PPG Meeting Minutes for 9th September 2026
Meeting Venue: Marston Surgery @ Midday
Attendees:
Representing the Surgery: Anna Zajickova and Dr Gautham Adusumilli – GP Partner
Representing the PPG: Bill Garner, Ted Pilbeam, Pamela Francis, Jean Buchanan, Delise Ball, Marie Barlow and Kamini Patel
1. Welcome and Apologies:
There were no apologies but we welcomed our new PPG member Kamini Patel
2. Minutes of Previous Meeting:
The previous minutes were reviews agreed as accurate with no outstanding actions from the previous meeting.
3. Cranfield New Premises
The Practice provided an update regarding the proposed move to the new Cranfield premises.
Good progress has been made since the previous meeting. Funding for the relevant equipment and setup costs has now been confirmed, and the Practice has started planning and ordering appropriate items, taking account of supplier lead times.
The proposed lease is currently progressing through the legal process. The Practice Partners have completed a detailed review of the lease and have provided comments to their solicitors. Further discussions between the relevant legal representatives are ongoing.
The practice will provide a statement update that can be shared with patients.
4. Practice Staffing
The Practice provided an update regarding clinical staffing.
A GP currently on maternity leave is expected to return in January 2027. The previous ICB-funded maternity cover arrangement has ended, but the Practice continues to provide cover through a combination of locum support and additional clinical sessions.
The Practice remains a GP training practice and currently has GP trainees at different stages of training. A further trainee is expected to join in October 2026 on an 80% working arrangement.
The Practice also has nursing maternity leave arrangements in place, with appropriate locum nursing cover.
Long-term condition clinics continue to operate during the week and through Extended Access sessions.
The Practice management structure remains unchanged.
5. First Contact Physiotherapy / MSK Service
The Practice explained that the existing First Contact Physiotherapy service at Cranfield is affected by a change in provider arrangements.
The current provider is expected to continue supporting booked clinics for a limited period, but the Practice may temporarily lose the locally based First Contact Physiotherapy clinic from October 2026.
The Practice emphasised the value of this service, particularly because patients with musculoskeletal conditions can be assessed directly without initially requiring a GP appointment.
Discussions are underway regarding alternative provision, including opportunities associated with the new Cranfield premises.
Agreed action: The Practice will update the PPG once the future arrangements are confirmed.
6. Appointment Access and Online Triage
PPG members discussed their experiences of accessing the Practice through telephone, online and digital routes.
Some members reported that telephone access had improved, while others highlighted difficulties where their problem did not appear to fit easily within the questions presented by the online system.
The Practice explained that patient requests can currently arrive through several routes, including:
- online consultation;
- telephone;
- the NHS App;
- Practice staff;
- community healthcare teams; and
- other NHS services.
The Practice continues to operate clinician-led triage, meaning clinical requests are assessed by a clinician.
Under the current GP contract, patients must be able to contact the Practice throughout core hours and cannot simply be instructed to contact the Practice again on another day. The Practice must instead assess the request and identify an appropriate outcome.
Depending on the clinical circumstances, this may include:
- a same-day appointment;
- a routine appointment;
- telephone advice;
- referral to Pharmacy First;
- another community service;
- NHS 111 or another urgent service where appropriate; or
planned follow-up.
The Practice explained that appointment allocation is based on clinical need rather than solely on the order in which requests are received.
Demand has increased substantially, with the Practice now commonly receiving approximately 180–220 requests per day, compared with approximately 100–140 previously.
7. Same-Day and Routine Appointment Allocation
The Practice explained how same-day capacity is managed.
Not all appointments can be allocated at the beginning of the day because capacity must remain available to assess requests arriving throughout core hours.
Where clinically appropriate, routine or planned conditions may be booked in advance.
Acute presentations may require same-day assessment or signposting to another suitable NHS service if Practice capacity has been reached.
The Practice has also introduced an internal process whereby patients requesting a particular time may be contacted if the requested time is unavailable, but an earlier appointment is available.
The aim is to maximise available capacity and reduce unused appointments.
8. Pharmacy First and Other Community Services
The Practice continues to encourage appropriate use of Pharmacy First and other community services.
Depending on eligibility and clinical circumstances, community pharmacies can assess and manage a number of common conditions.
The Practice has developed standard patient messages to support signposting where clinically appropriate.
If a patient is not improving following appropriate pharmacy treatment, the Practice can reassess the patient.
The Practice noted that increasing patient awareness and use of these alternative services remains important in managing overall demand.
9. Did Not Attend (DNA) Policy
The Practice discussed the impact of patients not attending booked appointments without cancelling.
