Minutes Gosport Locality Patient Group Held on 18 th July 2017 in the Meeting Room, Brune Medical Centre Gosport, PO13 0EW 12.30 to 2.30pm Attendees Mark Wagstaff Co-Chair of Gosport LPG Janet Chapman Bridgemary Medical Centre Pam Marsden Gosport Medical Centre Marilyn Mullen Brune Medical Centre/Willow Group Margaret Lawson Brune Medical Centre/Willow Group Brenda Hadfield Waterside Medical Centre/Willow Group Nicky Staveley Chief Officer, Gosport Voluntary Action Fiona Todd Business Manager, The Willow Group Brenda Woon Engagement & Partnership Manager, CCG Speakers: Keeley Ellis, Head of Primary Care, Fiona Todd, Business Manager, The Willow Group, Jonathan Foley, Clinical Manager and Hazel Nicholls, Clinical Director, Southern Health NHS Foundation Trust 1 Welcome and Introduction 1.1 1.2 1.3 1.4 Welcome and Apologies The Chair welcomed all to the meeting. Apologies were received from Georgette Houlbrook, Sally Crooks and Dr John Buchanan. Minutes from previous meeting (held on 11 th April 2017) The minutes of the meeting were read and approved Summary of actions and matters arising There were no actions from the previous meeting Requests for any other business Vascular Services update Mark Wagstaff LPG questionnaire Mark Wagstaff Flu vaccines Pam Marsden Page 1 of 6
2 Focus items 2.1 GP Extended Access (GPEA) Keeley Ellis, Head of Primary Care Keeley explained that as lead for the Primary Care Team, her responsibility is to hold all the contracts for the GPs in the area and for commissioning the GP Extended Access Service. Details of the presentation can be found below: GP Extended Access - CEC.pdf Marilyn commented that the PPG was told that evening sessions were not going ahead due to a shortage of GPs. Keeley said this is correct, and has spoken to Gosport GPs to see how to combine services which are already available e.g. relocate extended hours from the practice to the Gosport War Memorial Hospital, so that the two services work together. This would then create joined-up services at scale, rather than in small pockets. In-hours and out of hours may be difficult going forward but there will be duplication of services up until April next year. The provider of the service is the GP Federation. It would be hosted via the Elderly Care Centre at GWMH and co-located with the central out of hour s service already running on Sundays. 2.2 The Willow Group Fiona Todd, Business Manager The four practices merged on the 1 st April and are part of Southern Health NHS Foundation Trust. They now have access to 38,500 patients full medical reports. There are still teething problems concerning the speed of access of EMIS and Docman in obtaining scans. The speed of access to records in Docman is not as quick as it should be. The plan is to have a central telephone hub. NHS England funding is needed for high speed communications. The four practices will be identified by one single j-code. Three new GPs have been recruited as a result of the merger. 12 full-time equivalent posts will be rising to 14. There is also a Same Day Access Service (SDAS) in the Willow Group. Patients can make their own choice and are able to move around the four GP surgery sites. It is better for patients with complex medical histories to stay at the same site for continuity of care. 2.3 italk/mind update Hazel Nicholls and Jonathan Foley italk is a partnership between Southern Health NHS Trust and Solent MIND. It is a primary care psychotherapy service. The service is operated by PWPs (Psychological Wellbeing Practitioners). PWPs are not Counsellors. They work directly into the Waterside Medical Centre using evidence-based interventions such as CBT (cognitive behaviour therapy), inter-personal therapy, couples therapy and guided self-help for depression, agoraphobia, blood injury phobia and PTSD (post-traumatic stress disorder). This therapy could be used following a road traffic accident where flashbacks occur. Clients who have experienced child sexual abuse would be referred into Step 2 and then wait for intervention. Previously there was a 90 day wait after assessment and some people were waiting longer than this for Step 3. This service was de-commissioned last summer. Currently, when a person comes into the service, the person s presentation is Page 2 of 6
