FARFIELD GROUP PRACTICE MINUTES OF THE PATIENTS COUNCIL MEETING Held on 2 nd August 2017 Present: Attendance sheet circulated. Attendance number: 10 Chair: Cheryl Lamb (Practice Manager) Apologies: Vicky Dodgson, Glenys Heaton, Paul Squires, Jan Richardson In Attendance: Cheryl Lamb (Practice Manager) Dr. P. Pue (G.P./Partner) Lizzie Lister (Operations Manager) Kasia Juraszewska (Enhanced Primary Care Co-Ordinator) Anthony Lawton Prescribing Team Cheryl welcomed everyone to the meeting, and said she would do the Chair, as Paul Squires was not well. The meeting was being held one week later than usual, because Arlene - who acts as Secretary, was away on holiday. Our Speaker for this meeting, was Kasia Juraszewska Enhanced Primary Care Co-ordinator, who had come to update the group on the Enhanced Primary Care scheme (EPC). She told us how she worked at signposting various types of illness, by means of referral as well as social prescribing and health navigation. Kasia said that the surgery is continuing to offer that service for another year. The EPC scheme provides the time and capacity to approach the patient holistically, i.e. the wider needs social, emotional, mental, relational or financial. In many cases, those issues appear to be the actual root and the cause of the physical/medical problem and once addressed and resolved, can Significantly improve patient wellbeing. The scheme has been running at Farfield Group Pratice for the past two years. There are many successful patient stories of how the service has improved the quality of life, and even save a life on one occasion. The patient is referred to a service mainly by GPs or in a few instances, by other healthcare professionals. It is not a self-referral service. Patients are selected on the basis of clinical assessment, when the GP can identify the need for extended support. The current heavy usage of A & E or O.O.H. are being looked at as this might indicate potential needs, and could save millions of pounds as well as a safety net. The EPC team work well with a wide range of problems, starting from strictly medical and helping with access to certain services, and even sorting our financial/housing/ relational issues etc. Two years ago, there were 56 patients identified with medium risk of being admitted to hospital. The list of patients has grown significantly and currently there are 133 patients on the list. This year, they also took on board patients with more complex needs. As a Care Co-ordinator/Navigator, Kasia s role is to signpost the patient to the most appropriate
2) Cont.. Service acting on the patient s behalf, being the advocate or bridge between the patient and the Service Providers. The EPC scheme has involved and used multiple organisations to address the unseen issues. Patients value having someone to turn to, as this relieves their anxiety. They are also using the voluntary services sector as well as the NHS. Cheryl thanked Kasia for her interesting and informative talk, which was appreciated by the group. 1. Minutes of the last meeting These were taken as read, and accepted as a true record. 2. Matters arising Mr. S. Bhowmick enquired as the current situation with the phone system. Cheryl said the practice were in negotiations with BT to provide a phone upgrade and more information would be provided when available. Mr Bhowmick raised an issue regarding online booking of appointments but would speak to Lizzie outside of the meeting regarding this. 3. Managed Repeats Anthony Lawton, who is helping the CCG to project manage the Proposed Changes to Repeat Prescription Ordering gave an overview of how the system would work, and provided the group with a document outlining the changes. This has been attached to these Minutes, so it can be kept for reference in future. 4. Surgery Update Dr. Pue updated the Patients Council members. Farfield Group Practice have been working together with four other local practices, to consider different ways to improve care for patients, Holycroft Surgery, Kilmeny Group Practice, Fisher Medical Centre and Crosshills Medical Centre. The practices are being supported by a GP super-partnership called Modality Partnership. There Is a national push for pratices to work at scale and by doing so, practices can take advantage of the benefits of being part of a larger organisation, and the efficiencies and opportunities that this brings. It also allows practices to improve services for patients. Farfield Group Practice is already working in collaboration with other local practices to deliver new services for patients. Physio First, Health Navigation and Extended Access being just a few of the improved services now being offered to patients. Dr. Pue advised that there are no immediate plans for Farfield patients to be seen at another surgery. However, it might mean that if we are short of GP s at a particular practice, a GP from one of the other practices might help out where needed. It may also mean the practices may share some Specialist services in the future which may be offered from one or more of the sites. Dr. Pue advised that more information will be shared with patients as we move forward. Cheryl advised that the Physio First Scheme would be continuing in the practice. The scheme allows patients direct access to a Physiotherapist for assessment and advice, for minor acute and musculoskeletal problems, such as back, neck, joint or general muscle problems. Patients are booked into the Physio First service via the Reception team. 5. Extended Access to Primary Care Lizzie Lister, the Operations Manager at Farfield, has produced a document giving all the information patients require to know how this service will work. The service will be available at Farfield surgery for each of the 6 practices involved Farfield, Holycroft, Ling House, Kilmeny, North Street and Haworth. Lizzie has provided a rota which shows when each surgery will be
