Re-Launch Petition 'IMPROVE GP ACCESS ACROSS PEMBROKESHIRE'

Disappointing Response EHRC

Response from HDUHB

Received today

Dear Mr Shutt   I have been asked to make contact with you by our Corporate Office to obtain your consent to share your emails with the Practice, a consent form is attached to this email. I would be grateful please if you could the form and return to the free postal address – Freepost Feedback @ Hywel Dda. A stamp is not required for your convenience. Alternatively, it can be scanned and sent to hdhb.patientsupportservices@wales.nhs.uk.   In the meantime, if you have any queries, or if you have any special requirements such as language, hearing or sight needs, please contact the Patient Support Contact Centre on 0300 0200 159 or at the above email address.   Kind regards Emma   Patient Support Co-ordinator/Cydlynydd Gwasanaethau Cymorth i Gleifion

My Reply to HDHB Dear Emma Thank you for your email, the Practice has received copies of my complaint and in fact, I recently met with them. I believe HDUHB has the responsibility for commissioning GP Services in the Pembroke Dock and Pembroke districts. So, in effect the complaint is as much about HDUHB's failure to do just that.  The system isn't working;  It fails to meet the Access Standard Wales,  It fails to meet the needs of several groups with Protective Characteristics and therefore is in my opinion Institutionally Discriminatory. I believe as a Public Sector Body that you have specific duties under the Equalities Act.  I would expect you to investigate the information that I have provided on behalf of the 255 Signatories of the Petition. The consent form that you have sent me authorising you to contact the surgery on my behalf and granting access to my Medical Records is totally inappropriate in this instance.  Please accept this email as my Written Authority to contact the Surgery during your investigations.

Forward

Hi I wish to thank you all for your comments and support. I am not closing the petition just yet. I would value your opinions on this question.

In the forthcoming General Election with the votes split in so so many ways do you think that an Parliamentary Candidate campaigning on a single issue

'Save and Support the NHS'  would get your vote.

I witnessed a similar and succesful campaign in the Wyre Forest and for those of you who can remember Martin Bell (The man in white suit) stood against 'sleaze' Cash for Questions.

They would still have routine Constituent Duties. In Parliament they can push for services in our 2 constituencies. Vote on improving the NHS particuarly local services and trade votes

The two incumbent Tory MP's are unlikely to get back in, only by default because the opposition parties are incompatible with each other.

I think people would be united around cherishing our NHS

Meeting with AMG

At the invitation of the Argyle Medical Group (AMG), I recently met with the Chair of the Patient Participation Group (PPG), The Practice Manager and two of her team, they are truly a team.

It was as I expected, made clear early on in the meeting questions regarding funding of AMG were off the table. I stated that they provide a public service paid for with public funds and that I thought differently.

The meeting wasn’t entirely harmonious, but it was candid, open and sometimes emotional. There were points of disagreement but we concentrated on the common ground.

E- Consult this has previously been piloted using only the Adminastration facility. It wasn’t successful from AMG’s perspective and there are no plans to implement the full system.

Positive outcomes:

A new Doctor is starting in the Autumn

AMG agreed they could improve communication principally via their website. I suggested they inform Patients of their successes and outcomes: Such as number of patients seen, minor surgeries carried out, blood samples taken, clinics attended and the myriad of other services they undertake on our behalf each month/quarter. They could also incorporate how recruitment is going (or not) and share with us the obstacles they face.

They will be moving to incorporate some booking of appointments via My Health on Line by the Autumn. This will not increase the number of appointments available. It will enable a limited opportunity to book appointments outside of normal practice hours and reduce the number of phone calls.

Those of you who continue to feel frustrated by the telephone appointment system, AMG offered some advice.

When you are triaged by the Doctor and offered ring back or an appointment you do not have to accept the time that you are given. If it is not practical. At this point you are entitled to ask for an earlier or later appointment.

For those of you with Care Responsibilities. There is a Carers Champion to help you, including help accessing the surgery. If you have not been contacted by them already you can ask the surgery to get them to contact you.

People with disabilities, that prohibit or impair them telephoning the surgery can contact the surgery in a more convenient way for them, then the surgery will look at alternative ways to accommodate their needs.

