DRAFT Partnership BIC Locality
Patient Engagement Group Meeting
20th January 2015
Board Room, Phoenix Court, Basildon
Present:
Lynne Powell
Peter Stone
Carol Gooch
Mary Abraham
Maria Mampilly
Muriel Bick
Ron Livesey
Naomi Redshaw
Barbara Lambert
Locality Manager Partnership BIC
Patient, Felmores Medical Practice (Chair)
Receptionist, The Knares
Practice Manager Felmores Medical Centre
Practice Manager Felmores Surgery
Patient, The Knares
Patient, Felmores Medical Centre
Patient, Laindon Health Centre
Patient, Felmores Surgery
In attendance
Jonathan Andrews – Medicine Management Team
Jeanette Hucey – Web GP
1.
Welcome, Introduction & Apologies
Apologies were received from Alison Reeve, Rama Sharma, Len Green and Paul
Downes.
Peter expressed his concerns that no-one had turned up to the last meeting and very
few apologies were made. LP said she had a few responses this month but would be
engaging with practices to recruit patients to this group. PS said that it was important
for patients to have a voice and would members see about encouraging others to
attend. LP explained that from April the GP contract would be changing and all GP
practices would have to have patient groups. LP said she was going to work with her
practices to assist in this.
2.
Minutes of previous meetings
The minutes of the last meeting were agreed as a true record.
PS distributed the presentation given by the Chair of the CCG at the last meeting and
asked if any comments could be fed back to Lynne.
3.
Medicines Management
1
Jonathan Andrews introduced himself and explained that he worked for the Medicines
Management team which was hosted by Thurrock but covered Basildon and
Brentwood CCG. He explained that the team were looking at cost effective, safe, high
quality best practice prescribing.
JA explained that there were three major areas of concern these are
1. Antibiotics
Global over prescribing of antibiotics has caused antibiotics to become resistant; they
are becoming less effective due to super resistant antibiotics. Discussion tool place
around when it was appropriate to prescribe antibiotics and JA shared ‘treating your
infection’ which has been produced by Public Health England as a guide to prescribing
and self-care for patients. Over prescribing of antibiotics is caused by patient demand
and GP education. JA explained that the Medicines Management Team were asking
GPs to delay prescription, possibly issuing but asking patient not to use it unless there
symptoms get worse as per the ‘treating your infection’ form or saying to the patient
you don’t need antibiotics but please feel assured that should your condition deteriorate
then there will be a prescription ready and waiting for you in reception. This is just two
ideas of how to reduce prescribing of Antibiotic. Discussion took place around over
use of Antibiotics and how this was not helped by the mass prescribing to animals
which has not happened since 2006 in European Community.
JA asked if anyone had heard of Clostridium Difficile, which is on the increase in our
hospitals. Patients general view is that this is a hospital acquired infection but its not it
is due to over use of some antibiotics



The bowel (gut) of healthy people contains bacteria (germs) that usually cause
no harm – these are often referred to as ‘good’ or normal bacteria.
Clostridium difficile (sometimes referred to as C. difficile or C. diff) is the name
of one of the bacteria that may be found in small numbers in the bowel of a
small proportion of healthy people (less than 5% - known as carriers).
Sometimes Clostridium difficile is found in the bowels of healthy babies under
the age of two.
Clostridium difficile bacteria are able to increase when there are less ‘good’
bacteria in the bowel. This means people with C. difficile bacteria in their bowel
are at risk of infection if they are treated with antibiotics.
Clostridium difficile bacteria produce two toxins (poisonous substances) that
can cause diarrhoea and damage the lining of the intestine.
Clostridium difficile bacteria also produce spores (bacteria with a protective coating )
which means it can survive for a long time on floors, surfaces, toilets etc. (you may
hear this referred to as the environment).These spores are resistant to general
everyday cleaning detergents and chemical disinfectants
Who is at risk of getting Clostridium difficile?
 Anyone taking antibiotics. Taking more than one type or multiple courses of
antibiotics increases the risk.
 People in hospital, especially elderly patients, and those who have had a long
stay in hospital.
 People with inflammatory bowel disease.
People on prescribed anti-ulcer medications
What are the symptoms?
