East Staffordshire Patient Engagement Group
Minutes of meeting held on Monday 5th April 2012
in the Boardroom, Edwin House, PCT Locality Office, Burton upon Trent
Present: Dave Kenton (DK) Alrewas Practice
Cyril Burton (CB) Bridge Surgery
Ann Tunley (AT) Carlton Street
Terry Marsden (TM) Winshill Medical Centre
John Bridges (JB) Tutbury Practice
Frank Morse (FM) Tutbury Practice
Alan Watkins (AW) Barton Family Practice
Betty Watkins (BW) Barton Family Practice
Jerry Latham (JL) Balance Street
Jennie Mechti (Wetmore Road)
David Mear (Dove River Practice)
Michelle Escombe (ME) Practice Integration Manager, ESCCG
Emily Davies (ED) Project Manager, ESCCG
Vanessa Day (VD) Patient and Public Engagement, PCT
ACTIONS1. / Welcome & Introduction:
Everyone was welcomed. Apologies were received from Richard Smith, Shelagh McKiernan, Marie Mavelock and Dave Bassett
2. / The minutes of the meeting held on the 5th January 2012 were approved as a true record.
3. / Matters arising:
Copying letters to patients. ED confirmed that posters should be on show in wards and clinics, making it know to patients that they have the option of receiving copies of letters. Members confirmed there were posters in out-patients and cardiology, but the latter were very small. DK said an email could be circulated to Queen’s staff suggesting that this information needs is made more visible. ED to feedback.
ED confirmed that the standard timescale for receiving copies of letters is 5 working days following a visit to a consultant. JB asked if patients’ responses were recorded anywhere and if not, how could this be monitored? CB suggested that every letter sent out to patients advising of their appointments had a sentence added to say that they have the option of receiving a copy letter. ED to feedback.
Online Patient Panel. ED advised that activating the use of the Patient Panel was to discussed next week and urged members to encourage other patients within their practices to sign up to membership scheme, which would trigger them being able to access the online Patient Panel.
A copy of the membership form to be attached to the minutes.
MAC UK
A position statement had been circulated, including the steps commissioners will be taking to address the issues raised. Members were keen to know how commissioners were going to proceed with this and asked how the contract was being monitored. ME advised that CCGs will be putting in place robust governance arrangements to ensure that this does not happen again. Andy Donald, the Accountable Officer for Stafford and surrounds and Cannock Chase CCGs will be taking the lead on this. Members asked for further updates.
GP working in Queen’s A & E
ME shared with the group an update on the Integrated Urgent Care Centre (IUCC), including its purpose why it was set up in the first place. (Attached.)
JB asked if there is a record kept of who goes through A & E and if so, is it possible to extract throughput in, say a 30 minute period in order to identify whether the service has resulted in a more efficient use of A & E? ME advised that this information is only accessible and extractable from the Queen’s hospital computer systems but she would get this for the next meeting.
The IUCC still operates over 5 days a week but this is due to increase to 7 days a week.
CB asked if the closure overnight of the A & E Dept at Stafford Hospital had impacted on Queens’s A & E. ME advised that Queens had seen an increase in throughput with ambulance diverts and there had been some problems with ambulance handovers at Queen’s.
There is a discharge lounge at Queen’s but this is not working as well as it should be. The CCG is in the process of evaluating this along with other front end services at Queen’s.
The introduction of the 111 service, combined with the renewed contract for the Out of Hours Service would potentially have an impact on A & E and members requested an update on both. / ED
ED
ALL
VD
VD
ME
VD
4. / Feedback on the PPE Workshop 20th March 2012
Members felt that the event was useful and informative; particularly the feedback from Bridge and Tutbury Practices on their experiences of setting up their PPGs. The overview of Clinical Commissioning Groups and how this was working in East Staffs was extremely useful. VD reported that Dr Pidsley had found the event really useful and was keen to have another one in about 6 months time.
AT asked that thanks be recorded to VD for organising and coordinating the event.
5. / Update on Staffordshire Cluster and CCGs
There is nothing to report on Staffordshire Cluster, other than the Health Bill receiving royal assent on the Tuesday 27
March and is now written in law.
DK asked if the Joint Commissioning Group was going to remain. ME advised that the JCU, managed through Staffordshire County Council, will remain and continue to work on commissioning services with CCGs.
JB asked if there was a simple diagram showing what health systems look like now and what they will look like post April 2013. ME said she would produce a diagram for the next meeting. A request was made to keep acronyms to a minimum.
ME advised that there are now 5 elected GPs on the CCG Executive. John Tansey and T Mead joined from March 2012. Rob Paton has had to step down from the Executive for personal reasons and his post is to be replaced. There is also a strong Practice Managers network to support the CCG. ME advised that she is leading on Partnerships in respect of authorisation. In respect of a GP presence at these meetings, it is difficult when the majority of their time is spent in surgery and asked members to consider say, half an hour’s attendance at meetings when items required a clinical input.
ME continued that East Staffs CCG is still a very small team, which does not have its full compliment of staff. An Accountable Officer to take the CCG through authorisation has also to be appointed and should be achievable in the next few months. The CCG Board is also required to have a nursing presence and ME had sent round a circular to recruit a Practice Nurse. The Board will also require a consultant, but this individual cannot have any ties with the local health economy, which will be a challenge. The other requirement on the board is the recruitment of 2 Lay Members, outlined below.
