MINUTES MORGANNWG LOCAL MEDICAL EXECUTIVE COMMITTEE La Parilla Restaurant Swansea SA1 8PL WEDNESDAY 12 August 2015

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MORGANNWG LOCAL MEDICAL COMMITTEE Suite E1, William Knox House, Llandarcy, SA10 6EL Tel: 01792 815954 Office Hours: 9.30a.m. 1.00 p.m. Monday Friday Fax: 01792 814938 Website: www.morgannwglmc.org.uk Email: morgannwglmcltd@btconnect.com MINUTES MORGANNWG LOCAL MEDICAL EXECUTIVE COMMITTEE La Parilla Restaurant Swansea SA1 8PL WEDNESDAY 12 August 2015 Items in normal text - for consideration / items in italics - for information / * indicates additional papers GUESTS AT FUTURE MEETINGS: Dr Mair Williams will attend the LMC meeting to be held on 8 September 2015 to speak about the Mullany Fund ementoring scheme. The Primary Care co-chairs of the Commissioning Boards will be invited to speak at the LMC meeting on 8 September 2015 A member of the ABMU strategy/planning team will attend the LMC meeting on 10 November 2015 to provide an update on the development of the CAMHS strategy. Mr David Roberts, Operational lead for Mental Health Services will be invited to attend the LMC Meeting on 10 November 2015 The Executive Team agreed that future speakers should be asked to submit copies of presentations in advance and limit presentations to 5-10 minutes to provide the opportunity for more questions/discussion GENERAL 1. Attendance: Drs: I Harris (IH), AP Rayani (AR), N Shah (NS)(Chair), A Stevenson (AS), H Wilkes(HW), J Kletta (JK), L El-Sharkawi (LE-S) Paul Williams (PW), Mrs M Liddell (ML), Executive Officer 2. Apologies: none 3. Notice of any other urgent business. The Secretary had added a few late items to the Agenda. 4. Minutes of: LMC Executive 19 June 2015 were ratified by the Committee and signed by the Chairman. LMC/ABMU Enhanced Services Steering Group16 June 2015: minutes were noted Full LMC 14 July 2015 minutes were noted 5. 5.1 5.2 LMC/ABMU Liaison Group 21 July 2015: draft minutes were approved for circulation Matters Arising LIN (Local Intelligence Network): A response is awaited from ABMU re LMC inclusion on this group Practice Manager Links to WG: Bro Taf, Gwent and Dyfed Powys LMCs had requested further information about the remit of the group. They would be advised to contact the group direct for further information.

5.3 5.4 5.5 Referrals to Swansea CRT / Child protection: No response received from ABMU. A further chasing email would be sent. Medical students/tutor payments: AR advised that feedback from some tutors suggested support for the proposed curriculum changes but as was agreed by LMC members the proposed reduction in payments was sending out the wrong message and a letter would be sent to the Director of Community Based Learning confirming this view. OOH / 111 The 111 pilot in ABMU was now planned to commence in June 2016 A draft SOP for Special Patient notes procedure had been received and the Exec were pleased that the decision to accept only emailed forms had been changed to include faxed copies. However it was felt that legible handwritten copies should also be accepted as there could be occasions when GPs did not have access to a PC to complete the form electronically. An additional form was also required for information about patients who were not palliative. /ML IHR: The Executive remains concerned that there has been little improvement in the accessibility of the IHR NHS WALES SHARED SERVICES PARTNERSHIP PRIMARY CARE SERVICES 1. Medical Performers List Additions/Removals / Partnership Changes / Other List Matters (i) SEE APPENDIX 1 ATTACHED (Only applicable to Elected Members) 2. Pharmaceutical List: (i) SEE APPENDIX 1 ATTACHED (Only applicable to Elected Members). 3. Other Contractor Services/List Issues: (i) KEY ISSUES 1. GP Clusters (standing item): The next meeting of the GP Leadership form was scheduled for September 2015. The new chair had not yet been confirmed. The Exec agreed that the LMC should be represented to ensure regular contact with the cluster leads ACTION: ML to confirm details of next meeting 2. Sustainability Programme: WGPC is arranging training on 9 September 2015 in the Grove Medical Centre. It was agreed that all Exec members should attend if possible. ACTION: ML to confirm names to WGPC PST (Practice Support Team) Visits: Visits were being arranged as required. NS has attended two, IH one and AR will attend one in August 15 LMC MATTERS: 1. Relocation of LMC Office: The date of transfer to the Grove Medical Centre was confirmed as 25 September 2015. Redundancy arrangements had been agreed with LR (PA) and the post of Secretarial Assistant had been advertised. Relocation costs were confirmed. 2. Financial Position : The Accounts for 2014/15 had been finalised for signature A summary of expenditure to 31 July 2015 was available 3. Pension Auto enrolment Scheme: The staging date for Morgannwg LMC Ltd had been confirmed as 1 Feb 2016 to progress 4. Executive team Structure: The Exec team agreed that co-opted members could claim one session for attendance at the LMC Exec meeting. Payment would also be made if a significant amount of preparation work for any project could be identified /confirmed.

