Download Minutes PPG meeting September 7th 2016 v1 draft

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Patient Participation Group for Chamberlayne Road Surgery - Minutes of the meeting held 15062016
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Those attending
Dr Jyotsna Patel – doctor
Adrian Murray Bradley – chairman
Sarah Murray Bradley – secretary
Magdalene Bailey
Ravilal Gorcia – practice manager
Jitendar (Jay) Kachela – local pharmacist
Anne O’Sullivan
Georgina Sarpong
Renatta Marakami – health care assistant and receptionist.
Malcolm Nash
Danielle Degerstrom – receptionist
Apologies
Ms Nikolett Kadas – Health care assistant
Judith Fletcher
Dr Kiran Sodha - doctor
Kirubai Kohout
Mythely Ganeshankugan - receptionist
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Composition of Meeting – agreement for minutes for the last meeting.
The minutes of the last meeting in March 2016 were agreed and have been passed for distribution
where necessary.
Members of the meeting represent a reasonable cross section of the patient population. The group
age range is from 30years to 75 years. The only patient groups not represented are mothers with
young children and the 15-30 age group. People in the group represent 7 different nationalities which
reflects the diversity of the practice very well. A married couple attends; also parents, grandparents
and single people. There is a good mixture of professions and some members of the group are
retired, one member is physically disabled, two others have a chronic condition.
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Matters arising from the previous minutes
Item 4, 1st paragraph. The report from the Quality Care Commission inspectors has now been
received in its final form and shows that the practice is considered good in all areas. The members
congratulated the staff for this excellent result.
Item 7, 1st paragraph. The chair reported that there had been an email from Tulip Sidique MP saying
that the debate on pharmacy closure had been adjourned. It cannot however be ignored and Jay
reported further in his report from Pharmacy.
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Report from Dr Patel and Mr Gorcia about the practice.
Nikolette has had to reduce her hours for personal reasons. She does however cover when the
practice is busy. Her enthusiasm and energy is missed by the practice and the meeting wished to
thank her for her work so far and wish her well.
The meeting was told of a new, extra, level of administration which the clinical commissioning group
has inserted between GPs and secondary care. The Brent Optimization Referral Service (BROS)
will act as a triage barrier between the GPs and referral of patients to secondary care. This has be
contracted out to Bexley Health Ltd (http://www.bexleyhealthlimited.co.uk/about) . Doctor Patel and
Mr Gorcia expressed some reservations about the impact that this will have on GP independence
and patient choice. This is reflected in an article in Brent Patient Voice (BPV) Newsletter of August
2016 (http://www.bpv.org.uk/will-optimisation-make-things-better-brents-new-referrals-service/)
which criticizes the move (and which is reproduced at the end of the minutes). The secretary has,
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on behalf of the PPG, signed up as a member of the BPV to receive further newletters which may
be of concern to the PPG.
The move of NHS England, London region, to Skipton House in the Elephant and Castle has
disrupted communications for GPs when they need to obtain new patient’s notes, Mr Gorcia told the
meeting. The transfer of notes has become a much longer process, making it difficult for GPs to
obtain a reliable medical history. This makes it particularly difficult as Dr Patel has recently received
an influx of patients transferred from another local GP, Dr Hussein, who has retired. It is hoped that
this move will not interfere with the transfer of records on a permanent basis.
Dr Sodha is continuing to work on additions to his series on ante-natal care available as a YouTube
video channel called `GP tips’. https://www.youtube.com/channel/UCZE6ryik8MrujUAC2Q25PQ/channels . Interested members can have a look via the url or by typing `GP Tips’ into Google.
This information would be a useful addition to a newsletter to inform and educate patients about their
own health care. The topic is particularly useful in that mothers with young children is just the group
that we cannot often get to attend the PPG.
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Report from Practice Nurse
The practice still has not been able to recruit a permanent practice nurse. However, Gracious Calit
is the part time nurse who comes between 17:00 hrs to 20:00 hrs on a Tuesday evening.
Immunizations, smear tests, dressings and travel vaccinations can be done in surgery during these
times. Both Renatta and Nikolette continue to provide Health Care at the surgery.
The annual `flu’ injections are about to begin, starting on 19th September. Posters and leaflets are
ready for display and distribution. In addition to this, patients aged 73 and 78 will be able to have
shingles vaccinations and this will also be offered to any patients over 70 that have missed the
opportunity in the last few years. The Pheumovax will be offered to all children in the `at risk’ group
between 2 and 4 years and the whooping cough vaccine to pregnant mothers up to 28 weeks into
their pregnancy.
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Report from Reception
Nikolette is no longer working full time but is available on occasion. The meeting welcomed Daniella
Degerstrom who is the new receptionist. Malcolm pointed out that the `call back’ option on the
surgery phone line does not work despite being offered. Ravilal says that he will remedy this.
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Report from pharmacist – Jay Katchela
Jay reported on the progress of the funding situation for local pharmacies. Although a debate has not
yet been held in parliament, he is hopeful that the cuts will not be as extensive as feared. He will
report on this at the next meeting. He pointed out that although there is apparently a glut of
pharmacists there is a dearth of local pharmacies. Possibly this can be accounted for by the growing
numbers of supermarket pharmacies which do not offer local services or support local communities.
Jay told the meeting of the implementation of the Accessible Information Standards and the way in
which these relate to local pharmacies. An article on this can be found on http://psnc.org.uk/wpcontent/uploads/2016/04/Community-Pharmacy_Accessible-Information-Standard_April-2016.pdf
but in brief it tells pharmacists that they should implement by 31st July 2016 :1. Ask: as a matter of routine you must find out if a new or returning patient has any information or
communication support needs relating to a disability, sensory loss or other impairment (e.g. stroke).
