Minutes of the Patient Reference Group of NHS Nottingham West Clinical Commissioning Group Thursday 4 February 2016, 6.15-8:30pm at Rumbletums Café, Kimberley Present: John Crouch Mark Russell Richard Eade Michael Rich Susan McNab Adrian Manhire Glen Swanwick Nicolas Harrison Joan Morley Bob Hill Peter Pickering Teresa Burgoyne Ali Harvey Julie Bryant Glenda Pitchford Richard Hepple Linden Medical Centre (Chair) West End Surgery (Governing Body Lay Member) Bramcote Surgery Saxon Cross Surgery (CIG Lay Member) Abbey Medical Centre Manor Surgery (Vice-Chair & CIG Lay Member) Valley Surgery West End Surgery Church Street Medical Centre Hickings Lane Church Walk Surgery Church Street Surgery Chilwell Meadows and Valley Surgeries Saxon Cross (HealthWatch Champion) Bramcote Surgery Abbey Medical Centre In Attendance: Racheal Millband Mariea Kennedy Nigel Hallam Vicky Bailey Sue Bishop Apologies: Craig Sharples Barbara Brice Shirley Inskip Jacky Williams Martin Plackett Communications & Engagement Manager PALS & Patient Experience Officer CCG Chairman Interim Chief Operating Officer Governing Body Lay Member (with a lead for Governance) Head of Governance, Quality & Engagement Manor Surgery Hama Medical Centre County Councillor & Health & Wellbeing Board Member Hickings Lane Item Discussion Lead 16/12 Welcome, introductions and apologies John Crouch, Chair, welcomed everyone to the meeting. Apologies for absence were noted. Declarations of Interest
16/13 No declarations of interest were received. 16/14 Minutes of the PRG held on 7 January 2016, matters arising & action log Two additions were agreed to be included in the minutes from 7 January 2016: 15/93 Teledermatology: This saved 70% of patients having to attend hospital and reduced the review time from 20-30 minutes to 10-15 minutes. GPs sent the patient s pictures and full case history (these were rejected if quality was not good enough). 16/07 Newsround: Church Walk Surgery had received an Outstanding CQC rating. Matters Arising: 15/99 Information Governance, Management & Technology Craig Sharples had spoken to Andy Hall, Director of Outcomes and Information, who had given reassurance about the new portal for sharing medical information between GPs and Nottingham University Hospitals. A telephone conversation was being arranged with Andy and Adrian Manhire. AM 15/60 Any Other Business: Councillor Adam Stockwell explained that a decision was still to be made by Broxtowe Borough Council on the community toilet scheme. 15/103 PRG s Response to Arriva: Mark Russell would keep the group informed about the letter on Arriva to the lead commissioner. 15/103 Broxtowe Borough Council s Planning Decision: The PRG was commended for its influence in the approval of planning permission for dementia bungalows in Beeston. (2) The contracting team had been made aware about patient concerns around X- ray delays. Nottingham University Hospitals had acknowledged issues around the reporting of radiology films. The trust had outsourced some of the reporting to reduce the backlog and assurance had been given to the contracting team that this work was being prioritised. Adrian Manhire added that there had been a considerable number of unreported Radiology examinations and those reporting outsourced examinations did not have access to old examinations for comparison. 16/03 Matters Arising: It was suggested that an update or summary sheet would be useful on the CCG s position on Warfarin testing. It was noted that a pharmacy in Somercotes was offering the testing and advice. Racheal Millband would explore. The issue had been of concern for over a year and was not yet resolved. Post-meeting note from Rachael Harrold, Strategy & Development Manager: The option of providing a level 4 anti-coagulation service is currently being considered as part of the review of the current GP led enhanced services. Finance is looking at the 2
costings. The aim is for the reviewed service to be in place by April 2017. It must be noted that Rushcliffe CCG is still in the early stages of rolling out the first wave after many months of review and planning. We will look to PRG to nominate a patient rep for this service review in due course. 16/04 Patient Survey: The majority of practices had achieved the 4% response rate for the patient survey. Some suggestions were made around areas of improvement for the 2017 survey. 16/08 Clinical Innovation Group: Michael Rich asked for clarity around the future of the Primary Care Development Group. Vicky Bailey explained that a number of discussions were taking place within the CCG which included the possibility of a Multispecialty Community Provider new model of care. A proposal would be made to the Governing Body. The group would be informed. (2): If the business case is approved, the 24/7 mental health telephone helpline could be operational by early 2017. 16/09 Any other business: Mariea Kennedy had explored patient concerns regarding inappropriate discharge times from hospital, some of which were late in the evening. The concerns had been raised with the quality and patient safety team and recorded as anonymously on the patient feedback system. However, without patient consent she was unable to speak directly with the patient. Action Log: The action log would be updated as the majority of actions had been completed. 