Barwell Medical Centre

PPG MINUTES

MONDAY 8TH FEBRUARY 2016

BARWELL MEDICAL CENTRE

Present:Dr. Darren Jackson

Denise Luton

Members (AP) & (LP)

(HC)

(JR)

(BP)

(EB JB)

(SH CH)

(WC) (CC

(JH)

(AW)

(MF)

(PS)

GuestsPav - Well Pharmacy

Lisa - Well Pharmacy

Natasha - Light Bulb

Kerry – Local Area C0-ordinator

Tracey – Carer (VASL)also PPG member

Everyone was thanked for attending.

In the last meeting there were several issues from the Well Pharmacy, most of these have now been dealt with. Unfortunately Paul Rix, the Area Manager for the Well Pharmacy, was unable to attend but Pav, the Pharmacist and Lisa one of the Assistants have kindly come tonight to answer any questions you have about the Pharmacy.

Representative from Well Pharmacy; Pav and Lisa

Pav explained that she has been through all the issues raised at the last meeting and spoken to individual patients about certain issues that were brought up at the meeting. Some issues are still “work in progress” mainly due around the electronic prescription service, this may be lack of education with the Pharmacy, Surgery and Patients and if everyone can work together hopefully we can make the system work for everyone.

Pav said that a patient had asked what it means if they have nominated Well as their preferred pharmacist, what this means is, once you have nominated the pharmacy then all your prescriptions will be sent directly to the Pharmacy so patients will not need to come to the surgery to order their prescriptions any more.

Pav said that rather than patients dropping their prescriptions off at the GP Surgery to drop them off at the pharmacy instead, this will help the pharmacy to try and keep to the 48 hours.

AJP - wanted to confirm the procedure that is dealt with if a doctors said they have sent your script to the pharmacy if you come straight to the pharmacy, state that you just seen doctor and then the pharmacy will put your name in the process box and you will be dealt with, as it would have done if you had taken the prescription in. When the doctor sends the script down to the pharmacy they won’t prepare the prescription until you request it. If you leave the doctors and go to the shops and come back that’s fine but your prescription won’t be ready for collection just because you have been shopping, you need to actually tell the pharmacy it’s there.

Pav said that things are improving, we are working together to make the system work, it was felt that the system worked well particularly over the xmas holiday period.

CC - said that her medication is never right, things left off, and then get things don’t need, she said she keeps telling them that she doesn’t need them but no-one takes any notice. CC said the girls in the pharmacy are very nice but feels they don’t listen. Pav said that she will speak with patient separately about their issues. Sometimes it may be that the medication hasn’t been updated at the surgery, i.e. if something has been stopped by the hospital, it may be that the surgery hasn’t had notification or that their medication hasn’t been updated.

HC - appreciate lots of patients to deal with -, Information provided says that prescriptions will be ready in 48 hrs, is that 48 hours for the surgery - example order over the phone at pharmacy on Monday, rang Tuesday told Thursday after 10am, is this due to high levels of work? Pav said yes very high volumes of work, they try and give a time that the meds will be ready so the patient isn‘t left waiting if they come in at 9am and the medication isn‘t ready till 11am, so if they give a time to come after then the patient won’t have to wait around. If you need the meds by a certain day because you are going to run out they will push you up the list so you are not without your medication. There have been issues with tasks etc at the surgery which hold it up.

MF- patient said she gets 28 tablets, she says that she worries she will run out of tablets. Pav will pick up with patient and will try and move the date of the patients prescriptions so will move the repeat a few days before so she will have her medication before she runs out.

AJP asked what is the process for updating repeatmedication.

DPJ said doctors update repeat medications every 12 months and if any medicines have been stopped patients can request them to be taken off their list. The pharmacy cannot take medications off the repeat list.

LP - at the last meeting was mentioned about how some medication can change colour name and shape - she wanted to thank Pav for sorting this out for the patient. Understand that this does happen because of suppliers but if you have any issues just call the pharmacy and check prescription is correct.

AJP wanted to know what happened to white tear off part of the prescription, Pav said that these are still given out but there may be some issues with not all receptionists adding the information i.e. Healthy Heart check, or Diabetic check so that it prints out on the prescription.