The toxins C. diff produces irritate the bowel lining, causing symptoms that can include
2
diarrhoea (which can be watery or like mucous, smelly, and bright in colour). You may
also get abdominal (tummy) cramps, fever (a high temperature), nausea (feeling sick)
and loss of appetite. In most people symptoms are mild and a full recovery is made.
Although diarrhoea in elderly people can result in dehydration (loss of water from the
body) leading to serious illness. Some strains of C. diff are more likely to lead to severe
life threatening illness. Patients who develop a severe form of the infection where the
bowel is seriously damaged may need to have an operation
A discussion took place around patients saying they were allergic to antibiotics which is
found not to be the case in many cases as antibiotics do cause upset stomach etc.
Allergies would be rash etc.
2. Wastage
There is a huge amount of money wasted on prescriptions that are not needed and this
is down to patients stockpiling and the GP not reviewing repeat medication.
Pharmacists are now checking on repeat prescriptions and asking patients do you
actually need the medication.
JA gave brief overview of Electronic Prescribing and how this was being rolled out into
Basildon and Brentwood and explained how the prescription would be sent to a
pharmacy of patient choice.
3. Self-Care
JA explained that in the next financial year Medicines Management would be working
to promote self-care which will include patients not attending a GP appointment for
vitamins, paracetamol, and anti-histamine as all these can be purchased at the
pharmacy with advice from the pharmacist.
A discussion took place as to why unused medicines could not be used? JA explained
that once medication had left the pharmacy, the pharmacist could no longer guarantee
the safety of that medication and therefore the medication must be destroyed, this
could be because potentially the medication was stored incorrectly i.e. at the wrong
temperature, it could have been tampered with etc. JA explained that there is a charity
called Inter-care who took in unused medicines but explained that the General Council
of Medicine do not allow this from our GP practices.
PS asked if Jonathan would come back to the meeting in a few months to update on
progress,
LP to invite JA to July meeting
4.
Web GP
Jeanette Hucey, Associate Director of Transformation gave an update on Web GP. JH
explained that BB CCG were successful in being awarded £240,000 from NHSE to
improve access for patients. JH explained that 41/44 practices had signed up to the
Web GP which was being introduced in phases. JH gave an overview of how the
system would work and free up GP time. JH showed patients presentation which is
available to view on www.webgp or if patients want further information.
5.
Locality Update
PS advised that due to his on-going illness he is unable to attend the Locality Board
meeting for the foreseeable. It was agreed that Vice Chair Mr R Livesey would be
invited in his place.
LP explained that at the last Locality Board meeting a presentation by Medicines
Management was given around cutting down on waste, reviews of repeat prescriptions
and Electronic Prescribing.
3
The next Board meeting in February would be looking at a work plan for Partnership
BIC for the next 12 months.
6.
Update from PCRG
No update available
7.
Issues to escalate to PCRG
None Reported
8.
Any Other Business





8.
LP distributed BTUH mystery shopper
NR asked if on the Treating your infection if the word drooling could be removed
or changed
LP To feed back to meds management
MM asked how she could organise patient transport for an elderly patient that
needed to go to a London Hospital. LP asked what was the clinical reason he
needed transport. LP gave overview of the patient transport costs and
explained that each case was considered. LP to escalate to Paula Saunders
Discussion took place around BTUH A & E department and why it was so busy;
members agreed that it was due to patients going for the wrong reason. LP
explained that the CCG were working with GPs to educate patients, LP also
explained about the GP in ED. That there was a GP whose job it is to deflect
these cases if possible. Members asked if this was working?
Phlebotomy at BTUH was again raised and the huge waits for blood tests. LP
explained that the phlebotomy services were being reviewed by the CCG. MA
said that her surgery offered blood tests but due to the courier coming early in
the day they were limited to how many they could take. MA told her patients
that they could come for the blood test but would have to take the test to BTUH
themselves
Date of next meeting & Future Dates
The next meeting of the Partnership BIC Locality Patient Engagement Group will be
held on Tuesday 24th March 2015 10 – 12 Board Room Phoenix Court, Phoenix Court,
Christopher Martin Road, Basildon SS14 3HG.
It was agreed to hold meetings at two monthly intervals and review in six months
Future Meetings to be held in the Board Room at Phoenix Court from 10 – 12
Tuesday 26th May
Tuesday 4th August
Tuesday 29th September
Tuesday 24th November
Tuesday 19th January 2016
Tuesday 29th March 2016
4