16/15 Introduction from Vicky Bailey, Interim Chief Operating Officer & update on dermatology services Vicky Bailey introduced herself to the group and explained that she had been covering as Oliver Newbould s interim replacement. Vicky was also the Accountable Officer for Rushcliffe CCG. She had visited all the GP practices within Nottingham West and was keen to understand the benefits and challenges for local patients. An update was provided on dermatology services. Vicky explained that regular reports were given to NHS England and there were no adverse issues following the independent review. Additional quality monitoring visits had been arranged by the CCG and local patients had been involved. A question was asked about the extent of locums being used by Circle. Currently there were three locums employed in the department and one was shortly due to become a permanent employee. Mark Russell stated that a key concern of the PRG was that lessons should be learnt to ensure it did not happen in future procurement exercises. Vicky replied that in future, the CCG would make certain that all potential staff transfers were aware of their position under the TUPE regulations well in advance to avoid a repeat of the outcomes of the Dermatology contract. 3
16/16 Linden Medical Group s consultation on proposed closure of branch surgery in Wollaton John Crouch updated the PRG about Linden Medical Group s engagement exercise on the proposed closure of their branch surgery, Doctors Corner, in Wollaton. Currently patients are seen at both Stapleford and Wollaton sites. The proposed change would see 3,000 patients moving from Wollaton to Stapleford or re-registering at other surrounding practices. The practice had been working closely with the PPG, CCG and NHS England to ensure all patients and stakeholders had their say until 28 March 2016. Two public meetings had been arranged on 11 February, 2-4pm and 25 February 6-8pm at Wollaton Vale community centre. PRG members were invited to attend and support the meetings. Racheal Millband explained that the NHS had a legal duty to consult on any proposed significant service changes. A legal challenge (Judicial Review) could only be made if a public body failed to consult. The final decision would be made by the CCG and the views of the public would be taken into account. 16/17 Feedback from other meetings attended Patients had felt that the CQC inspection for Manor Surgery had gone well and Saxon Cross had received their overall rating of Good. West End Surgery had received its second CQC visit. Joan Morley had attended the North Broxtowe Networking Forum. Mark Russell had attended a workshop run by the East Midlands Clinical Senate which looked at services which might be fragile i.e. difficult to recruit doctors. Glen Swanwick had attended a financial members meeting with NUH Three PRG members had attended meetings on the transformation agenda. This included MSK (musculoskeletal, Adrian Manhire), long-term conditions (John Crouch) and the Citizens Advisory Group (Mark Russell). It was noted that wider colleagues had been very impressed with the patient input from Nottingham West. Transformation would be added to a future agenda. 16/18 Vicky Bailey suggested that members should explore the Shared Decision Making website and patient aids - http://sdm.rightcare.nhs.uk/ - which helps patients and health professionals reach a healthcare decision together, i.e. knee replacements. Update from Governing Body, Clinical Innovation Group and Primary Care Development Group Governing Body Mark Russell updated the group on the last Governing Body meeting. Highlights included a powerful patient story about a same sex couple s experience through the midwifery service and an update on the difficult financial situation locally. The 4
affiliated commissioning policy for rare conditions was approved across the East Midlands to ensure consistency. A presentation had been given by the County Council on their budget and the difficult decisions that were being faced. A good report had been prepared on the CCG s communications and engagement activity. Racheal Millband agreed to circulate the report. Clinical Innovation Group A summary of the meeting had been shared with the group. Following a discussion on mental health, a query was raised about children s mental health and whether a new mental health centre had opened at QMC. Racheal Millband would explore. It was noted that there were plans to look at the high drug spend of certain practices as well as over prescribing in pharmacies. The other two main areas of overspend were NUH and Circle where there had been unexpected elective work. Vicky Bailey suggested that the PRG could further explore reducing medicines waste. 16/19 Update from Nigel Hallam, Chairman Nigel Hallam, CCG Chairman, thanked the group for his invitation to the meeting. Nigel praised the group and the progress it had made in bringing the patient voice to the forefront of the CCG s work. He added that reaching a wider, diverse audience remained important and the CCG would achieve this through a multi-platform approach i.e. social media, public events, partnership working. He explained that subject to national approval, Vicky Bailey would be confirmed in the permanent role of Chief Officer for Nottingham West and would also continue her Rushcliffe role. Nigel continued to champion transparency and openness within the NHS and invited members to the Governing Body meeting at Trowell Parish Hall on Thursday 24 March, 1-4pm. Julie Bryant had agreed to help promote the meeting locally. 16/20 16/21 Any other business Saxon Cross asked for templates to be shared on terms of reference requiring a signature from PPG members. It was noted that NAPP had examples. Items going to GB/CIG No items would be taken to the meetings. 16/22 Date of next meeting & close The next meeting would be held on Thursday 3 March, 1.15pm-3.30pm (12.45pm for drinks and networking) at a different venue Trowell Parish Hall, Church Close, Trowell, Nottingham NG9 3QW. Free car parking would be available. 5