

• To act as a liaison between patients, doctors, staff and other health-related organisations
• to encourage self help
• to promote patients' needs and interests
• to support the Practice.

Stamford Surgery PPG is an independent group of volunteers who are all patients.

Stamford Surgery PPG will hope to achieve and expand on those activities to better support the Surgery in the future.

We are currently recruiting for new members, if you would like to be a member please get in touch using our secure online form and you will receive a response as soon as possible.

Terms of Reference

1. Definitions

• Lakeside Healthcare Stamford GP Practice: Referred to as the Practice
• Patient(s): Patient(s) registered with Lakeside Healthcare Stamford
• PPG: Patient Participation Group – a management committee comprising some of the Patients.
• The terms PPG, management committee, and committee all mean the PPG.
• Annual General Meeting (AGM): An annual meeting of the Patients and the Practice

2. Background
The PPG has been set up as a result of the requirements for patient participation as set out in the NHS England Standard General Medical Services Contract.

An extract from Section 5.2 is shown in Appendix 1. The primary role of the PPG is to follow the general principles set out in Section 5.2 of the contract.

 3. Aims of the PPG

• To work with the Practice to provide practical support, to obtain and provide feedback from Patients to the Practice and to provide strategic input and advice.
• To encourage cooperation between the Practice and Patients.
• To facilitate regular meetings between Patients and the PPG, where the Practice can be invited, providing feedback to the Practice.

4. Purpose of the PPG

• To give the Practice and Patients the opportunity to discuss topics of mutual interest in their Practice.
• A forum for Patients and the Practice to improve and develop services within the Practice by co-production.
• To provide an opportunity for Patients to make positive and constructive suggestions/ideas about the Practice and specific medical conditions.
• To encourage health education activities within the Practice.
• To strive to engage all Patients.
• To involve patient participation in future commissioning of Health Provision.
• To ensure Patients know how to contact the PPG by e-mail.

5. What the PPG does

• The PPG is both a communication channel between the Practice and the Patients and a practical group of hands-on volunteers to bring about continuous improvement. Ensuring Patients are aware of how to contact the PPG via e-mail and forward e-mails to the PPG.
• The PPG facilitates effective relationships between the Practice and Patients by communicating patient experience, feedback and suggestions for improvements. It also validates initiatives from the Practice around proposed procedures and new developments.
• The PPG works collaboratively and positively with the Practice to actively improve services and facilities for Patients and to act as a sounding board for the Practice on issues affecting Patients.
• The PPG builds two-way communication and co-operation between the Practice and Patients, other individuals and organisations in healthcare, and the wider community.
• The PPG acts as a representative group to support the Practice and influence local provision of health and social care.
• The PPG works with the Practice, in accordance with clauses 5.2.4 and 5.2.5 of the Standard General Medical Services Contract (2019) to ensure reasonable efforts are made to implement improvements which have been agreed between the Practice and the PPG.

6. Online Members Group

• The PPG may set up and operate an Online Members Group. Patients who would be interested in participating may register their interest and email address via the Practice.
• The Online Members may be contacted by the PPG periodically to disseminate news items, and to be asked to respond to questions or surveys in order to obtain views on specific matters.

7. PPG Structure and Membership

• The PPG shall normally not exceed 15 members. The PPG shall appoint individual members when needed, always ensuring that the PPG is as representative of the Patient community as is practicable.
• Any adult Patient, aged 18 or over, may apply to join the PPG and will become eligible to join as and when vacancies occur, or they may nominate themselves (or are nominated) at each AGM. Removal of a Patient from the Patient list means that he/she ceases to be a member of the PPG.
• The carer of a Patient is eligible to be a member of the PPG even if the carer is not a patient at the Practice.
• The PPG will normally meet at least quarterly. In the absence of any apologies or available explanation, any member not attending three consecutive quarterly meetings will be deemed to have retired from the PPG. Meetings are subject to a quorum of one more than half of the members of the PPG. The PPG will extend an invitation to the Practice to attend its meetings. The PPG will also extend an invitation to Patients and carers to attend meetings quarterly to give Patients sufficient opportunity to express issues and concerns with the Practice [and to benefit from presentations given by clinic and wellbeing experts].
• Minutes of meetings of the PPG will normally be circulated, once accepted as a true record, to the PPG members, the Online Members Group, the Practice website and displayed at the Practice surgeries. Confidential information shall be omitted from the minutes.
• Members of the PPG shall respect the confidentiality of any information provided that is not in the public domain.
• Members of the PPG must not use the PPG as a forum for pursuing individual personal complaints or agendas. Members of the PPG must not breach patient confidentiality which is of the utmost importance. Members of the PPG must treat everyone on the PPG fairly, equally and with respect.

