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| 2013 |
Executive Committee Members: Patricia Daniels (PD), John Doland (JD), Doris Halls (DoH), Graham Hardy (GH), David Harper (DaH), Joyce Jarvis (JJ), Nick Martensz (NM), Anthony Mitchell (AM), Josephine Powell (JP), Chris Stannard (CS)
Emilio Ceraudo (EC) and L.M. Stockman (LMS) were absent with apologies.
Surgery Representatives: Fiona McGlashan (FM)
The minutes from the meeting of 24 July 2013 were corrected and approved.
JD invited FM to present the surgery report.
FM began her report by telling the meeting that today was Dr Bhandari's last day at the surgery, but that Dr Fiona Irwin had just joined the surgery and had seen her first patients today. The surgery now has three GPs, working as follows:
Thus there are always two GPs working every day.
CS asked about Dr Irwin's background. FM explained that Dr Irwin had recently qualified, and had been working in Bedfordshire before joining the maple surgery. Dr Irwin has a special interest in family planning.
FM then turned to the refurbishment of the surgery building. She said that there would be no changes to the building in the current financial year. The cost of repairing the roof and bringing the whole building up to the standards required by the Care Quality Commission would quite likely exceed the cost of a completely new building.
CS asked where a new building might be put. FM said that this wasn't clear. It might be possible to house the practice temporarily in a Portakabin whilst the current building was demolished and re-built. JP asked whether it would be feasible to completely re-build. FM said it was unlikely in the current economic climate.
AM asked who was the landlord. FM replied that this is the regional Clinical Commissioning Group (CCG), with Serco contracted to carry out maintenance.
GH asked where the money for refurbishment or re-building would come from. FM said that the CCG, as landlord, would have to pay for the work. Ian Burns at NHS Property Services would make the final recommendation.
GH noted that the County Council plans to build hundreds of new homes in the area, and that they would need primary health care services. He asked whether the county council should help pay for any re-building. CS mentioned the new development at Northstowe, and asked where the new residents would go for primary health care. FM said that a health centre was part of the plans for Northstowe, but until it was ready, residents of Northstowe would come to the Bar Hill surgery.
AM asked whether the surgery and/or the PPG should write to the Parish Council regarding any plan to re-build the surgery. GH said that the Parish Council could not provide money. AM agreed, but said that the support of the Parish Council would be helpful in raising funding. He said that the support of local MPs and councillors would also be valuable.
JD noted that the Parish Council would have to be consulted on any planning application.
JD then asked FM to update the meeting on the subject of problems with prescriptions.
FM said that a meeting will be arranged with the Tesco pharmacist to discuss prescriptions which go missing. She said that some "missing" prescriptions occur when patients mistakenly believe that they have a repeat prescription when they do not.
JP asked whether records were kept of prescriptions that are sent directly to the Tesco pharmacy. FM said that the surgery kept records of when every prescription was collected, whether by the patient or by Tesco pharmacy. She couldn't say what records were kept by Tesco.
JD noted that the Tesco pharmacy was now displaying a notice which tells people to allow FOUR days before their prescription is ready for collection.
CS suggested that one cause of the problems may be the high turnover of locum staff at the Tesco pharmacy. JD said this was unlikely, as many locum pharmacists refuse to work at the Bar Hill Tesco because it is such a busy pharmacy. He said it was more likely that mistakes were made simply because the pharmacy is so busy.
GH asked how the prescriptions got from the surgery to the Tesco pharmacy. FM explained that prescriptions were collected from the surgery by the Tesco pharmacy staff, but these collections were not on a regular schedule. They happened whenever someone from the pharmacy was passing the surgery. She said that things might be better if the pharmacy went back to having regular collection times.
FM reported that the number of DNAs in August to date was 60. This was lower than in previous months, but August tends to be a quieter month because of people going on holiday, so fewer appointments were made overall. She noted that a reminder has been published in the Bar Hill News to encourage people to call to cancel appointments that they cannot attend, but perhaps the surgery needed to send out letters with sterner warnings about non-attendance.
DaH said that LMS had compiled a collection of DNA policies from numerous practices around the company. He passed a copy of the document to FM. He said that many practices take no action after one DNA, but send a formal letter after a second DNA, and some practices reserve the right to remove a patient who has three or more DNAs.
CS told the meeting about the policy at a Chelmsford practice where he has recently been working. This practice has had similar problems with DNAs, and has adopted a very strict policy. Some patients have actually been removed from the practice's list for repeated DNAs.
JD drew attention to the article which LMS had found in the Journal of the Royal Society of Medicine and posted on the PPG web site. He said that it contained some interesting discoveries, especially that posting "X people did not attend their appointment" notices in surgeries did not have the intended effect of reducing DNAs, but that positive messages e.g. "X people DID attend their appointment" did reduce DNAs.
FM explained that the surgery is taking steps to remind patients about appointments by sending text messages to their mobile phones. The surgery also sends text messages to patients who miss their appointments.
