Minutes. Gosport Locality Patient Group Held on 21 st April 2016 in the Meeting Room, Brune Medical Centre Gosport, PO13 0EW

Transcription

1 Minutes Gosport Locality Patient Group Held on 21 st April 2016 in the Meeting Room, Brune Medical Centre Gosport, PO13 0EW pm Attendees Mark Wagstaff Carol Wood Liz Mearns Donal Collins John Buchanan Councillor Roger Allen Mike Brown Lyndsay McLees Co-Chair Head of Communications, NHS England Managing Director, NHSE (Wessex) Gosport MCP Bury Road Surgery Gosport Borough Council Gosport Medical Centre Gosport Medical Centre - standing in for Pam Marsden Brockhurst Medical Centre Chair of F&G Group of Diabetes Waterside Medical Centre Brune Medical Centre Brune Medical Centre Stoke Road Medical Centre Rowner Health Centre Communications & Engagement Manager, CCG Richard Geall Raymond Hale Paul Hutton-Dunton Georgette Houlbrook Marilyn Mullen Chrissie O Neill Audrey Starkey Emma Giles 1 Welcome and Introduction 1.1 Welcome and Apologies Apologies were received from Richard Geale, Pam Marsden, Judith Coleman and Carol Winter Minutes from Previous meeting (held on 21 st January 2016) The minutes were approved as an accurate record Summary of Actions and Matters Arising Phlebotomy Mark and Keith attended this meeting which wasn t as positive as they had hoped. The meeting was held by the CCG and there was recognition that the current situation is not ideal and very confusing and it was agreed that starting afresh would be the best outcome but potentially difficult given the complexity of phlebotomy services. 1.4 Requests for Any Other Business None 2 Focus items Page 1 of 8

2 2.1 Gosport Locality, Hampshire Multi-speciality Community Provider (MCP) Dr. Donal Collins, Clinical Lead Donal began by giving encouraging feedback on the Same Day Access Hub at Gosport where things are working well. The next stage is to implement e-consulting software - into local practices. The Hub still has some obstacles around creating urgent face-to-face GP visits and a need to free up some further GPs to support it. The Hub recently saw 2,000 contacts in a week (a 15% increase) so the online system is critical to its success. The benefits of working together are numerous and have been seen by practices not involved in the Hub. Two practices in Lee-on-Solent are now looking to create a more local Hub in order to address same day access and urgent care patients as well as manage nursing home visits. Other issues include paramedics from South Coast Ambulance Service (SCAS), who were assisting with the triaging of patients have had to be stood down due to insurance indemnity increasing significantly. The new employed model was discussed at the last TARGET meeting. Currently many GPs are self-employed, which leaves practices very unstable in the current climate. Coming together on one common contract will reduce risks and remove current pressures on GP practice businesses and improve the service for patients. The MCP is piloting a voluntary contract in Gosport this year and finances are in place to achieve a successful outcome. Those GPs who choose not to come under the common contract will still have to agree to the same set of standards as those GPs who do. The standards include offering to create a cohort of carers who could sit with a patient potentially overnight until a local GP can visit first thing the following day to assess them and, where possible, avoid unnecessary hospital admissions (which currently stand at 20%) and enable patients to remain in their own home. The Hub is planning to extend its hours to 8am to 8pm, six days a week and combine with the out-of-hours service and use the same systems to enable consistency and flow of information between clinicians and other health professionals. The new car parking charges at Gosport War Memorial has resulted in a number of concerns being raised and members of the LPG have written to both Southern Health NHS Foundation Trust and the local MP to share these, as this will have a very big and impact on the ongoing success of the SDAS Hub. 2.2 Proposed vascular services reconfiguration NHS England Vascular services include Aortic aneurysms, disease of the main carotid artery and arterial blockages which can place further risk on limbs. Services consist of specialist surgery and less invasive treatments such as CT and MRI technology. In 2014/ patients living in South East Hampshire were identified. NHS England is aiming to achieve a world class high quality sustainable vascular service for patients in South East Hampshire that meets national standards of clinical best practice and retains a sustainable specialist workforce. Page 2 of 8

