Southwell Medical Users Group
Minutes of the meeting held at 7.30 pm on Monday 1st October 2012, at the Southwell Medical Centre.
Present: John Elkington, Nigel Kenward, Dr Bajracharya, Pat Palmer, Gillian Ramsey, Peter Hancock, Bobby
Craik, Tony Morris, Ronald Smithers, Paul Smith, Carol Tinker, Glenys Breedon, Jen Stark, Sheila Fox, Donald
Fox, Ted Waters, Martin Lloyd, Marian Kemp, Jane Ellis, Sarah Angell.
1.
Apologies: These had been received from Dennis Brown, Mary Dakin, Ann Smith, Catherine Skelton,
Geoff Tinker, Dr Cottell
Nigel Kenward as the new Practice Manager was welcomed to his first meeting of SMUG.
2.
Minutes of the meeting held on 2nd July 2012: These were approved as a correct record.
3.
Matters Arising:
3.1 – Progress with the nurse triage trial –
Dr Bajracharya reported that this system was working very well, with positive, informal feedback from
patients. When available appointments are filled on a Monday morning, a nurse will discuss the
patient’s concerns/illness with them and, depending on the situation, offer them a later appointment or
give them an appointment specially embargoed for emergencies. The scheme may be extended to a
Friday.
3.2 – QIPP proposals and Practice budget
A great deal of work is being done on this both at practice level with, for example, referral meetings
three times a week, and at group practice level, working together to reduce costs. Concern was expressed
over:
 improved efficiency leading to a decline in the quality of service, being finance driven not clinically led.
 the drive to cut costs also affecting the financial viability of hospitals such as Newark.
 the impact on doctor/patient consultations.
 the delay in non-emergency referrals which affect quality of life for an ageing population.
3.3 – Progress with commissioning of new computer system
The system is now running smoothly, despite some initial hiccups which included half a day when the
system was down nationally, and the practice had to revert to their back up plan – paper! It is no longer
possible to display on the screen in the waiting room how long a delay there might be for an individual
doctor. The system would allow the check-in screen to display how many patients were ahead. Setting this
up will be looked into.
4. Chairman’s Report:
SRG – Stakeholder Reference Group
CCG - Clinical Commissioning Group
AQP – Any Qualified Provider
PPG – Patient Participation Group
NAPP – National Association of Patient Participation Groups
John reported that:
 There had been meetings of the SRG in July, August and September at which various presentations had
been made.
1








5.
Concern was expressed at these meetings about the fragmentation of the NHS with competition from
services from private providers.
In theory quality is required for the acceptance of contracts. The initiative is directed from National
level where a cost is attached to a service. Companies will tender on the quality and service they would
provide for that fee.
The initial exercise was to choose three services out of a possible seven. However, there is a list of 39
expected services of this type which are likely to be put out to AQP.
Newark and Sherwood CCG have appointed a new Accountability Officer, who also works for
Mansfield CCG some SRG members were concerned that there may be a conflict of interest.
At the recent PPG group meeting attended by some SMUG members the topic of self-help groups was
discussed. There is a directory of information about the 250 self-help groups in Nottinghamshire. Dr
Bajracharya said that often printed information was out of date and he recommended searching on
Google or the NHS website. John wondered if any self-help groups were required in Southwell. Pat
said existing groups such as the Pink Ladies worked well. It was recognised that care was required
when setting up such groups.
There was concern about the link between poverty and child obesity. Parents may not have been taught
to cook, or learnt about healthy lifestyles in school or at home, and this is being reflected in current
obesity problems. There are initiatives at Childrens’ Centres and by Newark and Sherwood District
Council in schools to help this issue.
NAPP has recommended that local PPG’s such as SMUG should make more effort to tell people what
they are doing. Could SMUG improve communication? Possibilities:
- Set up a virtual group reached by email
- Establish discussion forums when required
- Make more use of SMUG’s page on the practice website, perhaps with photos.
- Set up a Facebook page for SMUG, taking care with monitoring
- Post on What’s On in Southwell website.
For a future patient survey a member on the CCG with a marketing background suggested that a good
idea was to ask just one question: what is the one thing you would improve?
Secretary’s Report:
It was agreed to renew the lottery licence with Newark and Sherwood District Council at a cost of £20.
6.
7.
Treasurer’s Report:

Pat reported that £150 had been collected for Doctor Cottell’s retirement. At the appropriate time, when
he has decided on what he would like for his gift, Pat will get this organised.

The balance in the account is £983.91. The Minster School’s bill for the hire of the hall for the
Alzheimer’s meeting was still to be paid. Dr Bajracharya indicated there was nothing the practice
required, but he would discuss this with his colleagues.

