Whyteleafe Surgery Patient Forum
Wednesday 7 March 2012 at 7pm
Minutes of the Meeting
Present: Richard Allen Patient Representative (EsyDoc)
Theresa Archibald Practice Manager
Susan Cornish Patient Representative (Chairman)
Gordon Frost Patient Representative
Con Latham Patient Representative
Tony Lidbury Patient Representative
Ronald Shrieve Patient Representative
Dr Victor Tun Senior Partner
1. Apologies for absence
Apologies were received from Neila Gibson and Wendy Denne
Apollonia Koukios has not responded to messages enquiring about her continued interest in the group and will be removed from circulation lists for the time being. This was noted with regret by members of the Forum and the requirement for a suitable replacement to represent younger patients at the meetings was acknowledged.
2. Minutes of the meeting held on 7 March 2012 and matters arising
The Minutes of the meeting held on 7 March 2012 were agreed as a correct record. There were no matters arising not covered elsewhere on the agenda.
3. Action Plan from Patient Survey
o Review progress
Members of the group were thanked for their input into the plan following the last meeting which enabled publication of the report by the end of year deadline.
A copy of the Action Plan has been displayed on the main notice board in the waiting room and on the practice website since the end of March 2012.
In line with the recommendations of the plan the waiting room display has been extended to cover the points from the patient survey the Forum wished to publicise. This has fulfilled the communication element of the plan but it was decided that more could be done to extend awareness about services available to patients. In particular the needs of patients with Learning Disabilities were discussed and the involvement of the practice in a pilot Mencap project was explained.
A further in depth discussion about access to GP and nurse appointments followed. The practice has been liaising with another ESyDoc practice who have recently introduced a new appointment system whereby all requests for GP appointments are triaged by the GPs and appointments allocated according to need. The patients and GPs at that practice are very pleased with the outcomes of this approach and the possibility of trialling a similar system at Whyteleafe is going to be considered. The problem of telephone access when operating this arrangement was raised and this will need to be investigated.
The website report will be changed to explain the acronym DNA (did not attend). The increased use of phone reminders for patients attending nurse chronic disease clinics has been successful. Alert messages are being applied to display on computer screens when patients who are known to frequently miss appointments make new bookings.
The Emis Access system required to facilitate online booking of appointments will not be used for the time being. Whilst the convenience of this method of booking is clearly attractive to some patients, the introduction will not solve the current problem whereby some patients attend for trivial ailments and viral illnesses while others who have a more pressing need of an appointment are unable to make a booking. Some patients are still unaware that they can book appointments up to four weeks in advance and the receptionists’ role in communicating this information is important. It was clarified that GPs do have the facility to over-ride the booking arrangements when it is particularly important for a specific patient to make a follow-up appointment.
o Next steps
A new display will be made on the waiting room notice board to extend understanding about use of NHS resources. This will include information about what to do and where to go in the event of an emergency. It was noted that the definition of “emergency” varies from patient to patient. The introduction of the 111 service from April 2011 will help to resolve this issue as all patients will be advised to telephone this number and will be signposted to the service most appropriate for their problem. In the meantime it would be helpful to give further information to patients about the appropriate use of Walk in Centres, Minor Injuries Units, the Urgent Treatment Centre and A&E departments at East Surrey Hospital, Harmoni Thamesdoc Out of Hours services, NHS Direct, pharmacists, and 999 calls. Similar information could also be made available on the practice website.
A questionnaire will need to be carried out this year and it was agreed that this would be discussed at the next meeting of the Forum with a view to carrying out the survey in the autumn. The wider virtual email group will again be consulted about the content of the questionnaire and some of the questions from last year will be retained in order that direct comparisons can be made.
Feedback to the patient population on progress of the action plan was discussed. Susan suggested that information could be incorporated into the annual Chairman’s report which will be published on the website in the autumn and it was agreed that this was a good idea.
4. Feedback from ESyDoc Patient Reference Group meeting
o Attended by Neil and Susan Johnson on behalf of Whyteleafe
We are grateful to Neil and Susan Johnson who agreed to attend the ESyDoc meeting as none of the patient Forum members were available on that evening. Susan Johnson has indicated that she is willing to join the Forum but was unfortunately unable to attend this evening’s meeting. Her name will be added to the circulation lists and we look forward to her involvement.
Susan reported that the meeting had been interesting but that she had not been in a position to contribute to discussions as a first time attendee. Michael Wilson, the chief executive at East Surrey Hospital had addressed the meeting to explain what he had achieved in terms of the new endoscopy unit and improvements to the A&E department. The introduction of radiotherapy and services for chemotherapy by 2013 were also mentioned. His address had been marred by the use of acronyms and “management speak”.
Problems of car-parking at East Surrey hospital were discussed at the ESyDoc meeting and Dr Michael Bosch talked about mental health issues.
