Local Medical Committee Meeting 14 April 2015
MINUTES OF THE COUNTY DURHAM AND DARLINGTON LOCAL MEDICAL COMMITTEE HELD ON TUESDAY 14 APRIL 2015 IN THE BOARD ROOM AT APPLETON HOUSE
Present:
James McMichael Chair
David Robertson Hon Secretary
Fiona McConnell Chester-le-Street
Rushi Mudalagiri Easington
Norbert Dielehner Sedgefield
Catherine Doidge Easington – Practice Manager
Denise Scott Easington – Practice Manager
Claire Elder LMC
Invited:
Andrea Jones Darlington CCG
Gill Findley DDES CCG
David Graham ND CCG
Judith Mashiter Healthwatch County Durham
Number / ItemL15/33 / Apologies for Absence
Tanya Johnston (CLS)
K V Reddy (Easington)
Robin Wade (Salaried)
Kamal Sidhu
Richard Harker
Heather Prestwick
L15/34 / Minutes of the Meeting held on 3 March 2015 – signing of the minutes was deferred until May.
L15/35 / Matters Arising
Pharmacy Matters
Co-hosting – the LPC will organise a meeting.
Compliance Aids – The LMC had contributed to guidance that had the potential for using a variety of compliance aids more appropriately. Although the pharmacist leading this piece of work had left it had been picked up and was going through a process for approval and implementation.
L15/36 / Clinical Commissioning Groups
Darlington CCG – Andrea Jones
CQC visits – Whilst CQC had visited most practices in Darlington there were a 3 practices yet to be inspected. The CCG had been given the impression that all practices would be visited in a single round. The LMC had contact the CQC about this discrepancy and been informed that practices could only know for certain that they were going to be inspected when they received the official direct and individual contact from the CQC 14 days prior to the date of the inspection.
Models of Care – Darlington was shortlisted for vanguard status and although unsuccessful was nevertheless going to implement many of the ideas in its proposal. AJ said maybe the LMC should invite Jenny Steele to the LMC to update.
Federations – robust clinical involvement has been employed – Prof Peter Spurgeon from Warwick University was working with the CCG in developing a database for Primary Care.
PMS – all but one Practice reverting to GMS from PMS. A forum is being set up to discuss future spending, co-commissioning, primary groups, re-cooped funds and recommendations.
Elderly Multi-disciplinary Teams – Meeting set up with CDDFT to discuss.
DDDS – Gillian Findley
DDES is Level 3 Co-commissioning. NHS England is producing the handover documents.
PMS Review – Information will be shared when it is all collated. 70% of Practices are now GMS.
Community Matron Monies - money will now be shared between:-
Diabetes
Community Nursing
Specialist Nursing
Mental Health
Career Start – Lots of interest has been expressed and an advert is within the BMJ. Presently this is a scheme for DDES, but should the take up be great there may be opportunity to roll this out to other CCGs.
IG Toolkit –
Practices were being supported to complete the IG Toolkit that encompasses 13 requirements for general practice to self-assess against. Completion of these self-assessments is necessary in order for practices to ensure that their HSCIC services continue to be provided.
DR pointed out that The Information Governance Training Tool (IGTT) is separate and is not compulsory for GPs and GP staff although practices may opt to ask staff to use some of the IGTT modules, in order to meet requirement 8-117 of the IG Toolkit.
Nurse Revalidation – is being introduced with a variety of requirements similar to GP revalidation. It is anticipated that most nurses will be able to fulfil the requirements but it might be more difficult for those working within Care Homes, for Local Authorities and Occupational Health Nurses.
North Durham – David Graham
Weekend Opening – No monies had been secured from the Prime Ministers Challenge Fund and therefore these would end in April. There is a little funding from other sources and some surgeries will stay open for another 6/7 months.
Out of Hours Service (Elderly) – the 3 Federations are talking about a service that would cover weekends involving the elderly and frail. No further details available at present.
