Cheddar Medical Centre Patient Participation Group Minutes of Meeting Monday 14 July at 7pm Present: John Pimblott (Chair), Elizabeth Herridge (Secretary), Pauline Drummond (Practice Manager), Elaine Snow (Practice Receptionist), Ann Clarke, Susan Thomas, Lois Emm, Glenys Runciman, Christine Sims, Suzanne Green, Anna Dormer, Alan Taylor, Elizabeth Parry, Brenda Anderson, Allan Weare, Jacqueline Scoulding. Apologies: Kokila Lane, Andrew Fairhurst, Anne Langford, Ingrid Pattje and a representative doctor. Minutes of the last meeting: The minutes of the PPG meeting of 28 April 2014 were reviewed and approved. Welcome: John Pimblott welcomed the group and asked everyone to introduce themselves and give information on their special NHS interests. This varied from mental health, cancer support, dementia and serious illness. 1. PPG role, purpose, structure, contact: John Pimblott thanked Pauline Drummond for her huge role in keeping the PPG going to this stage. John issued a document which is attached as APPENDIX 1 with his view of how the PPG will go forward in the future. The role of the PPG will also go on the website. He explained that Cheddar PPG has been/will be in touch with other PPGs. (There are three other PPGs in the North Federation to which the practice belongs – Axbridge and , Burnham and Brent and Brent Area.) The PPG will now be patient led with Practice representatives attending meetings. Pauline Drummond explained to the group how the CCG (Clinical Commissioning Group) is set up. John asked for a volunteer to be Vice Chair as from time to time he is away on business. He wants the PPG to be open to as many as would like to join but wants a core group who meet more frequently than the quarterly meetings. He asked volunteers for this group to email him on [email protected] Action groups can be formed as and when the need arises. Action: Volunteers needed for Vice Chair and core group; PPG information to go on the Practice website please. 2. Tessa Munt MP meeting feedback: To date, there has been no feedback from Tessa Munt MP on her meeting with the PPG and the questions put to her. Action: John Pimblott to chase Tessa Munt’s office. 3. Transport report: The Chairman thanked Suzanne Green for her excellent work on hospital transport, attached as APPENDIX 2. This information, when finalised, will go on to the website in the surgery for use by patients. It was proposed that a hard copy leaflet for patients could be produced and Pauline Drummond said the surgery would be happy to do this.

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Also suggested was publicity about hospital transport to be on the radio and in the newspaper. Christine Sims volunteered to find out how villages operate their village car schemes. Cheddar does not have one. Pauline reported that some patients find it difficult to get to the surgery, particularly in the winter months. The PPG’s project on transport was presented to a meeting of the CCG Clinical Operations Group, COG. David Slack, Managing Director, Somerset CCG says the NHS is not responsible for patient transport but two actions were minuted to clarify transport communication, see APPENDIX 3. North Somerset Council has a ‘one stop shop’, but this will not happen here as Somerset CCG plans are in place for 2014-2016 and there are no further funds available, especially given CCG clarification that transport is not CCG responsibility but that of local authorities. However, the surgery could produce signposts and put it on the website under the heading of Transport. Jacqueline Scouling emphasised the need for clarity especially when people are very ill and possibly overwhelmed. Pauline Drummond to ask the doctors if they are aware of the PPG’s findings that different rules re transport exist at different hospitals … this fact might influence a patient’s choice of hospital. The PPG agreed to talk to as many people as possible about their transport experiences and report back. Action: John Pimblott to contact about their budgets for hospital transport, communication etc; Pauline Drummond - transport information to go on surgery website; chase David Slack for further information; working with Christine Sims and Suzanne Green to kindly prepare hard copy leaflet for issue in the surgery when work is complete.

4. 2014/15 Action Plan: The Chairman stated that this will stay on the agenda to monitor progress. 5. Practice Report: Attendance monitoring: Attendance has improved and at present there is no need for PPG involvement. Appointments can be made online with 10% of patients signed up for MJog. New clinical system implementation: “EMIS Web” is now the clinical operating system. It is used by the entire practice for everything. It is a modern system and is user friendly. Enhanced Service Specification (ESS): Nothing to report. Pauline Drummond reported that there are three health service commissioners, NHS , Somerset County Council and the CCG. From April 2015 NHS health checks, chlamydia, smoking etc. will be put out to tender and as a result there is the possibility that the surgery will not be able to offer these services. Care Quality Commission: The first inspection of the practice will take place by 2016. The practice will ask the PPG to be involved.