3) Cont on duty. This information sheet will accompany these Minutes as a separate sheet. 6. PPG Network Meeting feedback This meeting was held on 13 th July, 2017 at Skipton as usual. Unfortunately, we did not have a representative at the meeting, who was able to provide feedback. Cheryl promised to share the Minutes from the Network meeting when they are sent to the practice. 7. Any Other Business a) The Pharmacy First scheme continues to be available across Airedale, Wharfedale & Craven CCG area, and practices are being encouraged to signpost patients to the service. Evaluation of the scheme has shown the service has reduced demand on out of hours and emergency services such as A & E, and it has improved access to GP appointments. Key messages for patients are:- *The local Pharmacy can give free advice and if needed, medicines for common illnesses, so patients do not have to make an appointment with a GP. *The Pharmacist is a qualified health care professional who can give good advice on managing many minor conditions. The Pharmacist may offer a private space to talk to patients about their symptoms. If the problem is serious the Pharmacist will be able to recognise this, and advise the patient to see the GP. *Patients who don t normally pay for prescriptions may be supplied medicines free of charge. *Patients who do pay prescription charges, will be given advice and can purchase over the counter medicines for much less than the cost of a prescription. b) Castleberg Hospital Giggleswick, Settle Due to safety concerns, services at Castleberg Hospital were temporarily withdrawn from April 2017. The CCG as main Commissioner of Services at Castleberg Hospital, are looking at the future of the service previously provided at the hospital and are asking local people, service users and other stakeholders to help design future services. The CCG will be holding a number of drop-in sessions in Craven in August and September. To see a list of the free sessions, or to find out more information about Castleberg Hospital, please see the CCG website www.airedalewharfedalecravenccg.nhs.uk. 8. Date of next meeting - Wednesday, 25 th October, 2017 at 6.30 p.m. There being no further business to discuss, the meeting then closed
Background Proposed Changes to Repeat Prescription Ordering Requests to reissue repeat prescriptions are typically led by patients and carers and frequently by community pharmacists in a process known as managed repeats. Not all pharmacies offer this service (they are not contractually obliged to do so) but there is convenience for patients as well as a business purpose. However, there is evidence that the managed repeats system increases medicines waste and can reduce medicines safety. Airedale, Wharfedale and Craven CCG has considered a number of options in consultation with GP practices and proposed that a reduction in the number of patients that have their prescription orders managed by a community pharmacy would lead to reduces waste and improved patient knowledge and safety. Why are we making these changes? We know that many millions of pounds of medicines are unused and discarded every year. By asking patients to be more engaged with the medicines ordering process we have evidence from other CCGs that have implemented similar changes that this reduces the number of prescription items that are ordered and patients do not build up stocks of items that they do not need. This also increases safety as excess medications are not available in people s homes. As many pharmacies handle a great number of repeat prescription requests some of them do not have time to contact every patient. We believe that if pharmacies are ordering for a smaller number of patients that are identified as having a specific need then the service for these patients will improve. We know that the online ordering systems that GP surgeries use are convenient for patients and aid practice workflow dealing with repeat prescriptions. How are we making these changes? GP practices are actively promoting use of online services. We also have a working group consisting of the GP practices and CCG medicines management team working on implementation of the project. It is likely that practices will ask pharmacies to stop ordering medicines on behalf of the majority of patients around this autumn time. The GP practices and pharmacies will identify patients for which continued assistance from the pharmacy is appropriate. What will not change? This change will not affect people who currently order their repeat prescription from their GP practice and patients requiring specific assistance with medicines ordering will still be able to access this on a named patient basis. Pharmacies will still be able to collect prescriptions from the GP practice. Patient Engagement We are looking to gather thoughts on the proposed changes as these changes will affect how some people order their repeat prescriptions in future.
Other Approaches Alongside this project the CCG medicines management team will support GP practices in increasing uptake of electronic repeat dispensing. This system allows up to 12 months electronic batch prescriptions to be signed so that a monthly prescription request made to the GP practice is unnecessary and the pharmacy checks the appropriateness of each supply between GP reviews. We will also stipulate and promote local standards of good practice by issuing a list of good practice standards that pharmacies are expected to adhere to when managing a patient s repeat prescription order. Claire Kilburn Senior Pharmacist Medicines Management Team North Yorkshire and Airedale Wharfedale & Craven CCGs 30 th June 2017
Extended Access to Primary Care 1. Extended Access is the provision of core GP services outside of the current standard GP hours (8am to 6:30pm) Monday to Friday. 2. 6 Keighley Practices involved - Farfield, Holycroft, Ling House, Kilmeny, North Street and Haworth 3. Extended access face to face GP/ANP appointments available WEF 1 August 2017 31/3/18 4. Service will be hosted at Farfield appointments are 1830 1930 daily 5. We will still be providing the CaSH (Contraception and Sexual Health) service on a Monday evening. 6. Farfield will provide GP/ANP session on a Thursday evening with Dr Pue and Sandra Smith (ANP) 7. Extended Access Service include a. Face to face appointments with any Keighley practice GP/ANP at Farfield Group Practice, b. Practice Nurse Respiratory appointments (Farfield practice will see only Farfield patients) and c. Farfield Pharmacist (Haroon or Idris) ringing Farfield patients with medication reviews. 8. Appointments for ACUTE issues and to be opened at 0830 on the day and each practice will have an allocation to ensure fair share according to list size currently under review. 9. Essential that all patients details are checked and they are consented to share or they cannot be seen as GP won t have access to their records. 10. Information on website http://www.farfieldsurgery.co.uk/extended-access-information/ 11. Farfield will provide Reception cover with current staff on a Monday and a Thursday. Other nights will be manned by other practices. 12. You might be seen by another GP from another practice and any onward referral or tests will be sent through to Farfield to be actioned the following morning.