Cannock Chase Clinical Commissioning Group South East and Seisdon Peninsula Clinical Commissioning Group Stafford & Surrounds Clinical Commissioning Group

Bullet Point Messages from Seisdon District Patient Group 6th December 2018

Apologies Janet Aldridge

Attendance Lyn Hingley (LH) – Moss Grove Surgery Chair of meeting Anne Heckels (AH) – CCG Lay member for Patient and Public Involvement Sandra Wilks (SW) – Russell House David Edwards(DE) – Russell House Kath Frain (KF) – CCG Primary Care Manager Penny Allen (PA) – Tamar Surgery Ruth Morris (RM) – Russell House Janet Aldridge (JA) – Gravel Hill Surgery Adele Edmondson (AE) – CSU Senior Communications and Engagement Manager Clare Plant (CP) – CCG Administrator Communications and Engagement Team Elaine King (EK) – Lakeside Medical Practice Liz Gilson (LG) - Tamar Surgery Jenny Robinson (JR) - Moss Grove Surgery Ian Wright (IW) – Healthwatch Iris Fieldhouse (IF) – Bilbrook Medical Practice Lucie Higham (LH) – Redmoor Health

Declarations of Interest and Actions Taken to Manage Conflicts The group confirmed that there were no conflicts from declarations of interest.

Actions arising from Meeting 6th September 2018  Formal minutes will not be provided for the meeting in future. Actions will be captured on the Action log and bullet point messages will be provided for key discussions to share with PPGs. The group were not happy about this AE advised that she would take back to the CCG and will provide an update at the next meeting. The following advice has been received from the CCG’s Deputy Director of Corporate Services, Governance and Communications: According to the Companies Act 2006, formal minutes are only required to be taken for an organisation’s highest decision-making body i.e. the Governing Body and any formal sub-committees. Beyond that, any other meeting is deemed as an unincorporated general meeting and therefore the legal provisions do not apply. For the district patient group meetings, the group’s own Terms of Reference dictate the process, so the group could, if it wanted to, revise the terms of reference to say it will produce bullet points and action notes rather than minutes. This is also supported by the ICSA – Governance Institute’s guidance.


Cannock Chase Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stafford & Surrounds Clinical Commissioning Group

The group discussed preference for bullet points or Minutes, PA advised that she would prefer to have full minutes but that she would accept the majority decision to receive bullet point actions.

 The group raised concerns about travel distances for ladies who needed breast screening. Why was the mobile breast screening unit removed from Clinic? Being relocated in means that some women find it difficult to travel to the appointments, particularly if they are using public transport There is a concern that accessibility has impacted on women taking up the screening What efforts have been made to try and find a new location in the Codsall area?

The response from NHS , was: - To find a suitable site for a mobile breast screening unit, a number of factors need to be taken into consideration. The site needs to have space as the units are quite large, they also need to have access to a generator and water for the units to be able to function - The mobile breast screening unit had to be removed from Codsall Clinic due to subsidence on the carpark and the fact that it wasn’t possible to have a generator on site to facilitate the functioning of the unit - They did and have since considered other options in the same locality but even working with District Council, they have not been able to find a suitable alternative - It costs around £5,000 to relocate the unit each time but also it means that the unit would be out of operation for two days while it was being moved and the equipment stabilised - There is no evidence to suggest that relocating the impact has had an impact on uptake and no issues have been picked up through patient feedback i.e. complaints, soft intelligence etc - The unit in Wombourne provides a service to women from Brewood, Perton, Coven, Wombourne, Perton and Codsall and due to the geography of the peninsula, wherever it was sited would mean that some women would have to travel further than others - The unit now comes under the Dudley Breast Screening Service and women do have a choice about where they would attend for follow up clinics, including Cannock or - Breast Screening is delivered in three-year periods and the next round for the Seisdon area will be taking place from early January to mid-March - NHS England has committed to review uptake again at the end of the next round but with the caveat that nationally there has been a drop in women taking up breast screening and there are other factors as to why women may choose not to take up breast screening AE advised that the CCG have taken this issue as far as they possibly can, the service is Commissioned by NHSE and that we are unable to address this issue further at future meetings.


