Minutes of Llanfyllin & District Medical Practice

MINUTES OF LLANFYLLIN & DISTRICT MEDICAL PRACTICE PATIENT PARTICIPATION GROUP

HELD ON MONDAY 9TH SEPTEMBER 2013, AT 6.30PM IN LLANFYLLIN MEDICAL PRACTICE

Present: Mrs F Hunt (Chairman) Cllr Aled Davies, Montgomeryshire CHC Mr Malcolm Foulkes, Four Crosses Mrs Anne Hughes, Llansanffraid Mr W O Jones, Pool Quay Mr Bernard Morgan, Llanrhaeadr Mrs Ann Williams, Llanfyllin

Mr Russell George AM Mrs Gwyneth Bird, AM’s Office Mrs Pat Ward, Powys teaching Health Board

Mrs Susan Lewis, Practice Manager, Llanfyllin Medical Practice

Mrs Andrea Blayney, Montgomeryshire CHC (taking notes)

Apologies: Mr Peter Cannon, Mr Digby Davies, Mrs Mair Hughes, Cllr Mrs Eldrydd Jones, Mrs May Lloyd, Ms Juliet Nixon, Mrs Pauline Page-Jones, Mrs Maxine Roberts (Montgomeryshire CHC), Mrs Maureen Wilde, Mr Peter Skitt (Powys teaching Health Board)

Action 1. APOLOGIES FOR ABSENCE

The apologies for absence were noted, as listed above.

2. NOTES OF THE PREVIOUS MEETING HELD ON MONDAY 1ST JULY 2013

The notes of the meeting held on Monday 1st July 2013 were agreed as a correct record.

3. MATTERS ARISING

(a) Minute 3b Matters Arising Waiting Times for Powys Patients The Chairman reported that she had written to the Chief Executive of Powys tHB on 9th May 2013. A response had not been received from him. The Chairman telephoned the Chief Executive’s office and was advised that it was understood that Peter Skitt had answered the queries. The

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Chairman had spoken to Peter Skitt today (9th September 2013), and he provided the following information:

. Powys tHB had the best figures for the 26 week referral to treatment across Wales and met the 95% target set by Welsh Government.

. The Health Board acknowledged that there was a problem with waiting times at Robert Jones and Agnes Hunt Hospital, especially for spinal and shoulder surgery. There were capacity issues in each of those specialties. Those waiting times were no longer acceptable to Powys tHB and it had requested RJAH to set out a plan on how to reduce those waiting times by the end of September. In addition, Peter Skitt was speaking with the Royal Orthopaedic Hospital in Birmingham to check whether that would be an option which could be offered to Powys patients.

. Powys tHB would be contacting the patients who had been waiting a long time to ask if they would be willing to take up the offer of Birmingham.

. It was not acceptable for any patient to wait over the 36 week referral to treatment time.

. A clear set of rules regarding waiting times would be considered by Powys tHB Board and, when agreed, would be circulated to GPs and patient participation groups.

. For any further queries, please refer back to Peter Skitt.

The Practice Manager explained that, from the GP perspective, there were improvements; it was about Powys tHB being able to commission the services required.

Mrs Pat Ward added that Peter Skitt was keen for the Locality Team to look at the pathways for patients with spinal conditions to see if other options might be appropriate, eg physiotherapy or pain management. The option of bringing in an additional clinical specialist to review patients who were waiting was also being considered.

Members would like to receive further update at the next meeting.

(b) Minute 3c Matters Arising Welsh Health Specialised Services Committee (WHSSC) The Chairman informed members that the patient did get the desired treatment and was reported to be doing well. The patient’s husband wished to thank everyone involved in pushing this forward, especially Russell George AM, Cllr Aled Davies, the Practice GPs and Frances Hunt, Chairman of the PPG.

(c) Minute 4 Update on the Message in a Bottle Scheme / ICE Cards It was reported that about half of the ICE cards had been collected by Page 2 of 6

patients, and stock of the bottles was down to the last few.

It was DECIDED to check with the Lions Club what the minimum order of bottles would be and to consider whether to purchase more at the next meeting of the PPG.

Members also asked whether it was worth talking to the local Ambulance Service to check what they thought of the scheme.

It was reported that the information held in the bottle had proved very useful for a patient who had been taken to hospital recently.

(d) Minute 5 Update on the Patient Survey

The Practice Manager advised that there were still some survey forms in Reception waiting for collection by PPG members. She urged members to collect them and complete them – the feedback was very useful.

4. DISCUSSION WITH RUSSELL GEORGE AM

Mr Russell George and Mrs Gwyneth Bird were welcomed to the meeting. The following matters were discussed:

. Waiting Times – Russell George explained that this was an issue on which he did most casework. He also had difficulty obtaining a response to letters he had written to the Chief Executive of Powys tHB. He had anticipated that the waiting time would go back to 26 weeks in April 2013 but that did not happen so he had written to the Health Board. He had requested a copy of the letter which had been sent to providers but had not received that.

Russell George had regular and very useful meetings with the Locality Manager, Peter Skitt, but he wanted to receive a formal answer.

The first letter to the new Chief Executive of Powys tHB would be about waiting times.

. WHSSC – This Committee looks at referrals and decides whether people in Wales can have specialist treatment. Mr George had been concerned about the way the patient from this area had been dealt with by WHSSC. With the patient’s consent, he had detailed the case in the Assembly. The Health Minister had said that there was a review of WHSSC being carried out at the moment. Russell George hoped that it would be recognised that there were examples of the system not working as it should.