3 Currently there are four hospitals providing vascular services across South East Hampshire which are Queen Alexandra in Portsmouth, Royal Hampshire in Winchester, Southampton General and St Mary s Newport, Isle of Wite. Of the four, both Portsmouth and Southampton offer the full range of services and Winchester and St Marys patients are seen as out-patient clinics and receive simpler procedures. For major and more complex surgery they are referred to and treated at Southampton. NHS England is proposing to create one network which will be based at Southampton where all major and/or complex surgery will take place. Southampton General has refurbished a ward with extra beds with additional vascular nurse specialists to care for patients as well as a newly built operating theatre that can offer vascular surgery and interventional radiology in parallel. Fewer patients are requiring emergency vascular surgery mainly due to a reduction in those smoking, general improved health, improved screening programmes and less invasive treatments This and the reduction in the number of specialist surgeons available and the new move to seven day working, means vascular services needs to change in order to meet the new national standards. These standards include ensuring staff see a wide range of cases, covering a population of at least 800,000 and 24 hour access to specialist care including six vascular surgeons, six interventional radiologists and specialist nurses with sustainable on-call rotas. As a result of Southampton already being the central point in the network for Winchester and the Isle of Wight, being a major trauma centre for Hampshire and covering a population of 900,000 it was natural choice as the vascular services network centre. Patients will continue to be treated at their local hospital for simpler procedures and minor surgery, diagnostic tests and treatments which do not require overnight stays along with all rehabilitation following surgery and support services such as podiatry. There will be two /three surgeons based at Portsmouth to ensure patients with diabetes, kidney problems, cancer or injuries can be monitored. The next steps in the process will include patient engagement events between April and June to enable patients to raise their concerns around issues such as patient safety, clinical expertise, services based at hospitals nearest to where the patient lives, transport for patients and visitors, how the services will interact to ensure a seamless service and information around making an informed choice about their treatment. For those wishing to be part of the vascular feedback group, please contact Emma Giles CCG Communications and Engagement Manager and she will pass your name and address onto Carol Wood at NHS England. Page 3 of 8

4 3.0 Standing Items Regular Updates 3.1 Feedback from the Fareham and Gosport Community Engagement Committee The focus item was an update on the Gosport MCP project by Kerry Cooper which was very well received. Some Fareham practices are keen to act as 'fast followers' and set up similar joint working arrangements in Fareham. It was Keith Barnard s last meeting as Chair of the group and he was thanked by everyone for all his efforts over the last few years. He will be sorely missed. A new lay member to take Keith's place has not been advertised to date so in the interim Pat Shirley will chair the group. 3.2 Feedback from Patient Groups Gosport Medical Centre Pam Marsden Gosport Medical Centre recently achieved Dementia Friendly Status. There are improvements and a refurbishment planned to the surgery as identified. Patients are being informed of this achievement by distributing leaflets and displaying posters in the surgery as well as the PPG Newsletter. Also a Dementia Adviser Service comes to the practice once a month to support patients and their carers with dementia. The surgery has signed up to Safety First and using QASAR with regard to hospital discharge issues, i.e. reading diagnoses and medications of discharged patients as well as difficulties with patient transport. Staffing remains the same with no changes. There are now two volunteers who have offered to do signposting. During the recent PPG meeting, held on 12 th April awareness was raised regarding car parking and Southern Health NHS Foundation Trust agreement with NCP to take over and manage the parking at Gosport War Memorial Hospital and that charges will rise on 3rd May This information was only received by the surgery a couple of weeks ago and the PPG feel patients will be angry and upset as the new charges will be 1 for the first hours and then 2 for the second hour. These charges will be 24 hours. The PPG identified and raised the following concerns: Taxi /car drop offs Triage where patients wait for longer than an hour Minor Injuries will also have the same problem Patients who have to leave their cars if they need to go to hospital in an ambulance Surrounding roads will be used for parking The parking charges are too high with no flexibility for patients collecting prescriptions or making an appointment The above will affect patients attending Gosport War Memorial Hospital as well as Minor Injuries and GP Surgeries. There is no information about how these new parking charges will be managed. Page 4 of 8