assessed by Jonathan and his team, to see if they need face-to-face intervention. The new service went live on 10 th July this year. There used to be one hub which was based in Eastleigh. There is now also a community hub at Gosport Business Centre. 75% of people who are referred should receive an assessment within 42 days. The second appointment will be within 28 days of this. People who receive treatment usually get well. Nice Guidelines are: Step 1 GP consultation Step 2 telephone consultation or on-line service (self-referral) consisting of 4 6 sessions and will depend on wellbeing scores which will determine where the treatment will be held. Step 3 face-to-face IAPT (Improving Access to Psychological Therapies) for moderate to severe depression, 16 sessions with a maximum of 20. Patients can access the service again if they need to. 75% of patients with depression recover within six months to one year. Step 4 CMHT (Community Mental Health Team) Step 5 Inpatient Unit at Elmleigh, Havant The Recovery College is linked into Step 4 and 5. The age range is 16 plus, the oldest person in the service so far was 95 years old. Cards advertising the service have been issued to all surgeries. GPs signpost patients to the service but quite often the patient does not turn up for the appointment. At Waterside, patients can directly book into the appointments system. Hazel was concerned at the lack of awareness of the italk service as only one member of the group knew about it. Hazel said that the italk service has the capacity to receive more referrals so would appreciate more help with publicising it in the area. Margaret who is a Surgery Signposter, received a phone call from a person who was presenting with suicidal tendencies. She suggested italk, the Samaritans or the Wellbeing Centre in Gosport. Hazel confirmed that this was the correct thing to do. Brenda Hadfield runs support groups for people suffering from long term pain, in Fareham and Gosport and wanted to know where she can refer people to who may have potential suicidal tendencies. Nicky said that Sally Bigham, the Project Manager for Surgery Signposters, will be in touch with Hazel to discuss referrals in more detail. Nicky felt that the GVA newsletter would be a good place to advertise the italk Service. Solent MIND will continue to run the Wellbeing Centres. This is a separate contract for Step 2 interventions. italk are now linking in with the Solent MIND Wellbeing Centres. Lots of development work has been done with the Eastleigh hub as well. Nicky mentioned that the volunteer Community Connectors work within Solent MIND. This is a service running in Gosport. The Community Connectors offer their support in accompanying the person to the italk service. The Chair thanked the speakers for their input. Page 3 of 6
At this point, Steve Southwell joined the group. Steve is a member of the South of Butser Locality Patient Group, a member of the Homewell.Curlew practice PPG in Havant and a Trustee of Havant MIND. Steve is also the Chair of the recently formed Mental Health Forum (MHF) which is being administered by the CCG and supported by the lead GP for mental health, Dr Emma Nash. Steve Loe is the Senior Commissioner for mental health services in South Eastern Hampshire CCGs and also attends the forum. The group is seeking feedback from service users in relation to the MCP service specification and how the CCG commissions mental health services in the future. Two meetings have been held so far. At the last meeting members were asked to bring their main concerns back to the meeting concerning what does/doesn t work well at the moment. The next MHF is to be held on 20 th July at 10.30am in the Southwick Room, at the CCG CommCen building. The purpose of this meeting is to discuss the feedback and to map out the way forward. The main priority is to inform the service specification but in the longer term will be looking at how to shape mental health services in the area. Steve suggested using satellite hubs to talk to service users in the location. Also to seek the views of Patient Participation Groups (PPGs), Locality Patient Groups, (LPGs), Gosport Voluntary Action, Community Action Fareham, Community First and the two MIND organisations. 3 Standing Items Regular Updates 3.1 3.2 Feedback from the PPGs Gosport Medical Centre Pam Marsden The surgery has started using Webpost this is where the practice sends out letters to patients electronically to Webpost and they are then printed, packed and sent. It is much more cost effective and saves a lot of time. Visits by patients to the signposter and springboard volunteers have increased. The PPG will be carrying out another patient survey in the late summer with an emphasis on awareness by users of all the different ways they can access the practice and its facilities. Unattended appointments since January 1 st this year up to circulation of the practice spring newsletter, amounted to 45 hours wasted time for bookings with the doctors and practice nurses. 3.3 Bridgemary Medical Centre Janet Chapman The practice has been accredited as a dementia friendly surgery. The pharmacy system at the surgery is working well. Carers and veterans are being asked to be identified so that medical records are coded. Printed appointment slips are being given for appointments made in person. Text Page 4 of 6
