MINUTES OF LLANFYLLIN & DISTRICT MEDICAL PRACTICE PATIENT PARTICIPATION GROUP

HELD ON MONDAY 11TH NOVEMBER 2013, AT 6.30PM IN LLANFYLLIN MEDICAL PRACTICE

Present: Mrs F Hunt (Chairman) Mr John Biltcliffe, Arddleen Mr P B Cannon, Llanfechain Cllr Aled Davies, Montgomeryshire CHC Mr Digby Davies, Llansanffraid Mr Huw Edwards, Llansilin Mrs Anne Hughes, Llansanffraid Mrs Mair Hughes, Llanrhaeadr Cllr Mrs Eldrydd Jones, Meifod Mrs Gwenan Jones, Meifod Mr W O Jones, Pool Quay Mrs May Lloyd, Guilsfield Mrs Ann Williams, Llanfyllin

Mr Peter Skitt, North Locality General Manager, Powys teaching Health Board Mrs Pat Ward, Powys teaching Health Board

Mr Alastair Carmichael, Business Pharmacist, Llanfyllin Medical Practice Mrs Susan Lewis, Practice Manager, Llanfyllin Medical Practice Ms Juliet Nixon, Llanfyllin Medical Practice

Mrs Andrea Blayney, Montgomeryshire CHC (taking notes)

Apologies: Mr Malcolm Foulkes, Mr Bernard Morgan, Mrs Pauline Page-Jones, Mrs Maxine Roberts (Montgomeryshire CHC), Mrs Maureen Wilde

Action 1. APOLOGIES FOR ABSENCE

The apologies for absence were noted, as listed above.

2. NOTES OF THE PREVIOUS MEETING HELD ON MONDAY 9TH SEPTEMBER 2013

The notes of the meeting held on Monday 9th September 2013 were agreed as a correct record.

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3. MATTERS ARISING

(a) Minute 3b Matters Arising Welsh Health Specialised Services Committee (WHSSC) The Chairman advised that the CHC Complaints Advocate was awaiting information from the family about how they wished the complaint to go forward.

(b) Minute 3c Matters Arising Update on the Message in a Bottle Scheme / ICE Cards It was AGREED that the Chairman would make contact with the Lions Club to order 300 further bottles at the best price possible.

(c) Minute 5b Ideas for Future Projects for the PPG – Flu Awareness It was reported that uptake for the flu vaccine had been slower than anticipated. There were still spaces and clinics available for patients to receive the vaccine.

The Chairman confirmed that she had written to all County Councillors in the area and requested them to promote information about the flu vaccine.

The Practice Manager explained that the age group of people most at risk of catching shingles was 70-79 years of age. The vaccine was being offered to patients aged 79 years in the first instance, and then to patients aged 70 years, it would then be offered to other patients between 70-79 years over the next eight years to pick up everyone in that age group. It was being done in stages because of the low availability of the vaccine. It was hoped that there would be greater availability in the New Year. The Practice would then run a campaign and write to everyone who would be eligible.

(d) Minute 5b Ideas for Future Projects for the PPG Mrs Ann Williams said that she had attended a craft fair at Y Dolydd. People there had said they would be keen to support the PPG if a craft fair was organised.

The Chairman informed the meeting that Llanfyllin Practice had offered to pay the membership joining fee for the PPG to join the National Association for Patient Participation. The Chairman had accepted the offer and members confirmed their agreement and thanked the Practice.

(e) Minute 7b Any Other Business – Public Toilets in Llanfyllin The Chairman confirmed that she had written to County Councillor Barry Thomas regarding the proposed closure of public conveniences. An acknowledgement had been received but not a full response.

Mrs Ann Williams explained that Llanfyllin Town Council was still in

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discussions with Powys County Council and, at the moment, the public conveniences would remain open until the end of December 2013. There was a problem with the sewage drains from the toilets in Llanfyllin and the County Council had said it did not have the budget available to carry out repair work.

It was confirmed that the conveniences in Llanrhaeadr remained open at present. County Councillor Aled Davies thought that the Community Council would take over responsibility for those.

Llansanffraid Community Council had not been able to obtain any data about running costs from the County Council. The Community Council planned to hold a public meeting to ascertain the views of residents. In the meantime, the toilets would be open until the New Year.

Meifod Community Council had agreed to take over the running of the public conveniences in Meifod. They held a public meeting and there was strong opinion that the toilets should be kept open. Meifod Community Council had managed to get costings from the County Council.