Cannock Chase Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stafford & Surrounds Clinical Commissioning Group

Action: AE to provide Imre Tolgesi with contact details for NHSE, with a view to having a breast screening unit sited at the new Codsall Community Hub.

 Even though most patients in the peninsula would prefer to be taken to New Cross by Ambulance they are taken to Dudley. AE to seek clarity from Ambulance Any crew of an ambulance will make a clinical decision at the point of assessment when they arrive with the patient. A crew would take a patient to the hospital of their choice if there is a clinical reason which meant it is the most appropriate clinical setting for the patient to receive treatment. However, this is dependent on many factors; one being the A & E pressures at the time and the patient’s condition. When the issue was raised at the Commissioning Patient Council, Dr Mo H asked the condition of the patient and he was unconscious. The request was made by the patient’s wife; therefore, the crew would have made their decision in the best interest of the patient and his condition at the time. Mark Docherty from WMAS is attending the next Quality and Safety Committee in Common on Thursday 13th December a further update will be given at the next meeting.

Lucie Higham - Engaging Through Social Media

The most popular forms of social media are Facebook, Twitter and You Tube, however there are many more.

Social Media is a compliment to traditional engagement methods and is not meant to replace, face to face meetings which is still the strongest medium. However, having both gives a wider demographic of the public an option to engage in a way of their choosing.

LH recommended that all Practices set up a business home page with a picture of the practice, opening times and other general information about the practice. This will ensure that when patients search on Facebook there is a consistent page that can be viewed even if it is not used for messages.

LH shared that it is important that limits are set from the outset, regarding consistency of response times, to manage patients’ expectations.

There are many good sites that can be used to pick up and share interesting and relevant health related information, such as NHS Choices, Public Health England and You Tube. Posts that have a picture are always viewed most, but acronyms and health terminology should be avoided. Always try to use wording that stimulates conversation and will encourage messages to be shared.

If making a video about the practice, or a particular health promotion, videos should be kept short and to the point. Ensure that target audiences are agreed and show


Cannock Chase Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stafford & Surrounds Clinical Commissioning Group

the human face of the practice. Use appropriate practice staff to get messages across and encourage people to watch.

LH recommended that messages are shared with local groups, gyms etc. to get key messages out to the broader patient population.

If used proactively Facebook can free up time for Practice staff and reduce attendances at MIU. For example: • Practices can promote details for Emergency Dental Services • Sign post and give advice regarding repeat prescriptions and emergency repeat prescriptions. • Advise where to go for the morning after pill and sexual health related queries. • Signpost to appropriate mental health providers for those patients experiencing anxiety and or other mental health illnesses.

Imre Tolgesi – Codsall Community Hub ‘Codsall Community Hub will see the present building refurbished, extended and new car parking built. This will allow for tenanted occupiers to increase in number from 19 to 28. The new Community Hub will encompass a café, library, three tiers of government, a wedding and conference venue, retail, a GP Surgery, small businesses, Police and NHS Trust. Overall, seven public sector buildings will be integrated into one, saving taxpayers £1.7 million in running costs and creating an income generating building for the Council, securing its long-term future. Over the past three years, the Council building has evolved, reducing the Council Office footprint by 50% with the remainder let out to new partners. With more interested occupiers wanting to join them in Codsall but no more available space to rent, a business case was created and approved to invest £9.9 million to enhance the building. The new Community Hub will also improve the building’s visual connection with the community, with a proposed new extension for the relocated library, a new front entrance, retail unit and NHS space. Russell House GP Surgery also plans to move in, providing the practice with much needed additional space to expand the number of GPs for the community’s growing population. South Staffordshire’s physical and mental health, children’s and social care, housing and benefit teams will also be brought together into an integrated space at the Community Hub, enabling service transformation and delivering a swifter triage of services for those working with the district’s most vulnerable residents.’  The group discussed Public Transport Links in the area and how these could be improved, they also discussed the environmental impact of improved transport links. IT advised that the Authority is working with Highways England to look at Pinch points in key areas.  The group shared that the site needed more disabled spaces than the ones currently allocated in the plans. IT shared that the plans are not complete and that the number of disabled spaces will be looked at again.


