Latest Patient Board Meeting Minutes

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Wednesday 9th of October 2024

Full meeting minutes are available upon request, this is a summary of the discussions.

Update on Services

The surgery had their first 2024 flu vaccine clinic (co-administration of Covid-19) on the 5th of October for those aged 65 and over. Some of the Board members attended and commented that it ran efficiently. This coming Saturday (the 12th of October) those under the age of 65 in clinical at-risk groups will be offered the vaccine in the morning and those over the age of 65 in the afternoon. Mop-up clinics are available throughout October and November. 

The funds the surgery receives for the Covid-19 vaccine have been reduced (from £10.06 to £7.54 per vaccine), despite Covid-19 being a complex vaccine to administer as it requires inputting on a separate clinical system and it needs to be drawn-up. The flu funding has remained at £10.06. this may mean the surgery is not able to offer this service in future seasons, as it is not viable if the funding remains as it is. Some surgeries elsewhere in the country have already ceased to offer the Covid-19 vaccine to their patients for similar reasons. 

While alternative providers are offering the Covid-19 vaccine through walk-in centres, it raises the question as to how those who are housebound or in a care homes will obtain the vaccine. The surgery currently proactively visits these patients. Again, the current funding does not support us to continue doing this.   The partners feel a strong moral obligation to its patients and is hopefully changes will be made ahead of the next season but we cannot assume it will continue.   

The respiratory syncytial vaccine (RSV) vaccine is being offered to those aged 75 – 79 years of age. The flu campaign was delayed until October this year, but the vaccines were delivered by the manufacturers in September.  This meant that the vaccine had to be stored for a month before use. Consequently, due to fridge capacity, the surgery has not been able to offer all eligible patients the RSV vaccine straight-away. However, the campaign runs until August 2025 and we will ensure that all those eligible will have the opportunity to receive the vaccine.

Transport

Last month Councillors on the Council’s Transport and Connectivity Committee voted by 5 to 4 against the proposed car park charges, including that adjacent to the PCC, on Westbury Hill. Bristol City Council had received a huge public response to the proposed charges prior to this meeting. Of a total of 67 written statements of which 56 of these related to the Westbury-on-Trym car park site, all but one opposed to the proposed charges. Of the 67 responses 70% of them mentioned the surgery. Tony noted the comments below should the topic arise again:

• 30 minutes free parking has been suggested in some of the statements, but this does not support patients to attend the surgery. The PCC has always collectively agreed that an hour would be required as a minimum.
• Some patients may be deterred from attending consultations if the parking comes at a cost. This could be stressed as a concern in any future public submissions
• WoTSoc (Westbury-on-Trym Society) noted in its statement that the PCC had paid for car park layout originally and this may strengthen our case for arguing against any proposed changes.

The informal local transport group which is looking at WoT traffic issues more widely is reviewing whether and how the layout of the car park could be improved to remove the current hazard of blocking traffic building up at its entrance, spilling onto Westbury Hill. Vehicular access to the PCC should be improved as a result. 

The same local group is currently revising its Discussion Paper of suggestions for a range of improvements in traffic and transport locally, in the light of the expected traffic growth on the A4018.

Councillor (Lib Dems) added that the Green Party would try to reintroduce and force this charging proposal were they to be re-elected with an overall majority.  The Lib Dems had suggested that offering 1-2 hours free car parking could be considered as a compromise, but the Green Party did not agree to this.  So, this issue could potentially return in 4 years and is one for us to keep under review. 

The Board requested that our gratitude to the two board members who have kept us all updated, their support and updates to the Board have been invaluable.

Digital Inclusion

The surgery have now hosted three Digital Inclusion workshops and the last one in September went well. We agreed that some patients would still prefer to use the telephone to contact our services! 

We are working towards a coffee morning in November to provide patients with wider information about our services. We will also provide information about the digital services available. November the 12th 10:30am to 11:30am. Our Group Room has limited capacity so it will be a small-scale event initially. 

GP Collective Action

Dr Eachus summarised that collective action means that the majority of practices are taking steps as advised by the LMC (Local Medical Committee of the BMA). This can be challenging as we all have different demographics within our Locality and one size does not fit all.  

Dr Eachus explained that this action is not a strike and it is not about pay or anything to do with the earlier junior doctor strike.  It is being undertaken to protect patient safety, protect the general practice workforce and to address the increase in Primary Care workload that has happened at the same time as funding has been eroded.  

The actions that the LMC have recommended that we undertake are: 

Sept/October: review our appointments structure to ensure that we can undertake care within safe working limits. We want our clinicians to have a safe workload, both for patient safety and to avoid clinician burnout.

November: try to reduce practice bureaucracy by being able to use a single referral template for all providers. 

January 25: stop taking over prescribing of specialist medication that have been started in outpatients and that require complex follow up and monitoring, without adequate funding. 
Also stop monitoring of high-risk hospital patients, such as those with eating disorders or bariatric surgery, where there is no funding to support staff and time to do this work. 

The surgery remains hopefully that things will change with the new government. Agreed we will not change our wording on our website relating to collective action, at this time, as we do not want to cause any alarm or worry. The back-office teams also need to be considered and whilst we want to safeguard our GPs, any action taken will be to safeguard the entire practice team and our patients. 

Surgery Website

Board fed back that it is clear and much more user friendly then it used to be. Noted that there is a page relating to important dates and this need updating. 

Charity

Whilst this is not something the surgery is considering, some surgeries across the country, have set-up a practice charity to support equipment costs where the contract does not support them.  For example, to purchase waiting room chairs.  This does not sit comfortably with the partners as patients already contribute to the running costs of the NHS through taxes. Nevertheless, some surgeries have felt they have needed to do this to support the funding shortage in Primary Care. 

Most of the board were strongly opposed to this although some commented that schools have been doing similar things for some time to i.e. raise funds for playground equipment.  A few also said it would be worth discussion if it came to it.   The surgery reiterated that it is not considering this, but we wanted to raise it with the board as some sites have set-up successful charities. Whilst it does not sit comfortably with the partners we also wanted to consider any opinion the board had which may have differed. It was confirmed that this will not be pursued at this time.

AOB

The patient newsletter created by the Board has received warm feedback from those attending our vaccine clinics. 

Imaging is now at Cribbs Causeway for most patients rather than Southmead.  It was agreed that this could be added as a next Newsletter item, so patients are aware of the change.

The Patient Board will next meet on 15th January 2025 at 1pm to 2pm.