Southwell Medical Users Group
Minutes of the meeting held on Monday 30th March 2015 at 7.00pm at the Southwell Medical Centre
Present: Dr Amit Bajracharya, Paul Smith, Dennis Brown, Pat Palmer, Gillian Ramsay, John Elkington, Peter Hancock, Barrie Ellis, Tony Morris, Dr Nigel Nice, Jane Ellis, Glenys Breedon, Isobel McKenzie, Kate Sartain, Sheila Fox, Donald Fox, Ronald Smithers, Sheila Webster, Carol Tinker, Geoff Tinker, Marian Kemp, Martin Lloyd, Ted Waters, Bobby Craik, Joy Pragnell, John Pragnell.
1. Apologies: These had been received from Nigel Kenward, Ann Smith, Mary Pay, Lesley Barker, Jen Stark, Bill Evans, Wendy Evans.
2. Presentation –Dr Bajracharya gave a short presentation about his visit to Nepal following the earthquake on 25th April. He had approached a number of local practices before his visit and through their generosity had been able to take boxes of medical supplies with him which despite being left behind in Delhi arrived safely within a couple of days. His slide show illustrated the utter devastation in Kathmandu and in the small surrounding villages with many buildings no longer fit to use. He explained that he and his friends were able to distribute much needed supplies and to provide medical assistance to the villagers affected by the devastation but noted that it would take a long time for the situation to return to something like normal. He encouraged anyone thinking over taking a holiday in Nepal not to put it off as tourism was one of the mainstays of the Nepalese economy. The main emphasis at the moment was on providing temporary accommodation as it was monsoon season. It was also important to help the children to return to their education for which money was required for new desks, books and paper as much of these had been destroyed when the school buildings had collapsed during the earthquake. Dr Bajracharya thanked the local community in and around Southwell for their generous contributions sent via the internet to DEC or through the collection at the medical centre. The total amount (with the tax return from gift aid) was nearly £4,870. He suggested that the balance of the money collected at the medical centre that had not yet been sent to DEC (approximately £2,250) could be used to purchase new desks, books etc to help re-equip the schools. There was general agreement by those present.
Paul thanked Dr Bajracharya for his presentation and noted that Nepal would be in need of support for some considerable time.
3. Minutes of the meeting held on Monday 30th March 2015: These were agreed as a correct record
4. Matters Arising – Minute 2. Paul commentated further on the presentation given by Hayley Allison and the recent press coverage of the bed closures and lack of nurses. It was clear that Newark hospital was still having some difficulties. Geoff Tinker noted that the Newark Strategy produced by SFHFT was inconsistent on this point as it allowed for resources to be diverted from Newark hospital to Kings Mill during the winter peak. The problem appeared to be the lack of commitment and support from the consultants, despite their contracts requiring them to perform services at both sites. Ted Waters suggested that perhaps it was time to abandon Newark hospital altogether!
Minute 5. Paul reminded the Group of the agreement to help the Practice to promote the use of the internet and access to summary care records. Dennis suggested that this should be planned for the autumn.
Minute 11.2. Paul noted that a report on the progress of the Better+Together programme had been included with the minutes and reported that Robert Ferris-Rogers had suggested that someone from the PRISM team could address a future SMUG meeting, perhaps in the new year.
5. Chairman’s Report – Paul Smith
Paul commented on an issue that had been raised by several members concerning the total collapse of dermatology services at NUH. At the recent open meeting about CCG activities, Robert Ferris-Rogers had advised that the Newark and Sherwood Clinical Commissioning Group (N&S CCG) had contracted for these services with SFHFT to be provided in a community setting. Kate Sartain was concerned that the Gateway was still allowing patients to make the choice of accessing dermatology services at Queen’s despite the problems. Dennis agreed to investigate.
6. Secretary’s Report – Dennis Brown
Dennis reminded those members who had not done so to complete the form attached to the e-mail circulating the minutes to formally agree to have their contact information recorded and circulated.
He also reminded the Group that he would be retiring as Secretary at the AGM and offered to provide information about his role to anyone thinking of volunteering for the job.
7. Treasurer’s Report – Pat Palmer
Pat reported that the account currently stood at £395.63, although this included the sum of £196 collected after the open meeting on dementia. A cheque for this amount has been sent to the charity suggested by Prof Dening, and acknowledged, but not yet processed by the bank (Post meeting note: this has now been presented and cleared). The available balance was £199.63.
Pat gave notice that she would not be standing for re-election as treasurer at the AGM in January.
8. Report from the Medical Centre – Dr Bajracharya
Dr Bajracharya thanked Gillian Ramsay for arranging new art display.
He was pleased to announce that a new lady doctor, Dr Tomlinson-Cox, will be starting on the 10th August. Dr Tomlinson-Cox is newly qualified and will be taking over what was Dr Ockleford’s patient list (latterly that of Dr Bartholomeuz). Until then the Practice has invested heavily in providing cover with two locum GPs, both females, who are here for the summer, Dr Hafeez (who was originally a trainee GP at the Practice) and Dr Ferris. This should prevent any loss of appointments when doctors take their annual summer leave.
Dr Bajracharya noted that, recently, they had been able to match supply and demand pretty consistently with appointments available until 8:20 / 8:30 am most days. However, pressure on appointments continues to be very high, reflecting the national trend. He asked all patients to consider seriously if they need to see a doctor. He pointed out that relief from minor illnesses or conditions that may get better in a short time without treatment was available at the pharmacists.
The Practice is continuing to recruit staff to replace resignations. He reported that they had appointed a new receptionist, Fiona West, but there are still vacancies for another receptionist, an IT manager and a healthcare screener. Interviews are scheduled.
The Practice was still awaiting the CQC report, although initial feedback had indicated that there was nothing untoward to worry about.
