CLEVEDON MEDICAL CENTRE
PATIENT PARTICIPATION GROUP
Minutes of Meeting 15th May 2017

Chair Person: Margaret Blackmore (MB)

Minutes: Julie Davidson

Attendees:

Julie Davidson (JD) Business Manager, Alison Lee (AL) Operations Manager, Martin Hime (MH), Pat Cowie (PC), Valerie Lush (VL), Jennie Briscoe (JB), James Millett (JM).

Visitor: Carole Franks from 1 in 4 service, Clevedon branch.

Apologies :Mr & Mrs Maxey, Mr & Mrs Fisher, Mrs Stuart.

Minutes

  1. Present and Apologies

As listed above. We welcomed Carole Franks to the meeting from Clevedon’s 1 in 4 service.

  1. Minutes of last meetings (20th May 2017)

The Minutes were approved.

  1. ‘1 in 4’ service, Old Street, Clevedon Progress Report, Carole Franks.

Carole has kindly returned to share a progress report on the future of the ‘1 in 4’ service.

An action group was started in January 2017.

The Action Group queried the costs of running the service with the local authority to understand the magnitude of the funding issue which threatens the future of the service. Council funding cuts are the root cause of the issue. They were also able to outline the service provision to the funding department.

The ‘1 in 4’ service had their AGM in March which was well attended by service users, volunteers and officers for ‘1 in 4’ and there is a meeting being planned in the next few months for all interested parties to attend and vote on proposals of future funding and service provision.

The Clevedon branch is currently open for 3 days per week and the typical footfall is approximately 40 service users per week.

To date, there has been some progress made:

  • The operational deficit from last year has been cleared.
  • The local authority funding team are supportive of the service and this year’s funding is being offered for the clinicians in the service (employees).
  • A local businessman is supporting the service and has taken on the property lease and utility bills for 1 year.
  • There is a different funding offer on the table which gives 6 months’ provision.
  • Ideas for fundraising to support the service are being suggested.
  • Service users are open to considering higher fees for activities.
  • There are now considerations about how best to operate the service and what models should be used (as now, or as a drop in service without employees).
  • The forthcoming meeting will develop proposals for interested parties to vote on and the Action Group welcomes attendance from all supporters. Date to be advised.

If the ‘1 in 4’ service would like to do any publicity events at CMC, they are welcome to approach us with ideas.

4.1 Hearing Event for Patients

JD suggested that we gather all the information and resources for the event and make a static table-top display in the medical centre for patients to access. We can invite Sunnyside Surgery to participate so that we can advise patients on which services are available via the NHS and privately and demonstrate consistency of services across the town. Groups which provide help and advice to those patients who are hard of hearing or deaf, could be approached to support the event with materials or a presence on site.

PPG members could participate and support patients on an ad hoc basis if a timetable was produced and volunteers agreed to support the event. The display could be in place for the last two weeks of June.

All agreed this was a workable idea.

Action: JD to liaise with MB, organise and deliver the event.

Action: All PPG members to consider if they wish to attend the event at any time in the fortnight (Mon 19th to Friday 30th) to support patients. If so, please let Julie or Alison know.

4.2 GP Event idea

It was agreed that we should aim to do this event as a public meeting in the same format as last time, preferably in September, and definitely before Christmas.

The following ideas were recorded as potential content for the meeting

  • Role of GPs
  • how whole system works
  • what doctors do these days
  • what is an emergency and what is the concept of an emergency for patients
  • expectations of patients
  • what is acute care
  • what are minor illnesses

MH suggested that the first three items were all informative topics for patients and JD suggested that we could consider preparing this information and sharing it as patient information leaflets.

The next 4 items all relate to clinical aspects of patient care and would work very well in group discussion setting with PPG members leading the discussions.

MH also suggested it would be helpful if we had members of the practice clinical team available for these discussions, as well as a GP partner(s).

It was agreed that we should set up a mini-committee to prepare this event and Maggie, Martin and James all volunteered to do this with Julie. Other members are welcome to join us.

Action: Maggie will invite volunteers to a meeting at CMC.

  1. AOB

JB – Potential Care Home Development on old Cherry Orchard site, Clevedon

Jennie wished to check if there had been any approaches to the medical centre from the developers to care for the patients who will reside at the new care home and if there was any opportunity to consider a private service contract for GP services to the home. JD answered that we had not been approached but that it was possible that a separate service could be considered, but there are contracting guidelines which would be followed if it was to be pursued.

JD–Information regarding Mental Health services for patients

On behalf of MH, Julie had requested information on service provision from commissioners. We have offers of engagement from the commissioners and MH agreed for Julie to accept the recommendations and agree meeting date(s).

Action: Julie to arrange Mental Health meetings.

JB asked what could make the difference locally to address the funding shortage?

JD responded that there is clearly a multitude of causes and many ways to address this, however, the government will not be bailing us out, so locally we have to find ways to solve the funding gap. Hospital services are by far the most expensive activity our commissioners have to pay for. Using elderly care as an example, Julie outlined some of the background information which contributes to the serious funding problems for North Somerset and the wider community of Bristol, North Somerset and South Gloucester (BNSSG)

  • North Somerset has the highest migration rate into the county, nationwide, and of those migrating here, the majority are aged 65 years and above.
  • This influx has been happening for at least the last 10 years and is predicted to continue until at least 2030.
  • Emergency admissions to hospitals are one of the most expensive services our local healthcare budget has to pay for, (unlike a planned admission).
  • Supporting patients with planned care to avoid a crisis/fall/accident/exacerbation of disease, often helps to avoid an unplanned hospital admission.
  • Clinical evidence now shows that long hospital stays contribute to a deterioration of the patient’s physical condition, increasing their frailty as they lose more mobility with each extra day in a hospital bed (muscle loss etc.,). Costs of their care as they become more frail clearly will increase.
  • The shortage of care packages from agencies (funded and private care) to support patients to retain their independence and stay in their own home is seriously lacking in North Somerset and in BNSSG, and this means that patients are not able to be discharged from their hospital bed to home. This has been the ongoing situation for at least the last 4 years in Clevedon.
  • There is a shortage of care home beds and North Somerset Community Hospital in-patient ward is still temporarily closed.

Not forgetting that we also have the whole age-range population to care for locally, so elderly care is just an example. We will have less Doctors in the future, so we need to develop new clinicians to see patients for specific needs, supported by our Doctors and this will help us to manage the year on year increasing demand we see for our services.

There are no easy solutions for our BNSSG commissioners to find savings of £77 million in this financial year.

Date of next meeting:

Monday 4thSeptember 2017

Clevedon Medical Centre, 6-7pm

ALL PATIENTS ARE WELCOME TO ATTEND THESE MEETINGS