Minutes of Meeting of Llanfyllin Patient Participation Group Held on Monday 16Th May 2011 at 6.30 Pm
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MINUTES OF MEETING OF LLANFYLLIN PATIENT PARTICIPATION GROUP HELD ON MONDAY 16TH MAY 2011 AT 6.30 PM Present: Mrs P Page-Jones took the Chair Mrs J Bradbury (Llanfechain) Cllr A Davies (Montgomery CHC Rep) Mr R S Dawson (Llansantffraid) Mr H Edwards (Llansilin) Mrs A Hughes (Llansantffraid) Mrs F Hunt (Llanrhaeadr ym Mochnant) Mrs G Jones (Meifod) Mr W O Jones (Pool Quay) Miss G Lloyd (Llanfyllin) Mrs M Lloyd (Guilsfield) Mrs J Rogers (Llanfyllin) Mr G Tibbott (Llangynog) Mrs M Wilde (Llangedwyn) Mrs A Williams (Llanfyllin) Dr Melanie Plant, Llanfyllin Practice Mrs Sue Lewis, Practice Manager Mrs Andrea Blayney, CHC – taking notes Apologies: Mr John Bowen Mr Rob Lane Action 1. Minutes of Previous Meeting Held on 11th April 2011 The minutes were agreed as a correct record. 2. Matters Arising (a) Minute 3 – Update on New Members from Community Councils Andrea explained that she had contacted the Clerk of Penybontfawr Community Council. None of the Community Councillors had expressed an interest in joining the PPG so they had placed an article in their local newsletter but there had been no interest from that either. 3. Practice Re-Structure Members of the PPG had received a letter from the Practice outlining their plans to cease providing GP appointments, nurse appointments and the dispensary service from Llansantffraid Surgery. The building would instead be used by Powys Teaching Health Board (THB) community services teams for the area – district nurses, health visitors, chiropody, speech therapy and physiotherapy. Dr Plant explained that the GPs had spent considerable time looking at options, and she explained the reasons for the decision. It was difficult providing services over four sites, the Practice has 1000 more patients than five years ago with little extra money, but the catalyst was that the Practice had received a health and safety report which stated that the rooms in Llanfyllin, which were occupied by the community services teams, were too small for purpose. The THB was therefore LlanfyllinMinutes 16May11 Page 1 looking at the possibility of moving those teams to Welshpool. Where other practices had lost their community services, communication had disappeared and this had led to a lack of co-ordinated care. The Practice currently works well with the district nursing and health visiting teams and the standard of palliative care is amazing, and they did not want to lose that. So they had approached the Health Board with the suggestion of moving the community services teams to Llansantffraid. The building at Llansantffraid would still be owned by the Practice. PPG members then asked the following questions: . If this is a health and safety issue in Llanfyllin, will the rooms need to be changed a lot? Dr Plant replied no. The health and safety issue related to the rooms which were used for administration purposes by the community teams, which 10 people tried to use. There are also two extra school nurses coming into the area and there is no room for them. The THB had already removed physiotherapy from Llanfyllin because the physiotherapist retired and had not been replaced. Dr Plant also explained that they had assumed podiatry and speech and language therapy would move to Llansantffraid but the THB had informed them that this was being reviewed. The Practice was trying to get clarification on that, and would be urging the THB to keep podiatry in the area. Dr Plant said that any public pressure about that would be helpful. Will Four Crosses be able to accommodate more patients? Dr Plant said that they would be turning the treatment room into a consulting room, and they would be increasing the size of the dispensary. An emergency room would also be set up there. Will you be losing rooms? Dr Plant said they would gain rooms. The building in Llansantffraid is not being sold – the THB rent rooms in Llanfyllin and they have been asked if they want to rent Llansantffraid instead. The district nurses and health visitors will still use rooms in Llanfyllin for patient appointments as they do now. The Practice is pro-active and works very closely with the district nursing service, particularly for palliative care. People in the Llansantffraid area have real concerns. It is the older generation who are very concerned about how to travel to Four Crosses or Llanfyllin. How will elderly patients travel up to Llanfyllin? Dr Plant said that people must have to find transport for shopping etc, but she said that she did worry about transport for all patients as public transport in the whole area is appalling. She hoped that, as a positive move, the PPG would be able to set