BP – the patient said she came into the surgery and said thather son had run out asthma medication was told by receptionist at Barwell that too many people requesting “run out of meds” so would still have to wait 48 hours, although the patient said he wouldn’t have any medication at home for 2 days, they just said that it had come from management and would not even attempt to sort it out. DPJ and Pav said that the pharmacist can issue one off emergency scripts and then will get the script from the surgery, so in future just go to the pharmacy. (DA will pass this on to Practice Manager)

Alan Plumpton presented his update on meetings he has attended on behalf of the PPG;

OOH service and UCC - AJP is the Chairman, he told the group that the OOH service had been put into special measures last year but have since been revisited and been given a good. There are still issues with Senior Management roles. All existing managers have been looked at and new job descriptions etc have been sorted and things are looking better.

Reviewing 111 and OOH service, AJP asked patients to fill in slips asking if they used 111 or OOH and would like your comments, things like date, time results of visit.

EMAS (East midlands ambulance service) when a patient calls an ambulance there is a pathway that should be worked out but it appears that the UCC Loughborough get left out the loop, lack of usage, bypassing Loughborough and going straight to A&E. Sometimes patients need to go to a major A&E but if you think you might be able to be seen at the UCC please ask the ambulance service why you can’t go there.

Older persons unit is next door to UCC - you need to be referred by GP for this service and possibly would be referred from the UCC next door, to the older persons unit.

Not all UCC are the same but Loughborough is one of the best around and have xray facilities, diagnostics and doctors available to see patients.

H&B Community Healthcare Project;

What do we need - What medical services do we need over 18 months there have been a lot of meetings that have taken place.

Next meeting of the board is Feb 16th and AJP is on the board - information taken from Hinckley & Bosworth over 2000 people were talked to - now looking at what can be fitted in to the Better Care Together 5 year programme, the end of the 5 years being in 2019. NHS and Social Services to work together to try and make sure that there is no join that there is a smooth river running between services. The Hinckley element will feed into the Better Care together Programme it will become part of this programme.

There will be further consultation at the PPG Hinckley Locality Group later this week, to which AJP attends.

Another date is the 22nd March this is a meeting looking for people who wish to find out about the changes being discussed and possibly Volunteer to implement or want to help develop the plan, no further details available at the moment but if you are interested then AJP will pass your details on, so you can leave your details at the surgery or contact AJP direct.

Further public consultation is due in the Spring, there are still plenty of opportunities to get involved and air your views. Although requested, it has been discussed that an A&E or even an UCC is not affordable for this area. UCC are being looked into to see if these services can become available more locally. The project is looking at if a patient has non-life threatening problems where can they be dealt with locally instead of going to A&E. Things need to change and we need your help to change them.

CC – patient asked what is the Federation? - AJP explained that it’s where surgeries work together - there are 13 practices in H&B that have joined the Hinckley & Bosworth Medical Alliance, they supply services locally.An example is 24 hour ECG’s at Glenfield - setting up service provide this locally either in practices instead of patients having to go to Glenfield. We can send patients to other practices rather than hospitals.

AW – patient - what about these super practices – DPJ said there is difficulty recruiting GP’s and Nurses at present, no plans of local super practices.

Premises - DPJ said there are 3 possible sites in Barwell which are being looked at and when information is available we would call an extraordinary meeting for the PPG.

AJP said that one area to be looked at is at the moment in Hinckley there are 3 surgeries on one site near the hospital, we are looking at facilities, to see what is needed, looking at more services for Mental Health.

HC - are the funds provided under the existing budget - some things don’t actually cost money to sort some are pathway problems- i.e. doctors see a patient with hearing problems - send to consultant - consultant sends patient to audiology for tests, tests done, back to consultant – another Pathway would be doctors send patient straight to audiology cutting out one of the consultant appointments - LRI Alliance has patients on the board and they look at Pathways - they have saved £1m just re-routing patients, as described above.

DPJ said that the CCG need to make around £18m saving, the Government are not putting money in the pot locally as some of the national headlines state.

AJP showed a smart phone app “NHS now” which can help you find local NHS services and direct you to the right one(because phone knows where you are)We understand not everyone has a smart phone but people you will know, family, friends may have one so pass the word around.

112 - calling emergency service from a mobile call 112 this will help find you quicker from your mobile, they can find you within 5 meters.

AJP was thanked for his presentation.

