The Orchard Medical Practice CIC
Board Meeting
22nd December 2011
Group Room Hesa
12.30-14.00
Chaired by: Trevor Begg
Present: Dr Mohmed Adem (MA), Jennifer Rolland (JR), Wendy Chambers (WJC), Dr Satesh Sehdev (SS), Reshma Begum Gazi (RBG)-minutes.
Apologies: Cllr Jarjussey (Clr J), David Brough (DB)
Not Present:Douglas Parker (DP)
Introduction
TB welcomed all to the first formal meeting as the Community Interest Company was no longer running in shadow form since November 1st 2011.
TB had not received an apology from Douglas Parker for non attendance to the meeting today and requested WJC to check this. / Action
WJC / Outcome / Deadline
Matters Arising
TB explained that as this was the first formal meeting there were no minutes to the previous meeting and therefore no matters arising.
Today’s Business
TB explained that David Brough steps down from his role as interim Non Executive Director whilst in shadow form. TB thanked DB for all his work. TB informed that DB would be part of the advisory team.
Discussion led to the Hayes Town Engagement group which met bi-monthly during lunchtime at Botwell. TB suggested adding the Advisory Group meeting onto the Hayes Town Engagement meeting. Gemma Culverhouse, WJC and TB would rotate attending the meeting. Agenda items could be added to the meeting via Pricilla. TB would formally discuss with Pricilla and David. / TB / HTE group agreed to the proposal on the 24th of January
2, Transition Plan Review- Terms Of Reference
Members of the meeting looked over the terms of reference which needed alteration.
TB requested for Richard Eason to step down as secretary and either have TB or Susan Barber (Community Mothers) or TB would look into other possible candidates. Discussion around company secretary role and TB taking role on for the interim. No firm decision made. Review next Board Meeting.
JR asked if they NED’s would be paid for the work.
TB said at current they would not be paid for the work, apart from expenses.
TB clarified that SB was not a Non Executive Director and therefore once a part of the Board would not be paid.
TB informed the Board there was the option to have two NED’s possibly Susan Barber and Valarie Stango. VS worked within commissioning, currently CEO Harlington Hospice and would have the time required.
SS said Social Enterprise was community work.
TB said that SB would be the external facing role with Community Mothers and bring other objectives over 3 years.
TB mentioned that RN as Company Secretary had paid £20 per hr totalling £80. Therefore SB would be paid £20 per hr for 4 hrs totalling £80 for the meetings.
WJC asked if there would be any other additions.
TB said no there would be one figure. It would be a separate issue if SB were to get percentage of income generated.
TB suggested holding bi-monthly meetings.
TB asked if all were happy with Valarie Stangoe as Non Executive Director, all were in agreement.
TB to speak with Susan Barber, all in agreement.
MA and WJC raised discussion on linking mental health work in also as SB worked at THH.
WJC suggested using Community Mothers as an umbrella with mental health and immunisations etc underneath this.
TB would ask to look at these options.
SS asked TB into VS background work.
TB said NHS which would be helpful to the Social Enterprise.
1, Bi Monthly Meetings
TB suggested keeping at 4th Thursday of each month.
Please see embedded Meeting Schedule / TB
TB
TB
TB
TB / Amendments were agreed, document to be amended.
Review next Board Meeting
Extra Board Meeting January 2012
2, Transition Plan Review- Terms of reference
TB led the amendments to the document with:
- Bullet 5- to take out first 3 lines.
- CQC- to take out
TB said yes.
- Bullet 9- All agreed for TB to remain Chair from 1st November 2011 and to review November 2012.
- Vice Chair- All agreed to MA to remain Vice Chair.
WJC / Review Nov 2012
Clinical Governance
1, Policies
TB requested WJC to word policies as current and not shadow.
WJC stated clinical policies were outstanding all others were current and had met QOF reviews.
TB asked JR Clinical Governance lead if she was happy to work on policies.
JR said yes.
WJC mentioned currently the practice were working on PCT clinical policies.
JR and WJC would work together on this.
TB requested WJC to delete Community Advisory terms and add Hayes Town Engagement. / WJC
JR, WJC
WJC
SEIF 2
TB raised discussion on Capstick (legal firm). £3000 PCT error. Capstick would split bill in October 5 to £11,000
Capstick would offer legal work to value of £1000 which would equal 10 hours.
TB mentioned Capstick showed a vested interest in working with the practice and would look to offer better value.
TB raised discussion on Mclaren Perry July-August invoice of approx £26000. SS and TB had queried the invoice trying to reduce by 30% to which Mclaren Perry had failed to respond and had emailed the PCT in error over SEIF money.
TB explained as there was no legal contract with Mclaren Perry.
Performance
1. Quality Outcomes Framework- data
SS gave a breakdown of Population Manager figures. Current 764/772. Look ahead view with a projection of 94.2%, need to work to get 95%.
SS had given Elaine Rixon list of hypertension patients to call in for target.
SS mentioned diabetic patients were difficult to attain 100%. Although exception codes could be added.
There were only a few COPD patients for targets.
Mental health patient targets were improving.
Summarising at 56%, would have summariser in by end of next month. To look at in April once again
SS mentioned smears current target at 80%.
WJC noted QOF includes Smear disclaimers. Current 76%.
SS this did not show in population manager.
TB said KPI accepted smear disclaimers.
MA mentioned problem with Somali population and smears.
JR noted the smear uptake by the Somali population was improving.
