Whyteleafe Surgery Patients’ Forum
Wednesday 16 October 2013 at 7pm
Minutes of the Meeting
Present: Richard Allen Patient Representative
Theresa Archibald Practice Manager
Wendy Denne Patient Representative
Gordon Frost Patient Representative
Con Latham Patient Representative
Ron Shrieve Patient Representative
Victor Tun Senior Partner
Liz Wallace Patient Representative
1. Apologies for absence
Apologies were received Susan Cornish, Tony Lidbury, Sue Johnson and John Ritchie. Theresa Archibald chaired the meeting in the absence of Susan Cornish
2. Minutes of the meeting held on 10 July 2013 and matters arising
The Minutes of the meeting held on 10 July 2013 were agreed as a correct record.
o Community Matrons
The software required to support this initiative is still not working correctly and the practice is recommending patients to the Matron from personal knowledge of their circumstances.
o Text messages
There has been a glitch in the system and we did not realise until recently that reminder texts for appointments were not being received by patients. The fault has now been rectified.
3. To consider information relating to Practice arrangements:
Doctors
Arrangements for notifying patients of the impending retirement of Dr Ann Roberts and appointment of Dr Dan Matthews as a full time partner were briefly discussed. A notice has been placed in reception and the information is on the practice website. Dr Roberts has expressed a preference for a “low-key” departure due to her family circumstances. Liz Wallace reported that patients she had spoken to had consulted Dr Matthews when he was at the practice previously and were pleased that he was joining the practice.
The group were informed that Dr Rajarajan would be commencing maternity leave early in 2014 and that a maternity locum would be appointed to cover her absence.
Nurses
The specialist nurse who ran weekly diabetic clinics has unfortunately had to leave the practice. This means that diabetic appointments can only be offered on Fridays at the moment. The Health Care Assistants (HCAs) have been trained to carry out many of the procedures previously carried out by nurses and the number of appointments they offer has been increasing. This releases appointments for the trained nurses to concentrate on chronic disease monitoring and areas where specialist knowledge is required. Forum members were aware that many routine procedures are more appropriately carried out by the HCAs but this is not necessarily understood by other patients. Receptionists try to make appropriate bookings and it is important to help other patients understand the changing roles.
4. To discuss the care.data initiative
The practice has been recommended to discuss a new system of data extraction from NHS records with its patient participation group. GP practices have been informed that they must take “reasonable steps” to inform patients that, from this autumn, identifiable data will be extracted from their records and used by the NHS or private companies; otherwise they face action under the Data Protection Act. It was clarified that this scheme is different and completely separate from the Shared Care Record (SCR) system previously discussed by the Forum. (A SCR can be accessed by, for example, an Accident & Emergency department to provide specific information about a patient to help with their care).
The new system involves patient-identifiable data being extracted from GP records and linked with data from hospitals and social care. The information is then cascaded through the NHS to aid commissioning decisions, or potentially used by researchers and private companies for use outside the NHS. Patients who object to having data from their GP records extracted through the General Practice Extraction Service (GPES) will be given the opportunity to opt out. However, the code that needs to be applied to a patient record is different from that used to prevent creation of the SCR.
NHS England had ruled out a national publicity campaign, saying ‘practices are responsible for ensuring patients are made aware of the changes and to direct patients to further information, which should be made available in the surgery’ and giving GPs approximately eight weeks to make patients aware before extractions would begin. The practice was sent two posters and 100 leaflets with which to carry out this publicity campaign (there are just under 6,000 patients registered)
The practice heard today in the medical press that these extractions have now been delayed until next year after opposition from Local Medical Committee (LMC) leaders and campaigners who said patients should be better informed about the NHS’s plans to use their personal data.
The requirement that GP practices are solely responsible for informing patients about theCare.dataprogramme has been rescinded and a major £2m publicity campaign on the plans to extract and share confidential data next year has been announced.
The publicity campaign will involve sending information leaflets to all 22m households in England in a four-week leafleting campaign informing patients about theCare.data data extractions plans during January 2014. It has been reported that the leaflets would clearly set out howCare.data will work and how patients can opt out, while also setting out ‘the benefits it will bring’. Copies of the current leaflet were circulated at the meeting. These are being given to patients who attend the practice.