The Chairman explained that she considered that the WHSSC policies and procedures seemed to be completely awry. She had spoken to the Acting Chief Officer at WHSSC, but that person was only overseeing the organisation for seven days a month. The Complaints Officer at the CHC was dealing with the matter and Andrea Blayney Page 3 of 6

was requested to check how that was proceeding.

It was hoped that the consultants involved in the case had written to complain and raise their concerns.

. A&E – Russell George had seen the letter from Shrewsbury and Telford NHS Trust (SaTH) and the two Clinical Commissioning Groups which stated that A&E would be retained at both Royal Shrewsbury Hospital (RSH) and Princess Royal Hospital (PRH).

Russell George considered that the bigger issue was stroke services. That had been moved to PRH in Telford on a temporary basis. There was discussion about what should happen long term with stroke services. The statistics were showing that results for people were better since the move to one unit, but Mr George considered that those statistics needed to be looked at closely.

. SaTH and the Clinical Commission Groups had stated that there was a need for reconfiguration of health services in Shropshire, and Powys residents would be asked for their views. It was important to be realistic about what to put forward, and for people to work together to come up with a united plan to present to SaTH. Russell George said there would be a role for the CHC and he hoped the CHC would hold a series of public meetings for people to make their views known. PPG members said they would like to see a public meeting in the Llanfyllin area.

The Chairman thanked Mr George for attending the meeting and for his support.

5. IDEAS FOR FUTURE PROJECTS FOR THE PPG

(a) PPG members had received a copy of a paper produced by the Chairman with some ideas to consider, and also some information on the National Association for Patient Participation.

The following matters were discussed:

. Secure boxes to enable drop-off of repeat prescription requests – Members were advised that the Practice had received a number of requests from patients in Llansanffraid and Llanfechain asking for this. The community in Llanfechain had recently set up a scheme where volunteers collected people’s prescriptions and medication. The Practice was not able to set up a scheme of boxes in villages because of data protection issues.

After some debate, members DECIDED not to proceed with this idea.

. Newsletter – The Practice had produced a newsletter in the past but, in recent months, had concentrated more on the website instead. There is a page on the website for the PPG, where minutes of meetings are added, and other articles could be placed there too. The Practice was Page 4 of 6

considering producing a quarterly or bi-annual newsletter and could give the PPG a page in that.

It was AGREED to work with the Practice on a newsletter.

. Fundraising for Equipment – The PPG would need to know what equipment was required and how much money needed to be raised.

The Practice Manager advised that the Practice had a donations account which was used for purchasing items of equipment. In the last 12 months two new ear syringes has been purchased at a cost of £300, and blood pressure machines had also been purchased.

The Practice would like to obtain something which improved information for patients on all sites, eg notice boards and printed materials. The GPs were reluctant to have the television screens which included advertisements as there was no control over what was advertised and they did not wish to promote businesses.

It was AGREED that the PPG would look at fundraising for notice boards.

. Health and Wellbeing Fayre – This would be a big undertaking and would require a number of volunteers to organise such an event. It was DECIDED to leave this idea for the timebeing.

. It was DECIDED to organise a Spring Craft Fair as a fundraising event. Health information would be included at the event.

(b) Flu Awareness

Members were advised that patients could make appointments with the Practice to receive the flu vaccine – vaccinations would commence during the last week of September/first week of October. Two sessions would be provided in the Leg Club at Llansanffraid but patients would need to book appointments for those. Some evening sessions would also be offered, up to about 7pm.

All children aged two and three years old would be offered the vaccine this year. It would usually be given as a nasal spray.

In addition to the flu vaccine, people aged 70 on 1st September 2013 and aged 79 on 1st September 2013 would be offered a shingles vaccine.

PPG members were asked to disseminate leaflets on the flu vaccine and the shingles vaccine in their localities.

Members DECIDED to write to the local County Councillors to ask them to make contact with Community Councils in order to promote the information about the flu vaccination.

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6. NOTES OF MEETINGS OF OTHER PATIENTS FORA IN MONTGOMERYSHIRE

Members RECEIVED, for information, notes of the following meetings:

(a) Llanidloes Patients Forum meeting held on 19th June 2013

(b) Machynlleth Patients Forum meeting held on 21st May 2013

7. ANY OTHER BUSINESS

(a) Press Release from Shrewsbury & Telford Hospital NHS Trust re. Safeguarding Emergency and Urgent Care

Members RECEIVED, for information, a copy of the press release dated 12th August 2013, which confirmed the commitment that both RSH and PRH would continue to provide urgent and emergency care services in the future.

(b) Public Toilets in Llanfyllin

Mrs Ann Williams asked the PPG to consider writing to Powys County Council regarding its proposal to close the public toilets in Llanfyllin. The County Council had offered for Llanfyllin Town Council to take over the running of the toilets with a grant of £1500. However, the Town Council had been informed that the cost of running the toilets was £26000 per annum. Llansilin Community Council had taken over the running of the public toilets there several years ago.

It was AGREED that the Chairman would write to County Councillor Barry Thomas who was the Cabinet Member.

(c) IT System at Llanfyllin Practice

The Practice Manager wished to thank everyone for their patience whilst the IT system had been upgraded.

8. DATE AND TIME OF NEXT MEETING

The next meeting would be held on Monday 4th November 2013, at 6.30pm, in Llanfyllin Medical Practice.

(Note: this meeting was subsequently changed to 11th November 2013)

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