8. Annual General Meeting and PPG Officers

• The Chair of the PPG shall convene the Annual General Meeting of the Patients which shall be open to all Patients and carers. The AGM will be held each year, normally in January, at which PPG members and officers may be elected by the Patients attending the. The date, venue and time shall be published at least one month prior to the meeting by means of a notice in the local media, in the surgery waiting rooms by text message, sent from the practice and on the Practice website.  Agenda, previous AGM minutes and any other documents required for the AGM will be available on the Practice website for Patients to access and/or download prior to the AGM, to allow appropriate time for reading and compiling any requested additions, amendments or nominations.
• Officers of the PPG may include Chair, Vice-Chair, Secretary, and if needed, an Education Lead and a Treasurer. Other posts may be created at the AGM on a proposal from the PPG.
• All PPG member and officer posts will be up for nominations and election at each AGM and the maximum terms for officers will be three years.
• Nominations for Officer posts which are vacant or where the Officer is no longer eligible for re-election shall be made and seconded in writing to the Chair or Secretary not less than 14 days before the AGM. Members and officers will be elected by an open vote at the AGM
• Alterations to these Terms of Reference must be proposed in writing to the Chair or Secretary not less than 14 days before the AGM and must be approved at the AGM. You may contact the PPG Chair or Secretary using our secure online form

Latest Committee Meeting Minutes

If you require a copy of older meeting minutes please contact us via our secure online form

November 2024

1. Present

• Elaine Hooper (EH), Marion Pitt (MP), Morag Roberts (MR), Paddy Jelen (PJ), Mark Davies (MD), Dr Gavin Cattigan (GC), Cathy Bridges (CB), Emma Wilson (EW), Bev Williams (BW), John Morphy Godber (JMG).

2. Apologies

Ishobel McNab, Alison Mann, Judith Juniper, Paul Matthews.

(Item 3.4 on the Agenda was brought forward to allow non committee members to leave afterwards. JMG said that unfortunately Keith Spurr of SHEAC could not attend. 

The case for the purchase of a FENO machine (previously shared) was put forward by CB. The cost could not be met from the NHS contract and so the surgery had asked SHEAC for £3000. FENO (Fractional Exhaled Nitric Oxide)  would greatly speed up the diagnostic process for respiratory conditions such as alergic asthma. There are waiting lists of 4 to 5 months for current tests which take an hour. There are nearly 3000 patients registered with appropriate conditions and the numbers are increasing rapidly.

The committee recommended the purchase and JMG will inform Keith Spurr.)

3. Previous Minutes and Actions

3.1. Do patients using a proxy for communication with the surgery need to repeatedly confirm this. EW said that once an initial formal request had been processed there was no need to re-confirm.

3.2. Some people receiving a letter saying they are “pre-diabetic” hear nothing further. GC said that a patient should be invited to take part in an education process about diabetes and then be added to the routine annual monitoring programme. The education programme would advise on possible life-style changes for the patient as well as genetic issues and then the annual monitoring would monitor any changes. 

3.3. EW said that the operations manager was looking at improving the signage for the assistance doorbell at St. Mary’s. If patients are having difficulty getting through the doors pressing the bell will bring a member of reception staff out to help.

3.4. Improving content on noticeboards and links to local services on the website. EW confirmed that both are in hand and a meeting re the website is scheduled for later in the week.

3.5. FAQ Document

• GC went through the draft headings and topics and the committee considered the content would be on the right lines and looked forward to seeing something in writing soon.
• GC outlined that there would be sections describing the Lakeside partnership and how it works and relates to services in Stamford. He said it was important to say that it is the GP partners in Stamford who run our surgery not people in Corby. He said the document would explain the different kinds of practitioners available and how medication reviews work and how to order medications and book appointments. He hoped it would answer many of the basic, everyday questions patients have and are sometimes puzzled or confused by, e.g. why paper blood test forms are still needed.
• JMG asked how existing patients could get the information. GC said the information would go on the website and be available at the surgeries. JMG said we should not forget people who do not use the internet or even visit the surgery. He suggested that a summary could be given at the PPG AGM.

3.6. Chairs at Reception for Frail/Elderly patients:

• EW said that bariatric and high back chairs had been ordered for both surgeries.   

3.7. Anima Categories Not Always Appropriate:

• GC said that the Hereward surgery in Bourne was using Anima for triage and that soon our surgery would be able to tailor questions to better suit patients with multiple issues to report. 
• All Lakeside group surgeries use versions of Anima. Accurix is also used in Bourne for total triage. The Hereward surgery has just introduced a general Anima form, and it was agreed we should monitor this.  This can be used by phone or completed at home online.  It was agreed that this use should be looked at for Stamford. 

Action: GC to examine the total triage option.

3.8. Flu clinics:

• EW said that both Paul and Judith had helped out and this had been received very positively by both patients and staff. JMG encouraged more of the same in future. 

