Minutes of the
DOWNING STREET PRACTICE PATIENT LIAISON GROUP MEETING
Held on Tuesday 24th September 2013
In the Parish Room, St. Andrew's Church Rectory, Farnham, Surrey
Present Madge Green,(chairman), Philip Green, Dr.Viv Rishworth, Ken Maynard,Sue Haworth-Edwards,Cathryn Trezise, Christine McIntosh,Ian MacDonald,Valerie Fabry, Gordon Radley, Lesley Barton, Gillian Beel (8 patient representatives and 4 Practice representatives) page 2
1 Welcome
Madge welcomed Ken Maynard to the Group and thanked Gillian for bringing the refreshments as Valerie (W) was unable to attend.
2 Apologies
Dr. Kate Russell,Valerie Wilkins, Philippa Fabry and Tony Lennard. Madge explained that Tony may decide to leave the Group because of other commitments.
3 Minutes of last meeting
Agreed and signed off by the chairman
4 Matters arising
Gillian reported that the number of Disability Parking bays near to the Practice and the pharmacy are to be increased hopefully in the next month when the car park in Waggon Yard is expected to be resurfaced. The Group thanked Gillian for bringing their concerns to the attention of Waverley Borough Council. Lesley reminded the Group that the Practice with Care Farnham have already established the use of one of the parking bays (for a short period of time) specifically for drivers from Care Farnham to take patients to the surgery. Lesley asked if this could be highlighted in the Newsletter.
Action – Phil
Gillian also informed the Group that Surrey County Council has passed a new rule restricting the use of A frames.
Madge informed the Group that she contacted Dr. Andy Whitfield (chair of the Clinical Commissioning Group) and not Dr. Jane Dempster (commissioning lead for this service in Farnham) to express the Groups concerns about the Podiatry Service. She shared the contents of the letter with Cathryn. So far she has received an initial response but hopes to hear more.Madge asked if Kate has sent information to Valerie ( F) about local support for people with a mental health
Page 3 problem from the Mental Health Team. This led to a discussion about Mental Health Champions. Dr. E. Wernick, specifically for dementia. is one of the champions and Gillian is also. She explained that the role of the champions is to raise awareness about the needs of people with dementia so that there is more patience and understanding in shops and elsewhere in the community. Gillian hopes to talk with local schools. Madge wondered if something might go in the local paper about the work of the Group both now and in the past e.g. purchasing chairs for the surgery and the special 24 hour blood pressure machine, raising concerns about disability parking. There was a brief discussion and the Group agreed that this would be a useful way to advertise the Virtual Group too.
Action – Madge, Lesley and the Group
Valerie (F) asked if the patients in the Group could be involved in the production of the Newsletter
Action – Phil and the Group
Madge led a discussion about Group members meeting patients at the surgery. Madge and Ian did this once before some time ago. Viv suggested that the Group would need to give prior notice before coming into the surgery. Perhaps a notice could be set up saying when the Group might be at the Practice. She expressed concerns that some patients may not be willing to be approached directly to answer questions as opposed to completing a patient survey /questionnaire as they may be feeling vulnerable when coming in to see the doctor. Madge was unsure if questions were needed suggesting an impromptu approach but others in the Group thought that such an event needed careful planning and that questions would need to be open. Ken felt that questions either via direct approach to patients or in a patients survey needed to be part of a carefully structured approach and consideration needs to be given to the demography of the patient population. Chris wondered about using a notice board in the surgery to explain when this might happen if it does go ahead.
Ken volunteered his help and Valerie (F) and Madge also expressed an interest. Valerie wondered if Gordon had time to help and others might wish to be involved who were not able to come to this meeting. Page 4
The Group felt there was a need for more thought about this idea and some group members wondered about how to start to pull something together before a more detailed proposal is made to the Practice via Lesley.
