Coalfields Patient Forum Minutes

Coalfield Forum Minutes July 2015

MINUTES OF THE 54th COALFIELD FORUM 27 JULY 2015 KEPIER MEDICAL PRACTICE

  • Dorothy chaired the meeting in Karen’s absence.

Minutes of las meeting/Matters arising:


Carers Card:
Telecare was not going to discontinue the card service; rather Mike wanted to create a new format which stood out from e.g. a library card. Sue Goulding had secured SCCG funding and Mike had advised on content.

Approval was awaited from the Carers’ Association. Members were very appreciative of Mike’s efforts.


Patient Transport:
Dorothy noted that Aileen had kindly replied to queries about the service. For example, escort eligibility doesn’t relate to a scoring system rather to medical needs (NEAS could provide assistance). Recurring trips by ambulance could be flagged up on a form GPs can request. If a practice has opted out the company appointed by SCCG would deal with transport. Brian gave an example of good practice in his opted out GP practice. Members felt there were inconsistencies in the quality of service and more queries would be raised.
Mike felt a genuine carer should be allowed to accompany the patient. The meeting agreed that Malcolm should write to NEAS
via Aileen to express concerns about the service, in particular that ‘one size does not fit all.’


Patients Managing Ongoing Conditions:
Dorothy noted that Grangewood had discussed helping patients to access information. NAPP was a useful source but practices had to pay a subscription. NHS Choices was another avenue. The City and SCCG were due to meet in September this year to make recommendations across the City. Members were concerned that only two staff were working on this issue.
Margaret and Paul, members of the Coalfield Network area committee, reported that City Of Sunderland was inviting people to become health champions to advise on self care. Training would be given under the Living Well scheme. Members were concerned that medically unqualified people would be offering advice.


Sunderland Health Forum
Dorothy had attended the last event and reported a wide range of participants. It was noted that Sunderland Hospitals would provide a breast screening service only, with surgery being undertaken at QE Gateshead.
It was announced at the event that problems with reception staff at Urgent Care Centres had been resolved by training. However this was contradicted by an SCCG member who reported a very unpleasant experience. Brian said that a friend who had returned from Spain on entering Houghton UCC was asked if they had an appointment. He/she did not. The person, who was in severe discomfort waited 70 minutes to be triaged. It was thought there was a possible thrombosis and was advised to take a bus to A and E. Members felt not all was well at UCCs.


Community Engagement Code of Practice for Commissioning Health Care Services
Dorothy had attended the last meeting at which a draft code of practice was issued. The code of practice sets an agreement
between SCCG, City of Sunderland Council and ‘others?’ the latter being unspecified. Although the NHS Act 2006 is mentioned, setting out a statutory requirement to involve and consult patients, Dorothy felt that:
a) The document lacked clarity in communication and ownership. There was a distinct lack of plain English.
b) It did not suggest how patients were to be consulted and enabled to respond. Examples of projected procedure needed to be included.
Members felt consultation via a website was totally inadequate. Members felt PPGs and the patient locality groups, (of which our Forum is one), should be involved. We were a long established patient group which was ready to be engaged with. Malcolm was asked by members to write to Dr Val Taylor, SCCG clinical vice-chair to express our frustration and the need to be taken seriously as a reflective and responsive body. Members felt undervalued and underused.


Member’s Issues:

Carers:
Norma asked who was responsible for checking on care workers in their dealings with the elderly. She gave the example of her blind and deaf mother being put back into a wet bed and being cared for by workers who cut corners. Mike said Mr Revie was in charge of care services. Paul noted this was now Mr Alan Caddick and Mike suggested Norma should write to him.


Hetton New Dawn:
Margaret reported that some funding had been granted for services in the Coalfield area. Lonely and isolated people currently lacked contact. It was projected to set up afternoon social activities such as tea, gentle exercise and speakers. It was hoped to advertise the new provision in GP surgeries, libraries and home care services. Paul would be driving the Nissan Leaf vehicle provided by Gentoo so that people could be brought to the events.

£4,500 would enable one year of provision from September but there was uncertainty after that.
Mike noted that the Bethany church had a drop-in coffee morning each Thursday but, as a religious organisation it could not apply for funding. Dorothy asked if Margaret could report back in a year’s time to let members know about the project’s implementation. Paul said he hope to visited Coalfield PPGs to explain the aim of the project.

Next meeting:
Monday 19th October 6pm at Kepier Medical Practice.

These minutes are confidential until agreed as a true record at the next Forum.

Coalfields Forum Meeting 19 Oct 2015

MINUTES OF THE 55th COALFIELD FORUM 19/10/2015 KEPIER MEDICAL PRACTICE

Election of chair:
As Karen had resigned as chair a replacement was sought. Dorothy offered to take on the role, proposed by Kathleen and seconded by Norma. This was agreed by all members present. This meant a vacancy for vice-chair. Mike offered to take on the role and this was supported by all members present.
Malcolm was asked to write to Karen to thank her for her efforts as chair.

