BeechwoodPark
Inverness IV2 3BW
Tel: 01463 717123
Fax: 01463 235189
Textphone users can contact us via
Typetalk: Tel 0800 959598
/
DRAFT MINUTE of MEETING of the HIGHLAND AREA MEDICAL COMMITTEE
Board Room, Assynt House, Inverness /Tuesday 5 August2014 - 2.00 pm
Present:Dr Miles Mack, Chair
Mr Quentin Cox
Ms Sarah Prince (videoconference)
Dr Claire Robertson
Dr Emma Watson
Dr Chris Williams
Dr Susan Hussey Wilson
Dr Neil Wright (videoconference)
In Attendance:Dr Andrew Evennett, GP
Mrs Mary Morton, Head of Community Pharmaceutical Services and Chair, Area Pharmaceutical Committee
Dr Ken Proctor, Associate Medical Director (Primary Care)
Dr Margaret Somerville, Director of Public Health
Miss Irene Robertson, Board Committee Administrator
Apologies–Dr Jonathan Ball, Dr Jason Davies, Dr Duncan Gray, Dr Alistair Hay and Dr Iain Kennedy
1MINUTE OF MEETING HELD ON 27 MAY2014
The minute of meeting held on 27 May 2014 was Approved.
1.1Matters arising:
(a)Patient Booking System, RaigmoreHospital
Mr Cox advised he had not yet been approached to participate in the redesign of the patient booking system. It was agreed a further letter be sent to Linda Kirkland, Interim Director of Operations, RaigmoreHospital requesting an update on the position.
The Committee Agreed that an update on the position be requested from Linda Kirkland, Interim Director of Operations, RaigmoreHospital.(b)Priority Access for Veterans
Concern was again raised about PMS functionality in relation to identifying veteran related conditions. Mr Cox referred to the procedure in place in another board whereby it was indicated on the front sheet of the referral form that the referral was for a veteran. Consideration might perhaps be given to introducing a similar mechanism in Highland. Mr Cox also recommended that GPs put the consultant’s name on the front sheet of the referral form if they wished a named consultant to see their patient.
(c)Adoption of Lothian Letter
The Chair advised a letter had not yet been drafted for distribution to primary and secondary care clinicians clarifying respective responsibilities in relation to actioning results of investigations initiated in secondary care, follow up tests and care post-discharge. He agreed to write to Dr Roderick Harvey, Associate Medical Director, RaigmoreHospital with a view to progressing this matter and would take the opportunity in his letter to follow up the issue of locum induction packs.
As discussed at the last meeting, Dr Williams confirmed he would be raising a number of issues with the Health and Social Care Committee in relation to the need for standard working and clarity around roles and responsibilities to ensure joined up, patient centred care.
The Committee:- Remitted to the Chair to contact Dr Harvey with a view to preparing a joint letter and to invite him to attend the next meeting for further discussion of the issues.
- Noted Dr Williams would be taking forward a number of issues through the Health and Social Care committee.
(d)eMail Correspondence between Primary and Secondary Care and Decision Making Support
Dr Hussey Wilson confirmed she would prepare a discussion paper setting out some principles for using email.
She reported on discussion at a recent meeting of the GP Technical Group in relation to emailing or texting patients on clinical matters and getting patients’ consent to these means of communication being used.
The Committee Noted Dr Hussey Wilson would prepare a discussion paper on email etiquette.2AREA MEDICAL COMMITTEE ELECTIONS
2.1Chair
The GP Sub Committee had nominated Dr Andrew Evennett to take on the role of Chair of the Area Medical Committee for the remainder of Dr Mack’s term (to September 2015). The Committee endorsed Dr Evennett’s nomination, his appointment to be effective from today.
2.2Consultant Vacancy
The Committee was advised there had been no response to the request for a nomination to fill the vacancy created by Dr Andrew MacLeod’s resignation. Of particular concern was the lack of secondary care representation from the North & West area. Mr Cox and Dr Watson proposed to canvass colleagues with a view to identifying a representative.
Discussion followed in relation to raising the profile and highlighting the role of the Area Medical Committeewith a view to encouraging membership and engagement. Information relating to the Committee along with copies of its agendas and minutes was currently published on the NHS Highland Website. It was suggested that consideration be given to posting information about the Committeeon the Intranet to make it more readily accessible. With regard to Committee activity it was noted the use of the SBAR had been effective in bringing a range of issues to light and helping towards their resolution.
The Committee:- Agreed the appointment ofDr Andrew Evennett to the role of Chair of the Area Medical Committee for the remainder of the term of office.
- Notedthat Mr Cox and Dr Watson would canvass colleagues for a nomination to fill the existing Consultant vacancy.
- Agreed to give consideration to the use of the Intranet to publicise the role and remit of the Committee and its activity more widely.
3AREA PHARMACEUTICAL COMMITTEE
The Chair was pleased to welcome Mary Morton, Chair of the Area Pharmaceutical Committee (APC) who reported on the Committee’s activity and the topics currently high on its agenda. These included the following:-
- Prescription for Excellence. Mrs Morton reported on the various workstreams underway to deliver the aims and objectives of this initiative.
