Hilly Fields / Brockley Road Medical Centre Minutes of Patient Participation Group Thursday 26 September 2013

Transcription

1 Hilly Fields / Brockley Road Medical Centre Minutes of Patient Participation Group Thursday 26 September 2013 Attended: Mr Ronald Podd, Mr Richard Sutton, Mrs Doreen Sutton, Mr Neville McGhie, Mr Robert Ridyard, Mr David Seymour, Mr George Brown, Mrs Monica Applewaite, Mr Philip Clarkson Staff Members: Dr Girish Malde Senior Partner Mrs Smita Malde Practice Manager Hilly Fields Medical Centre Mrs Jacqui Henty Practice Manager Brockley Road Medical Centre Nikki Ford Senior Practice Secretary Apologies: Mr Peter Webb, Mrs Claire Freeman, Mr Stephen Locke, Mrs Gladys Etolue, Mrs Sheila Mitchell, Mr Peter Hall, Mr Paul Feeney Minutes taken by: Nikki Ford Senior Practice Secretary The Minutes of this meeting have been recorded and typed as accurately as possible. If you feel, however, that any information is incorrect please inform me by , telephone or in writing - Nikki Ford Senior Practice Secretary Smita welcomed everyone to the meeting and thanked members for attending. Dr Malde attended the meeting to give a brief overview of Clinical Commissioning and the GPs role. The presentation will be ed on completion of the minutes. 1. Commissioning News Clinical Commissioning overview Clinical Commissioning Group started on 1 April 2013, this is GP lead, was previously known as Primary Care Trust. Dr Malde explained who the Clinical Commissioning Group is made up of, 7 board members Dr Mark Rowland, Dr Majid, Dr Chen, Dr Abraham, Dr Gupta, Dr Enthwhistle and currently one vacant post. There are separated CCG s for Lambeth, Southwark and Lewisham. Dr Malde presented an outline of the draft strategy for the next 5 years. The challenge is that there are not enough resources to provide good care for Lewisham and what needs to be prioritized, looked at and needs action. The aim is to provide better health care and value for all Lewisham residents. The basic is that everyone has the same good access to primary health services and the aim is to involve patients in their care and have more integrated care. Finances There is a predicted 34 million deficit. How to spend money 1,000 will buy GP appointments, A and E attendances and to make people aware that every time a service is used there is cost involved. 1

2 Why is change necessary To improve the health of Lewisham residents and to make sure there is a high and safe quality of care for all. There are financial pressures so money needs to be spent wisely. How do we meet financial pressures? One of the priorities is prevention a huge resource in health and wellbeing and to have better links with Social Services, weight reduction programmes, smoking cessation etc. Lewisham have obesity surgery available and are improving on cancer diagnosis. Services Maternity services and acutely ill children are being looked at and Accident and Emergency will continue at Lewisham Hospital due to reversed decision by government. Looking after the elderly and end of life care, where more resources and money can be invested to enable more people to be cared for at home rather than Hospital. District Nurses, Social Services and Community Matrons are to identify people who are admitted frequently to Hospital and to provide care before needing hospital admission. Long-term conditions are to be managed more successfully and priority for dementia, mental health, COPD and asthma etc. and to deliver these services differently. This need to be clarified as to how services are accessed which will probably mean having more clinics outside of the Hospital. Patients unnecessarily attending Accident and Emergency for minor problems and the need to educate patients regarding this and identify issues regarding access to Primary Care and not being able to get an appointment with GP. Mr Ridyard enquired as to the end of life programme and do not resuscitate. Dr Malde said that the end of life care, previously called the Liverpool pathway, has been renamed but is the same for people who want to die at home and make life more comfortable. The do not resuscitate is part of end of life care. Involving patients The Commissioning group is asking patients Are you up for the challenge feedback needed regarding health services or any suggestions, comments or worries to let them know. Dr Malde said that this is quite an ambitious project and things can only be made better and changes made by people who use the services. GP Practices are also looking to their Patient Participation Groups to feed-back to. Education It is hoped that patients will make more of a contribution to managing their health and well-being by taking personal responsibility. Educating people is the key and to start at school age and making everyone aware of services available and how to access them. Mr Clarkson agreed that getting information out to patients and where to look was key. Dr Malde said that this is being done already within the Practice and by using buses and other forms of media. 2

