Whyteleafe Surgery Patients’ Forum
Wednesday 10 July 2013 at 7pm
Minutes of the Meeting
Present: Richard Allen Patient Representative
Theresa Archibald Practice Manager
Gordon Frost Patient Representative
Con Latham Patient Representative
Tony Lidbury Patient Representative
Sue Johnson Patient Representative
Ron Shrieve Patient Representative
Victor Tun Senior Partner
Liz Wallace Patient Representative
1. Apologies for absence
Apologies were received Susan Cornish and Wendy Denne. Susan had asked Richard Allen to act as Chairman in her absence and those present agreed with this arrangement.
2. Minutes of the meeting held on 1 May 2013 and matters arising
The Minutes of the meeting held on 1 May 2013 were agreed as a correct record.
o Car Parking
Richard Allen reported that he had taken up the issue of proposed changes to parking arrangements in the area with the leader of Surrey County Council. The matter is to be considered by a local Tandridge committee in the autumn and the needs of patients attending the surgery will be considered. There is a possibility that the council may negotiate free car parking for patients in the British Rail car-park if undue car parking restrictions are imposed in Station Road. However, the current expectation is that the proposal to have resident only parking will not go ahead due to lack of support.
There were no other matters arising not covered elsewhere on the Agenda.
3. Update on local/national NHS developments
o Patient Forum Action Plan
Stroke Prevention
This session took place on Saturday 1 June 2013. Approximately 50 of the 100 patients invited were able to attend. Unfortunately the nurse who was due to provide the education element of the programme broke her wrist the day before the event and Apodi were unable to find a replacement clinician. Feedback from patients who attended was mixed. Some patients appreciated the opportunity to see a specialist at the practice while others only saw a nurse for standard for routine measurements and commented that it was a waste of their time and that they received a better service from the Practice Nurse. This was disappointing as it was the education element that was felt to be of value. No contact has been received from the company following the clinic – but feedback will be provided to the CCG who initiated the programme and to Apodi in due course. Patients who were unable to attend on the 1 June 2013 were told by Apodi that they would be invited to an alternative clinic at a local practice but have not heard anything since.
Community Matrons
The software that identifies patients at high risk of hospital admission has been unavailable for several months while confidentiality issues around the new CCG are being resolved. Community Matrons are continuing to see patients recommended by the practice and it is hoped that the risk profiling software will be available again in the near future. This will enable the practice to participate in a new Directed Enhanced Service introduced by the Government this year. The practice wishes to improve liaison with the Community Matron and hopes that the number of patients on her caseload can be increased. Admission and attendance data from hospitals are combined with information about consultations and medication from practice data to give each patient a risk score regarding the likelihood of them needing unscheduled (emergency) admission to hospital. The scheme aims to provide intervention to keep these high risk patients in their own homes with appropriate care from community resources.
Receptionist Training Course
A suitable course provided by the private sector has been identified. Previously all new receptionists were sent on a comprehensive training course spread over several months which included course work submissions and/or exams. The training budget was withdrawn from practices several years ago and there is no longer any resource to pay for training – or any training provided by the NHS!
o Clinical Commissioning Group (CCG) Patient Reference Group (PRG)
Richard Allen and John Ritchie (a member of the electronic patient group) attended the meeting of the PRG on 6 June 2013 on behalf of Whyteleafe Surgery. John Ritchie has expressed an interest in attending Forum meetings and will be invited to join the group. Richard reported on the meeting to the Forum and the notes below are taken from the PRG Minutes:
Governing Body Meeting in public
The first Governing Body Meeting in public took place on Thursday 30th May. These meetings will be held every 2 months. Comments from Patients who attended this meeting were:
1. Lots of it was inaudible from where the public were sitting so this needs to be addressed and maybe microphone training is required?
2. Many felt acronyms were spelt out satisfactorily and this needs to be continued in future meetings.
The CCG will be advertising for 2 Lay Members to sit on the Governing Body Board The vacancies will be advertised in the local press and on the CCG website. A note will also be sent to Practice Managers to send out to their PPGs. Included in the advert will be details of the posts and the Terms of Reference.
East Surrey CCG website
John Stephen presented the new East Surrey CCG website (www.eastsurreyccg.nhs.uk) and demonstrated and explained all its features. It includes an ‘About Us’ page; a list of all the GP practices; services commissioned by the CCG; Freedom of Information; information on Voluntary Sector Organisations; PRG’s and PPG’s and a ‘Have Your Say’ section.
From the last PRG meeting it was picked up that often it isn’t clear where to go with a complaint. The website features a ‘How to make a complaint’ page which explains what to do when things aren’t right and how to inform the CCG. The first step should always be to raise a concern with your GP or whoever is responsible for that aspect of care. If you are still not satisfied, this page explains where to go next with your complaint. . The CCG’s aim is to keep it simple to use and we will value your feedback on whether the website is sufficiently user-friendly. This can be done by emailing () . There is also an ‘Ask Carol’ page which is an informal way for anyone to interact with the CCG.
