Held Tuesday 3 March 2020 at 18.30 at Willesborough Health Centre
Attendees:
- David Usher – Chairman
- Brenda Bryant – Secretary to PPG
- Dr A. Naky
- Keli Cooper – Site Manager, Willesborough Health Centre
- Jade Roberts Cadenhead, Receptionist, St Stephen’s Health Centre
- Cyrus Keeka = APPG Rep
- 12 members
Apologies:
7 apologies received
Invitee:
- Kate Regan – McMillan Nurses
David Usher (DU) extended a warm welcome to Kate Regan (KR) and said the members were looking forward to hearing about McMillan Nurses in the Community.
KR said that McMillan are a team of four GPs and two nurses who work across East Kent to support GPs, Practice Nurses and other health care professionals with providing care for Patients with cancer. They work close with GP practices and provide training courses to Nurses, Health Care Support Workers, Paramedic Practitioners and GP’s to empower them to be more confident in having the difficult conversations that they can encounter.
They also provide updates around new information about cancer prevention, diagnosis, treatment and living with and beyond cancer.
Through their Social prescribers they empower people to seek advice for support to help with benefits, etc.
A monthly newsletter is issued predominantly aimed at Nurses making them aware of upcoming cancer campaigns.
A phone line is available not just for clinical staff but for everyone to ring for initial contact; help with finances; work issues; help patients with the benefits that are available to them. The phone number is 0808 808 0000
McMillan also provide one-off grants of £300 paid following referral, which can be used to assist with buying wigs, incontinence equipment, travel costs, etc. Full details can be found on the McMillan website.
A copy of Kate’s presentation is attached to and forms part of these Minutes.
DU thanked Kate for attending and all attendees agreed it had been a very useful presentation.
Minutes of Meeting of 4 December 2019:
Minutes agreed.
Matters Arising from Minutes of 4 December 2019:
DU requested an update following the meeting with the CQC on Friday 13 December. Dr Naky advised that the meeting was to gather information relative to changes in practices/staffing/patient demographic/ complaints regarding telephone access/ other services that were now available /PCN network changes/ surgery expansion, etc. Dr Naky advised there will be an inspection within 6 months and he thought it more likely before the end of June 2020.
APPG Update:
Cyrus Keeka (CK) gave a brief update as follows:
- Replacement of 111 – a new company will take over with effect from 15 April
- Urgent treatment centres in Dover/Deal/Ashford/Margate being set up. Some will be open 24 hours; some will be open 8am to 8pm. GP walk in centres will be withdrawn. The contract is due to start third week in April
- Will be manned by GP’s working in practices and Out of Hours GP’s. Referrals will be accepted from 111 and GP’s.
- Last APPG meeting will be held on 31 March at which time it is anticipated information regarding changes on the CCG reorganisation will be available.
Long Term Condition Event:
DU advised the meeting regarding transforming health and social care in Kent and Medway. A copy of his presentation is detailed below:
“Design and Learning Centre and the Kent, Surrey and Sussex Academic Health Science Network, both working for Kent and Medway Sustainability and Transformation Partnership.
This partnership set a challenge for the group to find new and innovative solutions with a focus on local care to support people with Asthma, Cardio vascular Disease, Chronic Obstructive Pulmonary Disease and Diabetes.
They were looking at these because around 255,000 people in K&M have 2 or more LTC’s and that increases with age.
Digital technology is integrated into our lives and it is felt that the Health & Social Care workforce should be fully competent, confident and capable in its use in the workplace.
How – Part 1
- Interviews with Clinicians
- Looking to see what and identifying credible, market ready, affordable, high impact innovations are around.
How – Part 2
- Initial workshop with 41 Clinicians, Practitioners and Commissioners help in early 2019.
- 4 Citizen focussed workshops during October to December 2019 to understand their experiences and how new technology could improve health and well being.
- Survey circulated January 2020.
Various ideas came out during the workshops.
Work has been taking place to integrate GP and Hospital records so each can see a patients records.
