Patient Panel
Minutes of the meeting held on Tuesday, 15 July 2014
10:00am – 12:00Noon, Boardroom, Floor 7, Regent House
Date of Meeting: / 17 July 2014 / Time / From / To
10:00am / 12:00Noon
Venue: / Boardroom, Floor 7, Regent House
Attendees: / (LH) Louise Hayes, Head of Communications
(EB) Elaine Borthwick, Patient Panel (Chair)
(PS) Pauline Slatter, Patient Panel
(MH) Maureen Harrison, Patient Panel
(VB) Veronica Bland, Patient Panel
(GR) George Rogers
(ML) Mike Lappin
(CM) Christine Morgan
In attendance:
(RR) Roger Roberts, Director General Practice Development
(VM) Dr Viren Mehta, Clinical Director
Apologies: / Gordon Smith, Irene Harris, Helen Adam, Evelyn Brown, Shirley Hamlett, Peter Jennings, Pat Fraser, Sue Carroll, Dr Sarmah
Minute Taker / Sue Jeeves, Personal Assistant
MEETING GOVERNANCE
Meeting Item / Responsible
1.  1. Apologies
1.1 Apologies were noted from:
Gordon Smith, Irene Harris, Helen Adam, Evelyn Brown, Shirley Hamlett, Peter Jennings, Pat Fraser, Sue Carroll, Dr Sarmah
2. Panel Business
The chair invited the group to raise items for discussion.
Several members requested that a discussion takes place about Healthier Together as this is now out to Consultation.
EB informed the Panel that the Stockport Vision session has been cancelled.
LH brought copies of the Healthier Together Consultation documentation which included questionnaires. She informed the Panel that if they are members of PRGs, EPGs or any other groups that a Clinician will be able to attend meetings if required, to discuss the Consultation.
EB informed members that she will be unable to attend the Panel Meeting on 16 September. It was agreed that CM would chair the Panel on this occasion.
Members requested an additional session on the Healthier Together Consultation. LH to arrange this prior to the next meeting of the Panel.
CM gave an overview of the Healthier Together Consultation. There is a huge financial issue facing the NHS. Its aim is to optimise care and improve quality by concentrating on areas of specialism, i.e. Stroke. Greater Manchester are working together and there are a lot of positives, for example, how doctors will work as a single service and will rotate around; this will be a good use of expertise. CM commented that there could be issues around access and travel for routine problems; it will not be easy for some patients to travel long distances.
CM commented that there will be an impact around children and young people. Clinicians are concerned that if acute surgery is removed, there will be delays and mortality rates may increase. There are 7 hospitals in Greater Manchester and 4 of these do not meet paediatric standards.
CM said that access is needed to paediatric services in hospitals and that a clinician is needed on site for 24 hours a day. She had concerns about how many Anaesthetists will be available and how quickly clinicians will be available in emergencies.
PS had concerns about the number of places being offered at the Consultation events across Greater Manchester. LH recommended that members book a place at the event being held at the Alma Lodge Hotel in Stockport on 12th August. LH said that the Communication and Engagement team would be willing to go out to local groups or have telephone conversations to discuss the Consultation.
ML commented that the Health and Wellbeing Board will be meeting on 13th September at Stockport Town Hall. He stated that these are public meetings and members are able to attend in order to hear the discussions taking place around Healthier Together.
LH informed the Panel that information will be accessible via the local press. LH/SH are responsible for getting the information out to the people of Stockport.
LH confirmed that there will be a bus/street tour for 2 weeks from 29th July. Key 103 will be promoting the Consultation and there will be a question time/panel session at the end of September.
ML commented that NHS Stockport Foundation Trust will be promoting the Consultation by having posters around Stepping Hill Hospital; three events are to be held for staff.
LH confirmed that all meetings/events will be professionally minuted and all views will be fed in.
