MARYLEBONE HEALTH CENTRE
PATIENT PARTNERSHIP GROUP (PPG)
Minutes of meeting 15.10.2012
Meeting Chair: JacquelineGlasser (Chair)
Present: Jeanette Creaser(JC), Drew Hyman(DH), ,Moosa Bhayat(MB), Jim McGeehan(JMc), Robert Eddison(RE),Charmian Bollinger(CB), Bernard Davis(BD),Andre Robert(AR) Dr Goodstone(Dr G) Judith Morris(JM)
Apologies- Hayley McHugh(HMc) Pat Green(PG),Sarah Redford(SR) and Marina(M)
1. Apologies noted.
2. Minutes of last meeting Minutes were approve by PPG.
ActionJC to ensure acronyms are explained clearly in body of the minutes when first shown
3. Matters arising:
All actions were noted from last minutes as being completed.
4. GP Update-Dr Goodstone
4.1 SAFE Prescribing- DrGoodstone described the practice safe prescribing policy. Depending on medication prescribed patients are given 3 month, 2 month or 1 month’s worth of medication. Most medications are prescribed on 2 monthly prescriptions. A patient’s medication should be reviewed on a regular basis to ensure patient is taking medication as required, and that there are no contraindications. This is best practice and work was also underway to ensure safedosset box prescribing processes.
4.2 Some patients avoid having reviews as they do not feel that they are necessary, or for otherreasons. PPG discussed actions the practice should take when a GP has asked a patient to attend for a medication review yet the patient just makes continual routine requests without attending for a medication review. PPG felt that safety when prescribing was something the practice was right to enforce and that patients had a personal duty to ensure that they attend medication reviews when requested. Following discussion, PPG felt that when a patient makes a routine request for medication after they have been asked not to do so until they have had a medication review with the GP, the surgery should only provide a 14 day prescription and the practice not hand over the prescription without the patient booking an appointment. If the patient then fails to attend a medication review, when they next request a prescription they should be given a 7 day prescription only. If the patient continues to refuse to accept a medication review then the surgery should invite the patient in to meet and discuss the situation with JC.
4.3 There are up to 30 ‘urgent’ requests each day for same day prescriptions, few of which are clinically urgent. Dr G explained this can be due to a number of reasons, patients going on holiday the next day who have forgotten to request a supply in time and whose supply will run out while away, patients attending private consultant clinics who prescribe a medication privately which the patient is keen to start taking and wants the surgery to change from a private to anNHS prescription, hospitals discharging patients with little medication, a patient running out, or a patient forgetting to order their medication in good time.
PPG had a lengthy discussion and feel strongly that reordering prescriptions in good time is the responsibility of the patient and that the patients should be made aware of their responsibility. When patients request an ‘urgent’ prescription due to their own error then a 14 day amount of medication should be given as with medication reviews.
Dr Gexplained that the surgery would not wish to withhold medication, however PPG felt that where a medication was requested which did not need to be issued immediately, then the surgery should insist that the patient waits for the normal turnaround of 48 hours.
Actions-JC and PPG to publicise pharmacy reordering systems which may help patients synchronise and be more organised when requesting medication. ON line ordering works well and patients should be encouraged to use that system so requests can be made when the surgery is closed. Repeat offenders of ordering ‘urgent’ prescriptions should be written to by JC.
4.4 Dr G thanked PPG for their consideration from a patient’s perspective and would discuss with the other doctors at the surgery.
5. PM update- Jeanette
5.1 Central Locality update- Ongoing planning to increase access at each surgery, to ensure that care is given in the most appropriate place (called Choose Well) and where possible in local practices by staff patients know and trust, and making improvements to the care provided.
Currently the Locality is looking at under 16 attendances and the practices are taking part in a pilot where parents would be contacted should their child attendA&E by their Health Visitor to review safeguarding issues or just offer support. Data will be collated to establish why patients attendedA&E rather than their own practice.
