Carnoustie Community Council
28 March 2016, 7.00PM
Laurie Lounge, Royal British Legion, Carnoustie
Minute / Subject/ Comments / ActionPresent
Arliss Rhind (AR) - Chair
Ed Oswald (EO) - Vice Chair
Natalie Ross (NR) -Secretary
Stuart Richard (SR)
Davina Braithwaite (DB)
Alasdair Murray (AM)
David Rorie (DR)
Joyce Beattie (JB)
Gavin Farmer (GF) / Other Attendees
Cllr Brian Boyd
Cllr Brian Bowles
Lynn McGowan
Dr Elaine McNaughton
Constable Steve Wilson
Not Present
Ken Naylor (KN) - Treasurer
Susan Dunn (SD)
Allison Edwards (AE)
Harry Ritchie (HR)
Cllr Helen Oswald
1. / WELCOME/ APOLOGIES
Apologies were received from Kenneth Naylor, Allison Edwards, Susan Dunn and Councillor Helen Oswald. Chair AR welcomed our guests from Carnoustie Medical Group, Lynn McGowan and Dr McNaughton, as well as Constable Wilson, invited by ARh in recent passing.
2. / MINUTES OF PREVIOUS MEETING
Minor spelling edits were noted from CC’s. With agreement to these changes being made, minutes were approved as final by GF and seconded by DR. NR to adjust and post to Facebook/ Library asap.
GF also advised the Defibrillator is not situated in the Premier Store on Barry road as circulated on social media; it is in the Co-op on Barry Road. Another is due to be posted in the Spar on the High Street.
3.
3.1 / MATTERS ARISING
Guests from Carnoustie Medical Group: AR welcomed LMcG and Dr McN to this evening's meeting. LMcG thanked CC's for the invitation and questions received prior to the meeting- CMG are keen to engage more. LMcG advised she had brought along handouts of upstair and downstair services, as well as a the guide for all patients available at reception, and the Practice leaflet. Dr McN advised she would like to acknowledge problems in General Practice overall, are greatly significant and widely publicised- Any specific issues experienced are welcomed to be discussed throughout.
Beginning with the first question regarding the request (not policy); asking patients to consider issues/ time needed, in regard to 10 minutes appointment system. Dr McN advised she has been with CMG for 30 years this year, working through many changes over those years. At the forefront, has always been- striving to give Carnoustie the best service possible. Dr McN advised that not many consultations involve just one problem, but GP's do appreciate patientsconsidering issues presented in one appointment; to make best use of time. Dr McN advised CMG have only been doing this for 2-3years, yet averages of patients seeking appointments has been 1.5 times more than the national average in Scotland for many years before this request began. What has changed, is people are living longer, generally living healthier, but there are now more disease processes with age. Carnoustie also has a higher percentage of over 65's compared to the Scottish national average. 22.5% of Carnoustie are over 65 years of age, compared to the 17.5% Scottish average. Over 75's are at 9.1% higher than the 7.7% average in Scotland. CGM do offer many more appointments than other local practices, therefore more can be seen, which also contributes to this statistic.
EO referred back to changes happening around a year ago with local pharmacies, and felt from feedback, that many people are having problems receiving prescriptions/ repeat prescriptions. People seem to be under different impressions of timescales. LMcG advised Boots are a business themselves and have no association to the Practice. Prescriptions take 2 working days to be created, to enable the GP to check medications and Admin to then create prescriptions/ repeats and produce one prescription for multiple requests. Pharmacies however, have stated they need longer, up to 5 days to ensure they have enough stock. At the bottom of prescriptions it does state pharmacies may need longer. Pharmacies report many people expect to wait and get prescriptions immediately despite perhaps not having enough stock. Different pharmacies have different suppliers. Boots have one supplier, yet an independent local pharmacy may have 7 suppliers and this can enable quicker delivery of prescriptions. LMcG advised prescriptions can be taken anywhere, it is the patients choice.
