Stennack Surgery PPG
Meeting Minutes
Monday 24th September 2012 – 6.30pm
Present (Not clear on the signing in sheet, apologies if incorrect)
Linda Petzing – Interim Chair (LP)
Fiona Vinnicombe – PPG Lead for surgery (FV)
Becky Cross – nurse
Miss Buckley
Liz Mogridge
Jane Grbovik
Chris Parker
Jane Parker
Mrs Stevens
Dr Wooton
Maureen Carroll
Alison Martin
Margaret Mudge
Terry Murray
Apologies
Dr Rupert Manley
Chris Gendall – Strategic Business Manager
Dr Sam Freegard
Gail Roxburgh - Nurse
Mrs Breakspeare
Mrs Proia
Mrs Alford
Mr F Richards
Pat Sanger
Suzy Goodeve
Introductions/Welcome
LP thanked everyone for attending and welcomed existing and new PPG members.
Pre-circulated minutes of the meeting on 23 July 2013 were agreed, approved and signed.
Allison May – End of Life Co-ordinator
Alison gave an informative presentation on end of life care. This links in with the Government's 2008 End of Life care Strategy, which states people are entitled to the best care no matter where they live and where they wish to die. Prior to this initiative 48% of deaths occurred in acute hospitals. Most people want to die in their own homes surrounded by familiar people. There are cost/capacity benefits for reducing admissions for this reason to NHS and improved patient choice.
Another aspect of the role is to ensure that all health professionals work in a co-ordinated waytogether; training GPs, community nursing staff and nursing home staff in the protocols and processes that promote high quality care.
Specific areas covered included explanations of:-
- The Liverpool Care Pathway
- Training of professional staff
- Interviews with carers of patients who had passed away to learn from their experiences
- Gold Standard Framework multi-disciplinary Meetings which have an up to date register of all those patients receiving palliative care
Group agreed with Alison on general inhibition to discuss death and dying in UK society. We should all be encouraged to discuss EOL wishes.
The EOL pilot is currently funded by the PCT until September next year when the decision on future commissioning will fall to Kernow CCG.
Further Group discussion ranged from Q&A about the service and why there wasn’t this level of support for mental health conditions and people affected by suicide. RW expressed a desire for this level of support to be made available throughout the NHS for everything.
One member of the group, praised the EOL service, reflecting on her experience following the death of her husband. It would have significantly helped and comforted on a practical and emotional level. AC&S continued to write to her late husband 3m after event and conflicting information from various health professionals also added to distress.
LP FV and the Group thanked Alison on a thought provoking presentation.
Matters Arising
- Microphone/Hearing Loop in Waiting Room – LP advised that a room-wide hearing loop would be impractical as it could result in other hearing aid wearers overhearing amplified conversations in the building. There are portable hearing loops available with limited range for 1:1 discussions. These could be used in consulting rooms in addition to the reception. There is still benefit in installing a simple PA system at the waiting room doors. The surgery is looking at reviewing the waiting room. These options will be included in the discussions, together with Who’s Who/Photos, Bio’s and other aspects of the waiting area.
- DNA’s –Positive posters are now in the waiting room thanking patients for attending appointments. FV explained that a series of letters would be sent to patients not attending or cancelling unneeded appointments She agreed to follow up/update progress on this and other initiatives on DNA reduction.
- Ultrasound Service- FOSS recently purchased a height/position adjustable couch, black out blinds and examination chair for £2025 to enhance the service available through the surgery. Members appreciated local access/reduced waiting. The organisation providing the service has two male sonographers. Questions were raised at the last meeting on a dignity issue and unavailability of female sonographers. One group member specifically requested, and was told she would have to go to Treliske, be placed at the bottom of the list, even then, they could not guarantee she would be seen by a lady. Another member had a scan at West Cornwall Hospital (WCH), undertaken by a female sonographer. FV agreed to ascertain the number/availability/locality of female sonographers in the patch. It was felt that the Referral Management Service (RMS) should be more open with patients on this sensitive issue. What is also of concern is why the RMS is not proactively promoting all services at WCH. It appears to never offer WCH unless explicitly requested by patients. Time after time, this option is being denied to patients for this and other NHS services. LP to raise these issues with the RMS business manager and report back to the Group.
- LP has since spoken to the RMS – Please feedback any comments re: bookings in general and whether the choice of going to WCH is being offered as an option if a clinic is provided there.
Chronic Disease
Statement to the group from a member of the data team following questions about chronic disease management at the last meeting and the importance of attending appointments -
Any patient with a chronic disease, such as diabetics, heart problems, asthma or chronic obstructive pulmonary disease (copd) is invited to attend an annual review at the surgery, in line with the department of health guidelines. This can involve taking samples of blood, urine, checking blood pressure and weight, or undertaking breathing tests.
Once these checks have been made, the patient is usually asked to make a follow up appointment to see the lead nurse that specialises in that particular disease to discuss the test results. At this second appointment a medication review is also undertaken to ensure that the patient is on the optimum medication for their condition.
In some instances patients have to attend more regular appointments (on a quarterly basis) to assist with the tighter control of their wellbeing.
