Minutes of Online Meeting Held Tuesday 1 December 2020 at 18.30
Attendees:
- David Usher (DU) – Chairman
- Lois Cavallero (LC) – General Manager (AMP)
- Brenda Bryant (BB) – Secretary to PPG
- Dr A Naky (AN) – GP
- Sian Webb (SW) – Site Manager – St Stephen’s Health Centre (SSHC)
- Cyrus Keeka (CK) – APPG representative
- 15 PPG members
Welcome:
David Usher welcomed everyone to the first on-line meeting of the PPG.
Minutes of Meeting of 3 March 2020:
Minutes agreed.
Matters Arising from Minutes of 3 March 2020:
DU requested an up-date on the CQC visit. Dr AN advised they had been in constant contact with the CQC particularly around issues of safety of services. Another meeting has been set for 11 December 2020 and he is anticipating a visit from the CQC probably around March/April 2021.
APPG Up-date:
CK advised this is now called Ashford Health and Wellbeing Reference Group. Ad-hoc sessions had been held every month but at the time of this meeting he had not received the Minutes from the November meeting.
He was able to report that most of the November meeting had been taken up with Dementia communications. Linda Cauldwell is asking for feedback on the experience of people living with dementia, either as someone who is suffering with dementia or caring for someone with dementia.
A paper had been previously distributed to members by the Secretary listing the “three questions” she would like further information on. Cyrus asked that if members had any ideas or suggestions for these to be emailed direct to the Kent and Medway CCG. The email address is in the Community Bulletin sent to members but for ease is [email protected]
Breast screening is now permanently located at the William Harvey Hospital with effect from 1 December 2020.
CK apologised on behalf of Paulyn Charlton who was unable to join the meeting due to technical issues.
Ivy Court surgery is being rebuilt and scheduled to open after Christmas. This surgery is for people living in Tenterden.
The Chairman thanked Cyrus for his informative update.
Ashford Medical Partnership (AMP) Update:
AMP is now designated as a Primary Care Network (PCN) in its own right under a new GP contract. Sian Webb (SW) has been appointed PCN Project Manager. New services will be set up involving new roles in Social Prescribing, Pharmacy Technician and Clinical Pharmacist.
a) Flu Clinic:
SW advised the flu season had been manic. When the flu vaccines were ordered the covid pandemic was not expected nor the number of patients taking up. 10,022 patients were eligible which doesn’t include those shielding or living with someone shielding.
6,728 vaccinations equating to 67% were completed in 9 weeks of weekend working. Clinics operated differently this year with social distancing being key and ensuring a safe environment for both patients and staff. There will be flu clinics on Saturday 5 and 12 December where it is hoped the majority of the outstanding patients can be vaccinated. After those dates, patients requiring the flu vaccination will be booked into normal nursing slots.
The following comments were made by members:
- Had tried to book a flu appointment at the beginning of October and was given a date mid-November. When she advised her employer they arranged for her to have the vaccination. She said she attended two appointments at surgery but was not offered the vaccine and was told there were only Saturday appointments which are not always convenient for everyone. She is still getting texts advising her flu vaccination is outstanding. SW said she would look into this.
- Had his flu vaccination with no problem and his wife was given hers when she collected medication from the Pharmacy but still gets communications requesting her to book appointment. Also received letter from NHS England regarding flu vaccination. SW advised that the surgery has no control over letters issued by NHS England and unfortunately not all pharmacies advise they have administered the vaccine.
- Do the figures above include those patients who had their vaccine elsewhere? SW advised they do.
- Are the figures available from last year to this year to compare? SW advised that the criterion is different this year. The patient list has grown with another age group included but take up in the new group is poor. A comment that is generally voiced when phoning patients to offer the vaccination is “don’t worry about me, leave it for someone else who needs it”. She stressed that if you are invited for a vaccination, then a vaccine is there for you.
- Had appointment with Practice Nurse HCA who offered flu vaccine. Nurse was advised that had previous allergic reaction and was it safe to have? SW advised this should be referred to senior clinician.
Dr AN commented that the first batch of the flu vaccine did not arrive until October which was later than previous years. Mass vaccination was not possible due to social distancing which caused delay in administering.
b) Covid:
SW advised the following:
- At the time of the meeting we had 321 positive results out of 33,000 patients and that 5,000 had been tested. High risk patients had been identified by NHS England initially with an extra 821 patients identified by the Practice. Support has been provided to shielding patients, prescriptions being sent EPS and linking delivery service for medication. Lloyd’s and Kamson Pharmacies have been very helpful.
- Currently we don’t have a lot of information regarding the vaccination programme but this is changing on a daily basis. SSHC has been designated as a suitable site to administer the vaccine. It is a large health centre which easily allows a one-way traffic system to be implemented.
- AMP has been asked to prepare for the vaccine to arrive mid-December but no confirmation of this date has been given. There will be 2 doses of the vaccine with the second dose given 21 days after the first. AMP currently looks after 3 Care/Nursing homes; smaller community homes and learning disability homes providing treatment plans/medication reviews, etc. Everyone who can, will help to administer the vaccine to the residents and support will be provided in delivering the vaccine.
- AMP is working closely with other PCN’s and the CCG to ensure the whole of the Ashford community support each other.
- As a PCN, AMP is taking part in a covid virtual ward for high risk patients who are shielding and tested positive. They will be given a probe to test their sat/oxygen levels which they will do from home. They will be contacted by the surgery for their readings. This will start on Monday 7 December.
- Currently there is no information on the components of the covid vaccine or the potential reactions.
