1. Introduction and Apologies

The meeting opened with a brief introduction and apologies noted, including RC temporary step-down. There were no urgent matters arising from the previous minutes except for ongoing demographic discussions, which were not deemed immediate concerns.

2. Review of Previous Meeting Minutes 

The previous minutes were considered detailed and comprehensive, with no significant issues raised. Some items from the agenda had been discussed at length during the pre-meeting, with positive feedback on various action points. A noteworthy comment came from a recently arrived trainee who highlighted the exceptional quality of the reception staff and their support to GPs, a perspective not previously emphasised, which was appreciated.

3. Open Meeting Reflection 

The recent open meeting was viewed as a valuable learning experience. The event featured two external online speakers, added to the technical challenges of using unfamiliar equipment somewhat hindered smooth interaction. Attendance was, however very strong, and the meeting was seen as more inclusive due to the venue size, allowing all interested parties to participate. Comparisons were made to a similar meeting in Adelaide, which had low turnout despite advertising, underscoring the relative success of this practice’s event. The possibility of using the same venue again was raised, though booking challenges and bureaucratic obstacles were noted. Improvements for future meetings include troubleshooting technical issues such as microphone and speaker quality to foster better audience interaction.

Plans were discussed to organise a visit for members to the Maggie’s Centre, recognising the potential beneficial opportunities it offers cancer patients and the potential to raise awareness of these.

4. Patient Complaints and Feedback

Some increase in complaints had been observed since the start of the year, possibly reflecting wider societal frustrations including cost of living pressures and NHS system challenges. Some complaints were not of significant substance and some related to wider systemic issues rather than individual practitioner performance, although some instances indicated lapses in empathy or communication from staff.

There was no pattern in complaints and repeat medication and appointment issues were not significant this year. The practice plans to conduct another comprehensive complaint analysis by the end of March to monitor trends.

5. NHS Patient Charter Introduction

The government is introducing a new NHS Patient Charter from October, outlining what patients can expect from general practice and what is expected of patients. The practice largely already meets these standards, though it will extend online consultation hours by 1.5 hours (from 5 pm to 6:30 pm) to comply. NHS England » Practice guidelines – you and your general practice

There is some concern that publicising the charter may raise patient expectations further, but overall it aims to standardise access and service levels across practices nationally. The charter must be displayed on practice websites by October 1st.

6. Practice Protected Learning Time

Historically, the practice has undertaken training on the last Thursday of each month for team learning and education which is highly valued for team morale and communication. We are committed to finding a way to continue this much valued and impactful training time within the remit of the new contract. The PPG members expressed strong support for this approach.

7. Patient Participation Group (PPG) Newsletter and Communication

The group discussed launching a PPG newsletter to increase patient engagement and transparency. An edited version of meeting minutes and practice updates (e.g., launch of social media accounts like Instagram) could be featured and disseminated via email and the practice website.

Challenges discussed included ensuring easy website access to the newsletter and PPG page, and creating a patient feedback mechanism via a monitored email or comments box. Concerns were raised about data protection, managing email volume, and the

need for disclaimers about the non-urgent nature of email communication. A comment box as opposed to direct email was favoured for ease of moderation. The existing featured email should probably be removed from the website.

The newsletter was proposed to follow the PPG meetings providing a sustainable communication channel with patients, showcasing practice developments and offering a forum for patient voice. Volunteers for a working group may be stood up to take this forward.

8. Staffing Updates and Partnership Changes

Staffing changes were announced: Dr Tom Aslan would be leaving the practice at the end of the month. The practice conducted internal interviews for partnership positions, with promising candidates identified but no formal announcements made yet. Maintaining practice ethos and culture was emphasised as critical in selecting new partners.

New staff members introduced include Tigist (receptionist), Sandra (data team), Emily (care coordinator), and Jenny (healthcare assistant). The practice continues to update staff photos and information on notice boards for patient awareness.

9. Premises and Facilities Update

Premises issues remain a concern. The Roy Shaw meeting room is currently unusable due to asbestos concerns, with conflicting survey reports about the severity of the hazard. Plumbing problems in shared rooms with mobile sinks limit usability, making it unsuitable for busy clinics.