2. Record: clearly and consistently record those needs in the patient’s records (paper or electronic).
3. Alert/Flag: the recorded needs must be ‘highly visible’ - so that it can be seen and acted upon
whenever the individual patient’s record is accessed. This should be done in the same way as for
any other risk information (e.g. known allergies).
4. Share: you should include information about a patient’s accessible information and / or
communication needs at referral and handover, following your existing data sharing processes.
5. Act: make reasonable adjustments so that people get information in formats they can understand.
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In theory this means that any problems that a patient has in communication should be flagged on
their Summary Care Record and thus be available to any qualified health care personnel who needs
to treat them and is authorized for access. As Jay pointed out, this will only really happen if there is
conscientious continuity of care from a local pharmacist who knows and understands his patients
because a patient’s permission is required in order for the pharmacist to access Summary Care
Records. Proper access for pharmacists will require better co-operation between GPs and local
pharmacists in order that the electronic information can be added to the patient’s records smoothly.
Further Information on the Accessible Information Standard is available on the NHS England
website. (https://www.england.nhs.uk/ourwork/patients/accessibleinfo-2/ )
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Newsletter 9 June 2016
The meeting were told that the Newsletter 9, which is a Special on Patient Transport, will be
available shortly. Dr Patel and Mr Gorcia had previously pointed out that there are dedicated GP
practices in Willesden, where Dr Burnley at 115 Pound Lane, NW10 2HU Tel: 020 8438 7330
registers homeless patients in the area. In Wembley there is a similar facility at The Wembley Centre
for Health and Care, at 116 Chaplin Road, Wembley, Middlesex, HAO 4UZ. Tel: 020 8900 5020
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Progress on web site improvements.
Malcolm pointed out that the practice web site is still not well organized. Neither the minutes of
meetings nor newsletters are available and nothing has been done since Nicolette’s first attempts at
remedying this some months ago. It is URGENT that the web site reflect the good record from the
inspection given to the practice, and give proper and up to date information on the services that are
available. Mr Gorcia said that he will address this matter as a priority and will engage the help of
the IT expert to make this happen BEFORE the next meeting. Sarah said that she would make
available folders containing the last 2 year’s minutes and a set of newletters so that these can be
properly incorporated in the web site.
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Any further business
Dr Patel wanted to ensure that patients know that the extended appointments on a Tuesday between
18:00hrs and 20:00hrs are ‘by appointment’ only. They are not offered on a `drop in’ basis nor is the
office open to take enquiries. This will be advertized in the next Newsletter.
Dr Patel reported that patients who are sent a GP questionnaire and do not respond, will be
automatically removed from the GP patient lists. She has no control over this. This is particularly
important if patient have changed address and so does not receive letters. So it is URGENT that
patient’s let reception at the surgery know if they have a new address and that they respond to
communications sent to them by the NHS.
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Date and time of next meeting
The next meeting will be held at 7pm on 7th December 2016, when, as usual, pizzas and fruit will be
available for all who attend.
Note 1 from Brent Patient Voice (www.bpv.org.uk)
Will “optimization” make things better: Brent’s new referrals service .
21 August 2016
In the real world “optimisation” means making things better. In “NHS speak” you can’t be too sure.
Brent CCG has contracted Bexley Health Ltd (BHL) to provide a Brent ‘Referral Optimisation Service’
(BROS). This will start on 1 September 2016. Brent Patient Voice has followed this development for several
months. We think it could have some advantages for patients and GPs but these now appear to be heavily
outweighed by its serious disadvantages.
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From 1st September all Brent doctors’ referrals of patients for specialist investigation or treatment must be
sent through BROS including hospital Consultant to Consultant referrals. The BHL website claims that this
referral management service will produce an improvement in the overall quality and completeness of
referrals and a reduction in unnecessary and inappropriate referrals which will improve both the efficient use
of NHS resources and patient’s time.
It is clear to us that this new Service will play a keystone role in the Brent Sustainability and Transformation
Plan for transferring much hospital speciality out-patient referrals to new cheaper community services run by
the single proposed new GP Brent Care Ltd ‘Alliance’ of all 66 GP practices.
The new referrals service is to be financed entirely by Brent CCG taking about £3 million per year out of its
healthcare leaving an extra healthcare “savings” of about £2 million a year after using £1 million per year to
pay for the new referrals service.
We have serious concerns about Brent CCG attempting to impose new restrictions on patient choice with
this service. NHS Improvement (the re-named NHS Monitor) issued new guidance for CCGs on 16 August
2016.
We also have serious concerns about Brent CCG attempting to reduce GP’s clinical independence to refer
their patients to the hospital services that they believe best for the patient. The referrals optimisation
service will never have met the patient and not have access to the patient’s full medical history.
Our concerns about this service have been greatly increased by Brent CCG at the last moment pulling out of
a meeting arranged by the independent statutory Local Medical Committee (LMC) on 16 August 2016 to
which we had been invited. Brent Patient Voice had given Brent CCG notice of our questions. The CCG
have not offered any new date for this meeting, and we are just told indirectly through the LMC that ‘they will
instead address your queries and concerns through their patient engagement structures’ without any date
suggested.
On 16 August we wrote a strong letter to Brent CCG protesting at their failure to answer our questions, and
pointing to their statutory duty to involve Brent Patients and public in their proposals for their healthcare
commissioning and changes to it that affect patients. Our letter has been acknowledged saying they hope to
reply by 1 September.
Our worries about the BROS have been increased by the report by Caroline Price on 17 August
in Pulse that a 6 week urology pilot ROS by NE &W Devon CCG has resulted in 142 (30%) of GP referrals
being sent back to the GP mostly to carry out more investigations themselves such as ultra-sound scans –
for which the GP’s complain they will receive no extra pay.
Peter Latham