Dr Bajracharya explained that the Practice was keen to work with SMUG on a couple of projects during the rest of the year. He referred to the issue mentioned under Matters Arising and noted that more and more of the IT system can be integrated with text messaging and email. For this reason the Practice were keen to gather email addresses and mobile numbers for as many patients as possible. This will allow appointment reminders and campaigns (such as flu) to be carried out automatically with savings on time, money and wasted appointments.
Also, now was the time to think about a patient questionnaire. In the past this has been done with the help of a small sub-group of SMUG to devise suitable questions. Volunteers from SMUG have then run the questionnaire in-house using hand-held computers. It may be possible in the future to carry this out electronically (by email / text etc) so it would be good to form a small sub group to start thinking how this could be achieved. Anyone interested in this should contact Dennis who will coordinate with Nigel.
Finally Dr Bajracharya reported that Billy had repaired the SMUG bench on two occasions this spring and will be re-varnishing it before the winter. When asked, Billy replied that the damage had partly been caused by misuse and partly wear and tear, but had not been serious.
Ted Ward related an incident where he had forgotten to pack his medication for a 10 day trip to London. The Practice had kindly faxed a prescription to a local London pharmacist which solved the problem. It was interesting to note, however, that the pharmacist was very surprised that we were still using faxes as locally they had moved to an electronic system. Dr Bajracharya commented that such systems were being investigated locally.
Ted referred to the proposal to gather patient’s e-mail addresses and suggested that a registration form could be included on the Practice website. Gillian also suggested an article in the Bramley. Ted then asked if it was proposed that patients would be able to communicate with the Practice by e-mail. Dr Bajracharya replied that this was not the intention as it would take too much staff time to properly monitor.
9. Open meetings
9.1.1 Report on Dementia Meeting, 12th May 2015 – Paul reported that this had been a great success with around 100 people attending. As Pat had mentioned in her report, £196 had been collected for Prof Dening’s nominated charity.
Kate Sartain referred to part of Prof Dening’s talk when he commented on the public’s concern over the lack of information, support and high quality care within the community. She mentioned that Norfolk had used the support of Admiral Nurse in a pilot project that had resulted in significant savings for the health and social care budget in the first 10 months by reducing the involvement of GPs, nurses and social workers and avoided unnecessary hospital admissions and care home costs. She suggested that N&S CCG should consider a similar approach. Paul replied that he had mentioned this to Robert Ferris-Rogers who had explained that the CCG had commissioned a similar pilot project using Compass Workers. Kate pointed out Compass Workers only provide some support to the carer, they are not fully trained and are not capable of filling the gap in the same way as Admiral Nurses, who are fully trained. She also mentioned that the pilot project was due to be evaluated July/August and that funding would cease around September – what would happen after that? (Note: Currently, the majority of Admiral Nurses work within the NHS supporting people in the community. However, Admiral Nurses also work in other care settings such as care homes and in the community supported by voluntary organisations.)
Jane Ellis asked if we knew the proportion of patients suffering with dementia. Dr Bajracharya replied that he did not know the numbers but suspected that it would be relatively high in the Southwell area due to the higher proportion of elderly patients. He agreed to investigate and report back.
9.1.2 Report on N&S CCG update 3rd June 2015 – Geoff Tinker reported that Robert Ferris-Rogers had given an interesting well delivered talk and had expertly fielded questions. It was disappointing that there had been less than 20 people to hear him. Paul echoed these sentiments.
9.2 Future meetings – It was agreed that the planned talk on power of attorney, advocacy, living wills etc would be arranged for late September or early October.
10. Art display - Gillian Ramsey – Gillian reported that the current display should be in place for the remainder of the year. The paintings had been provided by an art school and were by different artists so reflected a number of different styles. She also mentioned that it was becoming increasingly difficult to change the display every three months so having these paintings for an extended period was helpful.
11. Other reports:
11.1 Stakeholder Reference Group (SRG) - Geoff Tinker reported on the SRG conference held at Southwell racecourse on the previous Friday. The theme of the conference had been mental health which in itself is a huge topic and the conference had only covered four issues: dementia (both early on-set and age related); teenage stress, drugs and alcohol; post traumatic stress disorder (PTSD); and anxiety and depression.. There had been no formal speeches but instead the various aspects of mental health had been portrayed by actors in a series of short plays. After each play there were a number of multiple choice questions on which the delegates voted using a keypad system followed by an opportunity for general questions. Questions were answered by special guests: Dr Amanda Sullavan (Chief Operating Officer N&S CCG); Elain Moss (Chief Nurse N&S CCG); Dr Rod Kersh (Consultant and ex clinical director mental health unit Doncaster hospital); Paul Benton (Deputy Director EMAS); Roger Paffard (Vice Chair N&S CCG GB); Andy Evans (Programme Director, Connected Notts NHS).
Dr Kersh gave some interesting insights to the dementia strategy adopted by the Doncaster and Bassetlaw NHS Foundation Trust, a copy of which had been made available to delegates. Geoff commented that this was an interesting read and highlighted a whole different approach for the treatment of patients that also had dementia – for example providing drinks in china cups instead of in plastic beakers.
The issues surrounding PTSD were well illustrated by the actors and there were three delegates present who were able to graphically present their personal experiences.
Paul Benton explained how paramedics were trained to deal with patients who had mental ill health problems in addition to the physical problems requiring ambulance transport. He admitted that there was still room for improvement and training was continuing. He also gave an interesting account of the extent of alcohol related incidents which were no longer just a weekend problem. Ted Waters reported that Paul Benton had confirmed that the previous problem of ambulance drivers returning to base for lunch breaks (resulting in unnecessary long journeys) had been stopped and that drivers now took their lunch at the location they happened to be at lunch time.