Minutes of Crewkerne Health Centre Patient Forum held on Thursday 24th Nov 2011 at Crewkerne Health Centre (CHC) at 7 pm
Present: Neville Adams, Geoff Clarke, David Colwill, Kerry Cousins, Sue Dewson, David Hughes (Chair), Jayne Nicholas (Secretary), Roger Smith, Tesa Budd, Anne Down, Louise Walker.
Apologies: Lisa James, Sylvia Allman, Joan Farris and Biddy Martin.
Item / Action1. / Minutes and matters arising from meeting 25/10/11
The Treasurer role was discussed and agreed to wait until funds have been raised. Anne said that she may consider taking on the role in 2012.
The plans for the new Health Care Pharmacy were available for all to see and are attached to the minutes, plus a planned press release.
Louise gave some of the details and answered questions about the new service:
· It is a joint venture with Community Pharmacies and the practice
· CHC is keen to have input into the pharmacy management
· PCT granted the “100 hours” licence
· Will be open 7am to 11pm Mon to Sat plus 10 hours on Sunday
· The development will include a revamp of the front entrance which will have a ramp for wheelchairs/buggies and electric doors
· The patient notes will be moved to an off-site secure location to provide space for the pharmacy
· Will not be a full “retail” pharmacy but will provide basic over the counter medications.
· The new pharmacy will pick up prescriptions from the practice as the current pharmacies do and will not affect repeat prescriptions
· The Co-op pharmacy have been aware of the plans and had an opportunity to be involved
· Planning permission for the signage still to be received
2. / Information session – Commissioning with Dr Andy Dean
Dr Andy Dean gave some background to the current commissioning situation.
Twenty years ago GPs could refer and prescribe whatever they chose without worrying about costs. This was obviously unsustainable and they had to move to a more cost-effective system. GPs are joining together into groups of 10-12 practices to work out what will be required.
Clinical systems give information and costs on referrals, hospital episodes and performance against budget and if they are spending funds wisely.
An illustration of the “Commissioning Cycle” was shared and demonstrated the need to look after the whole community by looking at public health, historical information and what is happening currently. They will look at patient journey and identify issues like length of wait, journey, investigations, communication and outcomes.
It is now possible to anonymously interrogate GP systems and compare disease areas and spend with other areas and identify outliers. Management support has been provided by the PCT/Clinical Commissioning Group to enable GPs to do this work. Chard, Crewkerne and Ilminster Group meet monthly and recently looked at local clinical areas and how they are performing.
There is a national tariff for all conditions and services which is averaged across an area. Ensuring treatment is appropriate is not about cost saving, however, rationing is a reality but mainly in non-priority conditions.
Individual cases with high costs have special budgets attached which are shared across a wider area.
Practices are being asked to live within a budget which is calculated on patient numbers and outcomes. Budgets are shared across a group of surgeries. Most practices are overspending their current budget as hospital referrals are going up.
Data can be investigated to see where referrals are increasing and can ask GPs with specialist knowledge to look at specific areas. Current practice is to send patients to other local practices to receive treatment e.g. dermatology, joint injections which are run by GPs with a special interest (GPwSI).
EASE clinic is also a half-way house and referral management service for physiotherapy services which reduces costs and speeds up services.
The Clinical Commissioning Group will be able to commission new local services but will need to consider safety, implications for hospitals and the issue of commissioning and providing services potentially by the same GPs.
Kerry asked specifically about dementia services and plans to manage the likely increase in people suffering from this distressing condition.
Dr Nick Warner, Consultant Psychiatrist, visited CHC last week to talk to the GPs about assessing and managing memory loss, which is an issue as we live longer and dementia medications can be expensive. Dr Dean noted that several medicines are now coming “off patent” which makes them much cheaper. Tesa noted that fear is a huge part of dementia and Dr Dean commented that early diagnosis was an opportunity to prepare for the future.
The increase in elderly people in Somerset and the media’s constant encouragement to “see your GP” has resulted in the move to pro-active prevention rather than reactive treatment.
Dr Dean was thanked for giving his time to talk to the group.
3. / Out of Hours Services – Jayne Nicholas
Jayne shared a document she had put together showing the local Out of Hours options for when the surgery was closed: (see attached)
· Local Treatment Centre at Crewkerne Hospital
· Minor Injury Unit at Chard Hospital
· Out of Hours GP
· NHS Direct
· Yeovil NHS Health Centre (Boots)
· Emergency Department at Yeovil Hospital
Jayne suggested that by educating patients as to what services are available locally and the hours/days they are open, it would help ensure people accessed the most appropriate service and mayl cut down the waiting time people will experience.
The following suggestions were made as to how the information might be used:
· Add details to practice leaflet and website
· Put on dispensing bags/ pharmacy receipts/prescriptions
· A large print version should be made available
· Poster in the practice
· Stand at Farmer’s Market
· Town Council newssheet
· Media campaign
It was agreed to add to the agenda for the next meeting. / KC/JN
4. / Access Arrangements at the practice – Louise Walker
Dropped kerbs – Louise reported that Sylvia was no longer sure this was a good idea. Belle Vue Terrace has one but remaining pavements have a short and narrow area for dropped kerbs.
Louise offered to chase Mike Fear at the Council as nothing has been heard since the information that it was an “unadopted road”. / LW
5. / 2011/2012 Patient Survey – Louise Walker
Louise shared the Patient Survey the practice has put together on the new appointment system. Various amendments were suggested which Louise will consider. The plan is to send it to the 110 people on the Reference Group and put copies in the surgery as well as hand them to patients. It was noted that most patients on the Reference Group were over 60. / LW
6. / Next Meeting date
The next meeting will be held on Tuesday 24th January 2012 at 7pm at the Health Centre
. / All
1