There was therefore no need for a fund-raising raffle this year.

It was agreed after some discussion to donate £50 to the King’s Mill Hospital MRI Scanner Appeal.
This could be done from the Art Display funds.
Report from the Medical Centre –

Dr Cottell is to be replaced by two female doctors: Dr Kate Adkin who will work eight sessions Tuesday, Wednesday, Thursday and Friday: and Dr Fiona Pounder who will work six sessions on
Monday, Tuesday and Wednesday. Dr Cottell’s patients will be transferred to the two doctors.

David Mellor retired as Practice Manager last week to be replaced by Nigel Kenward, who lives in
Beckingham and was previously Practice Manager in Holbeach.
2

The new telephone system seems to be working well, with patients being informed where they are in the
queue.

As discussed the new computer system is working well.

Marian and others expressed concern over the new system for repeat prescriptions, which appears to
have some glitches including the continuing display of medicines no longer prescribed for the patient. It
was agreed the system needs to be reviewed and Dr Bajracharya will take SMUG’s concern to the
partners, to check back at the next meeting. The practice is looking at the future use of electronic, online
repeat prescriptions.
8. Open meetings:
8.1 Report on the meeting on Alzheimer’s disease and dementia
John thanked members for their support at the meeting which was well attended – 85 people.

The success was largely attributed to the publicity, particularly the distribution of 800 leaflets through
doors.

For the next meeting it was agreed to print 1000 A5 double-sided leaflets at a cost of about £40, at a
printers in Newark. SMUG details will be printed on the back. The possibility of a design with more
impact was mentioned.

Information could be posted on the What’s On in Southwell website.
8.2 Presentation by Dr Rob Henderson, consultant cardiologist on Friday 9th November
Information from Dr Henderson was still awaited. Paul will deal with this in John’s extended absence.
9.
Art display.

The current display by two local lady artists will be changed in November to a display by the John
Townsend workshop again. This would remain until the New Year.

Prebend Nursery has offered to provide work for a display, which would need pinning to the
group’s moveable display boards.

A letter is being written to the Head of Art at the Minster School with a view to providing a
showcase for pupils’ work.
10. Other reports:
10.1 Newark & Sherwood Clinical Commissioning Group (CCG) – Dennis had circulated a brief written
report (attached to these minutes). Peter indicated that he found the documents a struggle. Tony
commented that an integrated care programme would be welcomed.
11. Local Issues – There were none.
12. Future Agenda items – There were none.
13. Any other business. – Ron repeated the request for the practice to find equipment for SMUG to purchase
with its funds.
14. Date of the next meeting and AGM, Monday 7th January, 2013 at 7.30pm
3
10.
Other reports:
10.1 Newark & Sherwood Clinical Commissioning Group (CCG)
The N&S CCG has continued to develop the necessary plans and procedures and to accumulate
evidence that will lead to successful authorisation as a Statutory Organisation under the NHS umbrella.
The Governing Body has signed off all of the key documents including a forward looking
Organisational Development Plan and an Integrated Plan that includes the commissioning intentions in
some detail. Other key documents that signpost the way the CCG will operate including its
Constitution, various policy documents, Safeguarding Strategy, Communication and Engagement
Strategy, memoranda of understanding regarding collaborative commissioning and governance
arrangements with other CCGs, are all available to view in the Governing Body meeting papers on the
CCG website.
Various stakeholders (including service suppliers) have been providing their views on the viability of
the N&S CCG via 360 degree questionnaires. The Stakeholder Reference Group (where SMUG is
represented by John Elkington) was one of the groups involved in this exercise. The results of these
questionnaires will form part of the evidence that will be reviewed by the NHS Commissioning Board
panel in deciding if the CCG is ready to be authorised.
An issue that absorbed considerable Governing Body time during the confidential section of the last
meeting was the problems being experienced by the Sherwood Forest Hospitals Foundation Trust and
in particular how these will affect our patient population and future commissioning intentions. This
information is now in the public domain (letter from Monitor to SFHFT previously circulated) but a
decision on what action Monitor will take to mitigate the situation will not be taken until around w/c 8th
October.
On a more positive note the CCG is moving at pace to implement commissioning plans to meet its
vision of improving the health and wellbeing of the N&S population. Detailed operational delivery
plans have been developed for the CCG’s seven strategic areas for Health Improvement, the Integrated
Care Programme and the QIPP Strategy and Implementation Programme. The CCG is committed to
commissioning the best quality services within available resources, achieving the best service design
and working collaboratively to deliver large scale change whilst mitigating any risk to patients and
carers. There is tangible evidence that these programmes are beginning to show results.
4