The PPG would keep a watching brief on this issue.

4. PRESS ANNOUNCEMENTS FROM POWYS TEACHING HEALTH BOARD

Members RECEIVED, for information, copies of the following press releases from Powys teaching Health Board:

4.1 Announcement regarding the appointment of Mr Bob Hudson as Chief Executive of Powys teaching Health Board. Members noted that he would commence in post on 25th November 2013.

4.2 Announcement regarding Mr Peter Skitt’s appointment in a joint role as County Director for Ceredigion with Hywel Dda Health Board and North Locality General Manager with Powys teaching Health Board.

Members congratulated Mr Skitt on his appointment. He explained that he would be working with Hywel Dda Health Board in securing Bronglais General Hospital in Aberystwyth and aimed to form networks of care across the area.

4.3 Press release regarding self-referral for physiotherapy. Members were informed that the referral forms were available at all the Practice’s surgeries. The Chairman would send the information to the Chronicle.

5. UPDATE FROM LOCALITY GENERAL MANAGER MR PETER SKITT

Mr Peter Skitt provided the following verbal update to members:

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. One of the major areas of work was on pathways of care from GP to secondary care services and outpatient appointments at hospitals. This was reviewing processes and timescales for twelve care pathways.

. Welsh Government set clear guidance on waiting times - 95% of people should go through the pathway within 26 weeks, and the maximum wait should be 36 weeks. There were some providers who were not adhering to those waiting times. The longest wait was known to be 77 weeks.

It was confirmed that the waiting time was for referral to treatment. It would start on the date the referral was received and would end on the date of the first definitive treatment.

. Negotiations were ongoing with Robert Jones & Agnes Hunt Hospital Trust. The Health Board had agreed to put in a further sum of money to reduce the waiting time. There were particular issues around spinal surgery and neck surgery.

. There were discussions with Shrewsbury & Telford Hospital NHS Trust around respiratory medicine and providing more services in Powys. It was hoped that electrocardiogram (ECG) testing could be done either in Welshpool Hospital or Newtown by December 2013.

. A movement disorder clinic would be provided by SATH in Powys.

. The Health Board had set up a Clinical Musculoskeletal Assessment and Treatment CMAT) Service to triage people and help them before they see a consultant. The team included a specialist physiotherapist and podiatrist.

. The Maternity Unit and Minor Injuries Unit in Welshpool Hospital were being reviewed, in terms of where they were situated in the hospital. It would be better for the Maternity Unit to be on the lower floor so that a permanent birthing pool could be installed there. That work was in the very early stages of development. It may be necessary to close the unit temporarily whilst work was undertaken.

PPG members were given opportunity to ask questions:

. A member commented that he considered there was poor liaison between the GP practice and between different departments at Royal Shrewsbury Hospital. The member had been asked the same questions relating to diagnosis etc. He asked whether it would be possible for a patient to have a form to complete before attending an outpatient appointment to hand in on arrival, or could the information be obtained from the Practice.

Mr Skitt agreed to look into this issue and he would feed back via the Chairman.

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. A member asked about negotiations with Birmingham Hospital.

Mr Skitt explained that he had held conversations with Birmingham and Wrexham Hospitals. Birmingham was willing to take on certain procedures. RJAH had the opportunity to review the patient list and advise what they would be able to provide.

Mrs Pat Ward explained that the North Locality Team at the Health Board was much more aware of waiting times and waiting lists. The physiotherapy and occupational therapy waiting lists were monitored closely to ensure the waiting times were not breached, but also to try to bring the waiting times down as much as possible.

. A member asked for assurance that, if services were provided from Newtown or Welshpool, they would be as good as or better than services provided out of county.

Mr Skitt explained that the services would be provided by the same providers eg SATH and RJAH, but the clinicians would be coming into Powys. The quality of services would be monitored. The services also had to be provided without any increase in costs. Mr Skitt also advised that the new outpatient consulting rooms would be opening in Newtown Hospital soon.

Pat Ward added that some of the services were better and patients were being seen sooner. There were four visiting consultants for orthopaedics, and there was very close working with clinical specialists.

. A member asked why a patient who attended Welshpool Minor Injuries Unit with a broken wrist still had to attend RSH to have an X-ray.

Mr Skitt said it would depend on the time of day attending Welshpool. If a patient attended during the day, an X-ray could be done in Welshpool and sent to Wrexham for someone to read it. There were better IT links with Wrexham. The possibility of having video conferencing links between Welshpool Hospital and A&E at RSH was being considered.

