BUSHLOE SURGERY PPG
Minutes of the meeting held on 3rd March 2015
At Two Steeples Medical Centre
Present: Lynda Eaton – Member (LE) – in the chair
Shashi Jogia – Member (SJ)
Joan Pratt – Member (JP)
Jean Dale – Member (JD)
George Lanston – Member (GL)
Keith Price – Member (KP)
Pauline Rockley – Member (PR)
Summayya Kara – The Carers Centre (SK)
Julie Bentley – Assistant Practice Manager (JB)
Nikki Allen – Senior Receptionist (NA)
Sue Lobb – Member (SL)
Diane Elliott – Administrator (DiEl)
Jane Martin – Receptionist (JM)
Geoffrey Roberts – Member (GR)
Angela Roberts – Member (AR)
Doreen Corby – Member (DC)
Lynda Payne – Member (LP)
David England – Member (DE)
Dr Vikram Bolarum - Partner (VB)
Dr Chris Goes – Registrar GP (CG)
Robert Whitehead – Practice Business Manager (RW)
1. Welcome and introductions – LE welcomed everyone to the meeting in particular Mrs Jean Dale attending for the first time, also Summayya Kara from the Carers Centre and other practice staff attending for the first time.
2. Apologies – Rob Eaton – Member (RE), Maureen Lanston - Member (ML), Russ Hailes – Member (RH), Lynn Hailes – Member (LH)
3. Minutes of the meeting held on 6th January 2015 – the minutes were accepted as a true and fair record.
4. Matters arising (not on the agenda)
a) Signage – new signage has been agreed and now ordered, the cost of obtaining replacement directional signage with increased font size and better colour contrast remains a matter of discussion although RW indicated that it will probably fall to the Partners to fund this change.
Check-in screens – after a period of working well these have once again caused problems, IT technicians made some changes on Monday 2nd March however this has caused further problems so they returned again today we hope with a final solution. Time will tell. RW explained that the difficulty is that the check-in screens link with our clinical systems as well as linking the hardware in the building, finding one support technician to resolve all the possible combination of problems is challenging.
Telephones – the new telephone system was installed shortly after our last meeting and despite a few teething problems at that point the system has now settled in and is providing all clinicians with capacity and line quality that the previous solution had not provided. SJ commented he had not received a text reminder for a recent appointment and also had been cut off by the telephone system after waiting in the queue. RW to investigate the problem of text reminder and respond to SJ, if any Member has difficulties please do contact RW or JB at the time who can then investigate. JP commented that when waiting in the first floor waiting area she sought assistance from the member of staff (not Bushloe) on the reception desk only to be told “we can’t help as you aren’t one of our patients”. NA commented that staff can call down to other colleagues to answer specific queries. RW to flag up this problem with the other practice managers.
b) Funding Support – SL reported that an application for funding has been lodged with Waitrose for the purposes of funding toys for the Medical Centre, hopefully it will be given the voting process in coming weeks. SL proposed an idea of quiz sheets for raising funds, each sheet is sold at £1 with proceeds to the PPG account. Agreed that SL prepare some quiz sheets for distribution at the next meeting to all those who feel able to sell some to friends, family or colleagues.
c) CQC and Leicester Mercury Letter – no reply has been received to either letter. RW to forward a copy of the letter with minutes of this meeting to all members.
d) Signage to the Medical Centre – LE reported that County Highways department will not fund any roadside directional signage. RW commented that two sign posts remain from an old South Leicestershire College sign post on the south-west corner of our site and this could be used in future for a sign. RW to report to TSMC partners.
5. PPG Bank Account
LE has identified Barclays as offering the simplest offering. Agreed that LE as chair, AR as treasurer and RW as secretary should arrange to open at the earliest opportunity, the “Bushloe Surgery PPG account” with Barclays bank. Any two signatories to have authority over the account.
6. Carers Health and Wellbeing Service
SK introduced herself and also the Service which has now moved past the pilot stage and will be funded going forward although links with LCPT (the original agency supporting) will be broken and new links formed with VASL (Voluntary Action South Leicestershire). The aims of the service are to support carers with non-medical needs. A document describing the service was circulated. Work has been done in recent weeks to update the records of all patients who are registered as Carers, some are no longer Carers and there are undoubtedly new Carers. We now have a short promotional video that runs on the call-in screens in the waiting areas about the service. SK commented that some practices now have a dedicated area of their website for Carers and this might be something to consider in future. CG has done some work on the resources used by doctors and identified that using Carers Centre has meant a consistent approach is possible. Bushloe Surgery had only 54 Carers registered but with awareness increasing both for staff and patients this should only grow. KP enquired if the service worked with MENCAP – SK confirmed the Service works with Carers supporting those with mental health problems and learning disabilities e.g. the parent of a child with learning disabilities will think of themselves as a parent first and will not think of themselves as a Carer – which they undoubtedly are. SK encouraged Members to look at the new leaflets that are now available which provide a simple tear-off element as well as providing information and contacts about the Service. VB enquired it Social Services are able to share information about Carers – SK answered no, because of data protection regulations Social Services would have to obtain consent first before sharing any information.