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Medical Centre property update: The landlord is selling the property but it will not affect the NHS side of the surgery, just the Complementary Medical organisation. Cheddar Medical Centre has been a tenant in the current property for over twenty years and will continue to rent the property when a new buyer is found. New Partner: Dr Laura Martin (who is already at the practice) is joining as a Partner from 1 September. Long term locum, Dr Pippa Vickery is leaving. Locums will be covering until Dr Martin will take over. Pauline Drummond reported that there is a national shortage of doctors, especially GPs. Hopefully, different doctors will attend quarterly meetings. Pauline said the practice is happy to deal with all PPG concerns. Action: PPG to monitor patient concerns (and compliments!) and pass them to the Practice Manager, via the Chairman if preferred. 6. Somerset CCG Clinical Operations Group (COG) … participation by the PPG: John Pimblott reported on the meeting and said it was successful and a good opportunity to get the voice of our PPG heard. The PPG had a 20 minute slot, a slide presentation and a good discussion about the future of rural practices etc. Minutes Appendix 3 7. NHS England: John directed the group to the NHS Choices website. www.nhs.uk Information on the surgery can be found there from the patient surveys conducted by the NHS. 8. NAPP (National Association of Patient Participation): Discussion on the July ebulletin. This can be found on the website www.napp.org.uk Shortly, this will be circulated to members of the PPG with a password. Action: Pauline Drummond to get password from NAPP. ebulletin to be circulated. 9. Any other business: RCGP (Royal College of General Practitioners) Campaign: RCGP is saying they ‘can’t cope’ under present conditions with fewer people wanting to be GPs. The national campaign being run shows due care must be taken if surgeries are to operate as they do now. Pauline Drummond reported that insufficient money is being directed to primary care and pension changes are actively encouraging retirement among older GPs. The PPG is committed to fight for the surgery. Many of these points were raised with Tessa Munt MP. John Pimblott asked members of the PPG to go to the surgery and sign the campaign which is at the reception desk until 12 August. It can also be signed on line at http://www.rcgp.org.uk/campaign-home/get-involved/petition.aspx Date and time of next meeting: The next full meeting of the CMC PPG will take place at the Surgery on Monday 13 October at 7pm. ------Notes: Useful email addresses John Pimblott [email protected] (Chair)

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Elizabeth Herridge [email protected] (Secretary) Pauline Drummond [email protected] (Practice Manager)

APPENDIX 1

Cheddar Medical Centre PPG

Role − The CMC PPG clear role is to communicate, consult, share information and support Cheddar Medical Centre to support us, the patient, to try and ensure a ‘good patient experience’ throughout the health and care system

− The PPG will be transparent and open

− At a time when much has and will continue to change in the NHS, the Somerset CCG and the requirements of CMC, the PPG has a unique role to gather, communicate and action patient views, concerns and requirements to decision makers by any means possible. Patient participation is a strong directive in all the NHS England legislation

How − Encourage patients to be proactive; to seek patient views from time to time and to communicate and express views to the CMC, CCG, Somerset HealthWatch, etc. to influence local health and care provision.

− Communication from patient to CMC and CMC to patient on a range of issues concerning health, wellbeing and care

− Challenge and support services providers to improve service delivery

− Action group for specific issues as required

− Develop the PPG influence through best practice

Structure and Process − Not bureaucratic but effective

− Chair – as focus, Secretary, (Treasurer - not necessary) Do we need a Vice Chair?

− No restriction on the number of PPG members

− General meetings held every three months shall be open to all members of the PPG

− A core of 4/6 members who will act as a direction/policy who will meet in addition to the general meetings

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− Members form action groups as needed

