Meadowbrook Road Surgery
Patient Participation Group Meeting
Thursday 6th October 2016
12.00pm – 2.00pm
Venue – Coffee Cups, Thornhill Road, Halesowen
No1 / Attendees
Dr I More – GP Meadowbrook Surgery
Andrew Manning – Practice Manager Meadowbrook Surgery
Debbie Armstrong – Medical Secretary Meadowbrook Surgery
Carol Matthews – Prescriptions Meadowbrook Surgery
Pam Shore – Receptionist Meadowbrook Surgery
Davan Eustace – Pharmacist Meadowbrook Surgery
Ben Upton – Admiral Nurse Practitioner
Sue Bloomer – Integrated Plus
Margaret Allsop - Patient
Margaret Barge – Patient
Jane Beard - Patient
Paul Boxley – Patient
Anthony Brettle – Patient
Marian Brettle – Patient
David Burke - Patient
Kathryn Rudge – Patient
Jayne Stevens - Patient
Celia Tooth – Patient
John Tooth – Patient
Helen Tromans - Patient
John Tromans – Patient
Shirley Turner - Patient
Apologies
Paul Boxley – Patient
Katharine Scully – Patient
Elaine Stevenson – Patient
Mark Stevenson - Patient
2 / Welcome
Andrew Manning welcomed all to the meeting and thanked Coffee Cups for hosting the event and providing the catering. A copy of the minutes from the previous meeting and a slide presentation pack on the subjects to be discussed was issued.
Apologies received were announced and noted.
3 / Admiral Nurse Service
Andrew Manning introduced Ben Upton, Admiral Nurse Practitioner and thanked him for attending the meeting.
Ben Upton provided an overview of the work that the Admiral Nurse team undertake:
· The Royal British Legion works with Dementia UK to provide Admiral Nurses.
· They are specialist dementia nurses who give expert practical, clinical and emotional support to families living with dementia to help them cope.
· They undertake skilled assessments to determine the needs of family carers and the needs of the person with dementia.
· They are registered nurses, and have significant experience of working with people with dementia before becoming an Admiral Nurse.
· Most work for the NHS in communities, helping people with dementia to stay at home for longer. They also work in other settings, including care homes, hospitals and hospices.
· Ben covers the Birmingham area (including Halesowen) with two other nurses.
· Each Admiral Nurse service is operated as a partnership between Dementia UK and a host organisation, which can include the NHS, local authorities, charities and private providers.
· The service is a registered charity and it supports individuals who have served in the armed forces. The support also covers family members even if the service member has passed away.
· The help provided is wide ranging including financial help, emotional stress, care home support, handyman services etc.
· Eligibility covers individuals who completed National Service, war veterans (including conflicts in Falklands, Iraq etc) and the Merchant Navy.
· Advertising of the service is minimal due to cost and limited resources.
Enquiries and support requests should be made by calling the Admiral Nurse Service West on 0333 0114188.
The session generated some very positive feedback from all attendees and it was agreed that previously little had been known about the service both within the surgery and amongst patients.
Action – Andrew Manning agreed to make sure that all practice staff were made aware of the service. Additional leaflets/materials would be obtained for use in the surgery. An increased profile would be raised about the service in the waiting room.
Andrew Manning announced that the practice had been given the opportunity to use a Community Geriatrician Dr Ijaola to see elderly patients with complex conditions/dementia either at the surgery or at home. Availability was limited to approximately one afternoon every 6 weeks but would be in addition to other existing Community and Secondary care services that are available to patients.
Confirmation was provided by surgery representatives and Ben Upton that there is support available from a wide variety of sources for both patients suffering with dementia and their carers even if they are not eligible for the Admiral Service.
Andrew Manning encouraged individuals concerned with memory issues to make an appointment to see a GP.
4 / Integrated Plus
Andrew Manning welcomed Sue Bloomer to the patient meeting. She is the Integrated Plus Locality Link Officer for Halesowen and Quarry Bank.
Sue had previously attended a meeting in 2014 and a request was made at the previous meeting for her to provide an update on the success of this service.
A reminder was provided that Integrated Plus is delivered by Dudley Community Voluntary Service. It was established to:
· Take patient referrals from surgeries to support them to become more involved, connected and active in their communities.