Action – Group to discuss at the next meeting
Madge asked Lesley about the patient survey. Lesley explained that this will go out at the end of November. It will be on the website and survey monkey and will be sent out directly to patients via text. Ken asked about a two part approach rather than a single hit. A discussion followed about how to get more access to different patient groups i.e. giving a survey out to people visiting the flu clinics. Ken asked if we knew about other groups like ours and how they carried out surveys. Lesley reminded the Group that the National Association of Patient Participation had asked all affiliated members to hold an awareness raising event last June. Our Group had not felt ready to do this but it is an idea for the future. This might be a good opportunity to share the feedback from the survey and to gather new ideas about patient participation.
Madge asked the Practice about telephone consultations between doctors and patients. Viv explained that doctors ring patients usually within an agreed time frame. At present there are no particular issues coming through in complaints data to suggest there are problems as to how telephone consultations take place. Maybe patients do not know that they can ask to do this. Phil was asked to put something in the newsletter. Normally a patient could expect to arrange a telephone consultation earlier than it might take to see their particular doctor.
Action -Phil
111 Service Madge said that Valerie (W) had found this to be much improved since the last meeting of the Group. Madge raised the size of the Group asking whether the Group number should be limited to 15. Madge is concerned that as the Group grows the venue will be too small, and each meeting will take longer. Madge said she believes that the present membership is representative of the patient population. Several Group members felt that the Group is not representative of the patient population as 60% of patients are between 0-60 as many in the Group are older. Valerie (F) page 5
reminded those present that the Group recently voted against limiting the size of the Group. Gillian said that 15 members is enough people . Valerie (F) said that the Group is open to all patients at the Practice over the age of 16years.She also said that in her view the Group needs to guard against seeing itself as a 'committee'. She stressed that where as the Clinical Commissioning Group may be viewed in this way as it has specific business to carry out, a budget, and statutory duties and powers. Our Group has been set up by and with the Downing Street Practice in line with Government guidelines when introducing NHS commissioning to actively encourage patient participation. At the moment there is no pressure for a large number of people to attend. Valerie (F) said that maybe the Group could meet in a bigger venue so people could come along more easily. Viv said she did not wish to limit numbers but if the Group became very large maybe a different approach might be required. Sue said she did not wish to see the Group membership limited. Ian suggested that the Group could be limited to a small number Madge said she finds chairing the present group difficult as it feels like two groups. Christine queried this saying she did not know the group was split between patients and staff at the Practice. Madge said she meets all the patients in the Group personally but does not see Practice staff individually. She said she wants more contact with the Practice in her role as the chairman of the Group.She would like to receive reports directly to her about what is happening at the Practice. Lesley asked Madge what these might involve. Sue said she thought part of the idea of these meetings was to be the forum where such information is shared by the Group as a whole and not via one person. Gordon suggested setting up a 30's group which might meet once a year.Valerie (F) suggested making this into a sub group. The Group agreed and Valerie was asked to see if Philippa as the youngest member of the Group could think of ways to set this up and discuss these with Lesley.
Action – Philippa & Lesley
Madge asked for any updates regarding the prescription service and getting supplies from the pharmacy. Viv and Cathryn said that normally the chemist will ring the surgery if there are supply problems. Cathryn added to these minutes more information I.e.that pharmacies can choose their own suppliers and this sometimes governs what stock may be available to them, therefore sometimes a drug might not be available through a particular pharmacy but may be available elsewhere. Occasionally there are one off medical alerts via the MHRA, Medicines page 6 and Healthcare products Regulation Agency, which may take some products off the market to all chemists temporarily or permanently. Cathryn also said that there are Government restrictions also affecting what pharmacies can stock.