- Very lucky to have new fridges at SSHC which will be dedicated covid fridges. These fridges allow clinicians to see details of the vaccines without opening fridge doors. Vaccines will be delivered in batches of 100 and have a 5 day window to administer.
A comment was made by a member who had an appointment at SSHC and while sitting in the waiting area observed no-one sterilised their hands when they walked in. SW advised that unfortunately the sterilisers had been stolen from SSHC. 3 sterilisation points should be available before visitors reach Reception.
LC said that the presentation had given great insight into covid and what we know so far. Currently a project team is being put together.
Telephones:
LC advised that at the last meeting in March there was a lot of comment on telephone accessibility. The current telephone system X-on Surgery Connect has been in place for the past 2 years; staff changes and increase in patient numbers had all put pressure on the telephones.
In December 2019 over 27,000 calls were registered. There was a lull in calls when covid first hit and staff were able to answer greater number of calls. In June, July and August calls started to increase. Staff are better trained and more are answering the phones hence the figures are improving. A copy of the spreadsheet showing the telephone data is attached to, and forms, part of these Minutes.
DU commented that although he doesn’t have to contact the surgery regularly he has noticed a great improvement in staff answering phones. Even when he was 30+ in the queue he only had to wait a few minutes before his call was answered.
The question was asked if covid would impact on the improvement, LC advised that she thinks it will get worse in January particularly with the number of patient calls increasing with covid and immunisation queries. She is looking into using the flu mobile number as a possible dedicated covid number.
e-Consult:
DU asked whether AMP had plans to reduce the response time by not responding to e-Consult requests at the weekends and evenings as some surgeries have indicated.
LC advised that any e-Consult submitted on a Friday will be responded to by the next working day. The system will flag any emergency, e.g. chest pains.
SW added that the specified response time for e-Consult is 48 hours. She will look into the possibility of Saturday Reception staff being able to deal with any e-Consults that come in after 6.30pm on a Friday.
e-Consult went live on 9 March 2019 and was well received by patients.
- 10,002 e-Consult requests submitted
- 6,000 diverted to Clinicians
- 4,000 completed by Administration team
Of the above:
- 1,092 patients advised self-care at home
- 264 patients advised to seek help from Pharmacy
- 109 diverted to 111
She stressed that patient’s don’t need to take the advice and can speak to a Clinician if they prefer by booking a telephone consultation.
AMP is happy with the way e-Consult is operating and the feedback has been very positive.
A few comments/queries from members were made:
- (Q) I don’t use e-Consult often as it’s quite limited with options and missing things, so what do I do?
(A) e-Consult works on a pathway, if it doesn’t submit your question, contact your GP in the usual way.
- Q) What about those patients who want to use e-Consult but can’t read or write, this will disadvantage them.
(A) e-Consult is an extended service and they can still contact their GP in the usual way. It is hoped that a visual guide will be available in the future which may be useful for these patients.
LC advised that a Social Prescribing Link Worker by the name of Liz has now joined AMP. She works with patients who are elderly, vulnerable, have difficulty accessing GP services, disadvantaged patients, to name but a few. Any member of staff can refer to her and she offers a support service to these patients.
- (Q) Some questions are repetitive, can e-Consult be looked at to simplify and to stop repetition? Also can Menopause and maybe Minor Injuries be added to the list?
(A) e-Consult is an evolving programme and recommendations can be submitted.
Procedure for Patients to have access to their test results:
LC advised that currently test results can’t be accessed on-line. The Data Protection Officer (DPO) is looking into the process. Access to results can be easily done by completing a Subject Access Request, hand into Reception and results will be given. Form is on AMP web-site.
- (Q) Can results be emailed to a patient?
(A) This is a DP issue as it is difficult to verify a recipient by email as id has to be verified.
- (Q) If results come back normal but not happy with the answer and wants numbers. Can we have a standard form to deal with this? The form would give permission for results to be emailed to the patient.
(A) LC will check with DPO regarding permission form but patient can always ask Reception to read out the result numbers.
Menopause and HRT:
BB confirmed that the email sent to her by a PPG member had been forwarded to the Business Support Manager for distribution to Clinicians. Dr AN advised there has been a national supply problem for HRT medication and that GP’s are trained to deal with menopause.
- (Q) Dr AN said GP’s are trained to deal with menopause but some women only want to speak to a woman GP. How many female GP’s does AMP have now?
(A) Dr AN advised this is a market force problem. All surgeries have issues in retaining GP’s and whilst AMP are advertising they cannot promise female GP’s and cannot guarantee what areas of expertise they deal in. He appreciates that female GP’s are wanted but we do now have a Nurse who can help in this area.
- (Q) Menopause and HRT is a national issue and it is frustrating getting something to work. Can something be put on the AMP website covering menopause and can the leaflet she sent through be displayed in each surgery?
(A) LC advised she would look into this.
Dementia:
DU referred to the APPG presentation on 3 Questions to be Addressed and asked for any feedback to be passed to DU.
Any Other Business:
Du asked for copy of the Minutes to be put on website. LC said she would arrange.
The question was asked if Singleton Health Centre is going to open. LC advised that Singleton is open for specific clinics only. Dr AN advised that the position with covid has made it more complex. Singleton is designated a green zone; St Stephen’s a yellow zone and Willesborough a red zone. This will continue during the pandemic.
DU thanked SW and LC for their presentations and Dr AN for his input.
Date of Next Meeting:
Tuesday 2 March 2021 (on-line)
Finally, a very Happy Christmas to you all and best wishes for a healthy, happy 2021. Stay safe.