Southwell Medical Users Group
Minutes of the meeting held at 7.00 pm on Monday 7thJuly 2014, at the Southwell Medical Centre.
Present:
Dr David, Nigel Kenward,Paul Smith, Dennis Brown, Gillian Ramsay, Pat Palmer, Ron Smithers, Martin Lloyd, Carol Tinker, Geoff Tinker, Ann Smith, Kate Sartain, Nigel Nice, Sue Edmond, Sue Pearson, Sheila Fox, Don Fox, Bill Evans, Wendy Evans, Marian Kemp, Melitta Webster and Tony Morris.
1. Apologies: These had been received fromJen Stark,Jane Ellis, John Elkington, Glenys Breedon,Mary Dakin, Isobel McKenzie and Ted Waters.
2. Minutes of the meeting held on 14thApril 2014: These were approved as a correct record.
3. Matters Arising:
3.1–Seating outside the surgery for patient’s use –Nigel Kenward explained that the area by the entrance door was on a slope and attempts to level the area would result in a dangerous step being created. An alternative location on the grassy area by the waiting room window had been identified as a suitable alternative but would require some slabs to be laid. A quotation for this work had been obtained, but at £950 was thought to be too expensive. Further quotations were being sought and the work would commence when a reasonable price was found. Bill Evans suggested Tom’s Gardening Services as a possible supplier.
3.2–Provision of new toys for children to use in the waiting area –Nigel reported that the toys had now been delivered with the exception of the Lego items. Paul suggested that the photo shoot for an article in the local press should go ahead without the Lego so that the toys can be put into use. Nigel offered to find an alternative provider for the Lego if delays continued.
3.3 – Liaison with Southwell Neighbourhood Plan Committee–Paul reported that he and Nigel Kenward had met with Peter Pay and Southwell Neighbourhood Plan Steering Group (SNPSG) to discuss local health provision to 2026. Nigel noted that the Government had provided funding to local communities for the production of a neighbourhood plan to review amongst other things the provision of services of which health was one element. Two drivers had been identified, an increase in population due to house building and the rising age profile. The plan recognised an increase in population of approximately 500 and the Practice was confident that this could be accommodated in the current premises. The Practice also had no concerns in managing the services required for the aging population. The SNPSG will be producing a report in the autumnfor public review and comment. A copy of the notes of the meeting with the SNPSG is attached to these minutes. Kate Sartain questioned the projected increase in population and suggested that this appeared low considering the number of new houses in the plan. Nigel replied that this was the number provided by the SNPSG.
3.4 – Sleep Studies at Newark Hospital – Nigel Nice confirmed that sleep studies would still be carried out at Newark Hospital.
3.5 –Prime Minister’s Challenge Fund–Dennis confirmed that that theNottinghamshire and Derbyshire bid had been successful and the CCG had receivedguidance from the NHS England Area Team regarding the due diligence arrangements to allow the funds to be released. He noted that Kings Mill was now offering out-of-hours primary care services.
4.Chairman’s Report – Paul Smith
Paul was unable to attend the Stakeholder Reference Group (SRG) Conference on 27th June but thanked Tony Morris, Gillian Ramsay, Pat Palmer, John Elkington, Ted Waters, Geoff Tinker and Dennis Brown for representing SMUG at this event.
Paul had received notification that Healthwatch was holding a public consultation event at Newark library. Healthwatch was clearly very proactive at the moment and he suggested that it should be invited to arrange a similar meeting at Southwell library.
5.Secretary’s Report – Dennis Brown
Dennis had nothing to report of an administrative nature.
6.Treasurer’s Report – Pat Palmer
Pat reported that the balance in the account was £551.33.
7. Report from the Medical Centre–Nigel Kenward
Nigel reported that the Practice was working with the Southwell Flood Forum to determine how waste and surface water was managed at the medical centre site to determine if it contributed to the problems on the Ropewalk.