3 Mr Clarkson said that it isn t very clear what is happening and how commissioning works and that there is a lot of confusing information from the government. Working Together Dr Malde said that the links between health and social care, district nurses etc. will improve and will work more closely as a team. There are multi-disciplinary meetings taking place already where patients needs are discussed and identifed. Mr Seymour said that there was a lack of joined up thinking with services. When he became deaf and needed help for different departments an awful lot of time was wasted in giving information that should have already been available. A positive step to be more integrated. Dr Malde said that there is a long way to go as there are 3 or 4 databases which need to become one with the Hospital, GP, Social Services and District Nurses, this is the vision. Mr Clarkson said that NHS had already scrapped one system and asked if there were any immediate plans to move forward with integrations. Dr Malde said that some of the new system is still running, such as the Spine, but that this is 5 year plan to integrated care. Mr Clarkson asked if there would be a time that Hospitals such as Guy s and Lewisham would be able to access data. Dr Malde said that this wouldn t happen as there were so many different systems used within the Hospitals. Mr Clarkson said he had been told by his Consultant to keep his own copies of letters. Dr Malde said that you can request copies of letters from the Hospital, Guy s and King s College Hospital send out copies automatically, other Hospitals such as Lewisham patients would need to be requested. Mr Clarkson said that on a few occasions letters have not received at the surgery. Smita said that this would be down to something not working correctly within the Hospital system. Letters are received electronically. An explanation could be a delay in the letter being typed and sent. Mr Seymour said that it would be good for Opticians and Dentists to be more integrated. As they are thought of as medical services, but are sort of independent. Dr Malde said that Opticians now are integrated as patients can now be seen for minor eye conditions. Patients are seen and then referred if required and the Practice is notified. Dr Malde said that Dentist is commissioned differently by NHS England. Dr Malde said that services will remain at Lewisham, but that cost will be looked at. If patients specifically want to be referred to a particular Hospital then the CCG will be informed, choice will still be there. Mr Clarkson asked if a patient would rather go to Guy s could the commission say no Dr Malde said that this wouldn t be the case. Mr Podd asked if there were price difference with each Hospital. 3

4 Dr Malde said that rates are caped, an attendance at Accident and emergency at Lewisham is and at Guy s Hospital. Dr Malde advised that Lewisham Hospital is integrating with Greenwich to have cost effective treatment. Mr Sutton asked if private hospital would be used to speed up appointments. Dr Malde said that private Hospital such as the Blackheath will be commissioned to see NHS patients. Dr Malde said that certain procedures such as varicose veins are and cosmetic surgery will no longer be done on the NHS, such cases will be reviewed via a panel for funding, 98% are refused unless there is a very good case. Draft strategy to to PPG Members Nikki 2. Access Programme Appointments Smita informed the group that the CCG are commissioning a study as it had been found that Lewisham wide there is a constant issue with getting appointment and making calls to surgeries. The group made up of ex-doctors and others will collect information from Practices and produce a report. The information will be collected during an average week in a month and every phone call, how long it took to answer and when finished, what phone calls were about, what appointments were provided, emergency etc. will be given as a breakdown. This survey is free for the Practices. Once the information is collated a report will be presented and a meeting held to discuss the findings. The report will be discussed during the next PPG meeting. Access study to report back at the next PPG Meeting Smita/Jacqui 3. Survey Smita asked the group for any ideas regarding this year s Patient Satisfaction Survey. Mr Clarkson suggested reviewing the previous survey and asking if there have been improvements. Mr Ridyard suggested improvement of diagnosis and prevention. Smita suggest this could be asked in the form of are you aware of smoking cessation clinics and weight loss programmes and regular health checks. This was agreed. The previous survey questionnaire will be reviewed and a Questionnaire rolled out over the next couple of months. Smita asked if there were any further ideas regarding the survey then to please contact Nikki. Review Survey Questionnaire to devise and roll out 4