Minutes of last meeting/ Matters arising:
They were agreed as a true record. There were no matters arising that would not be dealt with in later agenda items.

Integrated Teams:
We were pleased to welcome back Penny Davison from SCCG whose role covered the development of community integrated teams.
a) SCCG had successfully applied to implement the Vanguard Programme, one of five models of care for NHS in the future. Finance was attached along with lots of scrutiny.
b) Penny said that Sunderland was already committed to working with the integrated teams approach. £6.4 million was added to SCCG planned expenditure.
c) The focus for the teams was care outside of hospital. Staff involved included district nurses, community matrons, social workers, GP practices, care homes and visiting care workers. The fundamental aim was to be proactive in maintaining care in the community, to work in a much more integrated way rather than simply reacting to health issues. Staff were working to avoid duplication and improve channels of communication.



By March 2016:

  • There would be co-location of staff, to include Age UK, community matrons, district nurses and adult social workers. When fitted out one of the five locations would include Houghton UCC.
  • The ‘recovery at home’ team would be based at Leechmere alongside the urgent care and intermediate teams.
  • 4-500 staff would be on the move and this would bring a change in culture and a period of readjustment.


Challenges:
1. How to work together? Teams have reorganised caseloads around GP practices and groups of practices. Relationships would need to be built.
2. To develop a planned, proactive approach especially for those frail and elderly with more complex care needs.
3. The teams would aim to identify vulnerable patients and generate a multi-disciplinary approach.
Mike asked what would happen if a carer went into hospital? Penny replied that an emergency care plan would be used.
Penny noted that we had yet to have an integrated IT system to enable information sharing. The aim was to have one record per patient.
4. The integrated approach in care homes would be evaluated to measure the difference made by the new approach. This would involve the skill set of the workforce and GPs sharing confidential information with other agencies.
5. Responsibility lay with each organisation’s accountable body. SCCG exec would receive progress reports. CQC had a monitoring role.
6. Investment is recurrent. £1million was being spent on new nurses with the same sum being available to cover extra GP time to visit patients at home and in care homes.
7. Age UK would deliver the patient and public element. Paul noted that Age UK had already visited Hetton New Dawn. He noted that HND was a voluntary organisation and wondered if there would be any financial support.
8. The Health Forum in November would include updates.
This was a transformation in working and Forum members expressed concern about the logistics of keeping a check on what was happening; who was ultimately responsible? Dorothy hoped patient groups would be consulted. Penny would check on this together with Age UK’s role in relation to consultation. An Age UK document was given to members. A new communications officer would be appointed (possible future visitor to the Forum).
Penny was thanked for her input.


Community Engagement Code of Practice


Members’ comments about the original document had helped to initiate a revision. Members felt that page one gave a much clearer statement of intention.
At an area meeting Mike had asked David Gallagher why a wider consultation of patient groups had not taken place. He replied that some groups didn’t work very well.


East Group Visit


This group works in a different way to the Forum which had always been run by patients. Their SCCG chair had left and this role would not be covered by the new member of staff. Dorothy had kindly visited the group to advise on how they might proceed. Apparently east group had experienced difficulty in getting professionals to visit to provide information.

This was certainly not the case in the Coalfield which was viewed as a model of successful working. It was noted that My NHS had replaced the original plan for five locality patient groups.


AOB:


a) A news report of GPs being given bonus payments to cut patent referrals to hospital was discussed. It was felt that this contradicted the notion of patients being given the most appropriate intervention by professionals. Malcolm was asked to seek clarification from Jackie Gillespie as to SCCG’s approach. Also did SCCG respond to requests for information about such preventative intervention?
b) Physiotherapy services had reverted to access via a patient’s GP.
c) Strategy for General Practice. At the last My NHS meeting a five year plan was put forward. What did patients envisage? They wanted easier access, an opportunity for triage (not simply speaking to a receptionist) and if necessary the chance to speak to a practitioner by phone.
d) There were major issues around the concept of an integrated IT system for patient records.
e) Geoff asked about the use of Houghton UCC by Coalfield patients. Were there any stats on patient visits on a practice basis? What costs were incurred by a patient visiting a UCC and a subsequent referral to hospital? Were the centres taking pressure off practices and hospital? Malcolm to ask Aileen for information.

Next meeting: Monday 7th December 6pm at Kepier Medical Centre.

Coalfields Forum Minutes March 2015

MINUTES COALFIELD PATIENTS’ FORUM MONDAY 2nd MARCH 2015 HERRINGTON MEDICAL CENTRE

MINUTES OF LAST MEETING/MATTERS ARISING:
The minutes were accepted as a true record. It was noted that there seemed to be a lot more happening with Healthwatch.