5. Constituency Vacancies: One sessional GP had recently expressed interest in becoming an LMC members and the appropriate form had been sent. 6. Newsletter: The value of the Newsletter was felt to be limited in its current format with the content often duplicating information previously circulated to Practices. A survey would be required to confirm this. A communications strategy needed to be developed which could include links to social media. PW agreed to review the website as a first step. A single page newsletter would be circulated shortly with a view to obtaining feedback from constituents. ACTION: PW/ML to progress 7 New LMC Listserver for Wales: The WGPC had proposed that a new Listserver be established to enable discussion between all Exec members in LMCs and the WGPC Negotiating Team. The Exec agreed to support this and all those present would be included. SESSIONAL GPs: 1. Swansea Sessional GP Group Next Meeting Thursday 23 July 2015 at 7.00 pm. no report received GP REGISTRARS: 1. VTS: There is a need to reintroduce links to the VTS to ensure GP Registrars engage with the LMC OUT OF HOURS/ACUTE GP UNIT/OTHER SERVICE MATTERS: 1. ABMU Out-of-Hours Rota Problems Standing item. None LMC / ABMU LOCALITIES / CONTRACTOR SERVICES LIAISON GROUP 1. Enhanced Services Steering Group 16 June 2015* see notes attached. IH advised that the group was currently reviewing three ES specs (Care Homes, Wound Management and Substance Misuse. Feedback was being obtained from Practices in NPT where the uptake of the Care Home LES was very low but the spec was close to being signed off. Data was also being obtained in respect of the Wound Management workload generated in Primary and from secondary care. Pricing arrangements in other Health Board areas were also being reviewed. A draft spec for Substance misuse was being drawn up. Date of next meeting: Tuesday 18 August 2015 2. Liaison Group Report Tuesday 21 July 2015* see notes attached. Date of next meeting: Tuesday 15 September 2015 ABERTAWE BRO MORGANNWG UNIVERSITY HEALTH BOARD 1. GENERAL i. Accessible Healthcare: Friday 4 September 2015 AR will attend. ii. EPAC: 26 June 2015 This meeting was rearranged to 28 July 2015 and attended by VV no update 23 September 2015 VV will attend iii. End of Life Care Group a delivery plan for EOLC has been produced* Guidance is being prepared on Subcutaneous Fluids. 16 July 2015* Dr SH attended notes attached 22 September 2015 AS will attend. iv. Perinatal Mental Health Implementation Group 27 May 2015 Attended by AR nil to report v. Mental Health Drugs and Therapeutic Meeting Tuesday 2 June 2015 Attended by AR nil to report Tuesday 1 September 2015 AR will attend

vi. vii. viii ABMU Commissioning Boards nil to report Strategic Immunisaton group: Wednesday 17 June 2015* - attended by JK (notes attached) Monday 14 September 2015 JK will attend Payment for Vaccines and Immunisation Costs : No response received from ABMU. This would be added to the agenda for the next Liaison Group meeting. /AR 2. PRIMARY CARE ISSUES ABMU WIDE: i. Datix Reporting in Primary Care: HW advised that she was working with ABMU to iron out problems with the system but Practices should continue to use it via the link on PC desktops. ii iii Violence against GPs : 24 June 2015 This meeting was cancelled and a new date is awaited Flu Planning 2015/16: A briefing report had been presented at the Liaison Group meeting which was asked to consider how increasing uptake of provision within community pharmacies could strengthen local partnership arrangements and improve uptake across ABMU. JK would draft a response detailing the LMC concerns. A Primary Care flu planning group has been established and although it included representation from general practice there should also be a LMC rep attending ACTION JK/AR LOCALITIES: Bridgend Locality: i. None. Neath Port Talbot Locality: i. None. Swansea Locality: none 3. SECONDARY CARE ISSUES: NPT Specialist Heart Failure Service: A letter had been sent to NPT GPs about changes to the service because of capacity issues. Proposed changes included shared responsibility for blood tests which was not clinically safe. A letter would be sent from the LMC to this effect with reference to the recently updated joint GPC and Consultant Committee statement on hospital test results and the statement on Duty of care regarding Drugs recommended from out-patient clinics. Inappropriate transfer of work: The LMC was receiving an increasing level of contact from constituents being asked to action/chase investigation or blood results and also requests to refer to another consultant / specialty. A firm letter would be sent to the Medical Director with a request that current guidelines be reissued to consultants. This also applied to the private sector and a similar letter would be sent to the Medical Director at Sancta Maria Hospital. WELSH AMBULANCE SERVICE NHS TRUST 1. None. HEALTH & SOCIAL CARE / SOCIAL SERVICES 1. Care Home Commissioning Group the LMC is to keep a watching brief. 2. Child Protection Forum: Thursday 18 June 2015 AR attended nil to report Thursday 20 August 2015 AR will attend

PUBLIC HEALTH WALES AND IMMUNISATION ISSUES: 1. Meningococcal B Vaccination Programme: Due to commence on 01 September 2015 but a problem had arisen with the supply of paracetamol sachets supplied with the vaccination. National guidance was required from WGPC ACTION: GPC WALES / GPC UK None BRITISH MEDICAL ASSOCIATION: 1. None. WELSH GOVERNMENT(WG) / DEPARTMENT OF HEALTH (DH) ANY OTHER BUSINESS 1. 2. NEXT LMC MEETINGS: Full LMC Meeting Tuesday 8 September 2015 at The Towers Hotel, Jersey Marine. LMC Executive Tuesday 13 October 2015 venue tbc.