1. Practice Plan
The practice plan has been developed following discussions with all staff and PG committee agreement reached on key objectives over the coming year

2. New Telephone System – Delivered Appointment Review System
Patient Experience
New Telephone System – Delivered
Appointment Review System
Review of Surgery Experience
Promoting Lifestyle Changes – 5YFV
Website Development
New telephone system has been implement and has been a significant improvement on the previous system. We are still fine tuning aspects of the system based on feedback and observations
Continually reviewing the availability and type of appointments and more appointments are now bookable online.
Following feedback from the patient group larger signage has been arranged and leaflet are positively managed by you. I am meeting with a representative of the patient screens on Friday to undertake the site survey and we hope to have screens in HRS in the next few months.
The 5YFV is promoting the NHS Health checks available from the age of 40 to 74 to identify people at risk of heart disease and encourage lifestyle changes to lesson later life illness. Clinically we are actively promoting awareness of lifestyle changes and a good example of is the heath promotion about sugar intake.
The website is constantly under review and we are trying to make it less text heavy with greater information. Looking at consolidating pages in order to create new sections. If you have any ideas about other information you would like to see on the website please let me know.

3. New Patients at Eddington Girton Nursing Home and St Edmunds College
Growth
New Patients at Eddington
Girton Nursing Home and St Edmunds College
Maintaining Individual Lists and Core Values
Implications for space and manpower
As you are all aware the new development at Eddington is now being populated. The first residents are Cambridge University key workers and shortly students will shortly start residing there. We are in contact with the colleges to raise our profile to the new residents
Another major growth impact to the surgery is the new dementia home which we understand will be an 85 bed home. The go live date is anticipated to be April 2018 and the manager is due to be appointed in November. We will be establishing contact with the person in due course.
You can all see the redevelopment of Mount Pleasant has started and when the rebuilding work is completed the accommodation will be for students and key workers from St Edmunds college. I understand that they accommodation is hoped to be available from September 2019.
All partners still value the individual list system and I know that you support this arrangement. Whilst the majority of GP surgeries in Cambridgeshire appear to be following the session based approach HRS do not have any intention to follow suit.
As the list size grows, which will be an impact of the various property developments within the area, we will be reviewing our working set up on a regular basis

4. Cambs Primary Care Network Working Closely with other Practices - 5YFV
Working at Scale
Cambs Primary Care Network
Working Closely with other Practices - 5YFV
I think that you will be aware of the 5FYW. In line with all practices we are continually reviewing the potential implications of the forward view and are discussing with other practices their views and ideas.

5. Unresourced and Inappropriate Workload Shift
Over the years there has been the approach to move workload from the hospital doctors to the GP and the recent contract there an intent to move various processes back to the hospital specialist to ease workload on GP. This change is not funded but the incentive to free up time for the GP is the benefit and we are hoping that HRS we see the benefit of this change over the coming months
The practice has also used this initiative internally and we are looking and lot to develop smarter working practices. .

6. Older People ( Safeguarding Vulnerable Adults)
Identification and Management of Patients with Frailty
New frailty index identified for those at risk of admission to hospital

7. Safeguarding Children Review and Update Policies
Dr Roque, our children safeguarding lead is continually reviewing our safeguarding policies. There was a major policy review undertaken in April.

8. Developing Girton Surgery and Dispensary
Girton Pharmacy
Developing Girton Surgery and Dispensary
The Girton practice is very popular with our patients and is an important part of the practice. We are looking at how we can best use the space available for the increasing workload see by the dispensary team

9. Review of the Induction Process
Staff Changes
Review of the Induction Process
We have implemented a new induction programme to ensure staff obtain an overview of the practice by spending time will all teams, including Girton, and they are provided sufficient time to settle into a new environment. We are asking for feedback from any new entrant and changes made accordingly

10. Developing the Use of Skill Mix Practice Nurse Skill Development
Revalidation from 2016
Developing the Use of Skill Mix
Practice Nurse Skill Development
Student Nurses
Ongoing process to confirm nurses revalidation
More nurses are able to undertake NHS Health Checks, Smears etc and we are continuing to support the nurses in the development.
The continued support for the nurses has recently seen the phlebotomists undertaking more tasks in line with HCA. We now have an extra diabetic nurse and another nurse in undertaking her spirometry training.
Although we were not allocated a student nurse in the latest placement round we are looking to provide placement opportunities for student nurses.

11. Apprentice Recruitment
We met with the people running the apprentice scheme but unfortunately at present it is not something we will be able to progress.

12. Relocation to Signet Court
District Nurses
Relocation to Signet Court
We were advised at the beginning of the year that the DN would move to Signet Court. Seemingly this is still the plan but no dates have been given and the DN like coming to HRS.
The impact is also being seen by the withdrawal of locally held MDT meetings, which we have strongly resisted. Unfortunately the decision has been made and we are looking to see how we can best deal with this ensuring that a patient received the necessary care.

13. Developing the Use of SystmOne Using Text Messaging and Email
Online Services
Developing the Use of SystmOne
Using Text Messaging and
Online Access to Records
Online Appointments
Consider Electronic Prescribing System
We have encouraged patients to sign-up for patient online and NHS England have requested our permission to use HRS as a flagship for Peterborough and Cambridge CCG as we are apparently the best performing practice to sign up patients online. 30.2% of our capitation have signed up.
We have relatively recently undertaken a push for patients to also sign up for text message. This is a very effective method to communicate with patients in a world where everyone appears to becoming busier.
More patients are requesting access to their records which we are encouraging. When request are received we are providing access from the date of that request.
The ability to book appointment son line is proving very popular and we are seeing more appointments booked this way.
We have considered the use of EPS but have decided that at present the system is not dispenser friendly.

14. Second Partner to Become a GP Trainer
GP Training
Second Partner to Become a GP Trainer
Dr Hayton has recently been confirmed as a GP trainer.