5 4. Other matters Review Letters / Invites Mr Podd suggested if invites for Flu clinics could be sent per household and not individual letters to save on postage. Mr Clarkson said that the difficulty with doing this is that one may be in agreement and the other not Smita said that this would have to be consent specific and would look into the feasability of this. Mr Sutton asked why letters can t be sent via . Smita explained that a large number of patients have not given their addresses. addresses are actively sought when patients attend the surgery, as per Information Governance Policies the Practice and patient confidentiality personal s addresses are not secure so only certain information can be sent. Sending letters per-household/husband and wife Smita Carers Mr Ridyard highlighted the need for carers to be identified. Dr Malde agreed that it is important to identify carers and strategies put in place for them. Smita informed the group that patients are actively asked if they are carer and once identified Lewisham Carers details given for accessing services available. Pharmacy Mr Ridyard expressed his satisfaction with the Pharmacy and their service. Group members were in agreement. Mr Clarkson said that he had had experienced a problem ordering repeat prescription online as there seems to be a problem reaching the Pharmacist. Mark had looked into this but he was still experiencing problems. Mr Pod said that this has happened at Brockley Road where his prescription hadn t been received by the Pharmacist. Jacqui apologized and said that there had been a problem recently with electronic prescriptions. Review appointment with Doctors Mr Sutton said that there is a problem getting to see the same Doctor for review. Smita said this is a problem because of Doctors working patterns and not all of them working full time. Smita informed the group that 2 new Doctors had recently been employed, Dr Sivanthi and Dr Okoli. There is another position to fill but this is proving difficult with availability of Doctors. The group discussed Doctors availability, urgent appointments and pre-booked appointments. It was agreed that if a patient needed to be seen urgently then if this relayed to the Receptionist an appointment would be given, it could not though be Doctor specific and the patient would have to see the Duty Doctor. Smita and Jacqui said that in no circumstances would a patient be turned away if they had requested to be seen urgently. 5

6 Mr Podd said that he had recently experienced difficulty in booking a review appointment for 4 weeks as Brockley Road as there are only 2 week book in advance appointments. Jacqui explained the reason for this was the high non-attendance rate for 4 weeks in advance appointments. Smita explained that Brockley Road and Hilly Fields although will merge to one Practice in the future will still have differences in their appointment systems. Smita said regarding the two Practice merging that the telephone systems are ready it is the computer systems that are not and so has been postponed. Mr Ridyard asked how many full and part time doctors at both Practices. Smita informed the group: HFMC 4 full time and 4 part time BR 2 full time 1 part time PPG Meetings To avoid confusion it was suggested that maybe Brockley Road and Hilly Fields could have separate meetings. The group agreed that they would like to continue with joint meetings. Mr Podd asked if matters raised in the PPG meetings were discussed with the Doctors. Smita said that there is a joint Practice meeting once a month where PPG points are raised. Addresses out of area Mr Ridyard enquired as to the choice to choose your Doctor, he said that problems can arise if moving out of the area or just outside. A home visit can be refused and request that you register at another Practice. If you are registered with the same Practice for 40 years and need support of people they know at the surgery this will be lost. Smita said that this can be down to the Practice as there are different areas and boarders, some GP surgeries may agree to it however, other services may not available. Mr Ridyard said that this doesn t happen too often, Smita agreed and said that it is very difficult to disagree with the patient, but boundaries are set and if not made strict this causes lots of problems and complaints. Jacqui suggested letting the CCG know of this concern. 5. Virtual Group Feedback There was no feedback from the Virtual Group. Mr Clarkson said he had checked and no comments were made. Nikki will send out a welcome message to when members register and encourage comments and suggestions and discussions. Welcome to virtual group Nikki 6