They advised that is no point ringing before 08:00hrs. The Chair of the PPG promised to post minutes of their future meetings on the AMG Website.

AMG are not obliged to make public the Minutes of their weekly meeting with Hywel Dda University Health Board (HDUHB) because AMG are a Private Business, not a Public Entity. Similarly, I suspect HDUHB who are a public body will reject my Freedom of Information request for these weekly minutes, because the other party is a Private Business.

AMG would rather receive 250 personal complaints than a very public petition. However, we did achieve what we asked for.

My opinion and most of you never doubted AMG are a hard-working, dedicated team trying to serve 23,000 patients with diminished resources. They are squeezed by the legitimate demands of their patients, the reality of UK wide under investment, lack of planning and the availability of aspiring GP’s.

Credit to AMG, they responded to our petition in an open and honest way. I will wait and see if HDUHB and The Health Minister also respond similarly. Do we stop now, or do we join with patients of other Pembrokeshire GP services and the ‘Save Withybush Campaign’ to get our MP & SM’s, County Councillors and County Council onboard to help resolve the ongoing accessing the layers of Health Care that affects almost every member of our County?

Service we should be getting

Pages 6, 8to 10, 15 & 16 Make interesting reading

20190502 - Access Standards - Guidance.pdf (wales.nhs.uk)

Institutional Discrimination

After identifying how the phone system impacts on several groups of patients I realise the system indirectly discriminates agains them.

I have today written to the CEO & Secretary of Hywel Dda UHB informing them that I have made a complaint to the EHRC. Details belowSteve Moore CEO Hywel Dda University Health BoardFurther to my earlier correspondence and Petition which now has 232 signatories. I have spent some time thinking about how various groups are affected by the telephone booking system at the Argyle Medical Group (AMG), Argyle Street Pembroke Dock.I have reached the conclusion that the current system Indirectly Discriminates against groups 2-6 below who have Protected Characteristics.This may not be intentional but non the less it results in the system at AMG being Institutionally Discriminatory and has been for a number of years.I await your response. For your information I have forwarded this correspondence with introductory comments to:The Equality and Human Rights Commission,Healthcare Inspectorate Wales, Eluned Morgan MS Welsh Minister for Health and Social Care, Simon Hart MP, Samuel Krutz MS

Update Argyle Medical Group

A member of the Social Media Group ‘Nextdoor’ Adrianne Leijerstam, has drawn my attention to an online Triage Portal, E-Consult Search for your

eConsult NHS GP practice | Contact your doctors      (ctrl & click)

 I think if employed here in Pembrokeshire it would in some way level the playing field regarding GP Appointments. For those who use the internet this is how it works. You select your surgery, complete the diagnostic questionnaire. Admin and Medical forms are separated at E-Consult. The forms forwarded to the appropriate Surgery for Triage. It is already up and running in Health Boards in Wales and is in use in 40% of GP Practices. It is commissioned by the Local Health Board who have the responsibility for the provision of GP Services. I would welcome your feedback. Meanwhile I will send details of the scheme to the Agencies and Politicians who I sent the original Petition to, hopefully whipping up some support

Update & Invitation to meet

I have received an invitation to meet, next week with the Practice Manager at AMG and the Chair of the Patient Participation Group. Below are some of the comments that I want to take forward. I would really like to know your opinions and areas of concern.   The current appointment system is a ‘Telephone Lottery’ Treating everyone the same is not treating people Equally. The system disadvantages’ or discriminates against the following groups. Some of these Groups have ‘Protected Characteristics’ and are covered by the Equalities Act.

1)People Engaged in Employment or Education. Under the existing system if wish to make an appointment you need to book a day off. Be showered and dressed to telephone the surgery at 08:00 hrs. Then be available to answer your phone between 09:00 -11:00hrs to be triaged by the doctor. if they decide to see you then you have a short space of time to get to the surgery. If you have mobility problems, are reliant on Public Transport from the surrounding villages, this can prove to be impossible. Taxi’s are too expensive for many.

2) Carers Parents/Guardians with Parental Responsibility & single parents. (this burden predominantly falls on Females, (Protected Characteristic) Same as 1) they have to, be ready to head for the surgery at short notice with 2,3,4 Children, or the person/s they care for in tow.