It was with regret that he had to inform the Group of the theft of a wallet from one of the consulting rooms. As a result of this, and the previous theft of some surgical equipment, the Practice had carried out a review of its security arrangements and would be installing CCTV cameras in all of the public areas (including outside). He noted that the cameras would also be used to monitor any aggressive or threatening behaviour towards staff. A total of 16 cameras would be used and would continuously record during the time that the medical centre was open. Recordings would be stored for 14 days.
Nigel reminded the Group that last November the Newark and Sherwood Clinical Commissioning Group (NSCCG) commissioned a report to explain the noticeable increase in deaths in the NG25 area between 2007-2009 and 2010-2012. This had been highlighted as part of a wider review of mortality across Mid Nottinghamshire. The review had been chaired by Councillor Laughton. The review concluded that the peak in deaths in the over 75 age group coincided with the opening of Southwell Court Care Home. The increase in deaths occurred because of the sudden increase in the number of elderly people moving to the area, some of whom died shortly afterwards. The NG25 area continues to have significantly better outcomes than Mid Nottinghamshire as a whole and the national average. The full report will be added to the practice website once it is made public.
Finally, Nigel reported that Dr Stuart Ockleford is likely to be leaving the Practice in mid August after some 16 years as a Partner. He is planning to move to Vancouver Island where he hopes to be able to enjoy more of an outdoor life style. Dr David confirmed that plans were being made to cover Dr Ockleford’s departure.
8.Future open meetings: Paul reported that he was still having difficulties in arranging speakers and venues for the proposed talks on diabetes and mental health issues. He had been surprised that the Minster School was unable to agree availability of the hall for September as it had not yet produced next term’s calendar. This was unlikely to be available until sometime in August. He reminded Dennis that he had yet to arrange a presentation by one of the NSCCG officers.
9.Art display - Gillian Ramsey
Gillian was pleased to point out the new display of water colours by local artist Pam Brewerton that would be on display until the end of the year. She also mentioned that she would be putting an article in the Bramley inviting other local artists to consider displaying their work in the waiting room.
10.Other reports:
10.1Stakeholder Reference Group (SRG) - Geoff Tinker outlined the working of the SRG for the benefit of new members of the Group. He reported on the SRG’s first conference held on 27th June at Southwell racecourse which had been attended by around 100 delegates. There had been key note speeches from; Dr Amanda Sullivan (NSCCG Chief Officer), Greg Cox (Assistant Director of Operations EMAS), Lynn Rutland (Locality Manager Northern Division EMAS), Caroline Baria (Service Director Nottinghamshire County Council) and Vicki Wells (Head of General Practice Inspection, CQC) and four separate workshops designed to increase the involvement of the patient representatives who had attended. Geoff thought that the key note speeches had been good although the presentation from EMAS had tried to show its service in a better light than was evident from the local performance statistics. Tony Morris commented that the workshops aimed at improving patient participation groups (PPGs) were only of marginal benefit to the SMUG delegates as we had developed beyond that. However, he praised the amount of work that had gone in to the organisation of the conference, particularly as it had been done by lay members. There was a general view from all of the SMUG delegates that more time should have been allocated for questions. Gillian Ramsay commented on the “market place” where organisations had been invited to man stands to promote their respective organisations. This had been provided to one side of the main activity and not many people had visited it. Also a number of organisations due to attend had not turned up on the day. Geoff noted that the SRG would carry out a full evaluation at the next meeting.
Geoff also mentioned that the SRG was currently undergoing a review on how it could best work with the NSCCG to help meet their joint objectives.
Tony Morris drew attention to a recent announcement from the Department for Health that the Government intended to place cancer and end of life care with private providers. He saw this as yet another example of the Secretary of State interfering with what should be local decisions taken by CCGs and asked Geoff to raise this at the next SRG meeting.
10.2Newark & Sherwood Clinical Commissioning Group (CCG) –Dennis had nothing to report as he had not been able to attend recent meetings.
11.Local Issues and Future Agenda Items – There were none.
12.Any other business.