The Locality is also looking at shifting patients from hospital anti coagulation clinics into their own GP practice or into a local GP practice service.
Work is also underway to look at the requests to GPs by local opticians for patients to be referred to a consultant ophthalmologist, often with no outcome from the appointment they attend. This happens because currently opticians cannot offer the checks which the hospital consultant can, which many opticians would have been happy and felt competent to do. This work is being led by Locality GPs, ophthalmic consultant and a representative consultant from the Opticians Committee.
District Nurses will be realigned from working across a mapped area to working with practices and being responsible for all their registered patients (within a reasonable travelling distance).Dr G described how this could work and gave examples of where it works well. PPG felt that this continuity of care and integrated care approach sounded practical and beneficial for the patient experience. Additionally they are keen to ensure resources are spread fairly across the CCG(Clinical Commissioning Group).The PPG was interested to hearDr G describe the co-location of social and health care teams and said that they would welcome this at MHC.
ActionJC to sendJM the meeting timetable for the Locality meetings.
5.2. Premises- Loose chairs have been taken for repair and recovering and when returned the benches would be adapted and recovered.JC explained that there may be a possibility of acquiring more space in the church. Partners were considering additional clinical space, meeting/social/exercise space for patients and offices for staff. PPG suggested that should this take placeMHC consider the need for space to collocate social care teams.JC would keep PPG informed if this does gather any momentum.
JChad met withTony Frazer Price who agreed thatArt in Marylebone( AIM) would like to help by providing photographs from A Day in the Life of Marylebone for display in the Waiting Room andJC shared a book of the photographs. It was suggested that photos of the Health Fair might also be displayed. ACTIONJC to contactTFP re advertising and photography for the fair and the patient who had expressed an interest in the selection of the AIM photos.
5.3 Survey on minor surgery results were presented and discussed and PPG was pleased to note that the results were extremely positive.JC said that the telephone consultation survey was now underway and gave PPG a selection of questions and an example of the whole appointments system survey which would be run at the end of October. The questions and survey were based on those suggested in the last survey and survey review discussions. Action PPG to feedback toJC any changed/additions or amendments required within the next 2 weeks.
5.4 Staff changes-JMcG would be attending the Practice to sit in on doctor Interviews as Dr Ortiz had decided to return to Spain and was leaving the surgery in January. 2 new reception staff would be starting, Tracey andCharmaine who were on probation, and if they pass probation they will be working on Reception in about 2 weeks post training.
5.5. PPGInformation -own leaflet is to be drafted by the Chair. Action Chair and JC.
Chair feedback fromHMc who had agreed to review the PPG notice board and she felt that it should be made more current and more visible.HMc had looked at the board and suggested it be moved, cleared and a coloured backing placed behind PPG notices to make them stand out. PPG agreed with the backing but were not sure where the board could be moved to make it more visible. PPG visited the space and considered a number of options. BD suggested a tickertape type PPG information screen which rotated and changed (such as on buses and in hospitals) might a better alternative and it was agreed thatJC should investigate the possibility of that . ActionsJC to investigate options andHMc asked to create backing for current board and update notices so board is more visible (but not move board at the moment).
5.6 PPG ThankedDr G very much for attending.
5.7 Complaints and comments: a concern had been raised by a patient related to the Fair whichJC had discussed with the patient who reassured about its intentions. A patient had raised concern that the Practice was too rigorous in challenging frequent do not attend patients. PPG said that they felt the Practice should continue to do so.JC reported a comment left by a patient who requested Yoga classes be reinstated atMHC. PPG agreed that as there was no space available Yoga classes could not be offered at the moment.
6 . Health Fair Update- CM
6.1 CB feedback that the working group had met a number of times.HMc had resigned but that another patient (Marina) had joined andJC said that a second new patient (Billie) indicated that she would like to help out where she could.