3.9. Availability of Appointments Online (SystmOnline):

• EH had been monitoring availability at 8 a.m. and had found no appointments on several successive days. 
• Following the meeting EW reported that an issue had been identified causing appointments not to show up. This has been fixed.
•  JMG asked if in fact there may be a fundamental issue with a shortfall of clinician hours compared to demand. GC said three more GPs had been recruited and consequently two locums lost. 
• PJ asked why Hereward seemed to be doing so much better than Stamford. GC said that the new system had only just been introduced. Previously they had a process beginning with a telephone call with a doctor which could result in further appointments or treatments. In a total triage model, the process initially will determine what is needed and if appropriate book the patient with the most relevant clinician who may not be a doctor but may be able to resolve the issue more quickly as a specialist. 
•  In Stamford there is no triage. MD said that satisfaction levels seemed to be much better in Hereward. GC said that the patient survey conducted last year had shown that many patients most wanted just to be seen by a doctor and not first to have any kind of triage. MD said that Stamford’s number of appointments per thousand patients is 50%higher than the national average. However, the number of GPs per thousand was at the average level. He said that this seemed to indicate a much higher demand in Stamford which the practice was not meeting. PJ said she had asked the CEO of Lakeside for the number of available clinical and specific GP hours but had not had a response. She wondered how the practice could work out its recruitment policy without such data.
• GC said that the population demographics would vary significantly among practices. A more elderly demographic would result in higher demand and more referrals to secondary care. 
• GC said that he could investigate available clinician hours in greater detail to report to the AGM. The committee welcomed this.

Action: GC to analyse available hours and the comparison of patient satisfaction between the poorest and best performing surgeries in the Lakeside group.
JMG drew the discussion to a close saying that we would keep returning to the issue and that the more hard information we could offer to patients the better. He hoped that GC could consider a presentation at the AGM

3.9.1. Being More Assertive with Unreasonable Referrals from Secondary Care:
GC said that he had noticed fewer attempts to push issues onto primary care where hospitals should be taking responsibility themselves. However, this was still a minority of incidents, but pushbacks were being accepted by PCH who generate around 95% of referrals to Stamford.

4. Key Performance Indicators

• 4.1. Some members had not been able to review the spreadsheet put together by Mark. JMG said he very much wanted us to develop a focus on the main issues the PPG should monitor. Mark said that clinical performance seemed good and that wasn’t an area the PPG was qualified to judge. However, we do need to work on access to appointments without waiting for the annual NHS data. 
• GC said that the practice has monthly figures which break appointments into the type of clinician. JMG asked for these to be made directly available to the PPG.

Action: GC/EW to provide monthly figures on appointments
GC asked PPG members to seek comments from anybody they know in Bourne to see how the new arrangements are working from the patients’ perspectives. 

4.2. Funding the PPG

EW said there is no contractual provision for a set amount of money to be provided by the practice to the PPG. However, she confirmed that the surgery would continue to meet requests for support with meetings and events as well as printing and other associated admin costs. She asked JMG to put in a request for support for the new PPG email group.

• Action: JMG to ask for financial support for the email group.
• JMG asked if the PPG should undertake fundraising for equipment for the surgery. This would involve setting up formal processes including changing our status.
• On the whole there was some nervousness about our patients’ attitudes to fundraising for the practice. Fundraising for the PPG may be more acceptable. EW suggested seeing how members of the email group might respond to the notion. JMG could speak with other PPG chairs to ask for their experiences.

Action: JMG to seek thoughts from other PPG chairs and put the issue of fundraising onto an agenda in 2025.

• EW had asked for ideas from the committee about charities that the surgery might support instead of having a staff secret Santa. PJ had proposed “CRY”,  a charity for children and young people threatened with cardiac problems. PJ to send EW information.

5. PPG business

5.1. Relationship with SHEAC

• The committee supported the proposal that we should work closely with SHEAC with their taking the lead on identifying and organising health education events. There are plans so far for maybe four in 2025 beginning with one on addiction in February. JMG would liaise with Keith Spurr to consider how the relationship will work. 
• A proposal to invite JMG to become a trustee of SHEAC was thought possibly to create a conflict of interests andJMG will therefore not accept. 
• Various members commented on how good the recent event on end of life care had been and how well attended.
• MP said she would also be in close touch with Keith as she sees him most weeks.

5.2. Email Group

• JMG reported that the email group now has 120 members. 90 of whom had come after a piece in the Mercury and only 20 from the Stamford Diary. He was also building links with the ICB and with other PPGs. 

5.3. AGM and PPG Meeting Frequency 

• JMG said he had booked the Arts Centre ballroom for the AGM on 21 January. He has invited the ICB but is awaiting a decision. The committee generally supported the idea of meeting more frequently even without the surgery reps. JMG said he would try to arrange an extra meeting as soon as practical.
• Members asked for the email address to join the PPG group. It is “stamfordppg+subscribe@groups.io". JMG said that posts to the group just come to him for approval as he wished to use the group primarily as a source of useful information. He said he would like us to have some kind of social media presence.