GP List
- Problem list
- Medication list
- Allergies
- Investigations
- Consultations
- Care Plan
Hospital List
- A&E attendance info
- Discharge summaries
- Out Patient letters and correspondence
- Maternity information
- Past & future appointment information
- Documents
All make for better benefits for patients and health care providers.
Mobile Applications.
Lots of applications out there. Some 366,000 apps for health and fitness with 5 million downloads a day.
Organisation called ORCHA that looks at, checks, evaluates and scores apps.
They look at suitability, condition matching etc.
The group is looking at all the feedback and ideas. They will then prepare a report with recommendations for the Clinical and Professional Board in March 2020.
DU advised that there was a slide presentation amounting to 60 pages. Should members like to have a copy they should contact the Secretary who will be happy to email a copy to them.
DU went on to say that Hospitals; IC24 and Ambulatory now have access to patients’ records from GP surgeries for East Kent and Medway as all East Kent surgeries now use same computer system.
At the current time, GP’s are unable to access hospital records.
Organisational Update:
Dr Naky advised recruitment is ongoing:-
- Recruited extra Nurses
- Recruited Phlebotomists for blood tests/blood pressure check who will operate over all 3 surgeries
- Recruited more staff for telephones
Changes being made to way prescriptions are requested with on-line access through Patient Access, NHS website, email direct to prescribing team.
RGN Celia is retiring at the end of March 2020 and RGN Yasmine retired at the end of 2019.
On-Line Services:
On-line e-consult launches on 8 March 2020. Patient’s log in on the Ashford Medical Partnership (AMP) website where they will be able to access a list showing the type of problem they wish to consult the doctor about. The GP will assess the problem and if they feel that a face to face appointment is required they will give the patient an appointment. GP’s can send a prescription direct to the Pharmacy for the patient to collect.
This system is approved by the CCG who chose e-consult model as the best for access/legalities/practicalities. E-consult can also provide patients with results/medication requests/administration requests, e.g. referrals and it is hoped this will reduce telephone calls by 30% in the future. Currently in the UK over 5,000 practices are using e-consult.
Currently patients are unable to get results on line but the plan is that these will be available through e-consult and patients will also be able to book appointments through e-consult.
Appointment System/telephones:
Keli Cooper (Site Manager, Willesborough) acknowledged that the phone system still isn’t perfect but by the end of January waiting times had improved. She advised that in September the call waiting time was over an hour but this had come down to an average of 27 minutes. During peak time on Monday’s between the hours of 8 – 10.30 am 40 lines are in operation and this number doesn’t move. Staff answers calls as quickly as possible with each call taking 1 minute 10 seconds to deal with. Half the calls are abandoned. In January a total of 56,000 people called.
PPG member CD advised she was sent an appointment letter for a diabetic check the next day which was inconvenient. She tried to cancel the appointment and waited over an hour to do this. She said “that while Patients had been understanding for over a year and things had gone beyond a joke and reasonability. Vulnerable patients were not coping with the system.”
Keli acknowledged this and said that management had listened to feedback and all available staff are now answering the phones.
Dr Naky advised that following the merger with St. Stephen’s Health Centre the inherited phone system did not allow for it to be integrated with Willesborough and Singleton surgeries. In view of this a whole new phone system for all 3 surgeries is being installed, hopefully by the end of the month thus separating to 3 sites again.
Face to face appointments had been reinstated due to vulnerable patients and people with language difficulties.
Dr Naky advised that realistically improvements should start to flow through by the beginning of May and it is hoped to offer on-line appointments for Nurse care, e.g. blood pressure, blood tests, clinics for smears, etc.
He went on to say that no GP’s were coming into the system and when GP’s left they were having to be replaced with Nurse Practitioners.
DU thanked Dr Naky for explaining in depth and being frank about these issues and asked if he could come to the next meeting to update Members.
Fund Raising:
The Easter Raffle will not now take place until the Summer.
Any Other Business:
The Coronavirus was raised and Dr Naky that numbers were still small and that each day brought different guidelines. It was anticipated that the virus will peak probably after 6 weeks. He assured the Group that should one site be affected then services can be delivered from the 2 other sites.
Date of Next Meeting:
The next meeting will be held on Tuesday 2 June at 18.30 at St Stephen’s Health Centre.