MINUTES OF CASTLE HEALTHCARE PPG
NOVEMBER 7 2017
PRESENT – David Luce, David Donovan, Ann, Coleen, Linda, Robert, Terry, Peter, Barbara, Louise
APOLOGIES –Karen, Dave Pratt
IN ATTENDANCE – Liz Walker, Dr Tewari, Dr Griffiths
1. Peter welcomed Liz Walker from ImROC who is managing the Live Well in Rushcliffe (LWIR) project and introductions were made. Later we were joined by Dr Trewari and subsequently Dr Griffiths. We understood that all three wanted to both inform and consult the PPG on a number of issues and so it was agreed that the planned agenda should be largely abandoned. In particular discussion of the Constitution would be postponed until the January meeting. Alan agreed to email all members a copy of the present constitution.
2. Liz Walker introduced herself and gave an enthusiastic account of the LWIR project which is funded for a year by Principia and managed by ImROC, a not for profit organisation. This is a social prescribing model aiming to support GPs when it is clear that there is a social component to the patient’s health problem(s) and also reduce non elective hospital admissions. The model seeks to identify patients who need greater connectivity to their community and help in setting health goals and/or becoming less isolated. Liz sees this as a two sided model; whilst some patients may need better integration into the community the community also needs to be a more accepting place. She is working with business, health organisations, housing, police, fire, etc. plus the third sector both to enable opportunities for meeting patient needs and for referrals/ signposting.
Accordingly 3 full time equivalent Health Workers are now appointed and 6 full time equivalent Link Workers. The former work with patients to discover their life style goals, the latter to support them in achieving them. Evaluation of the project is being undertaken by NTU. The university is also working on measures of cost effectiveness. Similar models have been tried in a couple of areas e.g. Frome & found to be cost effective. It is an ambitious project which, if successful, is likely to be continued & spread over greater Nottingham.
Dr Griffiths later indicated that he sees social prescribing as a means of overcoming the limitations of the medical model of healthcare & essential if the NHS is to cope with increasing demand. Targeted patients are likely to have issues with e.g. high BP, alcohol, overweight, mental health difficulties, isolation but could also include those with new cancers in the longer term. Managing long term conditions is also highly relevant but, initially, the project will focus on patients aged 40-60 and, therefore, exclude most of these patients. He described the model as a ‘big beast’ but, if only 5% of relevant patients can avoid diabetes, it would be worth it.
Dr Griffiths discussed publicising the scheme with us. Apart from the usual avenues, leaflets in key places etc, we suggested using media of all kinds but especially local TV. He also raised the possible content of a letter to targeted patients. He agreed to forward a copy of his draft for our comments. Dr Griffiths also briefly mentioned the offer of support from a new local firm in auditing the layout of information in the surgery at no charge. We supported the idea.
3. Dr Tewari raised the issue of medicine prescribing. He meets with the practice pharmacist once a month and presently they are targeting two key areas; safety & cost. They use a safety search engine to check the correct balance of meds & that there are no contraindications. Castle underspent their target by £4,000 last year but inevitably a tougher target is now set. Wastage continues to be a significant worry. Sometimes it can be detected e.g if too many inhalers are ordered by an asthmatic patient. But Castle is doing quite well on its targets, including reducing the demand for antibiotics, so the message is gradually being disseminated. Against this we have an aging population who tend to need more medication. A question was raised re plans for reducing the prescription of meds which can be easily & cheaply purchased over the counter. This hasn’t been introduced yet &, in any case, flexibility is likely where patients would find it difficult to pay, access a pharmacy or might be in danger of overdosing.
4. Survey – Robert has now produced the final version & it was agreed that we should start leaving copies on Reception & by the sign-in screens as soon as they are printed. We may also be able to leave them in the café & Alan will alert the virtual group. David Donovan offered to start analysing those returned. Analysis of the surgery’s survey had just been completed but isn’t available yet. Perhaps one day it may be possible to get frequent ‘survey monkey’s’ completed?! Louise will organise printing & distribution.
5. Self-Care Week – Louise had organised a small display on the information hub on receipt of some materials from the CCG. She had also messaged Sue Green to see whether there were any surgery plans. It was suggested that some materials could be added to the two existing health stands, one on each floor. Meanwhile it wasn’t felt that we were expected to do much as a group this year, ideas of a joint WB event having fallen through, & that in general the One You Campaign predominated.
6. CCG – Robert had sent key info from the last Patient Active meeting by email. Patient Cabinet meetings are now bi-monthly. A joint meeting of the two groups would take place the following week.
7. Virtual Group (VG) – there has been a request for the surgery to stop using gendered terms when addressing people on the electronic board as it can be upsetting to some patients. This led to a discussion of the use of middle names which some patients may prefer to remain confidential e.g. for use in data protection. Dr Griffiths thought both issues could be catered for.
8. A.O.B. – None. Date of next meeting: December 5. N.B. This will partly be a social meeting but we also have a speaker who will update us on Medical Research. Dr Singh plans to be in attendance and, as practice research lead, can tie in the work with Castle.