Minutes of a Meeting of the Clinical Governance Committee Held

NHS GREATER GLASGOW AND CLYDE EAST GLASGOW CHCP EAST CHCP Monthly GP Practice Feedback Meeting Tuesday 19th August 2008 at 1pm, Carntyne Medical Centre

Present: Irene MacPhail - Keep Well Social Referral - Co-ordinator – Glasgow East Sabrina Dean - Keep Well Administration Project Officer – Glasgow East Anne Scoullar - Consultant in Public Health, NHS GG&C Isobel Crilly - Lightburn Medical Centre Karen McMahon - Crownpoint Medical Practice Janice McPhail - Carntyne Medical Centre Lorna Bern - Carntyne Medical Centre Margo Clark - Carntyne Medical Centre Jean Keith - Carntyne Medical Centre Angela Livingston - Carntyne Medical Centre Cheryl Adair - Drs Jamieson & Day Cathie O’Kane - Parkhead Medical Centre Yvonne Melville - Parkhead Medical Centre Irene Proudfoot - Crail Medical Practice Barbara Cox - Crail Medical Practice

Apologies: Liz Graham - Dr Goldie Practice Rona Stirling - Lightburn Medical Centre Sandra Aitken - Drs Jamieson & Day Gwen Watt - Dr Dhami Kay Boyle - Dr Wilson, McGinlay & Sheppard Ann Moore - Crownpoint Medical Practice

1. Welcome & Introductions

IMacP welcomed everyone to the meeting and thanked them for attending. Introductions were made around the table. It was explained that this was an informal event designed to raise awareness of the working methods of each practice and to share information regarding Keep well.

IMacP welcomed Anne Scoullar to the meeting, explained that Jackie Britton would be leaving post on 29th August 2008 and part of Anne’s remit will be Keep well.

AS gave a brief resume of her background, explained that she is still learning about Keep well and will know more regarding the way forward after meeting with Jackie and Alex McKenzie.

2. Previous Minutes – Matters Arising

Everyone agreed that the minutes for the last meeting were an accurate reflection and there were no matters arising.

3. Individual Feedback – General Discussion

Rather than a general discussion and feedback from a practice perspective the group felt that they would rather discuss the issues relating to data extraction and the problems that had been identified through clinical evaluation.

IMacP explained to the group that as part of the clinical evaluation and monitoring of the project, statistics in the form of clinical data need to be extracted from the screens. However the IT department are having difficulties as there appears to be a problem with the data collected. IMacP went on to inform those present that Janice McPhail has been working closely with both the Keep well and IT teams to offer solutions and advice from a practice perspective on the problem.

IMacP stated that Marc Lang is currently updating and producing a new list for each practice, which will be sent out towards the end of the week. Practices are to put on hold working on the current lists and wait until the updated list is sent through. This updated list will show both primary and secondary patient numbers. IMacP apologised to practices present for the additional workload caused and went on to stress the importance of the practices ensuring they record everything on the CDSS and Tracking tool.

of 3 Discussion centred on the recent issues with the JBS2 data and the request for practices to update any missing information. The following points were raised:

 IP stated that data/information entered into the SPICE screen, does not cross over to CDSS. However, if information is entered into CDSS, it transfers to SPICE.  IP explained to the group that she had previously had problems in relation to entering an HDL Cholesterol and Cholesterol onto the screen. She resolved this by entering the Cholesterol, exiting the screen by saving the information and then going back into the screen to enter the HDL.  IP stated that there was no way to record a risk-score when the template was first developed and the practices were never asked to complete retrospective risk-scoring. Also, all practices calculate risk-scores differently.  Changes are made to the screens regularly and practices are not always informed of these changes. It would be beneficial if practices were notified of all changes (IP).  JMcP explained that most practices in East Glasgow use Care Management so this should reduce the workload the practices have when entering the information.  When the Keep well template was designed, no consideration was given to how it would work with the current systems used by Practices (All)  The list sent to Practices shows patients who are ‘deducted’ e.g. deceased – Marc Lang is trying to resolve this (JMcP)  When entering information for non-smoker, it must be done as clinical entry.  Templates focus on patients who are over-weight and want to lose weight, there is nothing for those who want to gain weight.  Screens only allow for ethnicity of White Scottish or White Irish to be entered, nothing for White English etc.

IMacP stated that it is evident that further training is required on ASSIGN and training has been arranged for 9th September 2008, she encouraged all practices to attend.

Food, Weight & Physical Activity

There was general discussion among those present about the food, weight and physical activity component of Keep well. The following points were raised:

 CA reported to the group that she had recently referred a patient to the Health Counsellor at the East End Healthy Living Centre (EEHLC) and when the patient attended, they were told by the receptionist that the Health Counsellor was not there. CA felt the staff at EEHLC should be more aware of services using the venue.  IP stated she had referred 2 patients to Glasgow Weight Management Service who had issues with the Psychologist e.g. bad attitude, ignored patients’ medical issues. IP only refers to GWMS as feels the other weight management services are ineffective.  IP attended a Shape Up class and felt it was unprofessional, poorly organised and the staff were not properly trained in giving weight management advice.  IP stated that she no longer refers patients to Eat Up due to previous negative experiences e.g. unable to contact service, patients waiting too long for appointment.  All present felt that the cost of Shape Up was not appropriate when considering the target group of Keep well.

4. A.O.C.B

Reports

MC stated she has problems when entering time of appointment, the system ‘times out’. BC explained she has already spoken to Marc Lang regarding this and he says it is a tricky problem to fix.

of 3 Joint Networking Event

IMacP explained to the group that the Joint Networking Event had been arranged for 23 rd September 2008. However in light of the recent additional workload those present agreed that is should be postponed and perhaps re-scheduled for later in the year.

Extension

IMacP reported that she has visited 2 practices regarding the extension and will be resuming the visits when it is clear who will be responsible for Keep well after Jackie’s departure.

IP stated that it would be beneficial for the extension if Keep well gathered data throughout the process rather than waiting until the project nearly over.

Clinical Forum

AS queried if those present think they would attend a meeting to discuss the 3rd year of Keep well and also if GP’s would attend. All present felt this would be beneficial and GP’s would be likely to attend.

5. Date of Next Meeting

Tuesday 7th October 2008, 12.30pm at Carntyne Medical Centre.

Next Meeting Tuesday 7th October 2008 12.30pm Carntyne Medical Centre