APPENDIX 2

Patient Transport Update With the help of Kokila, Elizabeth and Chris Sims, the update to the previous information is as follows: It is confirmed that there is a scheme operating in Somerset which is similar but not identical to that organised by North Somerset. Patients can contact the Patient Transport Advice Centre on 01278 727444 on weekdays between 8.30 am and 6.30 pm to see if they are eligible for free transport on either medical or financial grounds. If patients are not eligible for free transport, they will be directed to Somerset County Council’s Transporting Somerset Team on 01823 357688 for alternative transport information. Patients will then be told about Mendip Community Transport and Community Transport which operate volunteer driver services to local hospitals and other services available, i.e. the Sedgemoor Slinky bus. Further information that has been obtained since the last meeting is that the Red Cross are no longer offering general hospital transport as they could not cope with the demand. It may resume but not known when. The Red Cross are concentrating on the contracts they have with local hospitals. For patients who need to get to Southmead and do not want to drive to the other side of Bristol, there is a bus service that runs from Long Ashton Park and Ride to Southmead and return. The bus leaves on a half hour schedule. Mendip Community Transport appears to offer a satisfactory service for hospital appointments but it needs more volunteer drivers, people seem unaware of the service and because it is called “Mendip”, they are under the belief that it won’t cover Cheddar because Cheddar is in the Sedgemoor area. Some publicity asking for more drivers has been put into the Cheddar Valley U3A Newsletter, and posters are available for suitable locations. Patients who need substantial appointments, for example they need to get to Oncology on a daily basis, transport if required is arranged through the relevant departments although so far information has been found that shows that hospitals differ in their approach to hospital transport. For example Musgrove Park will arrange transport through the Red Cross on a no charge basis for patients to attend on a daily basis for treatments such as radiotherapy. There are no qualifying factors such as income or physical incapacity to access this resource. The BRI, however, apply qualifying factors such as benefit receipt or medical incapacity for free hospital transport, and then, it appears, there can be long waits for this transport. The BRI does offer the possibility of discounted car parking which is accessed through the relevant clinic.

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Suggested Way Forward Put the relevant information about transport options on the Medical Centre Website. This can be available immediately. Medical Staff to inform patients of this information. Produce a leaflet for patients who do not access the internet. There would be a question of funding for the printing. Leaflets should be given to relevant patients by medical staff. Publicity – Cheddar Valley Gazette has been contacted about an article highlighting the specific need for drivers for MCT. Pulse Radio has been contacted to publicise MCT. Both actions to be followed up. For further discussion What further action does the PPG want to take? Does the PPG want to discuss with the local Cancer Group what further help could be given to people who have to access the BRI for oncology etc for substantial amounts of time? The Medical Centre has mentioned an issue of patients having difficulty in actually getting to the Surgery. Is this something that the PPG want to discuss further? Community Transport. Wedmore has its own Community Bus. Is this something that the PPG would like to take further and involve other Cheddar groups, e.g. Cheddar Lions, My Cheddar, Cheddar Parish Council.

APPENDIX 3

Clinical Operations Group Minutes in response to the Cheddar PPG presentation The notes of the 11 June COG meeting were approved as formal minutes at the 9 July COG meeting and I have pleasure in detailing below the North Sedgemoor Federation Feedback session: Rosie Benneyworth welcomed the North Sedgemoor Federation representatives to the meeting and asked Matthew Dolman, North Sedgemoor’s Federation Delegate, to lead the discussion/feedback. Matthew advised that North Sedgemoor is a very rural area with a population of approximately 40,000-50,000 patients. Matthew introduced the representatives from the federation and then handed over to John Pimblott who updated the COG members on the following items:

. Meeting with Tessa Munt, MP. John advised that Cheddar Patient Participation Group (PPG) had a meeting with Tessa Munt where they discussed the importance and

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sustainability of smaller rural practices. They also discussed whether the use of Any Qualified Provider schemes by primary care commissioners could result in the creation of larger practices only. Ms Munt advised she would raise both points with , Minister of Health, seeking clarity and direction.

. Transport services. Cheddar PPG is also concerned about patient transportation to and from appointments in the Taunton, Bristol and Weston-super-Mare areas and the desire to have clearer information about the available transport services. The PPG would like to see a one stop shop for transport service queries. John advised that Cheddar PPG has seen leaflets from other CCGs on this issue but has not seen any leaflets from Somerset CCG so clarity and leadership were sought from the CCG for an integrated and sustainable model.

Ann Anderson thanked John for his presentation and for highlighting these points. Ann advised that the CCG commissions NSL to provide the patient transport service and the CCG has a number of other smaller transport contracts. Ann agreed for the CCG to provide clearer information on the available services. David Slack pointed out that the NHS is not responsible for providing transport services for patients but could assist by ensuring clear signposting for people to help identify transport sources. David also advised that there is a transport booking function under the BMS at Bridgwater and information about this should be recirculated. Rosie Benneyworth thanked the members from North Sedgemoor Federation for attending the meeting and for their valuable contributions.

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