Minutes of Bethesda Patient Participation Group Meeting

14 December 2016 Held at Darwin Court

Apologies: 5 members

Present: 11members , Clive Hart, Sue Clarke, Rachael Cousins.

Thanet Health Reference Group Meeting xx fed back on this meeting held on 7 December which both herself and xx attended. The meeting was led by Oena Windibank – Accountable Officer to Integrated Accountable Care Organisation (Thanet CCG). Her role is to improve and deliver acute and social care.

We have an increasingly vulnerable and younger community in Thanet and they are looking at a Five year forward view on out of hospital care. This is to see how people can be kept out of hospital and if they are an inpatient how quickly can we get them back into their own home. It has proved better for patient’s health to get back home as sitting or being in hospital bed can cause bed sores ,muscle wastage etc.

Stay Well is access to information, needs etc so that they get the right people at the right time. This is to include Mental Health patients going back into outpatients to make caring for the patient easier and more importantly it if for the patients benefit.

Primary Care Homes (previously known as hubs) of which there are four –Margate, Broadstairs , Ramsgate and Quex is where integrated community care organisation comes in .There are Primary Care Home Standards and also some that are specific dependant on the main needs in each area. These standards must reach the patients’ needs and not the providers. Thanet is the pilot centre for centered care –known as Esther, which was a patient centered model studied in Sweden. The patient was called Esther. Esther is a decision making patient/clinical pathway –the Esther Way and training will be commencing for a few people so that they can teach others. This transition is challenging and growing in the patient involvement. It will not be an easy challenge as it will come from the top ie consultants, GP’s, a team to manage care both medical and surgical into the community.

How do we get involved- Esthers are needed at every level, Healthwatch has been asked for help and they may be an Esther Cafe

Thanet GP’s will work together rather than using out of hours doctors. This will be more cost effective and will be trialled over the Christmas period.

Integrated Accountable Care Organisation (Thanet CCG) Various audits have taken place at EKHT across hospitals and looked at appropriate care etc and they believe people are safer out of hospital. They do a series of unrelated tests and then have to stay in hospital which can bed block unnecessarily.

“Integrated Acute Response Unit” will consist of nurses, therapists and GP they will work alongside consultants.

1 Arrive at the hospital, GP sees patient 2 Secamb sees patient if by ambulance

The Team will make necessary assessments working alongside A&E .At present they are now turning around 5 people a day who otherwise would have stayed in hospital.

The ART (Acute Response Team) –Hospital and GP looks after patient and speak to patients own GP to put them in the picture.

There are Esthers at every decision point. This is both health and care –not totally medical to meet the patients’ needs.

Clive Hart had tested the system with his mum and it worked and kept her out of hospital .Clive raised the fact that carers will not administer medication. His mum had come out of hospital with a prescription and therefore needed a MAR chart so she could be given her drugs.

Update on East Kent Strategy Programme –The consultation planned has been delayed until after the County Elections in the summer. The Sustainable Transfer Programme- East Kent Health Authority are currently more advanced than the rest of Kent and Medway with regards to this programme. There is to be a formal consultation for 90 days regarding this for the public to be involved .There is also a questionnaire for the public to fill in by the 23 December which was given out with East Kent Strategic booklets and there will also be workshops and listening events at the end of January 2017

PPG Initiatives and Best practice sharing Minster Surgery have set up a Walk for Life Club East Cliff have a lady that has set up an Overweight session when she realised that 7% of people are overweight and worked out that if they weren’t it would save the surgery a lot of money. The Grange surgery had Tea, coffee and cakes at their Flu Clinics which raised £1400 for charity.

Clive Hart, Lay Member of Thanet CCG attended the meeting and he talked about the points raised by xx as well as :

Care Homes- Clive said that the CCG have employed 2 pharmacists that will be doing medication reviews with patients in order to save wasted medication and money. They have already reviewed a Care Home where they found cupboards full of unused dressings that were not needed and the patients will now not have those items listed to reorder.

AOB xx talked about Healthwatch and the fact that a large proportion of Eastern Europeans do not attend the GP surgery for health matters they go straight to A&E as this is what they are used to doing in their own countries. This was discussed and the group felt that it is best to try and get education into schools for this and Clive said he was very active in the support of Physical and Social Education in Schools. xx said that all other countries that you visit if you need medical attention you have to pay for it, but here overseas visitors seem to take advantage of the NHS free treatment. This was discussed and it was raised that people should be asked to show their passports if they turn up at A&E. It was also discussed as to whether A&E should turn people away as it costs the surgery/CCG £60 for every patient that attends regardless of whether they are seen. xx suggested to Clive that maybe the council mailing department could be used to send out Health and Well- being information when they distribute leaflets for Refuse collection etc. xx said that Healthwatch have produced leaflets in Polish to try and spread the word. xx said that Transport can be a problem for patients when they have to travel to Ashford for Eye or ENT clinics . She feels that it is worrying for patients many of whom cannot see very well having to use public transport/try to get Patient transport to get there and it would be better to have the clinics locally. Clive explained that it is not possible to have all services at QEQM and the best hospital for these services is at Ashford. However the CCG are looking at trying to have consultants working over more sites for some clinics.

Rachael advised the group that Union Row surgery is closing at the end of February 2017 due to Dr Henry’s retirement and as there are no available GP’s to take over the surgery premises , Bethesda will be the main surgery taking their patients (between 3000 and 4000) onto our patient list . Due to the volumes involved Bethesda will be holding four Registration events in January to register these patients. It was discussed that if possible some members of the group may be able come along to these events to help out.

Rachael advised the group that a new Fraility Scheme has been started and we have 300+ patients on it that are felt to be at risk of A&E attendances or hospital admissions .Nicole who works for the Community Nursing Team and Zara who is employed by Age UK are working together on this scheme .They telephone the patients in the first instance and score the patients by using an Edmonton Fraility Scale questionnaire .Dependant on the results of this they will then if needed arrange to do a Home Visit to the patient. xx mentioned that the new patient transport service G4S was very good .He has had to use them four times recently and the service is very good Once they have the patients NHS number on record they do not need to ask a lot of questions each time they call to request transport so it is important when making a booking for the first time the patient has their NHS number.

General feedback from the group was that Rosie and Katherine the new trainee HCA’s are good and also Alison the Paramedic Practitioner is very thorough and helpful. xx said that Minster surgery PPG have raised a lot of money to buy the surgery equipment by doing fundraising events and she wondered whether it might be possible for our group to do something similar. This was discussed and it was agreed the group would think of ideas and to put this on the agenda for the next PPG meeting in February.

The next meeting date was agreed for Wednesday 15 February, however Darwin Court are no longer able to accommodate our meetings. Due to this our next meeting will now be on Wednesday 22 February at 10.30am and will be held at Bethesda.