MINUTES OF MEETING 21/01/2016

Lizzie Brain
B.D-M
A.M
J.N
A.H
M.R
E.S
Linda Lawton
J.W
J.N
T.R
R.J
Fiona Warren CCG
Jason Mather CCG
Debra Juett

At the opening of the meeting Fiona and Jason explained about what they do for hospital, community and GP services – ensure that enough service provision, meeting needs in general practice.  There are 57 practices in Nottingham City area.

Last times minutes were discussed point by point –

Merger is off

Pharmacists – pilot awarded to Derby

Appointment system changed – due to volume of calls, taken out doctor first, patients can now telephone and book appointments.

Problems getting through – seems better now, booking will settle the calls, patients should to discuss their needs with reception.

Doing medication reviews for authorisation for repeats. If health is stable yearly review or 6 monthly depending on patient.  Can notify through pharmacy to get a review.

Doctor first not feasible, very intensive.
Patients unsure of when PPG meetings are scheduled, A.M will put details on website when meetings are.

Phlebotomy – better, busier now. Warfarin tests now downstairs.

Prescriptions, 24 hour turnaround, issues are with the chemists rather than the practice.  Some pharmacists are issuing all medications whether requested or not.
Repeat dispenses, 12 prescriptions to chemist – alright for certain patients on stable medications.
Booking in machine – working now, Linda commented that it is sometimes user error – not pressing finish when completed – A.M herself booked in but it hadn’t registered. Perhaps a volunteer to help people use the machine to free up reception.

Suggestion was to have the machine where reception could see it (no where else for it to go though) and another suggestion to have some hand cleanser – check with infection control.

Results – we need to ask GP if patient ok to have a copy of results, we don’t always request the investigations so not appropriate for us to give out copies.  Also some result require explanation so a patient could misinterpret the result. 
Any impact on Boots giving flu jabs – not much impact noted.  
It was complicated with giving children the flu vaccine whether it was here or already had at school.  We also offer more than a flu jab so even if a patient has had it elsewhere they still may need to come to surgery for other vaccinations.

Issues with the fence around the front entrance discussed.

Weekend working – possible if we could get the staff, possibly nursing services such as a treatment room. Also should it be for routine, pre-bookable appointments to see a GP at weekends or just for emergencies.  Either way we would still need the staff to cover it.  Would be better for working people who cannot get out of work during the week.

Locum GPs get paid more that GPs – more admin to do as well for GPs.  We have Advanced Nurse practitioners, Practice Nurses and home visiting Practice nurses currently along with a physiotherapist

Access to records – especially City Council, a member has questioned the Information Commissioner about this and was told that the City Council can access records, asked Tracy Baker, no direct access, secured information and would need patients consent in writing.

Question about GPs being paid not to refer patients for tests etc – doesn’t happen, patients are referred as necessary.

Thursday half day – no problems, we have 42 hours contract so we have to close on a Thursday afternoon.  Some practices close a lunchtime, or switch the phones over, there is a long history of half day closing.

AAA test to check for aortic aneurysm.  This is on a screening system and patients are called for screening based on age.

A.M news letter – diabetes more prominent, tests available. Over 40’s are sent a health check invitation up to the age of 75 years. Highlights pop up on computer to check.
Drop in clinics – work well
Also mobile testing with thumb prick for simple screening.
Children can access via the school nurse.
Any suggestions for news letter? Discussed

Can patients put their views on NHS choices, rate the practice, people don’t tend to compliment even if a good service but will complain.

A warfarin machine such as the one at QMC was again suggested as it provides instant results. Lizzie commented that this is a serious thing to take on someone would need to be qualified to interpret the reading and provide the doses and also the hospital is contracted to perform this service.  Warfarin being slowly replaced by NOAC (new oral anticoagulants) and perhaps in 15 years no one would be taking warfarin.  Warfarin needs to be monitored constantly, making sure patients within therapeutic range for it to work and is mostly used by patients if atrial fibrillation.

BMI measurements – school nurses are checking children if overweight, they really need the patients history, social situation and to look at the whole story.

A member of the group mentioned about incinerators in Bulwell going ahead and will be burning contaminated waste on Blenheim Lane. Will have two 50m chimneys. General discussion about this and the relevance to this group.

Next meeting 7 April 2016