Dr. Darren Jackson did a short presentation on Arthritis;

Arthritis;

What does it mean? - Pain

What is it - Joint inflammation

Types of Arthritis - Arthritis in knee joint - Osteoarthritis – can show as wear and tear or degenerative

Rheumatoid arthritis - lot more inflammation often need to go on drugs

These are both common types of arthritis

Psoriatic arthritis, if suffer from psoriasis

Gout is a type of arthritis

Ankylosing spondylitis – affecting your back

Osteoporosis is not arthritis but thinning of the bones.

What support is there?

Get a proper diagnosis as to what type you have

Healthy lifestyle is the best way forward

Keeping active

If you are in pain, take the pain relief, as this will enable you to be in less pain and you will be able to be more active, which is good for you and will keep the weight down which can reduce pain in arthritis.

There is a lot of information on line for arthritis, if patients don’t have a computer if they know friends, family neighbours who have or can access computer at a local library; access the following;

There are National charities who can speak to people on phone

Arthritis care – – 0808-8004050

National Rheumatoid Arthritis Society

– 0800-2987650

CLASH2012 – Leicestershire Community Arthritis Support

03333-444611

Sound doctor is an on line programme covering diabetes, COPD, there is a module for back pain, videos speak to patients, experts, surgeons and physios, leaflets are available but you do need the internet to use.

Kerry Smith – Local Area Co-coordinator & Tracy Underwood - Carer support

Kerry said that they are working as part of the Better Care Together Programme - which AJP mentioned earlier. The Practice Newsletter has an article in it about carers if anyone has read it or would like to, which is very good as it demonstrates someone who is a carer and how important it is to have support out there.

Tracey, who wrote the article, is a carer herself- she is trying to form small local groups where you can get support linking in with Leicestershire Support for Carers Groups. Their aim is to get the right people coming to the groups.

Tracey said plenty of carers need support from other carers like advice and support, sometime they find themselves battling with the services to get advice but the best advice is from someone who is doing the job already. At present they are trying to work with the Surgeries to put a Carers support pack together, offering contacts and other details about support for carers.

The County definition of a carer is “someone who looks after someone else” if you pop round to do something for someone and they couldn’t manage without your help then you are an unpaid carer. The rules are different when trying to claim carers/attendance allowance.

New patients are asked on the new patient questionnaire if they are a carer and can be identified but it’s the patients who have been here for years that we want to identify. Once the groups are established they can be held at the Community House in Barwell or the Surgeries or Local Community Centre if rooms are available. AJP said it was a privilege that we have Kerry for 12 months working on this pilot scheme to see if it works, we don’t want to lose it we want it carry on so you need to tell your family, friends, neighbours to use the service.

LP said the pack is very important for patients who state they are a carer, they need to know where to go for help.

PH said in the pack can you say what a carer can and can’t do? He told that us that he has a neighbour’s key code, the alarm went on and he had a call from alarm company saying neighbour alarm was going off. When he went in she was on floor had slipped off sofa so he picked her up and put her back on the sofa. They had a cleaner who was also there, when the official carer came round to see patient they came to see PH and said don’t pick patient up again, the cleaner had told the carer that the person had been lifted on the chair. Kerry said something like Basic first aid would be good in the pack.

Light Bulb Service – Natasha;

This is a new programme, again a pilot scheme but if it works then the scheme will be spread over more areas, Natasha is employed by Blaby council at present but focussedon the practice in Barwell.

Looking at offering practical housing support in your own home to make it safe

i.e. grab rails, bath rails, raising toilet seats, beds, they also have occupational therapists in the team, assessment for wet rooms, stair lift. Through Assisted Technology patients can get on loan a day/night clock, pressure mats on chairs that are alarmed so the person caring knows if that person has left the chair or got out of bed.

Criteria must be 18+ vulnerable

Can only referred by GP at the moment.

Natasha is hoping to have a sit in session on a Friday at the surgery. so people can book in to see or she can pop out to see patient.

Posters will be coming out very soon just being finalized.

Way to refer is via GP/Reception - use First Contact which is another service where you can get help from and can get multiple services involved if you need them.

Light bulb also have a handy person working for them, who does small jobs around the house, moving equipment around the home, putting shelves up.

The scheme is part of Better Care Together – although a Blaby employee she is working closely with Hinckley and Barwell.

Does the service replace Occupational therapy? – they can look at things more complex -