· Improve quality of life.
· Support people to make a difference to their own communities e.g. through volunteering.
· Enable the voluntary and community sector to play an active role in integrated care.
· Ensure the social inclusion of patients is taken into account at multi-disciplinary team meetings.
The service has now been operating for 2 years within the Dudley area and to date 1500 referrals have been made. Analysis has shown that it has made a big difference within the community and estimated savings of £375k has been made to NHS costs.
Sue explained that she has been seeing patients aged 16 years upwards with all sorts of issues. The majority of referrals received result in a home visit. She also attends regular multi-disciplinary team meetings at the surgery to discuss patients and share information.
Examples were given where Sue had provided support to individuals which had a really positive impact on their lives.
It was suggested by the group that maybe there should be a designated member of staff at the surgery appointed to initiate referrals and make visits. This is apparently a role in place at another local surgery.
Andrew Manning confirmed that this comment would be taken on board but resourcing restrictions may make it difficult to progress.
Action – Andrew Manning to feedback at the next meeting on the progress made in relation to Integrated Plus.
5 / Meadowbrook Surgery Based Pharmacist
Andrew Manning introduced Davan Eustace to the patient meeting. She has worked at the surgery on a part time basis for 6 years as the Prescribing Pharmacist. Her hours have recently been increased from 4 hours per week to 12. In addition she works at 4 other surgeries in the area.
It was clear that attendees at the meeting were not aware of Davan’s role at the practice
Her work plan is designed both locally by the practice and also centrally by Dudley CCG. The aim is to ensure that all prescribing made through the practice is safe and cost efficient. In addition focus is geared to ensuring that there is a reduction in medications that are being dispensed to patients but not used.
Davan also explained that she saw patients at the surgery by appointment in relation to blood pressure issues.
Antibiotic Prescribing
Davan gave a presentation about antibiotic treatment.
· Antimicrobial resistance is a very real threat. If we have no suitable antibiotics to treat infection then minor surgery and routine operations could become high risk procedures.
· Primary care accounts for 80-90% of all antibiotic prescriptions which are mainly issued for respiratory tract infections.
· Inappropriate use of antibiotics can lead to increased risk of resistance and reduced efficacy of current treatment.
· More deaths occur from antibiotic resistant bacteria (e.g Sepsis) than lung cancer and bowel cancer.
Davan outlined that it is not always necessary to prescribe antibiotics as most coughs, colds, sore throats and chest infections would normally clear within a few days. The danger in prescribing for these illnesses is that our bodies will become immune to these medications and they will then not work properly when there is actually an infection present. She explained that antibiotic treatment was always usually necessary following surgery as an infection can easily happen at that time.
Dr More explained that before prescribing antibiotics for common ailments there are indicators they need to assess e.g. temperature, oxygen saturations, medical history etc.
Everyone was reminded of the importance of self- treatment if suffering from one of the common ailments. This includes:
· Have plenty of rest
· Drink enough fluids to avoid feeling thirsty
· Ask your local pharmacist to recommend medicines to help your symptoms and/or pain
· Fever is a sign the body is fighting the infection and usually gets better by itself in most cases. You can use paracetamol (or ibuprofen) if you or your child are uncomfortable as a result of a fever.
A reminder was given that contact should be made with the practice or NHS 111 if a condition appears to be serious. This will enable a proper clinical assessment to be made.
Feedback confirmed that the meeting attendees found the session useful.
6 / Meadowbrook Surgery
Minutes from the previous meeting were agreed and Andrew provided an update on the progress of the outstanding actions:
· Telephone System – Positive feedback on the new system was provided by a number of patients. It was confirmed that extra resource is now answering the phones at peak periods to try and improve the call waiting time.
Recent GP Survey results show that 78% of patients find it either ‘Very Easy’ or ‘Fairly Easy’ to get through on the phone. This is above the Dudley CCG average of 70% but below the surgery aspirations. It is hoped that the combination of the new phone system and increased resourcing will improve telephone access for patients.
· Did Not Attend Policy – Andrew Manning advised that 80 appointments were wasted in September 2016. As suggested at a previous PPG meeting these numbers are on display within the waiting room.
Close monitoring of DNA levels is still taking place. Since the previous meeting 3 patients have been removed from the practice register for persistent failure to cancel unwanted appointments.