3) People with Physical Disabilities (Protected Characteristics) The system fails or is difficult for people who may be deaf, visibly impaired or have physical disabilities and unable to use a phone. One patient, has to get her carer to call on her behalf. Resultant in their Personal Needs not being meet because of time restraints on domiciliary care. Doubly frustrating when they are unable to get through.

4) Elderly People (Protected Characteristic) May not be up to speed with technology, may be confused or in various stages of functioning dementia. May be unable to fully articulate their problems via a telephone.

5) People with Substantial Mental Health Issues (Protected Characteristics) Similarly disadvantaged/discriminated against as 4) above.

6) People with Learning Disabilities (Protected Characteristics) Similar to numbers 4) & (5 above.

7) Anyone who can’t afford or who are reliant on Public Transport.                                                            

People without or cannot afford the phone costs Which dependent on your deal can be between 12-35p per minute, or each call answered.                         Not unusual for someone to have to make 20 calls each day over several days. You do the maths      

Improvements I would like to see.

More face-to-face appointments.  

More Triage slots Allow a percentage of appointments to be booked online via ‘My Health Online’ A further percentage through an additional triage slot after 18:00hrs.  The remainder through the 08;00 slot I recognise this will not result in more patients being seen but it will help the groups identified to take part in the lottery.

Better communication between AGM and their Patients. A summary of the Minutes of meetings between the AMG and Patient Participation Group posted on the AMG Website A summary of the Minutes of the weekly meetings between the AMG and Hywel Dda Health Board posted on the AMG Website  

FOI Request for the Weekly Meetings between Hywel Dda HB and Argyle Medical Group

I have not received anything back from my request to AMG for copies of the minutes from the meetings of the Patient Participation Group.

Following todays message from the Health Minister I have requested Minutes from the weekly meetings between Hywel Dda and AMG. I am not confident they will respond as only HD are obliged to respond to FOI. Willkeep you informed.

Response from Health Minister, Another body kicking the can down the road

August 2022

Dear Mr Shutt,
Thank you for your email dated 26 July to the Minster for Health and Social Services
regarding GP services in Pembroke and Pembroke Dock. I have been asked to respond.
Thank you for sight of the petition, I am aware of the particular issues that you have raised
at Argyle Medical Centre. I understand that the health board are holding weekly meetings
with the practice to address the issues and supporting the practice to find short-, medium-
and long-term solutions.
Pembrokeshire, like many other areas of Wales are facing GP recruitment issues. Our Train
Work Live marketing campaign has been promoting GP careers and GP specialty training
and is shortly moving into its sixth campaign year. Since introducing our Train Work Live
campaign in 2016, there has been a marked improvement in the fill rate for GP training, it
aims to attract more people to work in general practice, including not just GPs but also
nurses and pharmacists.
To provide accessible and sustainable primary care now and in the future, we need to
develop and diversify our workforce, change the way we work and signpost people to
services to achieve our aim to deliver the right care, at the right time in the right place. In our
Programme for Government we have committed to deliver better access to doctors, nurses,
dentists and other health professionals and are working with a number of partners to take
this forward.
It is important to note that health boards are responsible for the delivery of health services at
a local level and for ensuring that they meet the needs of the resident population. I hope
you understand that neither the minister, nor her officials, are able to be involved in an
individual case or complaint, as it is the health board’s responsibility to deal with these
matters.
In the first instance, I would suggest that you discuss your concerns with the practice
manager. You may also wish to contact your local health board, Hywel Dda University
Health Board, to bring your concerns to their attention, using the following contact details:

Telephone: 0300 0200 159
Email: hdhb.patientsupportservices@wales.nhs.uk
Post: Freepost Feedback @ Hywel Dda

I hope that you find this information helpful.
Yours sincerely,
Jodi Sullivan

Share this petition

Help this petition to reach more signatures.

How to promote a petition?

• Share the petition on your Facebook wall and in groups related to the topic of your petition.
• Contact your friends
  1. Write a message where you explain why you have signed this petition, since people are more likely to sign it if they understand how important the topic is.
  2. Copy and paste the web address of the petition into your message.
  3. Send the message using email, SMS, Facebook, WhatsApp, Twitter, Skype, Instagram and LinkedIn.