6. NEW CAR PARKING SYSTEM AT ROYAL SHREWSBURY HOSPITAL AND PRINCESS ROYAL HOSPITAL IN TELFORD / INCREASED PARKING TARIFF

Members RECEIVED, for information, the press release issued by Shrewsbury and Telford Hospital NHS Trust on 29th October 2013 which outlined the new car parking system from 4th November 2013.

Some members had experienced the new system. One member said that there had been a long queue at the pay machine in the outpatients department but there was no queue at the treatment centre end. There were attendants at the machines to assist people.

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Members considered that there was still a major problem of lack of parking space. The lack of available space caused extra stress and anger for patients and visitors.

It was AGREED that the Chairman should write to the Chief Executive at SATH to express members’ concerns. The letter would be copied to Peter Skitt.

Peter Skitt also agreed to raise the matter through contracting services.

7. NHS ENGLAND CALL TO ACTION

Members RECEIVED and NOTED the information from the Clinical Commissioning Groups in Shropshire and Telford and Wrekin on the NHS England Call to Action. This was a national programme of discussion taking place across England with patients, carers, public, clinicians, NHS staff and others with an interest in the future of health services in England.

Although the closing date for responding to the survey had passed, members of the public had the opportunity to attend the conference which would be held in Telford on 25th November 2013 when the results of the survey would be presented.

Peter Skitt clarified that this was a national debate only about health services provided in England.

8. NOTES OF MEETINGS OF OTHER PATIENTS FORA IN MONTGOMERYSHIRE

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

8.1 Llanidloes Patients Forum on 21st August 2013.

Members AGREED to invite a representative from Shropdoc to attend a future meeting of the PPG.

8.2 Machynlleth Patients Forum on 16th July 2013.

9. ANY OTHER BUSINESS

9.1 Volunteer Car Scheme A member commented that the Practice was very helpful in providing information on the volunteer car scheme to patients. On behalf of the volunteer drivers, the member explained that there had been no increase in the mileage allowance paid to them for a long time.

Members AGREED to invite the co-ordinator from the Volunteer Bureau to attend a future meeting of the PPG. Page 6 of 8

9.2 New Business Practice Pharmacist The new Business Practice Pharmacist, Mr Alastair Carmichael, was introduced to members. He explained that he had been in post for five weeks and his role was to look at the operational side of the dispensary to ensure it was an efficient business. He said that he considered the Practice offered a good dispensary service but he would welcome feedback from PPG members.

9.3 Member Resignation The Chairman informed members that she had received a letter of resignation from Mrs Pauline Page-Jones.

Members AGREED that the Chairman should write to Mrs Page-Jones offering members’ thanks and best wishes.

9.4 Possible New Member The Chairman had been contacted by someone from Llanfihangel who was interested in joining the PPG. It was AGREED that she be invited to come along to the next meeting.

9.5 Llanrhaeadr Surgery County Councillor Aled Davies asked what arrangements were in place for Llanrhaeadr Surgery whilst water works were being carried out.

The Practice Manager advised that the Practice had been assured that there would be vehicular access to the surgery at all times during the works. The Practice was in regular contact with the Project Manager from Severn Trent.

The Chairman said that some of the ambulance drivers were not aware that roads were closed. The Practice Manager explained that the Practice had received a copy of the letter which Severn Trent had written to all emergency services.

9.6 Ms Juliet Nixon informed members that her role had changed slightly. Until Christmas, she would have the operational lead role which would involve dealing with any issues about the Llanfyllin surgery or the branch surgeries. She would still be in Reception as well.

9.7 Reviews for Patients with Complex Medical Problems The Practice Manager explained that the Practice had an automated system for calling patients in to attend reviews if they have complex medical problems. If a patient does not respond to the first letter, the system would send a further letter and patients could receive up to three letters. Patients were therefore being asked to inform the Practice if they did not wish to have a review and patients were also encouraged to make their own appointments for reviews. Posters would be placed in the

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surgeries in the near future explaining the system.

The Practice Manager also informed members that there had been some issues since the installation of the new IT system. Some patients who did not need reviews had received letters.

8. DATE AND TIME OF NEXT MEETING

The next meeting would be held on Monday 3rd March 2014, at 6.30pm, in Llanfyllin Medical Practice. A speaker from Shropdoc or the Volunteer Car Scheme would be invited to attend.

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