Andrew Manning confirmed that a patient’s age and medical condition would always be considered before fully invoking the DNA policy. This was to ensure that individuals are treated fairly by taking into account other factors that may be impacting on their ability to attend appointments.
· Parking – It was highlighted that there are 2 white vans that park on the road immediately opposite the surgery for significantly long periods e.g. several days without being moved. This is reducing the available parking for patients. Following a discussion it was agreed that a formal letter should be issued to the vehicle owners from the PPG courteously asking them to refrain from parking outside the surgery during opening hours. An update will be provided at the next meeting.
· GP Patient Survey – The results for the period July 2015 – March 2016 were circulated. These showed that the surgery score ranked them 425 out of 7708 practices nationally. This was a very good score with 97% of patients marking their experience of the surgery as ‘Good’ during this period. This compared to the CCG average of 85%.
Andrew Manning confirmed that the results have been reviewed and a number of actions were being put in place to further improve patient delivery including work relating to online access, telephony, patient waiting time and increased staff training. An update on progress will be provided at the next meeting.
· NHS Choices – Andrew Manning reminded patients about the importance of leaving feedback for the surgery on the NHS Choices website. The most recent feedback had been recorded in December 2015 and left anonymously. This was disappointingly some negative feedback that the surgery were unable to respond too without further information.
· Vaccination Season – The meeting was advised that the surgery had been very busy recently with over 1600 flu vaccinations being given during the previous 2 weeks. Flu occurs every year, usually during the winter months. It is a highly infectious disease with symptoms that can appear very quickly.
During the coming weeks the surgery would be running clinics for childhood flu nasal vaccines and shingles vaccinations for eligible patients over 70.
· Halas Homes – Andrew Manning and Kathryn Rudge (Halas Homes) had now met to review wheelchair access for patients. This item can now be closed.
· Online Access – This service has been very well received and approximately 29% of registered patients have now signed up. It enables patients to book appointments and order repeat prescriptions online. There will be further promotion of this service during the next few months to ensure everyone is aware of its availability.
· Staffing – It was confirmed that Mrs Elisa Barnsley had joined the team as a receptionist in June 2016. She has previously worked in a number of pharmacies including at the Queen Elizabeth Hospital in Birmingham.
· Secondary Care – Everyone was reminded of the importance of making the surgery aware of any significant issues with secondary care. This would allow the surgery, where appropriate, to escalate any concerns/problems to the CCG Quality and Safety Team.
Andrew Manning gave an example of this. During recent weeks he had received a number of patient complaints about the Podiatry service. This included waiting times of 9-10 months and patients turning up for appointments and being advised upon arrival that there was no clinic booked for that day. This is clearly not an acceptable situation. The meeting were advised that these concerns had been raised with the CCG and following our feedback along with other surgeries there was now a ‘Notice to Improve Standards’ in place at the Podiatry department. This had resulted in a new Manager being appointed which will hopefully lead to a service improvement.
· National Hate Crime Awareness Week – The stop hate campaign taking place between 8th-15th October 2016 was promoted at the meeting.
7 / PPG Purse Funding
Andrew Manning explained to the meeting that a grant of approximately £1200 was available to use for the benefit of the practice. This could be applied for to support innovation and the development of creative ideas or to improve the health and well being of patients of the surgery.
Attendees were asked if they had any suggestions to propose to enable an application to be submitted for the grant. Ideas mentioned included:
· A professional looking leaflet display
· A community related notice board and display unit
· A clock in the waiting room
· A waiting room face lift
· Purchase of additional home blood pressure monitoring machines
David Burke notified the meeting that he had been able to obtain a copy of the PPG Purse Guidance Pack and this detailed many restrictions to grant applications e.g. funds could not be used to benefit the practice in respect of decoration or the procurement of medical equipment. Andrew Manning was handed a copy of the pack to review.
Action – Andrew Manning to report back on the progress at the next meeting.
8 / Confirmation was provided that minutes of the meeting would be issued in due course.
Andrew Manning thanked everyone for taking the time to attend and for their valued contribution.
The next planned meeting will be in early February 2017 and invitations would be issued nearer the time.
Meeting Closed – 2.10pm
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