up a group of volunteers who could transport patients to and from surgeries. She believed there were people in localities who would be willing to do that. Dr Plant added that there are actually very few patients who walk to the surgery. Home visits are made on medical decisions and patients do their best to get to a surgery but, if they cannot travel and there is a medical need, the GPs will visit at home. Pauline Page-Jones said that, until a transport scheme could be set up, there is the volunteer bureau in Welshpool who run that service and it is important to get that information out to patients. Dr Plant said that the local papers were very willing to take information. There are also concerns about prescriptions when the nearest dispensary will be at Four Crosses. Dr Plant said that the Practice had been really pleased to have had a very positive response to their request for help with having a drop-off point for LlanfyllinMinutes 16May11 Page 2 medications. They had received enquiries from Llanfechain Community Shop and had received at least four enquiries from Llansantffraid. It was possible that some people might find it easier to get their medication than they have done before. However, controlled drugs and refrigerated items could not be delivered in that way. Julia Rogers then gave an explanation of how the medicines drop-off system works. She said that, at present, there are drop-offs at Penybontfawr, Llangynog, Meifod, Llanwddyn and Llansilin. Patients who wish to use the system have to sign a consent form. The system adheres to the dispensing doctors guidelines. They still have to insist on the 48 hour request for prescriptions. All the medication is signed out by the person who is actually making the delivery, signed for by the person who takes the delivery at the drop-off point, and signed for by each person who collects the medication, whether that be the patient or someone collecting on their behalf. Ann Williams said that the Red Cross were looking to provide an outreach service in this area, where a vehicle would be based somewhere for two hours a week, and they could do things like driving people to surgery. Dr Plant said that her worry on that would be that two hours might only be enough to take one person to an appointment, but it might be worth looking into whether they could assist with the drug delivery service. Sue Lewis agreed to contact Red Cross to talk to them about it. Will the practitioners who come to Llanfyllin Surgery still continue? Dr Plant said yes. The only change might be podiatry and speech and language therapy. The Practice would fight for those services to stay and for the THB to keep services in this community. Could the THB change their minds about the district nurses? Dr Plant said she was not worried about that as they had that agreement in writing. Is it true that, if the district nursing service had gone to Welshpool, they would have been using health care assistants instead of nurses? Dr Plant said she did not know if that was true. She said it was important to have someone with high level nursing skills to go out to do assessments. She acknowledged that there are very highly qualified health care assistants. She felt that the GPs and district nurses in the Llanfyllin area trust and complement each other very well. Jackie Bradbury said that she had asked for an item to be put on the agenda but it had not been added. She asked whether the Practice could do anything for people who are working because she had been approached by someone whose employers felt that he should not be away from work for so long when he attends doctor appointments. Is it possible to have more timed appointments? Dr Plant said that it depended on what the patient was attending for. It is not possible to give an exact time for same day appointments, but routine appointments should be more strict. The problems arise when patients have not requested longer appointments and then overrun. The issue of appointments is a huge one and there is a huge range of things around it. Dr Plant thought it would be really useful for the PPG to survey patients to get their views on appointments. Sue Lewis, the new Practice Manager, had some ideas on how to progress that. It would mean PPG members sitting in surgeries talking to patients. LlanfyllinMinutes 16May11 Page 3 Dr Plant then said that, if there was anything which the Practice had not answered or anything they had not foreseen, please contact them as soon as possible. She said that the Practice would like to support the PPG wholeheartedly, they were there to work with the PPG and help wherever possible. Sue Lewis then said that she was new into the Practice, she was not from a medical background but she had worked with groups similar to the PPG in the past.