Resignation – David Graham informed the Committee that with regret he had decided to resign from the CCG and return to Practice full-time. The LMC thanked David for his attendance and his informative updates and wished him the very best for the future.
L15/38 / NHS England
38.01 Cumbria and North East (Sub Region)
Tim Rideout will take over as Director of Operations on 5th May
It was decided that Tim should be invited to a future meeting of the LMC.
L15/39 / Secondary Care
39.01 TEWV Pilot on Monitoring BT/ECGs
The LMC had been given to understand that a pilot project was being developed to provide monitoring blood tests and ECGs by TEWV staff. The secretary hope that the lead for the project would be able to come to next month’s LMC.
L15/40 / Healthwatch
Judith Mashiter attended on behalf of HealthWatch County Durham (HWCD) It was recognised that whilst this does not include Darlington who have their own Healthwatch organisation the general approach is similar.
Websites for County Durham http://www.healthwatchcountydurham.co.uk/ and Darlington http://www.healthwatchdarlington.co.uk/.
Healthwatch is a statutory independent body, separate from Durham County Council but commissioned by the County Council.
The role of the consumer champion is to help the patient/service user as the
· Heart;
· Listen;
· Advise; and
· Speak up
The stakeholder map for HWCD is enormous. There is a Board of Directors and an Advisory Board plus volunteers and 6 employees. There are “Healthwatchers” who are the eyes and ears of the organisation in local communities.
All Healthwatch bodies have the right to “Enter and View” GP premises. This is an observation and NOT an inspection. These observations can be announced or unannounced. Representatives who carry this role out have been trained and these have been found to produce good experiences on both sides. There is a report produced from the visit where observations of negative and positive experiences are noted.
Members wondered how this fit in with CQC inspections and felt that this was another body wishing to inspect and turn up on the doorstep of GPs. Members also wondered how they made their decision to pick a practice – this was based on hard and soft intelligence. Members wondered if HW liaised with CQC on their findings. JM confirmed that there would be a report produced and this then would be in the public domain and available to CQC.
Members wondered what this lay person would be looking at and JM explained that this would be about service delivery and not data.
Members wondered what the threshold was for an inspection, ie how many bits of hard/soft data was needed before an inspection was deemed necessary. JM wanted to point out that HW was not a complaints or advocacy service.
Gill Findley pointed out that HWCD had been very useful in the Urgent Care Review and JM confirmed that DCC had used their services in connection with the service review for intermediate care beds.
DAR asked that JM and HW Darlington produce a joint briefing paper to send to all Practices so that all Practices are aware of the services of Healthwatch.
L15/41 / Out of Hours Issues
41.01 Urgent Care GPs North Durham
A response on behalf of the LMC had been sent highlighting:
1. The apparent lack of a robust process for informing commissioners when medical cover is not provided at CDDFT centres and UHND in particular.
2. The potential risks to patients and the knock on effects of using GPs from other centres to cross cover.
3. Whether there are additional factors that should be explored such as working patterns and conditions.
The LMC had learnt that although the situation was being monitored it remained unclear where any findings were being reported. Jan Panke () had indicated that he would be keen to heard from any GPs with experience of working in Urgent Care
L15/42 / Communication from the BMA/GPC
42.01 Subject Access Reports & Insurance
42.02 Fit for Work Scheme
42.03 Work Capability Assessments
Information on the above items have been forwarded by email to all Practice Manager for information.
L15/43 / Area Team – LMC Rep Performers’ Group
It appeared that funding for training and attendance at the key performance monitoring groups had would be provided by the Area Team and that confirmation of this should be available at the next LMC.
L15/44 / Date, Time and Place of Next Meeting
5 May 2015 @ 19.30 in the Board Room at ND: CCG Rivergreen, Durham
Private and Confidential
Ref: CNE/MINUTES/AGENDAS/LMC/Minutes 2015