Stalbridge Surgery
Patient Participation Group
Thursday 20th August 2015
The Health of Stalbridge Surgery
 Welcome
 Reasons for tonight
 Introduction of the Patient Participation Group
 Presentation on “The Health of the Stalbridge
Surgery”
The Health of Stalbridge Surgery
Who
David Gray
Representing
COPD
Rosemary Keen
Diabetics
Long term conditions
Merrill Halstead
Warfarin
Lucy Hart
Infants
Parents with children in Stalbridge
Amanda Pugh
Adults of Henstridge
John Foster Pegg
Over 65’S of Stalbridge
Angela Goss
Stalbridge and the close
Parents with children in Henstridge
Doreen Beaney
Ischaemic Heart Disease
Young adults
Marnhull
The Health of Stalbridge Surgery
 Patient Participation Group (PPG) Aims: Your views on improving the surgery
 Communication with the surgery
 Influencing future change
 Organising health promotion events
The Health of Stalbridge Surgery
 Our practice population is 4478 (18th August 2015)
450
400
350
300
250
Total
Males
200
Females
150
100
50
0
00-09
10-19
20-29
30-39
40-49
50-59
Age
60-69
70-79
80-89
90-99
100+
The Health of Stalbridge Surgery
 Patients aged 45-64 years = 30% (national 25% CCG 27%
 Patients aged 65 – 74 years = 16% (national 9% CCG 12%)
 Patients aged 75-84 years = 9% (national 5% and CCG 8%)
 Patients aged 84 years + = 3% (national 2% CCG 4%)
The Health of Stalbridge Surgery
 We are a dispensing practice, dispensing to 2001 or
45% of our population
 2169 Patients on any repeat medication = 49%
 955 on 4 or more repeat medication = 21%
 Repeat medication reviews every 6 months
The Health of Stalbridge Surgery
Name
Patient Count
%
Last Run
Baseline Date
02-Jun-2015
02-Jun-2015
2270
51% 02-Jun-2015
02-Jun-2015
Patients with 1 Medication course
525
12% 02-Jun-2015
02-Jun-2015
Patients with 2 Medication courses
384
9% 02-Jun-2015
02-Jun-2015
Patients with 3 Medication courses
287
6% 02-Jun-2015
02-Jun-2015
Patients with 4 Medication courses
224
5% 02-Jun-2015
02-Jun-2015
Patients with 5 Medication courses
202
5% 02-Jun-2015
02-Jun-2015
Patients with 6 Medication courses
146
3% 02-Jun-2015
02-Jun-2015
Patients with 7 Medication courses
101
2% 02-Jun-2015
02-Jun-2015
Patients with 8 Medication courses
103
2% 02-Jun-2015
02-Jun-2015
Patients with 9 Medication courses
57
1% 02-Jun-2015
02-Jun-2015
Patients with 10 Medication courses
55
1% 02-Jun-2015
02-Jun-2015
Patients with 11-15 Medication courses
84
2% 02-Jun-2015
02-Jun-2015
Patients with 16-20 Medication courses
9
1% 02-Jun-2015
02-Jun-2015
Patients with 21-25 Medication courses
2
1% 02-Jun-2015
02-Jun-2015
Patients with 26-30 Medication courses
0
0% 02-Jun-2015
02-Jun-2015
Patients with 31+ Medication courses
0
0% 02-Jun-2015
02-Jun-2015
Breakdown by age
Patients who have No Medication courses
The Health of Stalbridge Surgery
Budget
Year to date expenditure
Cumulative
Spend
(14/15)
(£)
Allocation 14/15
(£)
NHS BSA
in year
discrepanc
ies
Adjusted
Cumulative
Spend
(14/15)
(£)
Forecast Outturn
Cumulative
Spend
(13/14)
(£)
Variance;
cumulative
spend for
2013/14 to
2014/15
(%)
Forecast Outturn 14/15
(£)
2014/15 Under (-)
/ Over (+) Spend
(£)
2014/15 Under
(-) / Over (+)
Spend
(%)
730,374
762,599
0
762,599
736,108
3.60%
762,599
32,225
4.41%
2,099,971
2,183,438
2,561
2,186,000
2,167,148
0.87%
2,186,000
86,029
4.10%
833,032
854,513
2,894
857,407
824,846
3.95%
857,407
24,375
2.93%
1,871,619