Recent monthly figures demonstrate a significant amount of clinical time being lost through non-attendance. This affects appointment availability for other patients.
A revised DNA policy has recently been approved following review and external professional
advice.
The broad process is:
- following repeated missed face-to-face appointments within a 12-month period, patients will receive written communication;
- where non-attendance continues, the Practice may invite the patient to a meeting;
- the meeting provides an opportunity to understand whether there are barriers affecting attendance;
- an agreed plan may then be established; andany further action will be considered individually and proportionately.
The Practice emphasised that this is not an automatic removal policy.
Individual circumstances will always be considered, including vulnerability, communication difficulties, accessibility issues and other reasonable explanations. The purpose of the policy is to reduce repeated loss of appointments while maintaining fair and appropriate access to care.
Patients are encouraged to cancel appointments they are unable to attend so that the appointment can be offered to another patient.
10. Patient Behaviour
The Practice confirmed that unacceptable or abusive behaviour towards Practice staff is managed through a separate process.
Where appropriate, patients may receive a formal warning and concerns will be considered individually and proportionately. The Practice seeks professional advice where necessary before taking significant action.
11. Flu and COVID Vaccination Programme
The Practice provided an update regarding the autumn vaccination programme.
The Practice is planning dedicated flu vaccination clinics during October 2026, including Saturday sessions.
Additional clinics will be arranged where required.
Patient invitations and self-booking information will be sent once vaccine delivery arrangements are confirmed.
The Practice explained that some vaccine deliveries have been affected by national and supplier arrangements, but vaccination clinics remain planned.
Further information will be communicated directly to eligible patients.
12. GP Patient Survey Results
The Practice shared improvements shown in the latest GP Patient Survey.
Ease of contacting the Practice by telephone
2025: 35%
2026: 53%
National average: approximately 57%
This represents an improvement of approximately 18 percentage points.
Ease of contacting the Practice using the website
2025: 45%
2026: 49%
This represents an improvement of approximately 4 percentage points.
Use of the NHS App
2025: 35%
2026: 46%
This represents an improvement of approximately 11 percentage points.
Reception and administrative team helpfulness
2025: 62%
2026: 84%
This represents a substantial improvement.
The Practice welcomed the progress while recognising that further improvement is still required, particularly around ease of access and digital systems.
13. Friends and Family Test
Recent Friends and Family Test results were also discussed.
Positive feedback has remained broadly consistent:
- June: approximately 83%
- July: approximately 86%
- August: approximately 85%
The Practice will continue to monitor both positive feedback and areas where patients identify opportunities for improvement.
14. Extended Access and Additional Services
The Practice confirmed that Extended Access services continue to operate. These include weekday and Saturday appointments.
Additional services currently available include:
- long-term condition reviews;
- nursing clinics;
- contraception services;
- HRT and menopause support;
- coil-related services where appropriate;
- pharmacist-led clinical support;
- spirometry;
- planned complex-care appointments; and
- access to additional services through local provider arrangements.
The Practice continues to review demand and make best use of available clinical capacity.
15. GP Training Practice
The Practice discussed its role as a GP training practice.
GP trainees are doctors undergoing specialist training in general practice and work under appropriate supervision.
Trainees have access to senior clinicians for advice and their work is reviewed according to their stage of training and level of competence.
The Practice recognises the importance of patients understanding when they are seeing a GP trainee.
The PPG acknowledged the importance of training future GPs while ensuring appropriate supervision and communication.
16. Electronic Prescriptions
PPG members raised concerns about occasional delays between a prescription being issued by the Practice and becoming available at the pharmacy.
The Practice explained that once a prescription has been clinically authorised, it is transmitted through the NHS electronic prescription infrastructure.
Occasionally there can be delays within the electronic system or at the dispensing stage.
Where necessary, the Practice can provide the prescription’s electronic reference details so that the pharmacy can retrieve it from the NHS system.
Patients experiencing difficulties are encouraged to contact the Practice or pharmacy so the location and status of the prescription can be checked.
17. Patient Facilities
A suggestion was made regarding availability of drinking water for patients.
The Practice agreed to consider whether bottled water or another simple solution could be made available when required.
18. Practice Training Closures
The Practice will provide the PPG with details of planned Practice training dates once the forthcoming schedule has been finalised.
This will allow the PPG to help communicate planned closures or changes to services in advance.
19. Future PPG Open Meeting
The timing and location of the next PPG open meeting were discussed.
Members suggested that, if practical, a future open meeting could be held at the new Cranfield premises once operational.
The Practice and PPG agreed that this could provide a useful opportunity for patients to see the new facility. The final date and venue will be reviewed once there is greater certainty regarding the Cranfield opening timetable.