5 The PPG will be writing a letter to Southern Health NHS Foundation Trust, on behalf of Gosport Medical practice patients, with regard to the above concerns and asking for a review of their decision regarding their parking charges. Forton Medical Centre Carol Winter Forton Medical Centre is the first GP practice in the country to go into partnership with a private enterprise such as Southern Health NHS Foundation Trust. The advantages are numerous as they have within their list of healthcare professionals - GPs, Nurses, Pharmacists and Physiotherapists able and willing to fill locum appointments at short notice. Dr Larner has now joined the practice. By joining with the three other surgeries in Gosport at the SDAS Hub, Forton is supplying just two duty GPs to the Hub per week and consequently saved Duty GP appointments within the Practice. Forton also supplies ten duty nurse sessions to the Hub which saves twenty sessions of nurse time in the Surgery, thus freeing the nurses to run other Clinics such as Asthma and Diabetes. Local nursing homes have chosen to use technology plus a Community Nurse to obtain better ongoing care for their patients, via a link on a hand held tablet connected to the Hub. As a group the PPG discussed the way forward in patient care in relation to an older population, population increase in general and a lack of healthcare professionals to fill vacant positions. The Queen Alexander hospital was criticized with regards to the way drugs were taken from patients to prevent self-administration and then the wastage when they were needlessly destroyed. It was felt that some drugs are best taken at the usual times for that patient. The drug destruction policy was also brought up at the locality meeting and is being pursued. The Queen Alexander hospital was also criticised regarding the availability and easy access of patient notes. The comment from the surgery was that electronic discharges were making life a little easier for the GPs, but also that sufficient medication on discharge (i.e. a month s supply), would be the best way forward for all concerned. Another new innovation which is shortly to be introduced is e-consulting software. A basic questionnaire which could be completed by the patient/gp on-line and the answers to certain questions would then provide an indication to the person reading the questionnaire as to the course of treatment and on-going care. Services for Older people and those with Mental health Issues were also raised and discussed. Should it be necessary to introduce a Saturday surgery, the likelihood is that the early morning surgery on a Monday and the later Friday hours would be lost. Stoke Road Medical Practice Chrissie O Neill The PPG met on 18th April. Dr Rachael Ross attended and gave a very full and frank update on what was happening within the practice. The PPG discussed where the doctors were looking for help from the PPG, patient expectations and the way forward. Page 5 of 8

6 The PPG found it difficult to look into the future and make plans due to the present uncertainty. Talks are going on with three other local practices to all come under Southern Health NHS Foundation Trust, as the doctors feel that it is the way to go to keep the surgery going. Brockhurst Medical Centre Richard Geall The last PPG meeting was held on 10th March Five members attended and Richard welcomed Marion Hardy, a new member, to her first meeting. One member had attended a workshop at the Queen Alexander hospital on Understanding the Experience of the Older Person within the Local Health Service. The PPG was informed that Queen Alexander hospital and the Portsmouth Hospitals Trust are continually seeking volunteers for a variety of workshops, research and trials; all are designed to monitor and/or improve the service provided. Recent changes to the way in which health care is provided in the Gosport area confirms that they do actually listen and take action. The Brune Medical Centre PPG currently has 19 members, some of which form the Virtual Group, information about the PPG has been sent to a further four interested parties. With regard to the new website, this project is ongoing and the basic format has improved but the detail now needs updating. A patient survey had been compiled and was open for comment from the group. Joiners and leavers include the Triage Clinician and a medical secretary who both left the surgery on 30th March and these positions are being covered in-house. In addition, Sally Crooks, the current Practice Manager will be leaving the surgery on 29th April and Mike Porter, the practice Manager of Bury Road surgery will be taking on the role of Practice Manager to both surgeries from 3 rd May onwards. Dr Van Wyk will be leaving the practice on 25th May. The Practice Nurse, Kerry Meachen, continues to develop her skills in triage in preparation of becoming an Advanced Nurse Practitioner/Prescriber later in the year. Rowner Health Centre Audrey Starkey A member of the group had been to Boots Chemist to ascertain the services offered and leaflets are in reception. Due to only having two GPs, turnaround-times for prescriptions is now 72 hours for patient safety. Patients are being notified via the website, posters, JPX board, touch screen and through the pharmacy. From April patients requiring blood tests (not routine ones) following a GP appointment could book those at reception immediately after although cancellations would need to be via Brune Medical Centre directly. The 2016/17 flu clinics are now being planned and Saturday clinics are a possibility. Patients will receive reminders by text. The PPG has been asked if it might be able to assist this, although when it was originally proposed by the PPG, it was not a possibility. The surgery now advertises their private fees both in reception and on the website. Patient feedback remains mostly positive. The only negative appears to be waiting times for appointments. However, the surgery now has two Advanced Nurse Practitioners so it is hoped the situation will improve. Although the next CQC is expected, there has been no notification so far. However when they do visit, they would expect to see PPG Chairman. The Chairman has Page 6 of 8