Lay Members. There is a national requirement that Lay Members are recruited to CCGs. Lay Members will ensure that the public’s voice is heard and that their expectations are understood and taken account of. One Lay Member will have responsibility for Governance and the other for Patient and Public Engagement (PPE). ME felt that the Lay Member for PPE would be ideal person to chair the District Group, in view of their direct link to the Board. Details of how to apply for these posts will be known shortly and PPG/District Group members will be informed of when this would be.
CB asked if there would be training and support for the individuals appointed and ME confirmed that there would be. / ME
ALL
6. / Update on GP Commissioned Projects.
Paediatric services. A review of paediatric services is underway with a programme of work to redesign the pathway of care for paediatric patients. The programme is focusing on the needs of acutely ill children and those with developmental needs and disabilities, both in acute and community settings. The review will involve sharing with young people, parents and carers plans to improve pathways of care to ensure that its not just commissioners and clinicians making the decisions.
Long Term Conditions (LTC). The LTC programme aims to improve outcomes and experiences of patients in the most cost effective ways. Patients identified as high users of services will be able to access teams of health and social care professionals, who will coordinate their care and help them to self-manage, which should help reduce the length of stay in hospital.
Any Qualified Provider AQP). AQP aims to extend patient choice and improve quality of service delivery for identified services which are currently delivered by the NHS. In East Staffordshire the services identified are: nail surgery, ultrasound and adult hearing services. The CCG is currently working on specifications which will result in applications being invited from external providers, with services being secured by October 2012.
Frail Elderly. During 2011 Burton Hospital created a Frail Elderly Assessment Team (FEAT) to support the management of patients that require acute care without an extended stay in hospital. To compliment this team, East Staffs CCG has employed 2 Community Geriatricians to help bridge the gap between hospital and community teams in the assessment and management of frail elderly patients.
Palliative Care. Across the West Midlands, 53% of all deaths are in acute hospitals and there is a regional drive to reduce this. Along with other CCGs across Staffordshire, the CCG has agreed to reduce the number of people dying in hospital by 6% each year for the next 3 years. The CCG is exploring options around ‘just in case’ medication for patients to keep at home as well as increased support for local nursing homes. The CCG is also working to increase the involvement of community palliative care nurses for patients with long term conditions.
Winter evaluation
The CCG is currently in the process of completing an evaluation of the winter period and would welcome patient views and experiences, good and bad, of local services. In particular, they would like to hear about experiences of hospital stays, how patients were supported to get home and with experiences of accessing other services during the winter period. / ALL
7. / Feedback from PPGs
Carlton Street. AT reported that their survey returns were very good, with lots of relevant comments received. Looking at a DNA policy to address the number of ‘no shows’. They have had a new phone system and have put in place text messaging to remind people of appointments and are looking to buy a phone purely for patients to use to cancel appointments, with a ring-in-only option. They had held a health event and were looking to hold another one on the 8th September 2012. Everyone welcome.
Balance Street. JL reported on his link with the Uttoxeter Multi-Agency Group and an update by the Dept for Work and Pensions, who provide advice for patients claiming Disability, Attendance and Carers allowances. GPs are not at present approved referral bodies but on the basis that they are often the first point of contact for patients, it is reasonable to assume they should become approved referral bodies. For further information: www.dwp.gov.uk.
The response to their patient survey was very good, which had generated a lot of interest in the PPG, to the extent that they may have to introduce a waiting list. Now looking at the election of officers. Setting up a virtual group was put forward as an option to cope with the high level of interest in the PPG.
Winshill. TM reported that their next meeting was due on the 25th April, so nothing to report this time.
Tutbury. JB reported that at their AGM they had re-elected their officers. A programme of work for the remainder of the year has now been agreed and speakers would be invited to every other meeting. Had a presentation from the Community Nurse and District Nurse at their last meeting. The PPG has been asked by the practice to produce an article for their next Practice newsletter.
Wetmore Road. JM reported a very good response to the patient survey. They had analysed the results and produced an action plan. The free text feedback was very interesting and most of the issues raised they can address. They have a very strong core membership.
Dove River. DM reported their survey had been undertaken and feedback revealed that booking appointments seemed to be a problem. Very good feedback on patients experiences of the GPs.
Alrewas. DK reported that the surgery modifications to the entrance to the surgery and reception area will be completed shortly. Their PPG now has a communication sub group. They are looking to have an open day in May and are producing a newsletter.
Bridge. CB reported that the survey is complete and results and action plan are online. Booking appointments seems to be a problem, but this has been narrowed down to the fact that patients want appointments between 8-9am. They are also looking at DNAs.
Barton. AW advised that they had completed their patient survey and were very pleased with the high level of response and also the level of appreciation of the Practice by patients. They had identified a problem of dealing with delays with GPs seeing patients, which can cause some difficulties. Their PPG is still a small group. Their next meeting is being held in the morning to see if it results in more attendees. Contact has been made with the local 6th Form. The PPG to feed into the practice leaflet and work on a PPG newsletter. One of the next steps is for the PPG to become constituted.
8. / Out of Hours Consultation
The contract for the Out of Hours Service currently provided by Badger, will expire at the end of March 2013. Commissioners are keen to get feedback from patients and members of the pubic on their experiences of using the service using a short questionnaire. The questionnaire is accessible on www.keysurvey.com/survey/428828/5ddb and feedback is required by the end of May 2012.
9. / Any other business
AT reported that a Diabetes Support Group is being set up in the Burton area. The first meeting is on the 25th April from 6 – 8pm Fifth Avenue, Centrum 100, Burton.
10. / Date and time of next meeting
The next meeting is being held on the 5th July 2012 at 1pm in Meeting Room 1, Edwin House, PCT Locality Offices, Burton on Trent.