7. On-line Appointments
LE enquired if on-line appointments are available for all doctors – JB confirmed that they are, despite Dr Tobin experiencing over a period of time a high rate of missed appointments that all appeared to have been booked on-line. The only reason for not being able to find on-line appointments was due to a doctor being fully booked e.g. Dr Tobin who works part-time and will have other work e.g. as on-call doctor or home visiting doctor that reduces the number of appointments available in any week.
8. Electronic Prescriptions
LE enquired if there had been problems with specific COPD medications with nurses issuing scripts that were then not available via electronic prescriptions – VB commented that we would need to investigate and discuss this issue with nurses involved. VB/RW to action.
9. 28 day Prescribing versus 56 day Prescribing
LE had asked RW to find out if there was any truth in a rumour that other practices within Two Steeples were prescribing on a 56 day basis – RW confirmed that he had checked with Wigston Central who confirmed that they prescribe on a 28 day basis only. VB explained the thinking behind 28day versus 56 day prescribing which meant that whilst there is some savings in 56 day prescribing over a year because of the increased wastage associated with 56 day prescribing and the fact that batch prepared prescriptions or even online requests now mean a patient does not need to come to the surgery to place an order, and with the help of annual prepayments for prescriptions on balance 28 prescribing is the best outcome for all.
10. Missed Appointments
DE raised for discussion the issue of DNA’s (Did Not Attend) and the cost to the practice and more broadly to the NHS in general. Whilst the NHS should be “free at the point of use” it should not be disused. DE enquired if the practice was able to or did in fact use sanctions such as questionnaires, banning patients or fines? TT confirmed that her experience recently was that online booked appointments appeared to generate more DNA’s such that she stopped taking on-line bookings until her colleagues identified this and asked that she resume taking on-line bookings. VB stated that when appointments are booked up to 4 weeks in advance we have found more DNA’s presumably as a result of patients either forgetting or no longer being unwell. PR enquired if there was a way to stop serial on-line offenders – JB offered the solution of rescinding online access rights to a patient who DNA’s. SL proposed a “two strikes and you are out” approach to serial online booking DNA patients JB/RW to implement.
11. News from the Practice
· The end of March is the end of the financial year for the practice and many targets are concluded at the month end. New proposals for health schemes often start from the 1st April so this is a busy period for admin staff.
· We have said a farewell to Dr Farah Khatib who successfully completed her Registrarship with us in February and to Nurse Susan Grieves. We have a new nurse joining us on Monday 9th March called Sarah Kent.
· As part of an initiative to encourage more medical graduates to enter General Practice we have joined with eight other south Leicester practices to help train undergraduate students. This group of nine practices in total is split into three clusters of three and we will work alongside South Wigston Health Centre and Wigston Central to support two students at any time in their seven week placement in General Practice. Our first student has started this week and is called Jacob White.
· There will be a Protected Learning Time event this Thursday which means that the building will be closed to allow for training for all staff to take place. The training ranges from visiting consultants providing training to doctors, Basic Life Support training (required for all staff) to Fire Warden training.
12. AOB
a) SJ asked if it was possible to turn up the volume for the “Call” in particular on the screens on the first floor waiting area – RW to action.
b) JB wished to make Members aware that from 31st March 2015 it will become a contractual requirement that the practice provides not just online access to book appointments and order repeat medication, but also to provide access to medical records for those patients who request it. The approach of Bushloe Partners is to offer the basic service of access to medications, allergies and immunisations. JB asked if any members of the PPG who have online access would be prepared to trial the online access once a finalised protocol for access and the required consent and identification have been resolved – all accepted the challenge!
c) SL pointed out that from 1st April the urgent care provision changes and enquired if the list at the Oadby 8til8 would be continued – RW confirmed that the list is being disbanded because no other practice was prepared to take on the list and patients who had registered there have been asked to re-register with alternative practices – Bushloe has and is receiving quite a number of registrations from the 8til8. LE commented that a ‘wheel’ showing the range of services, what is provided where and how to access those services will be posted to all householders prior to the 1st April.
d) AR enquired if as a result of the publicised pressures on A&E the practice would be forced to open at weekends as some practices have already apparently been required to do? RW commented that there is an inexorable move toward seven day a week opening but that currently there is not the funding available to general practice to achieve that. Practices are being challenged currently to consider ‘federating’, by which it is meant forming groups of anywhere from 30k to 50k patients. Partners have agreed that the most obvious federation for Bushloe Surgery would be within Wigston (i.e. Bushloe Surgery + Wigston Central + Long Street + South Wigston Health Centre - a population of approx. 33k patients) however there may be some instances related to more rare conditions where a larger group possibly including Oadby might be appropriate. The theory is that through federating, groups can bid for services which when offered to a larger population make economic sense. Problems exist in relation to IT, confidentiality and working practices – so not a simple solution. RW added that since moving into TSMC a number of approaches have been made to make use of our rooms, most recently a request to use the minor surgery suite for a range of surgical procedures currently undertaken in acute or secondary care settings but which are now likely to be moved out into the community and to be delivered at primary care premises. Watch this space!
e) LP enquired if responsibility for blood test rest with the patient or the practice? JB responded that ideally it is both. The patient is expected to monitor and maintain their own diary relating to their care but the surgery also runs a diary that brings a back-up to recall of patients for blood tests. In addition for patients where blood tests are related to specific medications the prescription process includes a further check for blood tests i.e. the messages that can be applied to a prescription requesting further blood tests prior to the next issue of a prescription.