GR asked which body will take the decision. LH replied that an external company called ‘Opinion Research Services’ will pull all of the information together and the Committee in Common (the 12 CCGs across Greater Manchester) will look at all reports/feedback and make that decision.
GR queried why Primary Care was not consulted statutorily and requested that a question be formulated and put to the CCG.
PS requested that MH brings feedback from the SHH consultation meetings back to the next meeting of the Panel in September. / LH
LH
MH
3. Action Log
The following actions were closed and therefore removed from the log: 009/14, 011/14, 013/14, 014/14, 015/14
4. Guest Speaker
5.1 Dr Viren Mehta, Clinical Director and
Roger Roberts, Director General Practice Development
RR and VM provided a presentation to the panel on Enhanced Primary Care.
Patient Participation Group Reports 2013/14 have identified that improvements are needed around appointments, telephone services, access to premises, patient awareness of online services and customer service training. The results were as follows:
Improve access to appointments by:
·  DNAs - sending reminders by text
RR commented that these should be looked at in the context of each patient.
VM commented that if there are repeat offenders, then practices have the support of PRGs to take the correct action.
·  Having phone consultations and triage
·  Making more information available on the website to include, travel vaccinations, opening times
RR commented that there is no scheme to extend opening times beyond 8.00am – 6.30pm and currently in Stockport all but one practice offer these hours. Timings however may vary from practice to practice.
RR reported that due to a large government project, Bury will be opening 8am – 8pm to include weekends. This service may not be offered by the same practice and patients may have to travel to a different practice from their own but within the area.
·  Extending the length of appointments and booking system
RR said that some practices offer double appointments. There are on-going issues with the booking of appointments and negotiations may have to be made with practices.
·  Make equipment accessible to support self-management
VM commented that the level of demand is high for minor conditions and patients need the skills to self-manage.
·  An E-prescription system
RR commented that all paper prescriptions are being moved over to this system and patients will have to nominate a pharmacy for these to be sent to. He added that 70% of the population will be covered by one electronic prescribing system by the end of 2014.
·  Advertising of mental health self-help resources
VM said that a lot of information is available from the on-line library and local libraries in Stockport.
Improve telephone access by:
·  Having faster response times
VM stated that there are high number of calls especially on a Monday morning or after a bank holiday weekend
·  Having a call queuing system
·  RR reported that a more sophisticated telephone system which will include queuing options, is to being set up at two practices in Stockport, Bramhall Health Centre and Cheadle Hulme Health Centre
·  Having the telephone lines open until 6.30pm
Have a range of On-line services for example:
·  Booking of appointments
·  Access to records and results
VM/RR commented that as part of the GP Contracts this year, practices should be establishing plans as to how they will offer results and access to records. Some practices in Manchester have gone for ‘open access to all’ but there are no practices in Stockport offering this service. However if any patients have seen this system, it was suggested that this is fed back into their various groups.
·  Consultations by e-mail
VM commented that there could be a security issue around this. He said that e-mails could be sent directly to patients thus developing a relationship between GPs and patients. He added that this could also support patient self-help.
VM reported that the majority of older people visit their GP 15-20 times per year and young family visits have increased; this could be more to do with reassurance. Practices are managing this extra demand but have had no additional funding. VM added that patients who have urgent demands and long term conditions need to be managed.
VM commented that video consultation is another option. Asthma reviews are also being thought about via this service.
·  Prescription ordering
·  Health information for patient waiting area
RR said that he thought that information should be made more visible in patient waiting areas, e.g. videos and that patient notice boards should be kept up to date.
Access to premises
·  Car parking
RR said that this is not ruled by Stockport CCG but by Property Services.
·  Call systems in the waiting room
RR said that a number of these are built in.
·  Prescription systems
RR reported that this is a huge piece of work for practices and there are currently a number of variations.
·  Loop systems
RR commented that not all practices have loop systems but should be encouraged to put them in place.
Customer Services training:
·  50/50 split between staff needing training and being impressed with staff.