John James Morphy Godber
December, 2024 

PPG: AGM

Annual General Meeting 2024 Minutes

• Date: 15 January 2024
• Time: 6.00 pm
• Location: Stamford Town Hall, St Mary’s Hill, Stamford, PE9 2DR

Attendees

• Julie Clarke - PPG Chair (JC)
• John Morphy Godber - PPG Vice-Chair (JMG)
• Elaine Hooper - PPG Committee Member (EH)
• Harrish Bisnauthsing - PPG Committee Member (HB)

Invited healthcare guests

• Dr Gavin Cattigan - GP Partner/Non-Executive Director, Lakeside Healthcare (DC)
• Jessica Bawden - CEO, Lakeside Healthcare (JB)
• Dr Kate Berry - GP Partner, Lakeside Healthcare
• Dr S Dronfield - GP Partner, Lakeside Healthcare
• Dr K Tizzard - GP Partner, Lakeside Healthcare
• Dr J Moon -  GP Partner, Lakeside Healthcare
• Teri White - Lakeside Hub Manager (TW)
• Caroline Freeman - Lakeside Healthcare Group Communications Officer (CF)

Apologies

• Liz Thompson PPG Committee Member (LT)
• Paul Matthews PPG Committee Member (LT)

Welcome and Introduction by the Chair (JC)

BP Welcomed patients and invited guests to the meeting.

Minutes of last AGM, held 31 January 2023

Minutes were distributed to all attendees, proposed as accepted and seconded by patient attendees.

Matters arising from last AGM

No matters arising

Chair’s Report

JC read her report, reflecting on the past year. Although there is work still to be done, the improvement in performance, patient engagement and the work carried out to address issues raised in the previous year’s poor CQC rating was extremely welcome. JC listed some of the improvements made, where the practice had consulted with the PPG, listened and made changes. These included staggering appointments, so those who are unable to call at 8am, through work or family commitments, can now call or login as further appointments are released throughout the day; an improved online service, which is more user-friendly for patients and an increase in pharmacy staff. The practice has also increased its GP numbers by four. JC said practices throughout the UK are suffering the effects of reduced numbers of GPs and that, while patients must accept that pre-Covid levels would not return, there are positive steps in place. The practice currently has above-UK average appointments per 1,000 patients and its new software system will be able to direct patients who do not need to see a GP, but who still require treatment by another clinician or practitioner, can now be given an appointment directly with that service. She reminded patients that the PPG has an email address and a direct phone line and regular drop-in sessions are held at both surgeries. She urged patients to use these to let the PPG know about issues, which they will then feed back to the practice. JC then announced that she was stepping down as Chair of the PPG, since she is leaving the area and said that she hoped her Vice-Chair, John Morphy Godber would take up the position.

Address to the meeting by JB

JB made a presentation, aided by slides which had been provided in hard copy for attendees and offered a question and answer session afterwards. The slides gave an overview of:

• The workforce, including GPs, Nurses, Dispensary and Practice management. A breakdown of appointments in the past year, including face-to-face, telephone, home visits and video.
• Figures on the overview of the local and national picture, focusing on Lincolnshire GPs
• GP Recruitment
• An update on what the practice is doing to address the issues identified in the recent Care
• Profiles of the different roles within the Practice (with photos), including Emergency Care Practitioner, Physiotherapist, Social Prescriber, Practice Nurse and Pharmacy Technician.

A copy of the presentation has been made available at the surgery and patients can request a copy.

JB and GC then took questions from the floor

PPG Committee Terms of Reference (TOR)

Proposed new TORs, replacing those adopted in January 2023 were discussed and amendments were proposed. A vote was held and the TORs, including amendments were accepted. The new TORs will be signed off at the next committee meeting by the PPG Committee Chair and the Practice.

Votes on nominations for existing committee members and proposed new members

The Chair asked that the existing committee members, who had expressed a wish to remain on the committee be voted in. This was agreed.

Election of Officers

JC Proposed JMG to take the place of Chair and this was seconded by EH and JMG was duly voted in as Chair of the PPG.

Questions for the PPG

The committee took questions from the floor, although some were addressed to the Practice. A number of patients thanked the PPG Committee for their work and said that they were happy to see the improvement in service and communications between the practice and the PPG.

JB expressed her thanks to JC for the work she had done with the PPG and wished her well in her future endeavours.

AOB

JC said that the AGM had traditionally been held in January. This may not ideal, in terms of weather and dark evenings, so invited patients to let her know, by show of hands, if they would like to change the date to spring or summer. There was no appetite for a change and so it was determined that the AGM should remain for January 2025.