12.1 – Ron Smithers asked if the prescription on-line service had been successful and how useful it was to the Practice. Nigel explained that the on-line service for repeat prescriptions had been introduced in November last year and so far some 500 patients had registered to use it. The Practice felt that it reduced any ambiguity that might occur using the phone message alternative.
12.2 -Ron had also heard that the Practice nurses would like to have additional nebulisers and blood pressure monitors. Dr David said that the Practice would always welcome additional equipment. Nebulisers are loaned to patients for use at home and sometimes don’t get returned. These cost around £400 each. The blood pressure monitors cost around £50. Tony suggested that funds for these could be raised in a dedicated raffle.
12.3 – Geoff Tinker thanked Dr David for attending the meeting despite having had a last minute emergency just before the meeting started. He also felt it appropriate to record the Group’s appreciation of Nigel Kenward having attended all SMUG meetings since his appointment and for his candid and transparent support.
13.Date of the next meeting– After some discussion it was decided that the next meeting should be on Wednesday 15th October starting at 2:00pm. This would allow other members of the Practice staff to contribute to the meeting. Finally Paul thanked everyone for attending and encouraged all patients to make use of the many facilities now available at the Newark Hospital.
Consultation Meeting with Southwell Medical Practice, Southwell Medical Users Group (SMUG) and panel members from the Southwell NP Steering Group
Monday 2nd June 2014 (11am – noon)
Present: Peter Pay NP Steering Group Convenor
Paul Smith: Southwell Medical Users Group Chairman
Nigel Kenward: Health Centre Manager
Cllr Julian Hamilton: District and Town Councillor and NP Steering Group Member
Cllr Mike Jeffrey: Town Councillor and NP Steering Group Member
The Structure of the Surgery is that it is a ‘stand alone’ independent business directly contracting to the NHS (99.5% + of work currently undertaken) 26% of the building is leased to local community Healthcare Care Trust.
The Practice has approximately12000 patients on its books (including the Villages) and this workload is managed by 6.4 Doctors with nursing, clerical, cleaning staff and admin making approximately 28 in employment.
This currently works out at 1175 patients per Doctor, although access to individual doctors may vary as some do not work full time.
It is felt that if the annual rise in population in Southwell and Villages continues to rise, as per the last decade (until 2026 ) then the practice will have reached its limits.
At present the Surgery is open for 50 hours per week, mainly in the daytime.
Obvious pressure points are with the Elderly (65-90 ages) with 24.75% in Southwell.
Some 45.36 % represent the 25-64 age group and 26.13% are children aged 16 -24 years. This figure is boosted by Students during much of the year from BrackenhurstCollege. As the Surgery covers many of the surrounding villages a further 4801 needs to be incorporated into these figures.
At present the above does not present any organisational or planning problems, but if numbers did increase it may be necessary to utilize the building differently. It will largely be a reactionary, in conjunction with the HJC.
It was interesting to note that a pilot scheme is underway for a ‘Virtual Ward’ Some 26% of this belongs to the HCT. The idea is trying to keep people from going into hospital in the first place and facilitating their early satisfactory discharge. Patient Care Workers and a range of Patient Support Services offer an integrated service to all patients including patients of the medical centre. This is geographically based at Rainworth but covers the entire Newark and Sherwood area.
Concerns were expressed at the loss of appointment slots ( Patients not turning up ) but the Manager did not see this as a significant issue and it was deemed better than many other practices.
The Appointments system was discussed and it was felt that there would always be patients that were not fully aware of the way the system works. If a particular Doctor is required it may be best to try to visit the Surgery at 8.00am or 1.30pm and ask to take up released appointments. (On 3 or 4 early morning visits made in the last two weeks to the Surgery early arrival secured released appointments. There were between 12 and 19 patients waiting at 8am and they were given appointments in strict order by the staff).
The recent SMUG survey portrayed the practice in a good light, showing very high levels of satisfaction will all areas of the service. Many developments have taken place, and are continuing to be utilised, including an Internet Booking System which has been favourably commented upon by patients, including one letter in The Times !
1