Forum members questioned the need for a patient representative group at this level and wanted to know what the group was trying to achieve. It was felt that, although the meetings were very interesting and informative, there was little evidence of consultation or request for feedback from practice level meetings. It was suggested that specific questions or topics could be discussed by practice groups and the outcomes taken back to the ESyDoc group meetings. These comments will be fed back to the organisers of the meetings but it was noted that the practice groups themselves are in different stages of development and some practices only have virtual patient groups. The ESyDoc patient reference group is still at a developmental stage and it is anticipated that patient involvement will be of vital importance as the new Clinical Commissioning Group becomes fully established from April 2013.
5. Update on local/national NHS developments
o Clinical Commissioning Group (CCG)
The organisation of the CCG is changing as the Group moves towards authorisation from April 2013. The original Board is now operating as a committee of NHS Surrey (the Primary Care Trust). A new structure has been set up called the Practices Committee and this group met for the first time earlier this month. A GP with special interest/responsibility for commissioning from each of the 18 practices in East Surrey will attend each meeting as well as Practice Managers and (where appropriate)other clinicians from the practice. This committee will be the engine room of the CCG and will generate new ideas, embed commissioning into daily work in practices and ensure that practices stick to budgets for secondary care. It is expected that four further Committees (sitting outside the Practice committee structure) will report to the Board on Audit, Remuneration, Performance and Clinical Commissioning with an Accountable Officer and management function supporting these activities. CCGs will be able to buy support from Clinical Commissioning Support Organisations and these are now being set up using personnel from the current PCTs.
Members of the Forum were shown graphs showing the activity of ESyDoc practices for scheduled, unscheduled and A&E admissions for 2011-12. These include weighted data so that differing use of resources can be seen and direct comparisons can be made between different practices. A lively discussion followed about how practices can make a difference to the way in which money is spent in secondary care. The introduction of Telehealth as part of the work on Long Term Conditions was used as an example of a new way of working which should have considerable impact on the number of patients admitted into unscheduled care.
The Forum went on to discuss the first edition of the new monthly newsletter called ESy Insight which was published recently and circulated to members of the group for feedback. The newsletter is aimed at practice staff to inform them about progress and changes during the authorisation process. Members of the Forum felt that the publication was full of “classic internal management speak” and was light on specific information about achievements. However, overall the newsletter was considered to be a useful document. The members would like to continue receiving copies of the newsletter to update them on what is happening in the CCG.
o Care Quality Commission (CQC) registration
The practice will begin the registration process next month with an on-line application. There will then be a four week window between September and December when on-line registration must be completed. Action plans will need to be submitted for areas of non-compliance and inspection visits from CQC personnel will commence from April 2013.
o GP availability at Whyteleafe
Dr Roberts recently reduced the number of sessions she works from five to three and is now only available to see patients on Monday, Tuesday and Thursday mornings. Many patients who prefer to consult with Dr Roberts have been unable to do so and have been disappointed by her reduced availability. It was decided that a formal announcement would not be made to patients about this change in arrangements and receptionists have been encouraging patients to see an alternative GP.
6. Matters to be included in the Practice website
Minutes from the March meeting will now be published on the Whyteleafe Surgery website. The Patient Forum area of the website is available for any information the group wishes to publicise to other patients. A summary of the findings from the patient survey, a report about patient participation, the Forum terms of reference and details of the membership of the group are already available on the site together with a sign up form for patients wishing to join the virtual group.
7. Any Other Business
o BMA Industrial Action
Dr Tun explained the reasons behind the decision taken by BMA members to take industrial action this week. Whilst Dr Tun is personally supportive of the stance, patients will be seen as usual at Whyteleafe with only minor changes to arrangements for routine telephone appointments.
o Private Medical Cover
Richard shared his recent experience of obtaining authorisation for treatment for private medical care via BUPA. It seems that changes have been implemented over the last six months by the provider. This does not impact on NHS care.
o Repeat Prescription Service – Boots in Caterham
The lack of efficiency regarding the collection of repeat prescriptions from Boots in Caterham was raised as a matter of concern by a group member. The practice is aware that other patients have been inconvenienced by long waits for medication and reassured the Forum that the hold-up is not within the practice. It was suggested that a letter should be sent to the lead pharmacist at Boots from the Chairman of the Patient Forum to see if improvements to the service could be made.
8. Issues to be treated as confidential and therefore deemed to be Part 2 items of Minutes
There were no issues to be treated as confidential
9. Dates of future meetings
Whyteleafe Forum - Wednesday 29 August at 7.00pm
ESyDoc Patient Reference Group – Thursday 11 October – time and venue tbc
Whyteleafe Forum - Wednesday 17 October at 7.00pm
The meeting closed just after 9.00pm