7 recently stepped down, so the PPG are currently seeking a new one. Recruitment to the PPG remains an ongoing issue so a member of the PPG, Jo Hunt is preparing a leaflet to be handed out to patients and attached to prescriptions, to see whether this would attract new members. Following attendance at Waterside PPG, Ray explained it is run very differently to Rowner and they have talks from outside agencies. It appears that despite previously putting many obstacles in the way of any suggestions for changes and talks, the practice has realised this would be advantageous and is supportive of it. Brune Medical Centre Marilyn Mullen Dr Sabine Bohmer is leaving the practice where she currently works for three days each week. She will be very sadly missed by all of the patients. Brune medical Centre has attracted a newly qualified GP Dr James Tucker. Lee-on-the-Solent Medical Practice Mark Wagstaff The Practice PPG meeting was cancelled at short notice so nothing to report. The practice manager Ray Ewen left on 29th April and a new one, Nicola Gamblin, takes over from 1st May. Bury Road Surgery John Buchannon Issues still remain around Phlebotomy. While patients can now book blood tests via the reception desk, any changes have to be done direct to the Medical Centre desk. However, any patients trying to make initial bookings via the Medical Centre are referred back to the surgery. Although the surgery is not part of the Hub they are now going to link up with Brockhurst Practice for holiday and sickness cover for GP's. Further integration is also part of their future plans. A new Practice Nurse has just started at the surgery and she will be specialising in Respiratory and Diabetic care. She is initially working all day Monday covering Asthma and COPD reviews. The surgery will be employing a pharmacist for 1.5 days per week shared with Lee-on-Solent and Brockhurst. Waterside Medical Practice Staff changes at the practice include Dr Davis who retired from the Practice as senior partner however, he will continue to work five sessions a week at the Same Day Access Service (SDAS) on the practices behalf. Dr Mebrahtu has increased his sessions from three to four sessions a week and Francis Grundy recently replaced the outgoing Practice Nurse Nicola Colebourne. The PPG and surgery recently set up Facebook page and Twitter feed to help improve patient communication and they appear to be going well. The Spring Newsletter is available in Practice and on line and it will also be sent to all patients registered on-line. A copy of the PPG minutes is made available in a folder in the waiting area for patients to read is updated regularly. The PPG recently set up their own survey which aimed to find out if patients were satisfied with the services offered and invited suggestions. Over the duration of a week in February, six PPG members conducted a paper survey and received 122 replies which represented 1% of the practice. In general, patients were satisfied and were aware of, and used, the SDAS. The PPG is planning to take a further look at the suggestions shortly. As a result of the survey the PPG has recruited and welcomed two Page 7 of 8

8 more members to the group. The PPG received a presentation to help explain the Gosport Vision which was well received. The presentation will enable PPG members to clearly explain the problems and solutions to other patients and the difficulties which need to be overcome in order to provide a manageable medical service in Gosport now and in the future. 3.3 Feedback from the Voluntary Sector Health Forum Raymond Hale The Forum, which has now been operating for over two years, carried out a successful review of the priorities raised by the different health groups over that period and how they have been addressed by the CCG. The general feeling was that the priorities had been addressed but there was much more to do but also some new concerns have now been identified. A report was presented in regards to the Got It Right award, which was felt by some groups to be inappropriate for the health and disability groups as it did not cover their main function which is to provide support, information, advice and encouragement to others with similar conditions. A report was also presented about the Surgery Signposters project which is going to be extended to Fareham and Havant. The Fareham and Gosport Diabetes UK Group is now fully active in Gosport with regular meetings in the Waterside Community Church on the third Monday evening of each month. There was also a very successful public meeting in the Elson Library with about 40 attendees, as a result, further meetings are being planned. The purpose was to provide peer support to help people manage their own condition. The Group had been asked to provide the surgeries with Diabetes UK books for the benefit of patients and this should start shortly. The Group was also campaigning to increase the number of essential diabetes education courses available by using lay educators to help. The Group is also looking to see how they can improve the podiatry service in order to reduce the diabetic amputation rate, which is still too high, and very costly. 4.0 Any other Business None were raised Dates of Next Meetings Tuesday 19 th July Thursday 20th October Tuesday 24th January 2017 Page 8 of 8