1
2
3
WHITSTABLE MEDICAL PRACTICE PATIENT USERS’ GROUP
Topics discussed at the PUG meeting held on 3 rd May 2012
PUG Aims and Guidelines
The Patient User Group Aims and Guidelines have been reviewed and these are now in final form and published on the website.
Whitstable Integrated Health & Social Care Pilot (WISH ICP)
Dr Ribchester reported on a two year pilot in which the Whitstable Medical Practice is participating.
This is the Whitstable Integrated Health & Social Care Pilot (WISH ICP) and is in line with national strategy to develop integrated care teams throughout the country. In Whitstable patient care pathways have been redesigned, for example, services which were previously delivered within secondary care are now provided within primary care at Whitstable Medical Practice. Interim results for the first year are promising with cost savings to the NHS, care closer to home, shorter waiting and better patient experience. The doctors at WMP are committed to local integrated health care and believe this is the best way of delivering health services to the population of
Whitstable, which is now approximately 34,000.
The WISH ICP comprises the following stakeholders:
 Whitstable Medical Practice (WMP)
 East Kent Hospitals (EKHUFT)
 Kent Community Health NHS Trust (EKHT)
 Kent Family Services (KFS), S E Kent Ambulance (SECAmb)
 The Friends of Whitstable Hospital & Health Care and the PUG
The four work streams of the WISH ICP are: a.
Long term conditions b.
c.
Urgent care
Community elective services & diagnostics d.
Enhanced rehabilitation and intermediate care
Dr Ribchester said his presentation would concentrate on long term conditions but he would also give a summary of the other four work streams within the Whitstable Medical Practice.
Long Term Conditions
The most common long term conditions are arthritis, asthma, diabetes, cardiology, hypertension,
COPD, dementia, mental illness, depression and epilepsy and they account for 70% of health and social care costs, 70% of non-scheduled hospital admissions and 55% of GP consultations. The NHS strategy aims to reduce unscheduled admissions by 20%, reduce the length of stay by 25%, and achieve a cost reduction of £20 billion within the next five years. To achieve these aims a three point plan has been developed which will involve risk profiling, the development of integrated care teams at local level (Neighbourhood Care Teams) and the empowerment of patients to self care.
Whitstable Medical Practice has introduced self care initiatives for a number of long conditions with the provision of Specialist Nurses and GPSIs (GPs with Special Interests) who work with the patients and involve them in producing care plans for them to self-manage their conditions. These include:

4
5
 Diabetes care
 Home blood pressure monitoring
 Self care plans and “rescue prescriptions” for COPD and asthma patients
 Alzheimer café at WHC
 Telehealth – telephone advice and triage
 Telecare – using sensors to monitor conditions, ensure medication is taken, etc
 Directory of Voluntary Services
 Individual care plans for patients including those in residential homes
The use of these self care initiatives has resulted in cost savings and improvement in patient care and more patient satisfaction. For example:
 Diabetes: Cost savings of 50% with times for insulin initiation down and positive patient experience has been reported.
 Cardiology: Costs savings of 38%. The GPSI clinic has reduced hospital referrals, and in-house consultant clinics for Kings and East Kent Hospitals have reduced waiting times.
 Dementia: Introduction of integrated care pathway for dementia and adult mental health at
WHC, reduction in anti-psychotic medications prescribed in care homes, Dementia Café with
Alzheimer’s Society at WHC.
 COPD: Community support groups including the Breath Easy group, breathlessness clinics, community screening, treatment for obstructive sleep apnoea, self-management of COPD (pilot with SHA & Kent Community Health NHS trust) and a respiratory GPSI.
A member commented that patients with long term conditions were not always aware of support groups and community services and queried how this information might be made more readily available for patients.
The Medical Practice was fortunate in having a number GPs with Special Interests who specialised in some of the long term conditions. Their role was an advisory one and a point of reference for
GPs in the practice who would consult with them if they required help with managing a patient’s care. Patients were not able to self refer to a GPSI but their own GP might refer them to the GPSI if they felt a patient required more expertise care and advice.
Urgent Care – Minor Injuries Unit (MIU)
Since March 2011 the MIU at Estuary View has operated at Level 3 with a digital X-ray suite and is open 12 hours per day, 365 days a year. A Nurse Practitioner (ENP) and an Emergency Care
Practitioner (ECP) are in attendance with GP consultation when appropriate. Since October 2011 there has also been a consultant-led fracture clinic attached to the MIU. The MIU is much more convenient for Whitstable patients and the waiting times are shorter. In addition the potential cost savings to the NHS of having a Level 3 MIU and Fracture Clinic at Estuary View are significant.
Community Elective Services & Diagnostics
These include consultant-led outpatient clinics for cardiology, gynaecology, urology, orthopaedics, colorectal surgery and dermatology and there also a number of GPSI Specialist clinics. In addition there are day surgery services for carpal tunnel decompression, upper endoscopy, dermatology and cataracts. These services have achieved cost savings with a reduction in referrals and less Out
Patient Department follow-ups and greater patient satisfaction.
2

7
8
6
9
Enhanced Rehabilitation & Intermediate Care - Whitstable & Tankerton Hospital
An Integrated Committee is exploring funding options for a health and social care centre in
Whitstable. In addition there is a review currently ongoing about the Whitstable, Herne Bay and
Faversham Community Hospitals. b. c.
Practice Update
Dr Ribchester and Lesley reported: a. ENT Clinic
An ENT clinic will soon be opening at Estuary View which will replace the ENT outpatient clinic at Whitstable Hospital which is due to close and will also provide enhanced services for which patients currently have to attend hospital outpatient departments. The Friends of Whitstable Hospital & Healthcare have generously funded the purchase of the equipment for which the Practice is extremely grateful.
d.
MRI Scanner
A mobile MRI scanner unit will be visiting Estuary View later in the year.
Mobile Breast Screening Unit
The Practice had been approached about having the mobile breast screening unit at EV but this had proved impossible due to lack of space in the car park, particularly with the MRI scanner unit coming to EV later in the year, and it was not appropriate to reduce the car parking spaces available for patients. This means that Whitstable residents would have to travel to KCH in Canterbury.
Mental Health Week
The week of 21 st June had been designated Mental health Week and the Practice will be putting together a stand with information about how to get help for people suffering from mental health conditions.
Newsletter
The latest PUG Newsletter is now published on the website. It is hoped to publish three newsletters per year and the next one will be in August.
Next Meeting
The next meeting will be held on 17 th July at 10.00am. A possible topic suggested for a future meeting is the Kent LINK/Health Watch, which is a Government supported organisation whose aim is to involve local people in improving the health and social care services in their area.
3