5 News from the Practice
Practice Manager Lesley explained there are two main areas of funding affecting the Practice:- 1 funding that comes to every GP practice with their contract to supply services for the NHS ( this pot of money remains the same even if there is a need to develop a new service) 2 money for commissioning services managed by the Clinical Commissioning Group -which cannot be accessed by the Practice Lesley also gave the Group details of the demography of the patient population for the Practice as follows: 75% patients are 0-60 25% are over 60 16% are 40-49 The Downing Street Practice has more patients over 80 and over 90 than other practices in the area. The biggest usage of the services at the Practice are from the elderly. Lesley was pleased to announce the new telephone number will be in operation from the 2,3,4th OCTOBER – it is 01252 716226. Part of the role of the Group might be to encourage patients to ring at 11am rather than 9 am if their call is not urgent etc. Lesley said that the new website was up and running and asked the Group to have a look and send feedback to Suzanne Nichols (Lesley's deputy) at the Practice. Dr. Susan Cooper has started as a new partner at the Practice working working Mondays, Tuesdays and Thursdays ( working 2 days per week in October and 3 days from November onwards) Work is ongoing looking at how to improve the appointments system. Lesley said that all Practices in the area are under strain because of an ageing population. The Doctors Viv explained that there are 3 full time partners at the Practice, Dr. Ismail, Dr. Ballard, and herself. Page 7 Dr.Wernick has specific responsibilities on the Clinical Commissioning Group for people with dementia and in order to do this works one less session at the Practice. Full timers undertake 8 clinical sessions per week. Dr. Das and Dr.Ebrahim , salaried doctors work 4 & 3 sessions per week respectively. GP training grade doctors come to the Practice supervised by Dr. Ballard and Dr. Russell.Most hospital doctors do 4 months in General Practice. Those that go onto specialise in General Practice do 3 years training including spending time in General Practice in years 1 & 2 and doing the final third year completely in General Practice. Dr.Russell has the overall responsibility for managing this training.
Viv said that the Doctors are working long hours, up to 12 hours a day and often come in at weekends to do paperwork. Any extra work has to be absorbed by the Partners at the Practice.
Practice Nurses
Cathryn said that the Practice nurses have to have new training because of changes to baby vaccinations. There are flu jab clinics in October. There is to be a well children campaign. There is a national shortage of Practice Nurses and in particular specialist diabetes nurses. The Practice does not have a full quota at the moment despite advertising.
6 Patient experience, comments, and ideas
Madge told the Group that the Macular Society are opening in Farnham. Gillian encouraged more use of the Gostrey Centre.
Please refer to Matters Arising above
7 Updates
Reports from:
N. E. Hants & Farnham Clinical Commissioning Group page 8 Viv said that there are new Physiotherapy services but only one for Farnham based in Farnham Hospital and run by Virgin. There are plans to develop a forum for those working with patients with diabetes. There are increasing concerns nationally about people aged 55 years and under who have diabetes. Viv explained that any patient can request a check if they think they may have diabetes. There is an initiative to vaccinate against Shingles. This targeted at people aged 70 or 79 at the moment.
Farnham, Hart & Rushmoor Patient Participation Group
As Philippa was unable to attend the meeting the Group were asked to read the papers already distributed and those now attached ( please take a moment to look at the N.E.Hants & Farnham Clinical Commissioning Group's draft Five Year Strategy )and send their thoughts to Philippa via the Group Secretary's email address so Philippa can feed these back to the Farnham,Hart & Rushmoor Patient Participation Group. or for any patient (over the age of 16 years) wishing to be in touch via the Patient Liaison Group's Gmail address contact:
8 Report from the Virtual Group ( [email protected] ) Valerie (F) explained that she has met with Suzanne Nicholls and both had looked at the new Downing Street Practice website and the Virtual Group Gmail address. A lot more needs to be done to advertise the Virtual Group.
9 Social Event Madge said she would like the Group to meet socially perhaps for a cream tea. However the Group were not enthusiastic. Valerie (F) said she hoped an event would be organised at some point in the future by the Group open to patients and including a health promotion element. This would fit with our aim & objectives – see paper attached.
10 A.O.B. Lesley asked everyone to let her have their ideas for the Patient Survey by the end of October 2013. page 9
11 Date of next meeting The Group had an initial discussion to consider whether to hold an Annual General Meeting. Some ideas about venue size were considered.
Wednesday 29th January 2014 between 5-7 pm -to be confirmed
Gillian suggested booking the Gostrey Centre- to be confirmed
The meeting ended at 6.55 pm and the venue door locked by 7.15 pm
N.B. Please read the documents attached with the minutes
final document produced by Val Fabry on 17sth October 2013