DaH asked what percentage of patients have agreed to receive text messages from the surgery. FM said that this was about 75% of patients. The surgery now assumes that if a patient gives their mobile phone number as a contact number, they also consent to receive text messages from the surgery.
AM suggested that text messages from the surgery should include positive reinforcement messages along the lines of "X people attended their appointment this month".
JJ asked whether the surgery had analysed DNAs to find out whether there were "repeat offenders" who repeatedly missed their appointments. FM said that this information was still being collated.
CS asked whether other Malling Health practices had recommendations for reducing DNAs. FM said that she would raise this question at the Malling Health group meeting in September.
AM asked whether appointment reminders were also sent to carers of elderly patients or those with dementia. FM said that carers were often the person who made the appointment for such patients, and in this case, the carer was the point of contact, who would receive any reminders.
JD said that if "repeat offenders" faced the possibility of being removed from the surgery's list, then individual circumstances would have to be taken into account, to protect vulnerable patients who may miss appointments for reasons beyond their control. FM agreed that individual circumstances would always be taken into account.
DaH reminded the meeting that the PPG had prepared a draft patient brochure for the Acorn Partnership two years ago, and that some of the ideas had been adopted in the patient brochure that was eventually published. He gave a copy of the draft brochure to FM.
FM said that Malling Health have a standard patient brochure which is tailored for each practice. She passed round a draft copy of the brochure that has been prepared the the maple surgery and said that the PPG's comments were welcome.
PD asked whether it would be possible to circulate copies to all PPG members by email. FM said that she would email the Word document to DaH to distribute. DaH asked whether we could put a copy in the members section of the PPG web site, for executive committee members to download. FM said that this would be fine.
JP asked whether the brochure would be given to all new patients. FM said that it would be available to anyone who asked for a copy.
Action: FM to email a copy of the document to DaH. DaH to place it in the members section of the PPG web site.
JD said that it would be a good idea for the surgery and PPG to take part in the village fête next year. He suggested that we might organise a raffle, and seek contributions from health care companies and/or drug companies.
CS said that we could look again at the ideas from last year.
FM said that we needed something to attract children, since this would also bring their parents to the surgery/PPG stall.
GH said that the church had a "Suggestions Tree" at one village fête. People wrote suggestions on pieces of paper, and pinned them to the branches of a tree on a pin-board.
JP said that the walking group could also take part.
Action: Committee members will think of ideas for the next meeting.
JD reminded the meeting of the two previous Health Awareness Events which had been organised by the surgery and the PPG. These had addressed diabetes and mental health. He invited suggestions for future events.
AM suggested stroke awareness. CS suggested cholesterol reduction.
JP asked whether the surgery's GP had special interests. FM said that Dr Rasool had an interest in ophthalmology, Dr Prince was interested in mental health, and Dr Irwin in family planning issues. She noted that the surgery could also invite external experts.
FM then suggested that "healthy lifestyle" would be a good umbrella topic for a future health awareness event, as it could include healthy eating, controlling cholesterol levels, stroke awareness and other subjects with a broad appeal.
AM noted that "Change For Life" have material about healthy living to give away.
CS asked whether FM could ask the GPs for their suggestions and ideas.
DaH said that we would also have to advertise the event widely, including the Bar Hill News. JD noted that we would need to finalise details of a May event by mid-March, to meet the deadline for the April edition of the Bar Hill News. He also suggested that the event should be scheduled for later in May, to allow for the late delivery of some copies of the Bar Hill News at the start of the month.
AM said that we should also advertise the event on the Parish Council noticeboard and on the council noticeboard by the entrance to Tesco. FM noted that advertisements for the mental health event last year were also placed in shops in Tesco mall.
GH suggested that Tesco could be asked to support the event. FM reminded the meeting that Tesco provided the refreshments at the mental health event.
JD asked committee members to think about this for the next meeting.
AM noted that the map in the patient brochure showed the surgery in the wrong place. He also suggested that the long web site addresses should be replaced by shortened versions via a service such as TinyUrl, and with QR codes for people with smartphones.
PD said that she had put health walk information on the surgery noticeboard, with permission, but this had been removed a few days later.
FM explained that this had happened by mistake when surgery staff were re-organising all of the noticeboards in the waiting room.
Action: PD will put the information up again.
PD noted that Dr Rasool had referred a patient to the health walks. She asked FM to thank Dr Rasool.
JJ expressed concern that too much reliance was being placed on new technologies such as smartphones and text messages for communicating with patients. Many older patients were unfamiliar or uncomfortable with these technologies.
PD agreed that this could be confusing for some older people. GH noted that even some younger people are unable to use computers.
AM said that it was now possible to send text messages to ordinary phones as spoken messages.
The meeting adjourned at 7:45 p.m.
The next ordinary meeting of the Executive Committee of the PPG will take place at 6:30 p.m. on Wednesday, 25 September 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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