1,869,227
0
1,869,227
1,849,466
1.07%
1,869,227
-2,392
-0.13%
1,577,879
1,750,758
-17,219
1,733,539
1,605,718
7.96%
1,733,539
155,660
9.87%
735,330
715,453
-30,681
684,772
724,341
-5.46%
684,772
-50,558
-6.88%
632,187
635,386
0
635,386
625,701
1.55%
635,386
1,036,006
919,658
2,115
921,773
887,917
3.81%
921,773
-114,233
-11.03%
494,102
464,290
1,100
465,391
414,593
12.25%
465,391
-28,711
-5.81%
1,192,580
1,176,954
0
1,176,954
1,089,407
8.04%
1,176,954
-15,626
-1.31%
11,203,080
11,332,277
-39,229
11,293,048
10,925,245
3.37%
11,293,048
89,968
0.80%
3,199 0.51%
The Health of Stalbridge Surgery
 Stalbridge Surgery Staff
 Clinical Team
 Practice Manager
 Dispensary Team
 Reception Team
 Administration Team
 Attached / Visiting health professionals
The Health of Stalbridge Surgery
 Clinical Team
 General Practitioner - Dr Stephen Clayton
 Nurse Practitioner – Louise Moore
 Nurse Practitioner – Gill Cook
 Emergency Care Practitioner – Wayne Callow
 Practice Nurse – Sue Kinver
 Practice Nurse – Mandy Hogg
 Health Care Assistant – Tina Male
 Health Care Assistant – Claire Bentley
 Trainee Health Care Assistant – Alex Hill
 Dispensary Manager – Cheryl Tate
The Health of Stalbridge Surgery
 Dr Stephen Clayton
 Full time GP since 1992
Date
Education/Development
2015
3 month course in Dermoscopy, Cardiff university
2015
Practical Palliative Care for Prescribers and GP’s, Teesside
University, year long course
2014
GSF RCGP Quality Hallmark Award in End of Life Care
2013
Postgraduate Diploma in Practical Dermatology, Cardiff
University, year long course
2010
Palliative Medicine Course, Cardiff University
2009
PHTLS (pre-hospital trauma and life support)
2006/7/8/9/10/12/14
Immediate Life Support
2000/2012
Advanced Trauma + Life Support
The Health of Stalbridge Surgery
 Advanced Nurse Practitioner and Emergency Care
Practitioner role
 working independently within professional boundaries,
providing care for patients from initial history taking,
 clinical assessment,
 diagnosis,
 treatment,
 prescribing,
 appropriate referral,
 follow up and evaluation of care
Patients are seen both in surgery and at home, either routine
home visits or as emergencies
The Health of Stalbridge Surgery
 Advanced Nurse Practitioner – Louise Moore
 BSc (Hons) Nurse Practitioner 2004
Advanced Nurse Practitioner
2004 - present
Practice Nurse, Stalbridge Surgery
1994-2004
The Health of Stalbridge Surgery
 Advanced Nurse Practitioner – Gill Cook
 BSc (Hons) Nurse Practitioner 2009
Advanced Nurse Practitioner
January 2009 – present
Practice Nurse, Stalbridge Surgery
2004-2009
The Health of Stalbridge Surgery
• Emergency Care Practitioner – Wayne Callow
 2008-2010, BSc (Hons) Emergency & Urgent Care Practice,
Bournemouth University
 2007, IHCD Paramedic, SWAST
 2013 to current, Emergency Practitioner, Stalbridge Surgery
 2013 to current, Emergency Practitioner, Yeovil District Hospital
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Member of the Emergency Department team skilled in the assessment,
diagnosis and treatment of ailments and injuries both minor and major.
Leadership role within evolving Ambulatory Emergency Care team, part
of a national initiative finding new ways to manage patients safely whilst
avoiding hospital admission. Engaged with projects to establish and
develop team, liaison with hospital specialties.
