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| 2013 |
Executive Committee Members: Emilio Ceraudo (EC), Patricia Daniels (PD), John Doland (JD), Doris Halls (DoH), Graham Hardy (GH), David Harper (DaH), Anthony Mitchell (AM), L.M. Stockman (LMS)
Joyce Jarvis (JJ), Nick Martensz (NM), Josephine Powell (JP) and Chris Stannard (CS) were absent with apologies. JJ was represented by John Jarvis (JoJ).
Anthony Mitchell joined the Executive Committee.
Surgery Representatives: Dr Simon Prince (DrSP)
Lesley Davis (LD) was absent with apologies.
The minutes from the meeting of 29 May 2013 were approved.
JD said that the grass was being cut but that the interior had not had any repair work or redecoration done to it
Action: JD will speak to LD.
LMS reported that the Local Activities in Bar Hill leaflet had been updated last month and was available at the web site.
DrSP began his report by summarising what is known about the surgery and what changes have occurred since Malling Health Ltd. has taken over. He then highlighted that there were some concerns about delays in getting non-emergency appointments. Recent problems stem primarily from doctor shortages following a family bereavement and contracted locum GPs then not turning up. DrSP said that staff shortages are an increasing problem and that surgeries are being shut down elsewhere because they simply cannot get staff.
A new GP, Dr Fiona Irwin, will be starting in late August, taking over from Dr Sujata Bhandari. DaH raised concerned about GP turnover which was a major problem previously. Are we going back to the bad old days? DrSP acknowledged this concern but pointed out that Bar Hill actually has more GPs than is required by the NHS. A surgery is supposed to have one full-time GP for every 2000 patients and maple surgery has one full-time GP and two part-time GPs for a list of just over 3000 patients. As part of Malling Health Ltd. Bar Hill shares a practice manager, LD, with the St. Neots practice, but no clinical staff. JoJ asked about nursing provision, particularly with regards to diabetes management. DrSP announced that the surgery now had a permanent practice nurse although she was not a nurse practitioner nor a nurse prescriber.
GH then enquired about the merger of health and social services. DrSP did not have a lot of information on this other than the budgets are still separate and that there are a lot of problems, relating a story about an elderly patient forced to remain in hospital far longer than necessary because social services couldn't put together some kind of care package at home. GH volunteers at Addenbrooke's Hospital and has seen the problem of so-called 'bed blocking' where patients are ready to leave hospital but can't go home because of lack of adequate care. DrSP said he disliked the expression 'bed blocking' and thought that social services were failing. Carers are poorly paid, no doubt part of the reason there is a shortage of carers. AM said that carers were paid per person, not per hour, which could leave some carers making less than minimum wage. However, there is a new local system which may be available soon to handle these problems.
JD brought up problems with prescriptions, particularly repeat prescriptions, at Tesco Pharmacy. He said the patients were experiencing delays getting their scripts from the surgery or getting their medications from Tesco, often because Tesco receives a glut of scripts at one time. He suggested that the Pharmacy manager meet with the practice manager or deputy manager to see what can be done. DrSP agreed that this was a good idea and added that GPs tried to get the prescriptions signed before Tesco picked them up every day. JD said that there used to be two pick-ups a day but now it is only on demand and usually late in the day.
AM brought up the issue of prescriptions that have gone missing. DrSP said that this was definitely a worry. Were the scripts going missing at the surgery or at Tesco? Or were patients trying to dishonestly obtain multiple prescriptions in order to sell one of them on? This is a particular danger when the drugs have a street value. JD also pointed out that repeat prescription forms now have a box to tick at the top, indicating whether the patient wants to pick up the script at the surgery or have it sent automatically to Tesco, and that this may be causing confusion for some people. LMS confirmed that she often forgot to tick the box but hadn't had any difficulties.
AM said that he had heard complaints about patients on long-term medication having to get a fresh prescription every 28 days when they used to be able to get several months worth at a time. DrSP said that the 28-day prescribing protocol was NHS-wide and there for good reasons.
Finally, DrSP brought up the idea of the surgery becoming more than just a place patients go for appointments; a Health Hub where patients can get information about a variety of healthcare issues.
JD, among others, expressed his amazement at the number of missed appointments that were booked the same day. DrSP agreed that it was difficult to explain or understand. LMS suggested that part of the problem might be that some patients simply don't value their appointments. AM also said that if you weren't well-organised, you may forget you had a booked appointment. This didn't explain the large numbers of missed on-the-day appointments, however.
DaH commented that DNAs affected all patients, particularly in light of recent comments about the difficulties in getting an appointment quickly. Because Malling Health Ltd has only recently taken over the contract for running the surgery, it has no historical data with which to compare current numbers. GH asked if there was any way to encourage patients to keep their appointments but DrSP didn't think that there was. AM suggested that the surgery make it easier to cancel appointments, including doing it by text message or online. DrSP did say that the surgery was considering adding a mobile phone line to deal with text messages and agreed that it was sometimes difficult to get through on the land line.
GH suggested making repeat offenders call to confirm their appointments but AM cautioned that individual circumstances would have to be taken into account. JD asked if the same patients were failing to turn up for the their appointments or if it was a different patient every time. DrSP didn't know but said he would check. It was important to find out who was missing their appointments and why.
LMS asked if the surgery had an official DNA policy or whether this discussion was the prelude to putting together such a policy. DrSP said he wasn't aware of any such policy. LMS then outlined some DNA policies from other surgeries and passed along several printouts from the internet to DrSP for him to look at later.
Action: Discussion to continue at the next meeting.
AM serves on the Bar Hill Parish Council and thinks it would provoke useful dialogue between the groups if they have at least one member in common. The Parish Council frequently hears anecdotal information about the surgery and occasionally receives letters on the subject. This information usually goes straight to the surgery but the PPG allows another avenue of communication.
LMS reminded the Committee that it had assisted the Acorn Partnership in putting together the new patient brochure two years ago and asked DrSP if the new incumbents would like any help or advice. DrSP said that the surgery would welcome the Committee's input on this matter. LMS handed over a specimen patient leaflet from the United States and another appointment leaflet from a Cambridge surgery.
Action: Discussion to continue at the next meeting.
JoJ expressed his appreciation for the care given to his wife JJ during her recent illness. He cited the excellent treatment JJ received over the weekend by the out-of-hours service and the follow-up care from maple surgery at the beginning of the week.
The meeting adjourned at 7:55 p.m.
The next ordinary meeting of the Executive Committee of the PPG will take place at 6:30 p.m. on Wednesday, 28 August 2013, in the TNT Room at Bar Hill Church. Tea and coffee will be served before the meeting, from 6:00 p.m.
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