EO questioned waiting times for routine appointments now being around 2-3weeks. LMcG advised appointment availability can vary greatly, depending on patient availability, needs or any particular GP they wish to see, as well as that GP's availability on that particular day/ week. The reason for the longer timescales for routine appointments, is in part affected by day-to-day services offered. CMG offer on the day telephone/ face-to-face appointment services- but this does mean this takes away from routine appointments for GP's. Average requests for advice or to be seen on a Monday by 11am, is 110-120. It can be on average 70-80 on other days by 11am. That is over and above scheduled appointments. Continuity for patients and GP is generally more satisfying for both when seeing the same GP, but GP's need to also be available for emergencies on the day. Many practices have ditched routine appointments as they feel its not workable, however CMG feel many patients in this area find it more convenient knowing they can book ahead for some appointments and not always have to get a 'on the day' appointment. LMcG advised development meetings are held to look at these systems and improve access any way they can. They hope meetings such as this will also help. Cllr Bowles queried email contact with patients as trying to get through on the phone can be frustrating. LMcG advised they have tried this but patients were not always responding to offers of appointments. It also affects safety for patient as does not allow assessment of possible symptoms, e.g breathlessness cannot be heard via email by can be picked up via telephone. Requests for repeat prescriptions can already be done via the website/ email service. There is also the automated telephone service available- even when Practice is closed. This can be used to book/cancel routine appointments and request repeat prescriptions. CMG are awaiting 'Vision Online'- a new system from NHS to enable patients to use an appointment booking system online where you could view available appointments and book. Repeat prescriptions do now show the online address for doing further repeats as well as via telephone. Cllr Bowles queried perhaps a text message service to book appointments- However LMcG advised this would mean a staff member covering this and awaiting responses, whereas telephone service allows you to hear availability and book immediately.
Cllr Boyd acknowledged he is aware CMG are working to capacity and staff working very long hours, however does feel some people may not understand fully, the issues faced by staff. Cllr Boyd wonders what their plans are to achieve further resources, e.g more staff; as there is enough space. Dr McN referred to statistics showing many GP's are soon to retire and insufficient numbers of GPs are available to take over this expected loss, which is very worrying. Dr McN acknowledged this is not just Carnoustie; across Scotland there is a lack of GP's overall. Dr McN admitted she is often working 12 hours, and many young doctors are not seeing General Practice as an attractive career option due to the tough, busy hours. A third of the GP staff are likely to leave over the next 5years due to retirement/ illness/ stress so CMG are trying hard to make it look more attractive to qualifying doctors.
EO mentioned previous weekly news columns that used to be done to keep public up to date with variations. Looking at communication, they have considered social media but feel this does not work well professionally, to try and respond to the many criticisms made via this media. Dr McN admitted there is nothing more disheartening and disappointing than doing your best and still being heavily criticised. Trying hard to counteract issues,they have found many Facebook comments to be very damaging and can cause further distrust in the community. Criticism is encouraged but feel Facebook is not the best way to address it as one comment often spirals with other comments added and therefore unable to clearly address any initial points made. LMcG feels word of mouth has always worked best, along with local press. They do also have their website where lots of information is available also:
CMG are keen to have any assistance to promote this information. NR agreed to post some information regarding services available and the website. CMG have an in-patient group to try and assist with improving service and really hope they can receive more feedback to help with this.
LMcG advised the telephone supplier and system would be changed by next Monday due to current service having many issues and breakdowns. New system will be able to give queue position, giving informed choice of whether to wait or try again later. If people are really unwell they still have option to press 1 for emergencies. There are also far more lines coming in and this requires more staff, so 2 new staff have been taken on with a total of 40 hours now covered to assist.
JB raised issue with asking for an appointment and advised there was none available, but could speak to doctor- however told it may take up to a week. LMcG explained some doctors often have to attend training/ meetings/ cover emergencies, which can often delay responses, however only if problem is not an emergency. JB advised she then had to call back as her husband had been on the floor overnight. LMcG advised this was a helpful piece of feedback as clearly if staff had asked a few further questions, it would have been clear JB needed to speak to a Doctor sooner.Staff need to establish reasons better with some patients to ensure this is not delayed. CMG do have a variation of different tiered appointments- which perhaps patients are unaware of. This is helpful feedback to ensure staff make patients aware of this and for patients to understand why staff do ask questions
AM raised query over Carnoustie patients perhaps being more demanding that other towns? Are patients unrealistically demanding? Dr McN advised they just try to meet demand, and recognise that locals feel able to phone Practice and clearly they feel there is a reason to call.Patients make good use of accessible services, and CMG have been told by locums that patients expectations do seem higher. Dr McN as a GP who has only worked here, does struggle to understand this, but feels we have a knowledgeable and fairly active community, therefore perhaps the community engages more often with service to enable active lifestyles to continue.
CMGreally want to continue providing a good service, but this does need assistance from its community. E.g. do I need to be seen immediately, or can I discuss with close friends and family for reassurance. However there is also the massive worry that there will be some patients who 'don’t want to bother the GP' and GP's really want to see these patients, as often they should have been seen earlier.
AM asked if there are currently unfilled positions. LMcG advised there is one maternity leave due to be taken soon, but this is unable to be covered fully. A new nurse practitioner was taken on, who helps greatly in dealing with minor ailments and frees up GP times for more complex issues.