Patient Engagement

As Julie was ill Aileen had offered to help with this item. She noted that Julie was writing an updated SCCG perspective on patient engagement. We would invite her to the next Forum. Aileen reported that transformation aspects of the Plan on a Page were at the procurement stage. On the subject of the proposed out of hours service, invited patients had met with CCG staff using a very focused agenda to gain patient views (Malcolm had attended). Aileen felt this model of engagement had been very successful. Issues raised e.g. the problems of autistic patients when contacting services by phone, have resulted in revised standards being put into procurement documents. This was in sharp contrast to an MSK briefing where only 5 of the invited 500 turned up.


The LEBs were another source of valuable information. Malcolm had approached Jaclyn Hall regarding advertising of LEBs and resulting attendance. Meetings were posted on the CCG website, Twitter, Sunderland Echo and via the LEB contact list which included organisations across the city. Numbers attending were not always good but there was to be a re-launch in April when the LEB would be known as the Sunderland Health Forum. New ways to spread the word would be explored. My NHS would be used also as a means of contacting patients who can sign up via www.sunderlandccg.nhs.uk.

Aileen noted that the My NHS database would be fed into All Together Sunderland which included the health, education and fire services. The aim was to bring health and social care together.
Members discussed experiences with MSK health professionals and the importance of the chain of communication.

Members asked about the other area patient engagement groups. Only that in the east of the city was functioning. Aileen hoped to build on contacts with e.g. diabetic and heart failure groups. Aileen mentioned a forthcoming session she would be attending on developing patient leaders. Dorothy said she had investigated a three day course on this topic. When she asked how beneficial the training would be she was told she would be able to network. This appeared a very vague outcome stemming from some intense training. She learned that applicants would be vetted. Aileen offered to provide more information at a later meeting.


NEAS:
Malcolm reported that only those practices which had opted out of the patient transport booking system would be using the ERS Medical service. Members wondered how we would discover the efficiency of this new service. A Sunderland Echo article showed a wheelchair bound man who wasn’t granted transport. Members were concerned that a family member or carer would not be allowed to travel with the patient. There was a further burden for patients who were expected go through the process again for each new journey.

Members felt that there was a lost link between practices and patient. The practices had the best knowledge of the patients’ needs. It was hoped that the CCG would monitor the service and members could contact Aileen directly with patients’ experiences at [email protected]

HOUGHTON UCC:
It was hoped to have a rep from Northern Doctors at the next meeting.


AOB:

Geoff reported that a Westbourne patient with an injured child visited Houghton UCC and was told to make an appointment or visit their GP. Aileen said this was against the terms of the contract awarded to Northern Doctors. Houghton UCC WAS a walk in centre. Members were dismayed the reception staff at Houghton (who Brian Nelson believed were not employed by Northern Doctors) were continuing to offer the wrong advice.

Next Meeting:
Monday May 11th 6pm at Herrington Medical Centre. Malcolm was asked to invite Julie Whitehouse, a rep from Northern Doctors and someone from NEAS.

Coalfields Forum Minutes May 2015

MINUTES OF THE 53rd COALFIELD FORUM MONDAY 11th MAY HERRINGTON MEDICAL CENTRE.

HETTON NEW DAWN:
Dorothy welcomed the two reps from the charity and asked them to outline their role. The charity had been established for 8 years and volunteers met in Hetton ecumenical church where activities such as exercise, bowls and a luncheon club were provided for the elderly. Gentoo had provided an electric car so that those with mobility problems could be brought in. A dementia club was held monthly together with a luncheon club at Eppleton Primary.
Margaret and Paul explained that the charity wanted closer links with health provision. Age UK signposted people with dementia to the group. The focus was in the Hetton/Houghton area. City start up funding and fund raising provided some finance but most activities were self-funded. As well as volunteer workers, befrienders come into sessions to sit with members. Margaret and Paul were thanked for their input.


Minutes of Last Meeting/Matters Arising

These were agreed as a true record. Dorothy noted that Grangewood’s patient group had raised further issues about patient transport e.g. who determined whether or not a patient could be accompanied? How was a patient with unchanged circumstances and requiring a further hospital visit flagged up on the system? Aileen would be addressing the issues raised.


Marianne Donnelly From Northern Doctors:


Marianne explained that Northern Doctors held the contract for urgent care centres at Bunny Hill, Washington and Houghton. Access was by walking in or with an appointment via NHS111. They were not an overflow for primary care. Brian Nelson asked why the change from ‘minor injuries’ to ‘urgent care?’ Marianne explained that followed a nationwide shift in thinking. It was intended to intercept patients who didn’t need to visit A and E.
The centres were open from 10am to 10pm on weekdays and 8am to 10pm on Saturdays, Sundays and bank holidays. Brian wondered if the title ‘urgent care’ might put people off.