- Implementation of the Chronic Medication Service (CMS). Mrs Morton gave an update on the roll out of the serial prescribing and dispensing element of CMS. In response to a query, Mrs Morton clarified that serial prescriptions can be taken to any pharmacy for dispensing. It was noted the current system for serial prescriptions could not accommodate hospital prescribed drugs administered in GP practices. The need for a consistent approach to be developed was acknowledged.
- The Community Pharmacy SPSP application had been accepted.
- Acute Medication Service – links with GPs. It was suggested it would be helpful to develop referral pathways between community pharmacists and GPs. Mrs Morton agreed to take this forward through the APC and would also raise it at the next Pharmacy Contractors meeting.
- Control of Entry Arrangements and Dispensing GP Practices –changes to the way in which Boards considered pharmacy applications in remote, rural and island areas. A national workshop was to be organised for NHS Board staff who dealt with applications, the outcomes from which would inform the Pharmaceutical Care Plan.
- Delivery of pharmaceutical care to patients in areas where there were GP dispensing practices.
The Committee Noted the report.
4HIGHLAND QUALITY APPROACH
The Committee offered its congratulations to the Department of Microbiology which had received a quality award.
5REMOTE AND RURAL ISSUES
There were a number of workstreams currently underway:
- Lone working and IT connectivity.
- Widening the recruitment pool to include overseas applicants. Dr Williams noted there were no formal arrangements in place with regard to recruitment of sessional doctors to remote and rural areas. It was suggested that opportunities be explored to encourage locums working in remote and rural areas to take up substantive posts in those areas.
- 7 day working – a proposal was being developed around an obligate network with Edinburgh and possibly one of Highland’s RGHs to consider how support might be obtained/provided.
- NES – training programmes.
- A range of workstreams was being progressed through the RCGP.
The Committee Noted the ongoing activity.
6HIGHLAND HEALTH AND SOCIAL CARE COMMITTEE
Mr Cox and Dr Williams reported on the topics discussed at the meeting held on 10 July 2014:-
- Service redesign in Skye & Lochalsh and Badenoch & Strathspey
- Presentation on the Greater Inverness (Inner Moray Firth)Master Plan which aimed to rationalise NHS Highland properties and maximise their use.
- NHS Highland financial position.
- Chronic Pain Service.
- Oncology Service capacity – it was noted this was a national issue.
The Committee Noted the report.
7CLINICAL ADVISORY GROUP
There was circulated for information the minute of meeting held on 5 June 2014. An issue was raised by Mr Coxregarding waiting times for patients previously treated privately who required further treatment under the NHS. Following referral to appropriate NHS services, referrals should be treated equitably according to clinical need.With regard to patients offered an NHS appointment who then elected to have private treatment, their NHS slot could not be guaranteed. It was agreed to consider developing some further guidance in addition to that previously issued to clinicians by Dr Somerville to ensure clarity. Reference was made to availability of waiting list data which would give GPs some indication of when a patient may expect to get a follow up appointment.
It was noted that the Consultant vacancy on the Clinical Advisory Group remained unfilled.
The Committee Noted the Minute.8AREA CLINICAL FORUM
8.1Area Clinical ForumMeeting 29 May 2014
There was circulated draft minute of meeting held on 29 May 2014. The Committee noted in particular the discussion on delayed discharge.
The Committee was advised the Forum’s response to the Francis Report would be considered at the Board meeting to be held on 12 August 2014.
8.2Agenda for meeting to be held on 7 August 2014
Thecirculated agenda was received and noted.
The CommitteeNotedthe report of the meeting held on 29 May 2014 and the topics for discussion at the next meeting.9GP SUB COMMITTEE REPORT
9.1Reportof Meeting held on 17 June2014
Dr Hussey Wilsonsummarised the topics discussed highlighting the following:-
- Health Visitor links/communication with GPs – proposed Integrated Family Team structure and plans to improve channels of communication with GPs.
- Interpretation services – practices were being encouraged to use the telephone service rather than the face to face service.
- LearnPro License – GP access to the system.
- Requests for investigations/tests – pending implementation of OrderComms Dr Watson asked GP colleagues to include as much clinical information as possible on request forms. Some time ago Microbiology and Blood Sciences Labs had stopped entering clinical details into Medipath due to lack of administrative staff capacity. However, without this clinical information GPs were finding it difficult to interpret results, particularly those taken by other staff. Dr Watson undertook to look at re-instating this for primary care.
- Proposal to make GP referral letters available in SCI Store as a matter of routine – the proposal was supported by the GP Sub Committee. An issue was raised about letters from other Boards relating to Highland patients treated in their areasand whether such correspondence could be uploaded to, and accessed on SCI Store. The need to ensure an auditable paper trail was emphasised. It was agreed to raise this issue with Bill Reid, Head of eHealth.
The Committee Noted the report.
10ANY OTHER COMPETENT BUSINESS
10.1Ebola Virus
Dr Somerville advised that the algorithm which had been circulated to general practices was being updated, and the Scottish Government would be issuing new guidance in relation to blood samples. In the meantime GPs should contact Public Health if a patient presented who met the criteria.
The Committee Noted the action to be taken pending the issue of further guidance.
12DATE OF NEXT MEETING
The next meeting would be held on Tuesday 30 September2014 at 2.00pm in the Board Room, Assynt House,Inverness.
On behalf of the members and officers Dr Proctor wished to thank Dr Mack for his able chairmanship of the Committee over the past two years.
The meeting closed at 4.00pm
1