·  Receptionists have been given the slide presentation from the recent NHS Stockport CCG Quality masterclass as refresher training
Problems in General Practice:
·  Ever increasing demand
RR commented that practices are currently working at capacity and it is difficult for most to keep pace with what they have to do. Long term sustainability is difficult.
·  Loss of capacity and fear, to self-care
·  Movement of activity from hospital
·  Increased complexity with NHS changes
·  Ever increasing administration
·  Staff shortages
Staff could potentially opt for early retirement and this would create problems in the long term
·  Financial squeeze
RR commented that this was around finances and workforce.
CCG Response:
·  New investment in General Practice
RR commented that a new phone system is being looked at and will be rolled out. £2m is to be invested into general practice from summer onwards for the next two years. We will need to know how best to use this money, e.g. specialist clinics, longer appointment times. Records will need to be scrutinised to identify patients who are at risk of disease and action quickly. He said that there isn’t an evidence base to identify what will make this work. All 48 practices will identify their own solutions which the CCG will follow up. There will be a patient satisfaction element included. If successful, hospital activity will be reduced; a process will be necessary to manage this.
VM commented that from a CCG point of view, practices want to make this work. It may include opening one or two evenings per week and ‘buddying up’ with other local possibly smaller practices. The out of hour’s services will deal with urgent matters rather than A & E. Mastercall are to issue 3 documents around emergency situations.
·  Reduce administration
·  Improve phone systems
·  Closer working with social care and community
RR said that a lot of work is being done around this.
·  Contract issue -online booking, prescription ordering & record access
CCG Investment:
·  Significant sum proportionate to size of practice
·  Aim
-  To prevent development of ill health
-  To manage really well existing ill health
-  To put patient in charge of own care
VM said that he is looking at practices with a view of identifying who has difficulties in finding patients who are at risk of certain conditions. He said this could be a ‘buy-in’ exercise where all practices work together. For example, if a patient has high blood pressure, certain skills are required to interpret the results and this could be done by another practice.
External Developments:
·  GP Federation
RR said the Federation has been formed within the last two months and is called Viaduct.
·  Healthier together and South Sector reconfiguration
RR said that this is looking at wider health systems.
5. Q&A’s
5.1 Are there any policies in place re patients who constantly fail to arrive for appointments? VM replied that all practices should have individual policies re handling this issue. The CCG don’t have a view as it is between practices and their patients.
5.2 Does the CCG negotiate with suppliers to get equipment for patients to buy for use at home? VM replied that it is difficult to find one supplier as there could be a legal issue.
5.3 There is a variation of Quality and GP Care, does this work hand in hand? VM responded that there is a local Primary Care Quality Group. There is robustness around data checking but this is not happening across the whole of Greater Manchester. Stockport is performing well and targets practices with low prevalence or where staff have left due to sickness.
5.4 There are a number of patients who go to see their GPs where is it not appropriate; how is this challenged/support given to GPs? VM replied that an alternative needs to be created for patients who may not go to see their GP for a genuine reason, for example loneliness in the elderly.
6. Agree message to Governing Body
Ø  The patient panel would like assurances on local services being delivered when hospital services are being run by Salford Royal e.g. dermatology and neurology. There are concerns that patients will have to travel to Salford e.g. for diagnostics such asskin prick testing etc.
Ø  What did the Healthier Together committee consider and reject regarding community care & primary care changes? There does not seem to be much in the Healthier together consultation
Ø  The patient panel feel assured that £2Million are being invested in primary care and tailored to specific needs. It would be good to get feedback on this as it progresses.
ANY OTHER BUSINESS
·  EB to arrange a meeting with a representative from Health watch.
DATE AND TIME OF NEXT MEETING
The next meeting will take place at 10.3oam – 12.30 Tuesday 16 September 2014, Boardroom, Floor 7, Regent House, Heaton Lane, Stockport, SK4 1BS