In regards to any misdiagnosis- thankfully this is very infrequent. If any delay or complaint is made- this is discussed in staff meetings to avoid a repeat of this. CMG do get significant proportions of complaints but thankfully not many are due to this. Communication is the key.Results handling is time monitored, and results are looked at within 24hours of receipt. 100s of results are received daily and many are insignificantly abnormal. Any significant abnormalities are called about assoon as possible, but patients are urged to call for results if they have not heard back when expected- but this should mean there is not too much to worry about, if anything at all.
In regard to house building and capacity- LMcG advised they are not consulted/ influencing plans for house building at present. There is no planning for a second practice. CMG are a tenant in the downstairs part of the building to a Private landlord. NHS rent the upper part of the building. There is no money available from NHS to think of expansion. CMG would like to be involved in hearing about plans for building- Cllr Bowles and Boyd were very surprised to hear this, and will be contacting planning to discuss this. Until this is resolved- NR will look to send any relevant plans/ information to LMcG. Dr E McG stated in her 30years, no official consultations have been made with her involvement.
LMcG urged any involvment in the patient participation group to assist in resolving issues are normally held around 2pm on a Wednesday/Thursday. They have so far assisted greatly in improving some areas already.
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4.7 / REPRESENTATIVE UPDATES
Councillor Updates
Cllr Boyd advised March is a quieter month compared to February's discussions on budgets. He has taken on board situations of messy verges/ rubbish. He has been discussing with Waste Management, areas such as Barry Mill, near Roundabouts. BEAR are to be contacted by AC to clean up as they are paid to maintain. The Barry Bypass will also be looked at. Cllr Boyd took 30 photos walking dog on the bypass to Barry Mill to show litter issues. Seasonal staff will shortly be started. NR noted Upper Victoria raised via FB, also near golf course. Only 2 bins past the playpark area, towards golf course. NR has made a request via AC online enquiries for this to be addressed.
Bus timetables for east of town are being looked at and Cllr Boyd invited any issues. Broadlands is a good example- residents have raised the lack of service for people in the mornings- this has been passed on to be reviewed. An Audit review from Audit Scotland received; looking at how the council is spending public money.
Charrette attended- great turn out in afternoon and a quieter but still productive session in the evening.
The Kinloch Site is now with Economic Development, for sale. Signs due to go up shortly. A Car Show is planned for 8 May with good interest- good to see being used in the meantime. DR raised issue on maintenance of grass on the site, DR has previously maintained this but feels with health issues he may not be able to continue. No budget available from the Council to maintain: Cllr Boyd suggested perhaps another community member could assist. Anyone with a seated machine would have it done very quickly.
Beach Pavilion missives were signed last Friday-Will be good to see development there soon.
AR raised query regarding wide ramp before skate park being inaccessible- Yet this is written on maps outside leisure centre and elsewhere, as 'disabled access'. Cllr Boyd will look into this. NR mentioned disabled groups have great access via trains to visit the town, but access to the beach is poor, as is access to toilets. Cllr Boyd feels it should be better published that the Carnoustie Golf Hotel have public toilets, the Golf Centre and the Leisure Centre. EO mentioned elevated structure at Monifieth for wheeling down chairs to sit and watch the sea. Playpark is well known to be one of the best in the Angus area. Cllr Boyd will look at this map and query this access.
Financial Report
All CC’s confirmed they had received a copy of last months accounts from KN. Proposed as correct JB, seconded by DR.
Police Liaison
Many will be aware that 18months -2 years ago, community policing was almost pulled. On 21st March, himself and 3 colleagues formerly in community role, were asked to go back in post. There used to be 13 for the whole of angus. He is now covering Arbroath, Monifieth, Sidlaw and Carnoustie. The information received from being on foot and interacting with the community, is far greater than just police car presence. NR advised Srgt Morrison had been in touch via email advising that Bill Knight will be attending Aprils meeting. AR mentioned evening consultations with the younger population- Eric Robertson is a resource worker in Monifieth works with youths and agrees that the Leisure Centre is a great venue for holding youth events, especially in winter months. Carnouste 10-15 years ago had a big issue with older youth disturbances, and if this was happening now to the same degree- the service would struggle with current cutbacks.
In regards to vandalism- there has been some noted throughout, but more often on the outskirts. Youth disturbances are a big issue also, although less than previous years.
Will look to give breakdowns on callouts at future meetings to assist in advising the community better. Midnight football at Pitskelly, Friday Night Project restarting. There is free golf tuition for youths is also available at Carnoustie Links. A police surgery is hoped to be restarted and will be looked into finding a room at the ACCESS office/ Library over next week or so to improve accessibility.