Marianne explained that ringing NHS 111 would give the patient advice on the appropriate place to attend for treatment. Dorothy noted that there had been issues about access.

There was concern from members that there was no triage in place. Marianne said that receptionists trained in ‘urgent’ criteria ensured that those most in need of urgent treatment were seen within two hours, with others being seen within four hours. Receptionists could seek advice from medical staff.
Receptionists were employed by City of Sunderland but trained to standards set by Northern Doctors. There were monthly meetings between Northern Doctors and SCCG regarding any issues about the running of the service. There were nurse practitioners at each site together with a doctor. From September 2014 there was only one three hour period when a doctor was not on site in one centre.
Marianne said there was a robust complaints procedure in place.

The directory of services in the centres had been updated. Across the three centres most people were seen and discharged within an hour. At present Houghton was seeing 50 to 60 patients a day. Members felt more publicity was required so that residents knew what was on offer.
Dorothy thanked Marianne for her input.


Sue Goulding SCCG on the Current Patient Engagement Strategy:


Sue explained that the North of England Commissioning Support Unit was currently in Sunderland, working on the managing of the process of My NHS and patient engagement.
N.B. the Local Engagement Boards were now called the Sunderland Health Forums. Citywide meetings were advertised in the Echo, My NHS and via a list of contacts. These were bi-monthly, informative and interactive. The next agenda would address urgent care.

Sue explained that My NHS was a database of interested patients whose views were sought on services. Patients could apply using leaflets provided by Sue and also could identify areas of health provision in which they had a particular interest. Contact would be made by email, text and letter. Currently there were about 800 members in our area. It was hoped to expand this to get a better representation across the City. The SSCG website showed all activities.

Sue said the aim was to bring the Health and Wellbeing Board and the SCCG together to engage with patients. Dorothy felt it was important for members to pass on this information to our patient groups. It was noted that Aileen Sullivan and Dr Jackie Gillespie were serving the group very well. Sue was thanked for her input.


Best Practice/ Helping Patients to Help Themselves:


This was an issue raised by Grangewood PPG. Dorothy explained that each GP practice had methods in place to help patients to help themselves. Might these successful approaches be spread across the Coalfield area? NAPP had advice…Malcolm would send the latest newsletter to members. Mary noted that at Kepier practice, patients on entering the surgery could see a notice board which helped them to make informed choices when seeking health advice/treatment.

Malcolm added that Westbourne provided advice on a website and by telephone.
Mike wondered if members had used NHS Choices (provided by NHS England). This was a website listing ailments and up-to-date advice. He said there was a wealth of information and providing one’s postcode released a list of local services.

Also provided was monitoring information on local services and a chance to feedback on experiences. Members felt such a useful facility could be better broadcast.


AOB.

Mary noted that patients were being involved in signing off PPG reports. Mike wondered if, when prescriptions were held in advance at a pharmacy and an update was given after a hospital visit, were members having problems getting the revised script from the pharmacy. Members suggested that the problem probably lay with the pharmacy in question!
Malcolm relayed information provided by Jackie Gillespie.

The SCCG was restarting joint meetings with the Local Authority and currently planning how to use this year’s innovations funding. At the next locality meeting on May 22nd there was to be a ‘Dragons’ Den’ approach with interested parties putting forward a pitch and then it would be decided who would receive allocations.
Also, Sunderland in the past had a Career Start scheme which offered two year contracts for young GPs to enter general practice and have mentorship in host practices before embarking further on a career. Sunderland has restarted the scheme and ten places are on offer starting in August. It is hoped to attract young GPs to the City with a view to their remaining at the end of their contract and assisting with our recruitment and retention problems.
Mike raised the issue of carers’ emergency cards. A contact would be enacted should a carer go into hospital. The contract was now with Telecare which was unwilling to continue the service, blaming cost.

Mike offered to do the artwork for a new and improved card if funding could be found. Sue offered to look into possible funding streams and get in touch via Malcolm.
Paul (treasurer for Hetton New Dawn) noted some funding was available for lonely and vulnerable people (he attended the Area Network Committee).

The aim was to intervene in the early onset of dementia. He noted that Age UK and the Carers’ Association worked together in this area of need. ESSENCE was a programme of help and support for patients/carers. Members agreed to take this information forward to a later meeting. Mike noted that identify carers could be very difficult. He asked members to encourage referral to GP practices and the Carers’ Association.
Dorothy gave an example of very good practice by the Urgent Care Team. Gladys noted another positive experience from the service.

Next Meeting: Monday 27th July. Venue to be determined.
These minutes remain confidential until agreed as a true record at the next meeting.