Minutes of Kingskerswell and Ipplepen Medical Practice

Minutes of Kingskerswell and Ipplepen Medical Practice

Patient Participation Group

Meeting held on Wednesday 25th June 2014 atIpplepen Health Centre

People in attendance:

Health Centre Patients

Bill BarnesAnne Budd Katy Clarke

Eric CollarSarah GerryLesley Hocking

Ursula HuntPeter KerrLara Kramp-Chopin

Brian MacknessDavid MillerWendy Shillabeer

Imogen SewellSeona Wilson

Health Centre Representatives

Dr Nick D’ArcyGP Partner (Kingskerswell)

Bob HooperGeneral Practice Manager

Sonia CartwrightManagers Assistant & IT Lead

Lindsey EnglandAdministration Manager

1)Welcome / apologies

Apologies were received from Ian Cooper, Peter Lister, Muriel Poole, Rhona Renfry, David Ritchie and Julia Wood

2) Approval of last minutes and matters arising

The minutes of the previous meeting on 26th February 2014 were corrected for grammatical errors and were approved as a correct record.

Anne Budd wanted to clarify if the Weight Management Programme was the same as the ‘Change 4 Life’? Dr Nick D’Arcy explained that the weight referral management scheme was aimed at obese patients. A friend of Anne hadreceived a call from Crediton(?) but it sounded like they were not given all the information regarding the service.

Brian Mackness felt that the NHS 111 service had not been publicised enough, patients were confused as to what phone number they should use. Brian sat in on an NHS 111 meeting, he said it was a very complex telephone triage system, but run well. SWAST who run NHS111 had rolled it out in stages across the country; this area was one of the last so fewer mistakes had been made. The system has been set up as one access route for all of out of hours.

Eric Collar asked if there was any news on

• the parking at Torbay hospital now they have a new chairman?
• the locking of doors at Newton Abbot hospital?
• the appointing a lay person/patient to the Devon Doctors board?

Dr Nick D’Arcy had not heard of any changes relating to these matters which were all outside of the control and influence of the medical practice.

3) Practice team update

• GP team: Experienced GPDr Neil Hanley has joined the team until the end of October. Registrar Dr John McCormick would be leaving in August to take up a partnership at Chillington Practice in the South Hams and a new role with the Clinical Commissioning Group. The practice are expecting Dr Alice Beverly to take his place

Sadly Dr Charlotte Chandler will be leaving duringSeptember to join a medical practice in Exmouth, which is nearer to her home.

• Dispensary team: long serving employeeJulie Collins had left to join Day-Lewis Pharmacy but Jenny Clark a qualified Dispenser has returned to replace her.
• EU funded work placement: Robin Emond a 3rd year University student from Belgium was coming to work with the practice manager in July and August to help push forward a number of improvement projects

4) Joint work with Newton Locality Medical Practices

The practice had been working jointly with Albany, Buckland, Cricketfield, Devon Square and Kingsteignton on creating a New Proactive Case Management Register of the most frail / elderly / vulnerable patients in the locality. Generally these are about 2% of the practice population. All practices were participating in a new scheme to try and deliver an enhanced service to this group. In addition to a named GP to oversee their medical and care needs there would be apersonal care plan and multidisciplinary case review to try andhelp these patients avoid the trauma of A&E attendances and unplanned hospital admissions. In Newton Abbot locality Dr Nick Roberts was leading on introducing two special features

a.A specialist Frailty Service. Lead clinician (Dr Paul Johnson) and Manager (Solveig Sansom) had been appointed to develop operational detail and implement a specialist Frailty Service. Dr D’Arcy explained whatTEP – Treatment Escalation Planswere and how they worked. For out of hours copies of the forms were left in the patients’ homes. Sarah Gerry who works for the Ambulance service said how important these TEP forms were when emergency decisions had to be made about resuscitation

b.8am-8pm 7 day a week local GP support Lead clinician (Dr Nick Roberts) and Manager (Bob Hooper) had been appointed to develop operational detail and implement a local GP support service for the frail / elderly which extended beyond surgery opening times, up to 8pm weekdays and 8 to 8 at weekends. The local GP would have full access to individual medical records and care plans.

5) Changes to NHS England Patient Participation Group scheme

The practice will be preparing to start the new “Friends and Family test” later in the year. Originally this was due to start in October but Bob Hooper understood this had now been delayed until December. Bob said the funding for the local patient survey and annual action planhad been withdrawn to be replaced with the new standard NHS friends and family measure. A new leaflet/form was being developed.