The Health of Stalbridge Surgery
• Practice Nurse – Sue Kinver
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Commenced work at Stalbridge 2008
2015 Diploma in Diabetes
2012 Minor illness and injury 4 day course
2012 4 day course – Cardiovascular disease
The Health of Stalbridge Surgery
• Practice Nurse – Mandy Hogg
 2011 – Present Practice Nurse, Stalbridge Surgery
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Leg ulcer management and all aspects of wound healing
Doppler assessment - applying all levels of compression
bandaging if appropriate
COPD (dip) including education - ensuring and maintaining
quality of life.
Telehealth for COPD patients – triaging data and treat if needed.
Asthma (dip) including education - ensuring that good asthma
control is achieved.
The Health of Stalbridge Surgery
• Health Care Assistant – Tina Male
 April 2006 until present
 NCFE Level 2 Certificate in Nutrition and Health - November 2014
 Diabetes Primary Care Study day - September 2014
 Foundation in Diabetes March 2014
 Diabetic foot Problems – June 2013
 Basic wound care Study day for HCA and 4 credits, level 3 September, 2012
 Full NCSCT Certification as a Smoking Cessation Practitioner – June 2012
The Health of Stalbridge Surgery
• Health Care Assistant – Claire Bentley
 Joined Stalbridge January 2013 as trainee phlebotomist
 August 2013 – Phlebotomist
 January 2014 – commenced Level 3 Diploma in Health and Social Care

Throughout 2014 attended external courses for training on

ECG’s, immunisation, smoke stop, health check training, skills training for HCA’s
 September 2014 – over 75 assessment protocol
 July 2015 Completed Level 3 Diploma in Health and Social Care Social Care
 September 2015 – Wound management course
 2015 – Bereavement training, Weldmar Hospice, Dorchester
 2015 – QCF Level 3 Award in End of Life Care, Weldmar Hospice ,
Dorchester
The Health of Stalbridge Surgery
• Dispensary Manager – Cheryl Tate

Dec 2007- present
•
•
•
•
•
•
•
•
•
National pharmaceutical Diploma 1996
Registered technician GPhc 2005
Accredited Checking Technician 2005
PCT competency cert level2 in medication reviews 2006
Registered expert witness, NVQ assessor and modulator 2011
Drugs use management award (DRUMS) 2012
Monthly CPD clinical pharmacy and therapeutic assessments via Centre for
postgraduate education assessed by GPhc
Oversight of the provision of pharmaceutical service from the
practice dispensary
Conduct patient medication reviews
The Health of Stalbridge Surgery
 Practice Manager – Karen Piggin
 Started at Stalbridge April 2014
 Administration Team
 Chris Woodrow
 Penny Hill
 Reception Team
 Gill Ferrari
 Jackie Alford
 Debra Hancock
The Health of Stalbridge Surgery
 Dispensary Staff
 Dispensary Manager - Chery Tate
 Senior Dispenser – Dani Kingston
 Dispenser – Lyn Carpenter
 Trainee Dispenser – Gill Ferrari
The Health of Stalbridge Surgery
 Attached/Visiting Staff
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District Nurse Team
Community Matron
Health Visiting Team
Physiotherapist
Midwifery Team
Chiropody Team
Community Specialist Palliative Care Nurse
Chiropractor
Improving access to Psychological Therapies
Elderly Care CMHT
Community Alcohol and Drug Advisory Service
The Health of Stalbridge Surgery
 Practice Meetings
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Clinical team meeting every Wednesday 2-3pm
Whole practice meetings last Wednesday of the month 12:3013:00
Gold Standard Framework meeting last Wednesday of the
month 2-3pm – clinical team and attached staff
PHCT meeting last Thursday of the month 1-2pm
Quarterly educational day – whole clinical team
Protected Learning Time – quarterly - whole practice
Locality Meetings – monthly – Dr Clayton, PM Karen
The Health of Stalbridge Surgery
 One residential home for the elderly – 30 residents – The Old
Rectory
 Monthly ward rounds
 Quarterly EoLC register update
 One residential home for learning disabilities – 8 beds –
Sandhills
 Monthly ward rounds
 Quarterly EoLC register update
 One residential home for learning disabilities – 4 beds –
Hillcrest
 Monthly ward round
The Health of Stalbridge Surgery

Access to our clinical team
 Our passion is access, we see it as the key to the doorway
of our general medical services
 To this aim we have forged a multi-disciplinary approach
to primary care
The Health of Stalbridge Surgery
 See LMC documentation 24/2/15: This week the GPC of Northern Ireland published some workload data which I
am sure you will be interested in.
