Oakwood Medical Centre - Patients Participation Group
Minutes of meeting held October 14 2015
Present:
Monty Meth (Chair), Shirley Moy (PM), Elena Dellafiora, Lynn Lambert, Doreen Feldman, Tom Devine, Martin Dunn, Stephanie Jacobs, Della Patt, Nevin Kaleli, Rohinton Khajotia, Bernie Sandford (Bone Health Clinician) & Carol Sharp (Bone Health Fracture Prevention Lead Clinician).
Apologies:
Marilyn Brewster, Babu Shah, Maria Mitchell & Ruth Ross
Carol Sharp & Bernie Sandford kindly joined our meeting to raise awareness as to the service they offer in connection with falls prevention / bone health service for the Over 50s.
Bernie is new to her post with a background of 17 yrs in Intermediate care.
Bernie is a fracture Liaison nurse who works mainly with patients aged 50 –60 yrs who have already had a fracture and are now at risk. Bernie will also be involved with patients attending fracture clinics, to help prevent further fractures.
Carol Sharp works with the patients who are at risk of fracture and does many assessments in the patient’s home. She is likely to see the patients over 60yrs.
Carol left us with information leaflets and informed us that her referrals come from the following:
Ambulance services, GPs, other health professionals, community alarms and multi-disciplinary meetings. There are any reasons for a patient to fall, medical reason, in balance/ gait, a GP would first review the medication being possible cause if recurrent falls.
On receipt of referral Carol would go on to do an assessment.
One in two women is at risk of bones thinning/causing osteoporosis due to hormones/menopause. One in five men are also at risk.
NICE guidelines state that if patient is over 75yrs and no evidence of fracture then they need notbe referred for Dexa scan.
Part of the assessment includes assessing their bone health and possible risk factors are listed below:
Use of long term oral steroids Parent had hip fracture SmokerAlcohol
On four or more medications History of a fracture Use of insulin
An assessment tool is used to score patient risk and the patient would then fall in one of the following areas:*Green = lifestyle advice needed *Yellow= Bone density test which involves a DEXA scan*Red = Treat as high risk
Dietary advice would include oily fish /cereals
Twenty minutes to have face and arms exposed to daylight is deemed reasonable lifestyle prevention, although not all elderly patients are able to do this so Vitamin D /calcium supplements are also suggested. All recommendations are sent via letter to GP.
It was agreed that some clinicians recommend low dose supplements during winter months, regardless.
Other falls prevention advice is eye test, suitable footwear in some cases patients are referred to social services for fall prevention aids to be fitted in the home and for community matron to visit.
Carol confirmed referrals were being received from Oakwood Medical Centre’s maintenance of a GPs Falls Register. Only about six of the 49 surgeries in Enfield were said to maintain a register of patients with falls.
Good use of MultiDisciplinaryTeam meetings is they found some patients taking Alendronic acid for long periods of time , after 5 years this drug should be stopped for 2 yrs before restarted.
Patients who may have had a fracture in their younger days was likely to have been caused by trauma and this did not increase their risk of osteoporosis.
We all thanked Bernie and Carol for their attendance.
DNA:
Monty supplied figures of Did not Attend (DNA) results submitted from 9 practices in Enfield and we scored very well in comparison to other surgeries, which was good. Although Shirley felt the GP appointments offered by Carlton House being just 958 per month for a list size of 11,000 very low indeed and doubts it was correct.
Improving access pilot scheme:
Shirley confirmed OMC was one of the practices which had decided not to sign up for the improving access pilot scheme being introduced by the Clinical Commissioning Group at a cost of £612.000.The scheme was for surgeries to divert their patients - if they had no appointments available - to one of two sites, 808 Green Lanes N13 or Evergreen surgery, Edmonton Green N9, which would be open until 8pm on weekdays and on Saturdays .
The scheme would be run by the Enfield GPs in the Enfield Healthcare Alliance Network. OMC is a member of Enfield GP Healthcare Network which felt the money would be better spent if invested into all individual practices in Enfield to provide extra appointments for their own patients, where their medical records are available and follow-up treatment can be more easily arranged.It was thus safer and better for the patient & PPG agreed.
Shingles:
Patients aged 70, 72, 78 & 79 vaccine still available.
Friends & family test surveys:
Shirley informed the PPG that OMC scored the highest in Enfield for submitting this data and receiving the most responses. This is a contractual requirement.
Monty said he was happy that as only two patients expressed they were unlikely to recommend OMC, the figures were so low that it is not necessary to discuss as this will always occur with some people.
National Association of Patient Participation Groups:
Since joining this organisation last year Monty has received no correspondence from them and therefore felt we should not pay £40 to remain for a further year, all agreed.
Flu day:
Successful count last Tuesday morning was that 801 vaccines had been administered so far.
This year however all children are to have nasal vaccine and this has a short shelf life and is ordered via children’s vaccines by the nurses. Unfortunately there was a manufacturing delay and all Children had to be notified at short notice that this would not be available on 1st Oct . OMC had done its very best to contact all parents who had an appointment booked on flu day, but some did not receive txt message as mobile not on child records. Nasal flu vaccine finally arrived yesterday.
General feeling expressed that many now decline to have flu vaccine.
Pharmacists are now also giving it free, if patient qualifies for the vaccine.
AOB:
Monty raised the need for breast cancer awareness for over 70s.
Around 13,400 women aged 70 and over are diagnosed with breast cancer each year, accounting for a third of all breast cancer cases. 15 women over 70 die each day from breast cancer. Public Health England is urging all women If not within screening age to contact breast screening and request a mammogram. All ladies over 70 should have one every three years.
Shirley asked nurse Julieann to ask Julie & Asha to raise this when doing over 75 health checks. Shirley to put up notice.
NHS Choices:
PPG member Elena raised the negative comments on website, which is common for most practices, unfortunately.Shirley felt many patients only go to the trouble when negative and not as eager to make positive comments. This was a common feel amongst PPG, all are encouraged to remember to make positive comments as just as important.
Online access:
Are we planning on moving towards Skype consultations/online access to GP?
Shirley said “No, not yet although this is something that will probably become a mandatory form of access in the future.”
Later meeting time for PPG,
A patient who has approached Shirley and interested in joining our PPG but would prefer later time after 5.30pm, this was put to the PPG but all present preferred meetings earlier in the day.
Meeting closed at 11.25am.
Next meeting: Wednesday 13th January 2016 at 10am