TB congratulated the team on this improvement.
SS requested WJC to check on what information could be extracted on smears for KPI.
TB mentioned kpi targets had been met for prescribing.
SS gave breakdown to MA and JR on the prescribing. It was highlighted by all clinicians that the budget did not reflect the list size.
TB said this was another case for change under the KPI and suggested that a list be drawn up for the first quarterly Cluster meeting next year in order to increase prescribing budget. As the current budget did not allow for growth and was set at the start of the year.
TB asked it if was necessary to use SEIF money to get external help.
JR mentioned help received from Medicines Management at the PCT.
MA noted Talvinder from Meds Management had said TOMP were high on prescribing due to Kingsley Court care Home, which could not be improved any further.
MA reiterated as three prescribers at the practice the budget needed to reflect this.
TB suggested requesting a report from Talvinder to reflect this, which could be taken to the Cluster meeting due end of January start of February. / WJC
TB
WJC / Review in April.
Next Cluster Meeting End January
Next Cluster meeting
Performance
2. Key Performance Indicator
A&E Data- TB raised discussion on the TOMP A&E attendance data received from the PCT for October 10th 2011 to September 11th 2011.
The data showed TOMP as 13% per 1000 patients and the PCT at 19% per 1000 patients. With TOMP Urgent Care Centre use at 5.2 % per 1000 patients.
SS mentioned the low figures possibly due to addressing the frequent attendees.
.
WJC raised discussion on information received only yesterday where walk in centre were posting walk in patients with GMS1 forms, which had led to patients being registered by walk in centre causing confusion for the patients.
TB noted this was a serious issue which needed to be flagged to Bernadette.
SS mentioned the problem had occurred whilst under PCT but had not been addressed.
WJC suggested obtaining evidence (a copy of this letter from the patients).
TB suggested WJC to draft letter by SS to Head of Primary Care Contracts, Caron Clinton. TB would forward details to WJC. TB suggested meeting in early January when the letter could be viewed along with evidence and submitted followed by meeting with Bernadette.
SS suggested the evidence of patients returning to re-register at TOMP would be sufficient. SS was happy to take evidence to the next LMC meeting.
TB requested WJC to document this.
.
Discussion led to telephone consultations which had to be 10 minutes average in order to be logged.
WJC said these were currently split appointment cell and added to the session by the clinicians.
WJC suggested having one session on the book where all clinicians could add telephone consultations taken. This would be simpler data to extract.
MA suggested reception add patient when tasking request.
WJC suggested clinicians could “arrive, see and left” the patient once contacted.
It was agreed to pilot the idea and review at next board meeting.
TB highlighted that currently including telephone consultations, HCA appointments totalled 1744 per month. 24642 appointments per year with a list of 4500 pts
TB felt this was also a case for change to be made to the PCT. TB felt Access KPI target would need to be addressed to Bernadette also.
WJC added that currently the practice used urgent slots to meet the target.
TB informed and congratulated the Board that the clinicians were highly thought of at recent meetings attended. / TB
MA
SS, TB, WJC
SS
WJC
WJC
TB / Review Next meeting
Training
TB asked if there were any specific training needs.
WJC noted QMAS, QOF and change to SEIF.
TB suggested Company Law training to SS and MA as directors to a PLC.
MA agreed to this and TB would look into possible E-learning on this.
JR mentioned completing Governance training a few months ago which had been very useful. JR felt a need for in-house governance training for herself on Emis Search/Audits.
WJC would arrange training for JR with Nisha Patel Emis Trainer. TB requested that WJC take funding back pay for this out of SEIF.
TB would also speak with surgery in Brent running as Social Enterprise to see how they worked on this.
SS informed TB that life support training had been booked for all staff.
WJC mentioned fire safety training could be completed with a film.
Currently the staff were completing training on the revised matrix.
TB reported that any external training could be provided out of SEIF by end of March 2012.
SS asked TB for balance on SEIF.
TB said this depended on outcome with Mclaren Perry. With a possible £30,000 left to spend by end of March 2012. / WJC
TB, MA
JR
WJC
TB
WJC
Finance
TB reported that the finance was running to plan. Above on insurance. Under on service charge.
SS suggested discussing insurance at next contract review if over insured.
TB gave break down on insurance as £11012 per GP for 10 months totalling £800 over.
SS queried the annual fee of £4000 per GP.
WJC mentioned account returns were sent late to Stephenson & Co to enable financial report at this meeting. TB was given access to information on the account in view of this.
TB mentioned medicines.
JR was on top of order of meds.
TB requested WJC cc. TB into email to Bernadette to inform that PCT had not honoured prescribing reward.
TB highlighted that in was part of the contract that fee could be wavered if due to third party as above.
TB raised discussion on ideas for any other services to be provided.
SS mentioned MIND, mental health to be linked in.
JR suggested linking contraception education onto Community Mothers.
TB requested that ideas to be logged by end of December.
MA suggested Housing.
WJC suggested mental health triage nurse at Hesa.
TB requested all to email ideas by close of play tomorrow.
.
Agreed to trail telephone access and report back to Board in January. / ALL / End December 2011.
RBG exits meeting 14.45hrs
Next The Orchard Medical Practice Board Meeting
Thursday 26h January 2012
12.30-14.00
Group Room, Hesa- To Be Confirmed
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The Orchard Medical Practice CIC Board Meeting 22.12.11 Minutes.