Cannock Chase Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stafford & Surrounds Clinical Commissioning Group

 The group requested assurance that the GP Surgery is not free flow through the building and that it has its own access. IT confirmed that the surgery will not be free flow through the building, it is intended that the surgery will be located at the back of the building in what is currently the Library. The Library will move to a front facing position of the building with a new entrance.  The group asked how much patient engagement has been completed with patients at Russell House Surgery. It was recognised that the GPs at the Practice are wanting the move, however patients should still be consulted with. AE advised that she would seek clarity from the Primary Care Team.

Online Digital Consultation process NHSE are rolling out a national online programme which signposts patients to the correct service. EConsult is a platform that provides patients with an online triage service by completing a quick on-line form. It helps GPs to deliver better access to registered NHS patients by providing a round the clock portal where patients can enter their symptoms and receive instant self-help advice, together with signposting to NHS 111, pharmacies and other healthcare services. Benefits to the practice include: Work more efficiently, Give patients better access, make better use of primary care services. Benefits to the patient include: Get medical advice 24/7, capture critical illness earlier, feel more satisfied, diagnosis without leaving your desk, medication at your convenience. Sunil Sharma and Angela Bath are attending the Commissioning Patient Council Meeting on 9th January 2019 to advise and give a practical demonstration about the programme.

Liz Gilson - Tamar Medical Practice  Shared a patient story with the group about a complaint that she has made to PALS and David Lawton about treatment that they received at New Cross Hospital.

Jenny Robinson – Moss Grove Surgery  Elderly Patient referred to Russells’ Hall Hospital last week for tests and treatment, however when he was assessed in A&E he was advised by the nurse that there were no beds. By the time the patient left the hospital it was late and no – one helped him to get to the door of the hospital, which was quite a distance and he then had to ring a taxi to get home.

Penny Allen – Moss Grove Surgery  Patient receiving treatment for skin cancer at New Cross had their appointment brought forward because the Consultant had organised additional appointments. Cannot fault the excellent service and care that they have received.


Cannock Chase Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stafford & Surrounds Clinical Commissioning Group

Sandra Wilks – Russell House Practice  SW shared with the group that she was surprised to have been advised that MRI scans from Russells Hall Hospital are sent to London and Australia for review and diagnosis which is causing delays. AH advised that scans are sent to London and Australia to cut down on the waiting time for results, there is a shortage of trained radiologists, scans are sent electronically so the process is not delayed and all services that are checking the scans are quality checked to ensure that the standards are high.