After the January national campaign, patients will have four weeks to tell their GP if they want to opt out of their personal medical data being forwarded on to the Health and Social Care Information Centre (HSCIC), before any extraction of patient data begins.
5. To determine the content and timing of the questionnaire for the forthcoming annual survey
Copies of the questionnaire used by the Forum for last year’s survey were circulated. Since the last Forum meeting members of the e-mail reference group have been consulted for their input into the survey. Their responses had been previously circulated to members via email and were included in the discussions about the content of this year’s questionnaire.
The Care Quality Commission (CQC) Guide for working together for patient groups was also used to inform the discussion. It was agreed that the questions pertaining to a patient’s experience during a consultation with a nurse or doctor and with the reception team should be retained as they provide evidence about how the practice meets the CQC standards for treating people with respect and indicates whether their needs are being met and their rights supported.
Some of the questions included last time will be retained again to provide comparisons with previous year’s outcomes but some of the questions will be replaced. A draft of the revised questions will be circulated and it was agreed that the method used to administer the survey last year should be repeated as it was so successful. The survey will therefore be run over a three week period in November/December with Forum members coming into the waiting room to encourage patients to participate. Surveys will also be available on-line via our website. Consideration was given to obtaining views of those who do not attend the practice often and those with learning or physical difficulties or where English is not the first language. It was decided that the current methodology of collecting responses from the random selection of patients who attend or visit the website over a three week period was appropriate but that a separate project would be conducted to collate the views of patients with learning disabilities. This links with the work the practice has been carrying out with Mencap and the expertise of the newly appointed specialist nurses for learning disabilities can also be utilised.
6. To approve the Patients’ Forum Annual Report
This item will be carried over to the next meeting due to the Chairman’s personal circumstances.
7. Update on local/national NHS developments
o Patient Forum Action Plan
An updated version of this document was circulated in September. The plan will be revised again in early 2014 to reflect the outcomes of the 2013 patient survey.
o CCG Reference Group
The next meeting of the CCG group is on Thursday 24 October 2013. Richard Allen and John Ritchie will be attending. The agenda items of the meeting were read out but there are no specific items that require feedback from the Forum.
o Issues relating to CQC
Birchwood Medical Practice have shared their inspection report with Whyteleafe and copies will be circulated to Forum members to give them an idea of the areas that were considered during that inspection. Liz has also been looking at Nursing Home inspection reports on the internet to gain insight into the CQC requirements. Forum members suggested that it would be appropriate and useful for them to consider an annual summary of patient complaints and it was agreed that this would be an excellent way for them to be involved (patient identifiable data and clinical detail would obviously not be included in these reports).
o Enhanced Services arrangements
Despite the reassurances provided to Richard at the patient CCG meeting in June, the practice has been given six months contractual notice that the enhanced services it provides will be terminated pending review of these services in line with national requirements. These services include the INR clinic, phlebotomy, leg ulcer dressings, Zoladex injections, rheumatology drug monitoring, minor surgery and diabetic clinics. It is not possible to clarify exactly how the review will affect these services and identify the services that will need to be decommissioned in 2014/15. It has therefore been necessary to serve notice on all services in case they cease following the review. The difficulty this presents in terms of staff contracts for those nurses providing the procedures covered were discussed by the Forum. It was agreed that Richard would raise the issue again with the CCG at the October patient meeting.
8. Dates of future meetings
Date of next meeting to be agreed
9. Any other business
Emailing doctors
There has been comment about this recently in the national press. Whilst there would be some advantages to patients with this method of communication the resource implications need to be addressed more comprehensively before any changes are made. The NHS website had been beneficial in providing electronic information and advice to patients but this is generic rather than specific to an individual’s problem.
111 feedback
Forum members enquired about any improvements in the new 111 service since its launch earlier this year. The system does seem to be working more efficiently now from the practice viewpoint.
Pharmacy consulting rooms
The role of pharmacists in Medicine Use Reviews was raised. Patients were not aware of the introduction of this scheme and questioned its value and cost to the NHS. Dr Tun explained that patients should receive an explanation about their medication from their GP but in some practices this does not seem to be happening and pharmacists can provide this service instead. Pharmacists are paid a fee for providing each review.
10. Issues to be treated as confidential and therefore deemed to be Part 2 items of Minutes
There were no issues to be treated as confidential
The meeting closed at 8.50pm