 This looks at data for 2013/4 compared to 2003/4: 1. Consultation rate: 6.6/patient/year - increased by 63%
 All in house staff available online – NO RESTRICTIONS
 We have facilitated online appointments for many years, by a bespoke
system initially!
 www.stalbridgesurgery.co.uk
 When our website first went online back in 2004 we had around 20 website
visitors per day
 Over and above the growing number of our patients that access the EMIS
service directly (for repeat prescriptions and online appointment booking) we
are pleased to report that our own website now receives in excess of 1700 visits
each month.
 September 13th 2014 to October 13th 2014 – 1760 visits
The Health of Stalbridge Surgery
 Total number of appointments = 38,152
 = 8.55 consultations available per registered
patient
The Health of Stalbridge Surgery
 No figures pre April 2013 when we remodelled following a
GP partner leaving
 Changes
 Additional Phlebotomist > HCA
 Additional trainee HCA
 Additional ECP
 Additional PN day
 Dispensary Manager > treatment reviews
 Open every Saturday morning
 Flexibility on early mornings for example
The Health of Stalbridge Surgery
 In addition it is Dr Clayton’s pledge that he will see
patients on the day till they stop telephoning for an
appointment!
 “Any patient that feels they need to be seen on the day will
be seen on the day. We stay for as long as the patients need
us. I wouldn’t be able to sleep if I thought somebody
needed us but we were unable to offer them an
appointment.” Jackie Alford, Receptionist
The Health of Stalbridge Surgery
 Emergency admissions
 Reduction of all emergency admissions by 47.7% 2014
 Reduction of 57.8% those with 4 or more emergency
admissions 2013 > 2014
The Health of Stalbridge Surgery
 Over 75’s
 ED Attendances over 75’s decreased by 1.9% 2014
 Emergency admissions over 75’s reduced by 27.7%
The Health of Stalbridge Surgery
 Long Term Conditions
Coronary Heart Disease
190
4%
Heart Failure
75
2%
Stroke/TIA
104
2%
Hypertension
818
18%
Diabetes
267
6%
COPD
145
3%
Asthma
287
6%
Epilepsy
22
1%
Cancer
157
4%
Impaired Glucose Tolerance
104
2%
The Health of Stalbridge Surgery
The Health of Stalbridge Surgery
 Friends and Family Test comments January 2015
 Excellent service. We are very lucky to have you all at the surgery to look
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after us”
“Excellent service at all times”
“Friendly and reassuring staff. It’s always a pleasure visiting Stalbridge
Surgery”
“Stalbridge Surgery has come up to my highest expectations. Major or
minor issues have been treated kindly and quickly. I have always felt safe in
their hands”
“All staff are very friendly and helpful”
“Prompt action if I need it
kind and considerate. Will always listen
We have just moved into the area. The appointment system (and
technology) is wonderful compared to last practice
The Health of Stalbridge Surgery
Question
Response 2012
Response 2014
How welcome and relaxed did the 90%
doctor make you feel?
89%
Average colleagues
response 2014
89%
How much did the doctor involve
you in decisions during the
consultation?
Did you feel the doctor listened to
you?
Did you feel confident that the
doctor’s clinical knowledge was
good?
Did you feel confident about the
doctor’s assessment?
90%
92%
91%
91%
90%
92%
94%
94%
94%
92%
91%
90%
Did you feel the doctor addressed
all of your concerns?
91%
89%
Are you clear about what will
happen next?
Do you know what to do if your
condition gets worse?
89%
88%
90%
86%
How good do you feel the doctor
was at caring for you?
89%
90%
How easy did you find it to
91%
understand what this doctor was
telling you?
How confident are you that this
90%
doctor will keep information
about you confidential?
How confident are you that this
91%
doctor is honest and trustworthy?
89%
90%
94%
93%
93%
93%
The Health of Stalbridge Surgery
National GP Survey – Dorset Practices
The Health of Stalbridge Surgery
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