111 Update
A soft launch followed by a public launch was planned. The public launch has not taken place yet. The service locally has been ‘live’ since April but there have been some performance issues. The service has consistently been delivering national requirements/standards on week days. . At weekends the service hasn’t been delivering as well which is mainly due to staffing problems and huge peaks in activity at certain times. These peaks have been identified and staffing levels have been increased at these times.. East Surrey Hospital have not seen an increase in activity since 111 went live, and in fact weekday activity has decreased.
111 has a huge directory of services and when it is running as it should it will become a single point of contact able to give access to all the services available locally. The CCG would like to hear any feedback on 111. Any complaints can be sent straight to SECAMB who are very good at responding and trying to resolve the issue.
The NHS 111 contract is a block contract, based on predicted call volumes over 3 years. The provider (South East Coast Ambulance) will absorb any above this level up to 10%. Anything over 10% will be billed separately.
In year 1, the predicted call volume is 1.2 million (but in reality we have a buffer of up to 1.3 million). The price of this is £8,700,870. If we used all of our call volume up in year one (so 1.3 million) we would pay the equivalent of £6.25 per call.
Reports from Practices
Part of the meeting was to hear from PPG members about what has happened in their Practice PPG since the last meeting.
Richard reported the following on behalf of Whyteleafe Surgery:
Members of the Forum are aware of incidences of dental patients being referred to GP’s rather than the dentist due to no emergency dental services in Surrey. A second survey has been completed and an action plan produced. The Forum have a section on the practice website for comments and complaints. The practice has identified a problem whereby people can leave comments about a practice on the internet (Google Maps). This item generated considerable discussion. Repeat prescriptions – Forum members have found that some packaging for tablets have changed and the size/colour of tablets. Some boxes have even been found to be written in foreign languages. This can be confusing particularly for elderly patients. The CCG were concerned about packaging being written in foreign languages as this is against regulations. Patients were requested to report any cases of this to Carol Rowley.
A Question and Answer Session followed with the following points:
Q: How many bed blockers are there in Hospital at the moment?
A: At the time of the PRG meeting 36 patients at East Surrey Hospital were waiting for a decision on their referral and 100 patients had been deemed medically fit. This is 3-6% of the patients in the whole hospital Community teams are becoming closely linked with the wards so a patient’s care can be planned in advance of their discharge.
Q: What will happen to unspent budgets at the end of the financial year and how will it be spent?
A: The CCG actually has a deficit plan for this year as it will take more than a year to get back on track . Any underspends on the budget will help. If there is any underspend at the end of the financial year this will go on patient care and the Governing Body will agree how it is spent.
Q: Why are INR Clinics under threat at Whyteleafe surgery?
A: These are continuing to run and the patient satisfaction is very high for this
clinic.
Q: Another large housing development is being built near Townhill Practice, how will the practice cope with this?
A: Practices have a need to increase their practice list size and generally are happy to cope with this. Patients go where they want to be seen and feel happy with the care they are receiving. Not all these patients will end up at the same practice.
Q: Statistics show that if you have an operation later on in the week or at the weekend, there is a 44% increase in the probability of dying. Will the CCG monitor this and stop this from happening?
A: Resources at the weekend are less so there is less medical staff available. Most hospitals have recognised the need for 7 day working and therefore the number of consultants working at weekends has increased. The A&E department in SASH has improved greatly. GP’s will base a decision on the knowledge they have on the surgeon and the service that is being provided rather than what day of the week the operation will take place.
Q: To improve waiting times in A&E is there more pressure being put on the GP Practices? Will the CCG be keeping an eye on this?
A: It is important that the CCG has a good relationship with the NHS England Local Area Team as they will be commissioning Primary Care Services. The Area team is based in Horley so the CCG will have a lot of contact with them. The Area Team will be invited to a future PRG meeting so that any questions or concerns can be raised with them.
Q: Will there be an annual report in accounts?
A: There will be a report at year end which will be March 2014. It will also be reported at the AGM. This will be a public document and every CCG will issue their reports online and paper copies will also be available.
Q: Is patient choice still operating?
A: On ‘Choose and Book’ GP’s will be able to see all services that are available and their waiting times etc. This will enable the patient and the GP to see what service is best for the patient at that particular time. This is going to be re-launched soon.
Whyteleafe Forum members discussed the use of Choose & Book which is still operational at Whyteleafe although not used on every occasion because it is not clinician specific – ie you can choose the hospital but not which consultant is seen there.
Q: There are concerns about the Opticians referral pathway which need to be cleared up.
A: Most referrals come directly from the Optician. If the Optician cannot make the referral then they have a duty to write to your GP for them to refer you instead. If an Optician doesn’t do this patients are requested to report the issue to Carol Rowley ().
Some Whyteleafe patients are aware of the direct referrals from opticians operating in Croydon. Input to referrals from GPs can be valuable in terms of information about co-morbidities for example where a patient is taking certain medication that will affect an operation.
Q: Is there any financial benefit to practices if patients have private health insurance?
A: There is no financial benefit to practices but it does benefit the whole CCG and local health economy if you have private health insurance. The patient also has more choice of when they are operated on and by whom.
Date of next East Surrey PRG meeting
The next meeting of the will take place on Thursday 24th October between 7-9.30pm at Nutfield Lodge, Redhill. This is a change of date.