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B&NES ENHANCED MEDICAL SERVICES +

BEMS+ ANNUAL GENERAL MEETING

Minutes of Meeting held on Tuesday 5 July 2016

1.Present: Dr Louise Leach ChairRachel Walker Dr Olly Bradford Bonita Burrow

Dr Nick AlexanderLiam Harris

Dr Andrew Nesbitt Julia Griffith

Dr Chris LewisDr Vicky Jacobs

Dr Guy Worsdall

Dr Andrew Smith Melanie Gratton

Dr Fraser Head Roxie Minney Dr Charles Bleakley Kate Davenport

Dr Victoria Mc MasterKathryn Cross

Pattie Arklie

Apologies:Dr Sharon GillingsDr Samantha Gardner

Amanda SimpsonDr Laurence Heywood

Subject Discussed / Details of Discussion / Action Required
2. Approval of 2015 Minutes and Matters Arising / These were approved and there were no matters arising.
3. Chief Executive Report / This was presented by Dr Andrew Smith.
Services
DVT activity stable and the service is on EMIS.
Fracture Clinic long standing contract, that now covers two years, Dr Olly Bradford has increased his commitment, increase in number of long standing soft tissue injuries have caused the clinics to overrun as these patients cannot be seen within 10 minutes. We will be sending out a communication to GPs soon and amending the referral form.
Vasectomy activity is stable. We have given notice to the CCG that we do not wish to continue the contract after March 2017 because of risks associated with the service, the reduction in activity and the costs of running the service not being covered by the tariff.
Referral Support Service 24 practices using the service which is very busy, Dr Chris Lewis produces helpful reports for the CCG ;it may become slightly more referral management. The service is running out of space at Riverside.
FWW AS thanked all the staff that worked in this service. The service was of high quality and had high patient satisfaction but not able to prove to the CCG that is saved more money than it cost to run the service, so the pilot has ended.
Dermatology the CCG asked us to provide this service at short notice because the RUH waiting list was so long. However we were not able to secure consultant cover so GPs working in the service felt unsupported and we did not have the expected level of activity. We are still working with the RUH on a longer term solution that may involve GPs being trained whilst providing a service.
NHS Health checks outreach B&NES LA commissions this service from BEMS+ We are providing the service to hard to reach groups. The first clinic is booked imminently.
Social Prescribing BEMS+ is part of a consortium of other local providers in B&NES commissioned by Innovate to provide an app for patients and a desk top solution for GPs to be to refer to social prescribing more easily.
CEPN have been set up in the SW by Health Education England in every CCG area. BEMS+ is the only provider in the SW that was given the contract, elsewhere CCGs set these up. Our CEPN is very primary care focussed and Dr Nicole Howse chairs the network.
One Voice AS described all the meetings that he attends on behalf of Primary Care.
Primary Care Preparing for the Future
  • Skills for Health collaboration has been complex due to changes in the local primary care landscape. Workforce work streams were reported at the 7 June 2016 workshop. AS reported that Skills for Health have asked if BEMS+ could help promote their services which we are considering. LL asked BEMS+ request feedback/permission from practices about this.
  • Phone system 26 practices are now using this service and the contract runs for two years.
  • Interoperability the project has experienced delays due to lack of national and local health system progress.
YCYW BEMS+ is in an alliance with AWP, RUH, Sirona and Dorothy House. We are competing with Virgin. It is a complex procurement process. We are dialogue with the CCG today and tomorrow. The services being commissioned range from safeguarding to Home IV. We are just about to receive 56 contract schedules to review. The CCG have given GPs an opportunity to question the potential bidders at the next GP Cluster meeting. NA asked what influence do GPs really have. AS suggested NA ask the CCG this question at the GP Forum. CB asked what organisational form the alliance will be. AS explained it will be a not for profit organisation. AN asked who will have ultimate authority in the contract. AS explained that the alliance will have an independent chair and that each organisation will have an equal say equal vote on the Board. The influence that BEMS+ has is that we represent the main referrers into community services. The amount of investment into the procurement process is divided between equal shares and linked to current contract values. This benefits BEMS+ as our contract values are relatively low. AS explained that this process has improved working relationships between the CEO and senior Management Teams of the organisations in the alliance.
Organisational Development
AS explained that staff numbers have increased in RSS and FWW and that an Operational Manager has been appointed. We have a new fracture clinic administrator and finance manager. The Riverside premises for head office staff is also becoming very cramped. The Operations Manager is looking into alternative premises but this will need links with the rest of the NHS infrastructure. The membership of the Council in Bath is changing to reflect the new GP practices mergers.
Governance
BEMS+ will be launching a new logo in September. We have also invested in a new accounting system Sage 50.
What next?
We will be following up on Skills for Health work using the CEPN. We will continue to explore BEMS+ role in cluster working with practices. AS explained that in terms of services coming out into the community from the RUH that the RUH have advised that they want to have just one conversation with primary care, and that they want that conversation to be with BEMS+.
Next year BEMS+ will be concentrating on the YCYW procurement, working with the RUH, Dermatology, Diabetes, extension to OOH providing multi-disciplinary team response and MSK. / AS
NA
4. Clinical Governance Report / This was presented by Dr Fraser Head.
Incident Report He reminded the AGM that for each service that BEMS+ provides there is a clinical governance structure. Once a quarter the staff working in the service meet with FH and JG to discuss activity, key performance indicators, incidents, audits, complaints, compliments and any operational issues. The Management Executive Committee receives monthly reports from each service including the outcomes of clinical governance meetings. There were no complaints received by BEMS+ which was the same as last year. Compliments far outweigh the number of incidents showing that our services are very well regarded by patients. There were relatively the same number of incidents as last year bearing in mind the additional services we provide. There were no Serious Incidents Requiring Investigations. Incidents were administrative and none were clinical. They related to issues with transport and IG issues with patient discharges not going to the right GP practice. The report demonstrates that BEMS+ has learnt from these incidents and has changed processes as a result.
Audit Report Becky Wych was appointed to lead on the audit programme. She has produced an Audit Strategy and Policy and an Audit programme. The audit programme ensures that KPI are monitored for each service. Each site that we provide services from are audited for infection control, DDA compliance and Health and Safety. We have also benchmarked our services against other similar community based services. Next year we will be looking at auditing the clinical work of GP Specialists working in the service.
5. Change to membership to add GP Practice Nurses / JG explained that BEMS+ has appreciated having practice nurses working for them as they are able to bring a different perspective to the team. BEMS+ is recommending having a practice nurse on the Council. This will mean the BEMS+ Rules will need to change and therefore the membership need to vote on this. This proposal was supported by GW and seconded by AN. Everyone present supported the proposal to add a Practice Nurse to the Council membership. JG explained that Nicola Bebb from St Michael’s surgery will be the first nurse.
6. Financial Report (2015/16 Accounts) / This was presented by Julia Griffith. She explained that BEMS+ has made a small surplus at year end of £8K. So reserves are at a similar level to last year. Income and expenditure levels have increased due to BEMS+ providing more services. Head office costs have increased due to increased insurance costs, more MEC members, room hire and hospitality relating to GP Cluster meetings and travel costs to national conferences by the Senior Management Team.
7. Appointment of Auditor / The members agreed unanimously to Lentells being reappointed as the auditor.
8. Any Other Business / None.