6) GP Practice lists

In June, all practices in Devon Cornwall and Isles of Scilly were sent a list of patients who have not responded to an initial reminder letter sent to them in March and April by NHS England asking the patient to verify their address and status as a registered patient. The letters had been torn up as junk mail or considered a possible scam by many patients. As a result the Primary Care Services team (NHS Shared Business Services, SBS) had now dumped the work of following up all these patients up onto the GP practice administration staff. If the practices cannot prove the patient is resident at the address by the end of December they will be deducted from the GP NHS lists.The practice has over 600 records to check so far and no additional funding has been provided to deal with this additional workload.

7) 2014-15 Flu Immunisation programme:

This year the national Flu vaccination programme was being extended to include all 2, 3 and 4 year olds. Dr Nick D’Arcy explained that the young are amongst the vulnerable as they don’t have the immunity. Dr D’Arcy said that at age 5 plus they are slightly more robust but the intention was to eventually vaccinate all children up to the age of 17. The rest of the Flu groups are the same as previous years. The practice will take delivery of Flu vaccine stocks in late September and will be doing walk through flu clinics as normal starting with two Saturday mornings, one at Kingskerswell (11th Oct) and one at Ipplepen (18th Oct).

8) Meningococcal vaccination for students

This year studentsstarting University/Higher Education this autumn were being encouraged to have a meningococcal vaccination.

9) Evening twilight appointments

The twilight appointments have now gone back to Tuesdays and Thursdays on both sites but there will be more than one GP on duty on some of these evenings. HCA’s were also now offering late afternoon / evening appointments which was proving helpful for working people who want an NHS Health Check.

10) Wider Patient Involvement Issues

Brian Mackness kindly circulated his report (copy attached) on wider patient participation issues he had been involved with.

11) Ipplepen Dispensing Service Quality Scheme

Bob Hooper reported that NHS England had undertaken a routine inspection of the Ipplepen Prescription Dispensary. The conclusion in the inspector’s report read as follows:-

“I was impressed with the positive attitude of the staff at Ipplepen,which reflected a well managed; well motivated; well organized and documented quality dispensing service. Patients at the Surgery are fortunate to have such a good service.With the permission of the team at Ipplepen I would like to use some of your examples of good practice to share with other practices.

12) Clinical Risk Assessment Workshop

In preparation for a possible CQC inspection the practice had undertaken a “Risk Assessment” workshop with a facilitator from MPS (Medical Protection Society). The facilitator had been impressed with the practice organisation and management. A report of identified risks was being worked on by the practice team.

Lara Kramp-Chopin asked if Dr D’Arcy had anything to add about a story in the media today about a local family at Cricketfield Surgery whose child had tragically died . Dr D’Arcy explained that there would be press release tomorrow and he was unable to comment at the moment. He said that the CCG has done a lot of work with developing a new traffic light system and protocol regarding sepsis in children.

13) Any other patient feedback / other business

a) Appointments: Ann Budd had observed a lack of Practice Nurse appointments at the practice. It was a week before she could get an appointment to have stitches removed. Bob said there is currently a review under way to try and come up with a solution to free up more nurse appointments but he was not optimistic that a long term solution could be found.

Brian Mackness asked if there was a way to keep appointments for on the day emergencies. This however is something the practice does already. Dr D’Arcy said the practice does its best to make sure patients get an appointment when they want one and this was always challenging as matching capacity to demand each day was not easy, especially when holidays and sickness happen.

Eric Collar asked if the high DNA’s (Patients who booked but Did Not Attend) was a significant factor affecting the lack of appointments available for nurses? Bob said that other practices were suffering the same, and in most cases a worse DNA rate than Kingskerswell/Ipplepen. Katy Clarke wondered if it was patients with mental health issues that were not attending. Dr D’Arcy said sometimes urgent appointments were made in the morning but patients were not turning up later the same day. Peter Kerr felt it would be helpful if patients could be struck off after 4 DNA’s.

b) Dispensing: Immy Sewell asked why it was that some practice patients could not get theirprescriptions from Ipplepen when they were registered there. Dr D’Arcy and Bob explained that under current pharmacy regulations the practice was only permitted to dispense to patients in a controlled rural area who lived more than 1 mile / 1.6km from a Pharmacy. Some patient representatives recalled that when ASDA Pharmacy opened up in Newton Abbot the practice was instructed not to dispense to certain roads in Ogwell. Complaints about this restriction on patient choice had been made by this group and individual patients to the Department of Health and the local MP (Ann Marie Morris) but they were not willing to address this matter which protected Pharmacies from competition by GP dispensing practices.

c) Waiting Room music: Lara Kramp-Chopin asked whatpatients felt about music on in the waiting room as she personally finds it nauseating. Dr D’Arcy explained that inevitably some patients like and some dislike Radio 2 but the background radio played an important part in helping mask conversations at the reception desk and was therefore an aid to patient confidentiality.

Next Meeting

Wednesday 29th October at 18:30 at Kingskerswell Health Centre