All the above is specifically undertaken to ensure the patients general health is at its maximum potential.
Practice Leaflet
Briefly discussed. One member brought in a pre-amalgamation booklet, from one of the original practices. This included brief bios and other useful information. Proposed and agreed to review the leaflet on an ongoing basis. FV agreed to update the bio’s presented and add all the other clinicians. LP to monitor.
Young Persons Clinic
Group informed that a weekly drop-in clinics will start from this week running from 4-6pm every Wednesday. The PPG engagement work with St Ives School helped launch the service. RW, also mentioned it wasn’t the first time the surgery had worked positively with the school, saying how helpful they have always been. It was also noted no male clinician is being offered in this clinic.
RW expressed concern on no set minimum age around not involving parents of minors. FV explained all patients have a right to confidentiality regardless of age. The decision on the ability of a patient to demonstrate informed consent/right of confidentiality rests solely with the clinician (as per the “Gillick Competence” case in 1985).
The clinic is open to anyone under the age of 25. They will be seen by a specially trained nurse supported by Dr Shaw.
Carers
Linda mentioned that the surgery is attempting to reach carer’s to ensure that they are supported. The group was shown a proforma to complete and pass around the community. The Carer’s Service was mentioned. Free, 1:1 support, visits, completion of benefits forms etc. As well as help to access extensive support from community services across Cornwall. Representatives will be attending some of the surgery flu clinics.
Penwith Community Services Review
LP explained that there is a body with cross-representation across GPs, District Nurses, Social Workers, acute and community hospitals looking to improve the patient experience as the patient is transferred between different services. What was the transition like moving from acute to a community bed and what support received when moving back home? Medical professionals want to hear your story. The group was asked to pass the request out into the community. Please forward any feedback to LP. Dr Rainbow is one of the GP leads on this review board and would like the PPG’s input.
AM mentioned that it appeared that the District Nursing cover was very short over a weekend. She was surprised and thought that the provision would increase by virtue of pledge to deliver more home centred care. The group agreed to feed this back to the review via Dr Rainbow and GP PPG Leads.
Local Pharmacy Services
LP confirmed that the Boots Pharmacy at Carbis Bay is to close on 28 September. LP researched alternative options for those patients who rely on the pharmacy. She reported that the Boots Pharmacy branches at the Stennack and in the town offer a delivery service for housebound patients. Leddra’s pharmacy offer a delivery service to all patients from Tuesday to Friday, with a limited service on Saturday. A home visit for an annual review of medication can also be arranged. One member mentioned they ordered other toiletries and paid for them on delivery.
Several comments were raised about the waiting time at the Boots branch at the Stennack for completed prescriptions. Sometimes medication is not immediately available. One patient mentioned that her order was delayed due to her taking a larger quantity and therefore running out earlier than anticipated and her repeat request therefore being rejected as too early and the patient not advised. LP/FV agreed that it would be helpful if the surgery staff had informed the patient. FV to discuss with administration staff.
Another patient with a dosset box for medication was told that there were some changes. However due to visual impairment, the patient was unable to distinguish which tablets to remove and therefore the patient had to wait for the corrected medication to be arranged, which meant she was in fact taking the incorrect medication for several days. It was agreed that both the surgery and the pharmacy should be aware of these types of problems.
Chris Gendall is due to meet the area managers of all local pharmacies in October, LP will also attend and report back at next meeting. It was explained that all the scripts that previously went to Boots at Carbis Bay will default to Boots at the Stennack. FV explained process if people wished to nominate any other pharmacy.
Chris Gendall to remove Carbis Bay as an option from the Website.
PPG Membership Update
FV updated the group about the current number of PPG members. Currently 44 in the Actual group and 27 in the Virtual group. Members were reminded that it was agreed that if a member did not attend three consecutive meetings without giving their apologies that they would be moved to the Virtual group. They would still receive all the information.
PPG Structure/Roles
LP asked again if other members would be interested in taking on more specific roles for the PPG e.g. Deputy Chair, secretary, ambassadors. There will be an AGM in March 2013 where these roles will need to be in place.
Flu Jabs
The group was informed about the new drop-in flu clinics, and to pass this message into the community for anyone eligible. One member asked if there would be an egg free cultured option this year.
Action Becky Cross thought unlikely, but would check and contact the patient direct.
Newsletter
Several patients made favourable comments on the Day-in-the-life of a GP article. Everyone found it “fascinating, interesting and informative”. They had no idea of how much goes on behind the scenes. RW wished to acknowledge both newsletters have been produced to a very high standard and that a lot of work had obviously gone into the production of a useful and interesting publication.
AOB
RW mentioned and circulated information about the “CAN DO” conference to be held at Porthleven Methodist Church on 12 Oct 10-3. Leaflets and posters to be distributed in the waiting room.
JG mentioned the Chy-Sawel conference on 18 October at Alverton Manor, Truro on Mental Health in the 21st Century with guest speaker Dr William Walsh.
The meeting closed at 20.15
Next Meeting
Monday 26 November 2012 6.30pm Stennack Surgery Conference Room.