There is uncertainty over future plans for the building, with significant refurbishment costs (estimated £8-9 million) and no guaranteed funding due to ICB budget cuts and wider NHS reorganisation. The practice is the smallest neighbourhood area in North Central London and is not in an area of high deprivation, potentially reducing its priority for capital investment.

The practice expressed reluctance to take on legal and financial liabilities associated with the building’s condition. Meanwhile, use of the facility is limited to low-intensity activities like training and teaching. The practice lease is due for renewal in May 2026, but no plans for relocation are imminent. Meetings with Royal Free regarding extending the lease are underway.

10. Appointment and Patient Access Trends

It was asked if the waiting room was quieter than pre-COVID times, reflecting increased use of online consultations. Locally, the practice is delivering more appointments than before the pandemic, in a mixed model of face-to-face and virtual contacts. How busy the waiting room seems probably depends on when one is there.

Patient access and appointment management remain key priorities, with ongoing adjustments to meet demand.

11. Primary Care Networks (PCN) and Neighbourhood Working

The distinction between PCNs and neighbourhood models was discussed. PCNs are groups of practices working together on clinical care, particularly for chronic conditions and diagnostics, and have been established for several years.

Neighbourhood working is a newer, broader concept aiming to integrate healthcare with social care, mental health, housing, and education services for geographically defined populations of 50,000 or more. Camden’s PCN and neighbourhood geography is complex and somewhat fragmented, leading to logistical challenges.

The practice is part of the North neighbourhood, but it is itself located in the East neighbourhood along with many of its patients. This may in future complicate resource allocation and funding, which may be increasingly neighbourhood-based, raising concerns about future financial sustainability and service delivery.

Communication gaps between neighbourhood teams and practices outside of neighbourhoods have been noted, particularly in East Camden where co-location and pilot of neighbourhood services is better established.

The practice is engaging with national stakeholders to raise these issues and explore solutions, emphasising the need for alignment between patient residence and practice neighbourhood to ensure equitable care.

12. Leadership Succession Planning

The group discussed appointing a deputy chair to support the current chair (David), particularly during absences and to aid succession planning. Expressions of interest will be sought, with the partners to review candidates.

This proactive approach aims to distribute leadership responsibilities and ensure continuity.

13. Resource Support and Digital Inclusion

Efforts to promote the NHS app and digital services were reviewed. Although usage is increasing, it remains under 50%, with many patients unaware or unable to use digital tools effectively.

The practice plans targeted communication campaigns, including text messages and webinars, to educate patients on app benefits such as access to records, test results, and medication management.

There was discussion about whether PPG members could assist patients, especially older or digitally excluded individuals, with app usage in waiting areas.

14. Clinical Staff and Physician Assistants (PAs)

The practice currently employs three Physician Assistants (PAs'), who are highly valued and well-supervised. Their clinical work is of a high standard.

Recent national discussions about changing PA’s job titles and scope have caused uncertainty and stress among these staff members and we have been looking at how we make adjustments in light of this and support them in their ongoing roles. The PPG members reiterated their strong support for the work of our PAs.

15. Patient Information and Communication Boards

The practice has updated patient information boards throughout the premises, ensuring relevant and accessible information is displayed. No significant issues were raised.

16. Closing Remarks

The meeting concluded with thanks to attendees for managing a long agenda and a commitment to secure a larger room for future meetings to accommodate all participants comfortably.

 

Key Insights and Themes

· Patient-centred care remains a core focus, with innovations in communication and feedback mechanisms being actively pursued.

· The challenges of premises and infrastructure highlight the difficulties faced.

· Neighbourhood working and PCNs represent evolving models for integrated care but present complexity in geography, funding, and operational logistics.

· The practice is proactive in succession planning and staff development, ensuring sustainability and maintenance of culture.

· Digital transformation is advancing but requires ongoing efforts to support patient engagement and inclusion.

· Clinical governance and safety are prioritised with oversight of physician assistants and other staff roles.

· The introduction of the NHS Patient Charter will formalise service standards but is unlikely to disrupt current practice operations significantly.