Elaine King – Lakeside Medical Centre  Patient called an ambulance feeling extremely unwell, the ambulance arrived in 9 minutes, within one hour of arriving the patient was being prepared for emergency surgery. The nursing care and support from both the hospital and colleagues at the practice has been exceptional since being discharged.  Disheartened that in the bullet points from the last meeting it was noted that Lakeside do not have a patient representative, EK advised that although she works at the practice, she attends the PPG meetings as a patient and also represents Lakeside at the District Group as a patient.  EK shared that over September, October and November Lakeside had received 680 Family and Friends tests the results of which are listed below: i. 543 extremely likely to recommend the service to family and friends ii. 99 likely to recommend the service to family and friends iii. 13 neither likely nor unlikely to recommend the service to family and friends iv. 6 unlikely to recommend the service to family and friends v. 15 Extremely unlikely to recommend the service to family and friends vi. 4 didn’t know whether they would recommend the service to family and friends EK shared that it is unfortunate the Family and Friends tests do not allow for feedback, the practice are unable to address issues or look at reasons patients are unhappy.  There is currently a one week wait for a pre - bookable appointments with a GP however there are urgent appointments for those patients who need them on the same day.  Doctor Crews is returning to the practice after a four month secondment and has a Contract until August 2020.Dr Rizwan is joining the practice on 10th December until April on a four month placement.  Lakeside are now integrated with New Cross and they now have a Clinical Web Portal which allows the staff at Lakeside to access patient records at New Cross, giving the practice quicker access to information from Consultants.  Over July, August, September and November the practice have noticed that numbers of patients not attending appointments has increased. During this period this has equated to there being 7hours 40 minutes wasted GP Appointment time, 4 hours 30 minutes wasted Nurse appointments, 2 hours 20 minutes wasted Pharmacist Appointments. PA shared that since starting to use text prompts for patient appointments, the number of DNA’s at Tamar have reduced. EK shared that when Lakeside started to use the text system they also saw a reduction in DNA’s however they have now increased again.


Cannock Chase Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stafford & Surrounds Clinical Commissioning Group

 The practice is participating in an online e-consultations pilot starting in January.

Iris Fieldhouse – Bilbrook Medical Practice  Practice will be participating in the e-consult programme.  Practice is testing skype consultations for some appointments.  Practice works with Wombourne Clinic to provide the extended access hours and the system is working well.  Patient had a growth growing through their spine, admitted to New Cross for a 10 hour operation and is now walking again, excellent treatment and after care.  House bound patient needed a home appointment from Dental Service as they had chipped a tooth. Relative called service and was advised that dentist would only be able to come out if the patient was bedridden. Patient is not bedridden however they are extremely frail and blind. Three hours later the relative received a call back from the Head of Department to advise that a home appointment had been arranged for the following day. Treatment since has been excellent. AE advised that this service is commissioned through NHSE and that she would share this patient story with them.

Ruth Morris – Russell House Practice  PPG meeting held on 5th December 2018 Imre Tolgesi attended.  Election for Chair deferred to the next meeting.  Patient attended Cannock Hospital for a hip replacement recently. Before the operation a number of patients were asked to attend a hip and knee clinic to explain procedures. On day of operation patient arrived at the hospital at 7.30am, went down for operation at 9.30am and the procedure was done under an epidural. Patient was up and walking the same afternoon. During their stay in hospital, nurses came around regularly, pain control medication was given on time, the hospital was spotlessly clean and the nurses also looked pristine. Patient extremely pleased with the standard of their care.

Lyn Hingley – Moss Grove Surgery  On Remembrance Sunday, the police, ambulance and fire station all came together when a member of the parade had a massive heart attack and clinically died. The police conducted CPR, the ambulance service used the defibrillator and revived him. The air ambulance was called and the paramedics accompanied the patient in the Ambulance to Worcester where again he received excellent care. The patient is now out of hospital and walking around.

Feedback from Commissioning Patient Council meeting  PA shared with the group that other Districts are concerned about the increased pressures at New Cross Hospital due to the current A&E situation at Telford and Shrewsbury.


Cannock Chase Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stafford & Surrounds Clinical Commissioning Group

AH shared that the CCG are aware of this and that services are being monitored through the Quality Team, any increases in waiting time will be noticed. AE to speak to Chris Bird Director of Contracting to discuss possible increase in pressures at Newcross.

PPG websites AE discussed the new PPG area of the CCG website – this is now available for all CCGs across Staffordshire. The site is an interactive site with various information, events, sharing of good practice, speakers contact details and resources to support in running a successful PPG. The group have all received an email requesting their explicit consent to share their contact details to set up username and passwords to access the site. Action: All members to complete request and return to Clare Plant with their email details.

Date time and venue of next meeting:  Thursday 7th February 2019  10.30am – 12.30pm  Bill Brownhill Room, South Staffordshire District Council, Codsall, WV8 1PX.