6.2 CB confirmed date, time, and details of discussion forums, setting up arrangements and plans so far for the day. CB andJC agreed that the planning was in advance of other years and the working group were happy with work to date.
6.3 Posters and leaflets were handedaround. RE said he would contactActionAGEUK to see if they were interested in attending and DH would contactNeal’s Yard.
6.4 Raffle- M, the new member had agreed to manage the raffle with support fromJC.JG gaveJC some prizes and agreed to contact Atherton and Cox as well as leaflet dropping.
6.5 Refreshments were to be provided by the Coffee stall at the entrance of the church at a discounted rate.
6.6 Social services-JC to chase up to see if someone could attend the Health fair from Social Care ActionJC to ask
6.7 Confirmed helpers on the day-JM, RE,JG,CB,AR,JC, M. Action JG to ask PG,JC to ask Voluntary Action Westminster, Prim,Ethnie if they would like to help.
6.8 Chair thanked CB and the working group for all their hard work, successes to date, and PPG concurred.
7. Commissioning update (NHS Central London= NHSCL)
7.1. Discussion retransport: NHSCL confirmed that they are considering transport when work underway and when planning the Out of Hospital Strategy(OOH). JG described a scheme whereNHS will pay for transport for patients. JG said she would investigate further the Voluntary Drivers scheme. ActionJC and JG to investigate..
7.2 JG feedback from the CLH User Panel PPG event of 10th Oct where David Jones, Practice Manager of Newton described their ‘Virtual ‘ PPG – see 8.3 below, and Dr. Vaidya and Roz King discussed the NHSCL OOH, Shaping a Healthier Future planning. She reminded the PPG of 15th November (No Decision About Me Without Me) event
7.3 Learning Disabilities- Chair described an update from a meeting she had gone to which focused on how patients with learning disabilities access health care and described some of the ways in which this can be improved and made easier. PPG felt this was an area they would like to know more about.JC andDr G described the system run atMHC which gave PPG reassurance that patients atMHC with known learning disabilities appeared to be receiving a high level of care.
7.4 Chair described how at a patient forum planning meeting run by an advocacy project where patients had agreed 3 areas which should remain a focus in the year ahead for Westminster. Carers, Mental Health Programmes and Learning Disabilities.JC suggested that these may be areas which PPG would like to consider as work for year ahead. ActionJC to agenda for next meeting.
8. Work plan
8.1JC to contact Fran and wish her well from PPG. Fran may wish to be involved ‘remotely’ and enabling PPG members to be active with PPG remotely must always be considered.
8.2 Newsletter- December edition considered. Items to be considered: Choose Well, and alternatives toA&E services, In Case Of Emergency Scheme (ICE), Did you know section, Results of surveys, user event updates, Prescribing and Health Fair review. ActionJC to start to prepare draft.
8.3 Communications plan- Website- JG said that at the recent User Panel event it appeared that Newton only had a virtualPPG but no PPG where face to face meetings took place and that some were used solely for information sharing by the practice. PPG was clear that this was not their chosen direction of travel. However it was agreed to have a ‘Virtual’ as an additional strand could be helpful. Action: JG will explore and as a first step will speak to patients at the Mother and Baby clinic
9. A.O.B
9.1 Concern was noted about changes to services such at Western Eye Hospital.
9.2 PPG elections were held. JG was proposed as Chair byJC and seconded by DH, and unanimously elected. CB was proposed as Deputy Chair by DH and seconded byJM and unanimously elected by PPG as Deputy. Both were thanked by PPG and the practice for their work to date.
9.3JC gave out handouts related to the consultation on speciality older people housing in Westminster.
9.4 BD gave apologies since he would not be able to attend meetings again until May 2013. It was suggested that there should be juices and a few snacks for meetings in future.
Next meeting: 26th November 2012 6-8pm
The Marylebone Health Centre website addresswww.marylebonehealthcentre.co.uk
The Central London Healthcare website address www.centrallondonhealthcare.co.uk