North Locality Meeting Minutes for Winslow Centre, Park Road, Winslow, Bucks MK18 3DL

Transcription

1 North Locality Meeting Minutes for Winslow Centre, Park Road, Winslow, Bucks MK18 3DL Chair: Dr. Rodger Dickson AV CCG Members Abbrev Designation Present Apologies Rodger Dickson RD GP Partner, Norden House Surgery Joseph Rizzo-Naud JRN GP Partner, Whitchurch Surgery Andrew Silverman AS GP Partner, Ashcroft Surgery Shelley Wagstaff ShW Practice Nurse, North End Surgery Chris Davies CD GP Partner, Wing Surgery Stuart Mathews SM GP Partner, Verney Close Surgery Johnathan Pryse JP GP Partner, North End Surgery Rebecca Pryse RP GP Partner, North End Surgery Joanne Barton JB Practice Manager, Ashcroft Surgery Melanie Abbott MA Practice Manager- Wing Surgery Noel Ratcliffe NR Practice Manager, Norden House Surgery Debbie Ratu DR Practice Manger, Verney Close Surgery Dr Sara Ronaghy SR GP Whitchurch Surgery Dr R Bell RB GP, Edlesborough Surgery Patient Rep Abbrev Designation Present Apologies Graeme Johnston GJ Member of the Patient and Public Engagement Group John Wrigley JW Member of the Patient and Public Engagement Group Frank Donlon FD Member of the Patient and Public Engagement Group Paul Singleton PS Member of the Patient and Public Engagement Group Alison Peasgood AP Member of the Patient and Public Engagement Group Carole Penny CP Member of the Patient and Public Engagement Group John Smith JS Member of the Patient and Public Engagement Group Other attendees Abbrev Designation Present Apologies Jacci Shaw JS Locality Manager Vicki Parker VP Locality Administrator (minute taker) Colin Thompson CT Director of Operations and Performance- AVCCG Margaret Pickard MP Operational Manager Medicine- Milton Keynes Sophia Bergan SB Primary Care Transformation Lead- AVCCG

2 1 STANDING AGENDA ITEMS: FEEDBACK: a) Introduction and Apologies Introduction given by the chair Dr Rodger Dickson Apologies received as shown in table above b) Minutes from the previous meeting FD was in attendance at the December Meeting. He was incorrectly noted as giving apologies. Minutes agreed as an accurate record c) Declaration of Interest There were no new declarations. d) Feedback from CCG Executive Team Meeting Co-commissioning will be in force from April 2015, working jointly with Thames Valley, Chiltern CCG and Aylesbury Vale CCG Quality and Performance Issues at the Main Providers AE friends and family 95% of respondents recommend BHT, compared to a 91% recommendation rate across Thames Valley and 87% nationally. GJ feels this score reflects the fact that staff are more attentive and go round reassuring patients about waiting times etc. Stroke pathway The percentage of patients admitted directly to an acute stroke unit within 4 hours of hospital arrival was 89.9% for October, compared with 91% for September, and 76% for August.

3 C-Section rate the reported caesarean section rate for October is 25.1%, compared to 22.8% for September and 30.30% in August. Feedback paper from Buckingham Public Engagement This was a successful meeting which was well attended and expertly chaired by FD. GJ was pleased to see a good turn out from Public. VP to chase up the attendees who expressed an interest in getting more involved. VP to chase up the attendees who expressed an interest in getting more involved Vicki Parker A&E and pressures on inpatient beds As of today (7 th January 2015) 84% of patients were seen within the 4 hour wait target at SMH. An extra ward is to be opened up for patients fit for discharge. The system is under severe pressures and Primary Care is also experiencing the same issues. RP was contacted by Ian Cave, Urgent Care Commissioner at AVCCG to discuss using Nursing Home beds and Buckingham Community Hospital as a step-down for GP s. Since their initial conversation no progress has been made. CTh will chase this up IC. RP added that GP s were doing everything they can to avoid hospital admissions. However, some patients who had been kept at home as long as possible, had to be admitted to hospital in a more critical condition and this was adding pressures onto the system. JB is concerned over the dramatic cut backs in the District Nursing service. Edlesborough relies on its DN s to keep an eye on their elderly population. JS will send JB details of the Over 75 s Service which may be able to help in this area CTh to chase up IC on nursing bed progress JS will send JB details of the Over 75 s Service which may be able to help in this area Colin Thompson Jacci Shaw