reminders are being sent if the surgery has a mobile number for the patient. This is trying to reduce the number of appointments being missed. A reminder is being given that it is the patient s responsibility to leave three working days for repeat prescriptions and that urgent repeat prescriptions need 24 hours to process. Due to an increase in demand for same day urgent appointments the system has been changed. At the request of the doctors, the patient is no longer given a time slot but is asked to telephone the surgery and give a brief reason for the urgent request, then, if appropriate, is asked to attend the surgery, sit and wait to be seen. Late evening surgeries are now being offered on a Monday, Tuesday and Thursday from 6.00 7.00pm and Saturdays from 8.00 to 11.30am on a four weekly rota. 3.4 Willow Group meeting at Brune Medical Centre on Friday 14 th July Marilyn Mullen This was the first meeting and each of the four practices was represented. On 19 th June all practices were merged onto one data base. Appointments are now offered at all four surgeries. For consistency of practice, each surgery is to have similar notice boards including one for the PPG. There are now Saturday appointments at the same day hub arranged through the 111servoce. There is a GP, nurse and receptionist in attendance. It had been hoped to offer late evenings but although a nurse was available, GPs were not. The new telephone system has been delayed and the earliest date is now October. Rose Butcher, Community Matron, will be speaking at the next meeting in September. Alison Brimson from GVA gave an update of the Willow Group s strategy for Surgery Signposters. All four practices are to have open days in the autumn. This is to encourage patients to use IT links for example, signing up to e-consult. These open days will be held on Saturday mornings from 10.00 1.00pm to include refreshments, and will be linked to autumn flu clinics to maximise coverage. 4.0 Feedback from the F&G Community Engagement Committee (CEC) The focus items were: Mental Health Forum Annual Engagement Report for 2016/17 Analysis of Big Health Conversation Long-term conditions and mental health update Once approved, the minutes will be available on the F&G CCG website. 5.0 Feedback from the Voluntary Sector Health Forum Nicky Staveley The meeting was held on 4 th July. The focus was on mental health. The following organisations gave presentations: Richmond Fellowship Solent MIND Page 5 of 6
Kroma LGBT group Princess Royal Trust for Carers In the minutes thanks were given to Raymond Hale for his support over the years. 6.0 Feedback from MCP Mark Wagstaff The home visiting team are up and running. This service is provided by two community matrons. Fareham will be following on from the Willow Group model and will have a Same Day Access Hub at Fareham Community Hospital for four practices, starting in September. The practices involved are: Jubilee Surgery, Whiteley Surgery, Highlands Practice and Stubbington Medical Practice. 4 Any other business 4.1 LPG questionnaire Mark Wagstaff Mark shared the following comments received from the questionnaire: 1. Keep the meeting on track Mark responded that he will try to improve on this 2. Can we have all practices represented at the LPG? Mark will pick-up on this 3. Can we have Nicky Staveley from Gosport Voluntary Action as a permanent member at the LPG representing the voluntary sector? Nicky thanked the group and said that she may be represented from time to time by Mandy Bright who is the Community Engagement Manager at GVA. 4. Better sharing of good news stories. Nicky suggested that members could send these to her to put in the GVA newsletter. Brenda Hadfield suggested that each surgery has a voluntary sector notice board Nicky can help with this. Mark suggested the Terms of Reference be reviewed every three years and a vote taken for the Chair every three years. Mark thanked all for their contributions to the questionnaire. 4.2 Flu vaccines Pam Marsden Boots Chemists are now providing a flu vaccine service which is free and speedy. GP surgeries buy-in what supplies they feel are needed and then have to face wasting stock because of the competition. Marilyn from Brune Medical Centre, undertook to take up this issue with the practice pharmacist to see if there was any way of avoiding waste. 6 Dates of Next Meetings Future meetings will be held from 12.30 2.30pm on the following dates: 17 th October 23 rd January 2018 Page 6 of 6