4 2. a) SERVICE REVIEW Colin Thompson- Director of Operations and Performance- AVCCG Prime Ministers Challenge Fund Colin discussed the attached plan Co-creating a new model of care with our population MSP plan draft 3.doc The NHS is becoming a challenged environment and population based commissioning is going to be a big focus. Public Health presented to the Locality a few months back and highlighted diabetes, stroke and cardiac as big areas of concern in our population. AVCCG is going forward with co-commissioning and. Practices recently agreed to a change of constitution to reflect this. One of the questions to address is do you co-commission the entire QoF or take back to the areas of disease burdens? Clinical leaders will debate this and then will go out to practices for consultation. Vale Health has submitted a bid to the PMCF to fund extended practice opening hours. CTh is looking at how we bid into this fund and the challenge is to not write a bid that sets us up to fail. FD is going to help complete some of the missing headline content and a refined bid will be shared within the next few weeks. We have now purchased the MIG which will join up all the computers allowing records to be transferred on a view only basis into OHH and care homes. JP is excited by this concept and it s a great way to move forward. He noted the following points: In terms of academic links please remember to include the new medical school in Buckingham. Can the District Nurses be used in the last bullet point New model of workforce in place to support integrated approach to supporting LTC in the community as part of the locality team Progress to date does not mention Patient engagement. CTh has referred to the

5 feedback from the public engagement events and the practice visits and will add into the relationship with local community section. AS feels we need to be careful not to say there is a big gap in service when practices are closed. We need to define the word access in a more comprehensive way. The point about sustainability is very important. RD feels this is a real opportunity and we are in a unique position to take this up. NR asked if we have any idea how the adjustments in the QoF will work? CTh replied the challenge is to make it work. CTh welcomes any comments on the proposal. Please colin.thompson7@nhs.net The bid will go in at the end of January MK Stroke Pathways- Margaret Pickard, Operational Manager Medicine, Milton Keynes Margaret thanked the members for inviting her to the meeting. MK has made several changes over the last year to improve the stroke pathway and a lot of work is going into the quality of care. One of the most important achievements is the recruitment of an Advanced Nurse Practitioner for stroke which commenced in October Her role is to oversee all patients on the stroke pathway. She has been working closely with the ED to development relationships and can be bleeped from 9-5 when a potential stroke patient comes in. She will be able to fast track to the stroke ward and coordinate care for patients not on the stroke ward. The stroke nurse will provide information at each 10am safety meeting to advise inappropriate placements and details of patients waiting for transfers in and out of the unit. The team are working to raise the profile of the stroke unit and to work with the bed management team so beds are used effectively. Some of the stroke beds have been filled with medical patients. An agreement has now been made with the trust to ring fence two stroke dedicated beds per day. Unfortunately with the winter pressures this is not currently being achieved. The Bed Management Team are focused on finding the appropriate bed for a stroke patient

6 All stroke nurses have attended a training programme run by Bedfordshire University to ensure a highly trained team of nurses. Physiotherapy is now available 7 days a week. There is also a need to do same with the OT team but this being held due to funding. It was noted that Buckingham patients will go to Wycombe for thrombolysis. FD noted that JR is closer than Wycombe but RP finds referring patients into Oxford causes a communication problem. Follow up and community care from Wycombe is much better. Milton Keynes also receives voluntary sector support from Different Strokes Association and Stroke Angels Practice visit feed RD thanked the practices for giving up their time for these visits. Each meeting had a great turnout and RD was impressed by the ethos and professionalism of the practices. Many reoccurring themes were identified including extending hours, keenness to work collaboratively and maximising IT and workforce capacity. 3 MICRO COMMISSIONING/PEER REVIEW Referrals Data Overall we have increased referrals by 6% year on year against allocation of 19% However per 1000 population none of the North Practices are in the top 5. JS is working to develop this data further and asked members to have a look through and look at areas that are over allocation. Cancer 2 week waits Feedback from patients is suggesting that they do not receive the leaflet or explained the reasons why they need a 2 week appointment. It is important the information leaflet and importance of attending the 2 week appointment is discussed with the patient. If a patient misses their appointment, the team will liaise directly with the practice Practices to view data All Practices

7 JP admitted he is inundated with leaflets so sometimes forgets to hand these out although he always explains the reason for the 2 week appointment. f) December dementia diagnosis letter AVCCG has achieved one of the highest diagnoses of dementia in the Thames Valley. Colin Thompson would like to be kept informed of any issues arising from early diagnosis. Some GP s have experienced very upset patients who don t want to be labelled with Dementia while others have accused GP s of diagnosing just to get the payment. It is important the patient understands the benefits of an early diagnosis. Benefits of Diagnosis (2).docx 4 AOB RD met with Louise Forster- Cancer Research Early Diagnosis project This is a local quality improvement project which is Thames Valley wide looking at service improvement for cancer emergency admissions. The project has had a good sign up from AVCCG. The project received funding of 300k which covers 3 Primary Care Facilitators with funding for practices to get involved. Current data states that 25% of cancers are diagnosed in A&E. The project aims to get a better understanding of this data There are incentives for GP s to get involved including 250 for each GP to attend a 2 hour training event plus the information that is gathered can be used as part of appraisals and inspections. CRUK-SCN Early Diagnosis - Local Mee Contact details for Louise are on the attached presentation. RD encouraged GP s to contact Louise Forster All practices 5. Date of Next meeting:

8 Wednesday 4 th February 2015, 12:30 14:00pm at Winslow Centre. **Please note a sponsored lunch will be available at this meeting**