th
1.
PRESENT
Ian Gerrard, Ken Davis (Chair), Francis Little, Diana Lyon, Dr Richard Neep, Lucie Wattam, Sam
Arundell, Richard Matthews, Nick James, Janet Portman, Katy Blanksby, Alan Beasley, Jan Bird.
Michele Young joined the group as a visitor and depending on commitments may join the Group.
2.
APOLOGIES FOR ABSENCE
Carol Knock
3.
VISIT OF ANNE THICKETT - COMMUNITY MATRON
Anne gave the group an overview of her own experience and of the work she and her team undertake. She explained how the community matron and staff work with the practice and with the local authority care providers. The way the team works is already fulfilling the
'Joined Up Care' principles and practices and the relationship between the practice and the community health teams operates very effectively in service of the patients.
The details that Anne provided are appended to the minutes.
The PPG members found Anne's description to be very full and effective. Ken reiterated the Group's commitment to help the community matrons in any way we can. In particular
Nick and Ken will try to ensure the 'Joined Up Care' project recognises the effectiveness of the team's and practice's operation and incorporates this into the project implementation.
Ken will provide Anne with the PPG's input to Joined Up Care.
Action - KD
Nick asked if it was possible to create a 'typical case' and how the patient is
managed and we can take this into the Joined up Care Project Meetings and ask for the team to 'run the scenario'. Ann thought she could do this.
Action AT
4.
NOTES OF THE PREVIOUS MEETING
Proposed by Ian Gerrard and seconded by ; accepted as a true record and
signed by the Chair.
5.
MATTERS ARISING
 Integrated Care Programme – Nick and Ken continue to attend the Joined Up Care
Community Hub Meetings and we have submitted the paper containing our views and concerns that was circulated to all members. We have been told that the issues will be discussed at the next meeting. We will continue to monitor and contribute to this programme and we will input the concerns raised in Ann's presentation
 Action - NJ KD
 Virtual PPG – see project section.
 Waiting Room - Sam has organised the relocation of the 'Make the Most of your
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Appointment' leaflet holder. Sam reported that she is frequently replenishing the supply. Richard said that while patients are not using the leaflet at the consultation they could be preparing by using the guidelines. Ken reported that the monthly newsletter from NAPPS asks for input from PPG's on successful initiatives and asked whether we should send this. The PPG authorised this.
Action - KD
 Did Not Attends - Richard M. has reviewed the position with Sam. Alan has a number of ideas and Richard Alan and Ken have discussed these but feel that a number of policy points require clarification before we progress with a project. It was agreed that a policy points paper will be created and the practice policy will be discussed with the partners. Suitable action will be determined following that discussion.
Action - RM AB KD.
The potential withdrawal of the Texting Reminder system was discussed and it was felt that this was likely to increase the number of DNA's. The practice has tried to pressure the CCG to maintain this system but is concerned that it will be removed. The members asked if alternative commercially operated arrangements are available. They are but cannot be integrated into the systems. The PPG wish to pressure the NHS on this matter and authorised the chairman to write to Toby Perkins asking him to pressure the
NHS to keep this service. This will be raised at the Locality Group to ask the other
PPG's to do the same.
Action KD
 IG has permission for members to visit the 111 in small groups, the meeting has been set up for 26th February and attendees agreed.
6.
CCG COMMISSIONING INTENTIONS
We received a response to the questions we raised on Commissioning Intentions but this left a number of points unanswered. Ken and Carol have sent in another list! We have still not received a response about our second set of questions. We will continue to add pressure.
Action - KD CK
Frances asked questions on funding the NHS directly at the Unison meeting with the local
MP's but felt that the answers were generalised and politicised.
7.
FUTURE CALENDAR OF EVENTS/VISITS/AREAS OF INTEREST
CK has sorted out future meetings. If members want another subject to be covered please speak to Carol. Tanya Nolan, the Engagement Officer of Healthwatch is attending in April.
This will have to be fitted into the AGM.
As the practice is advertising for another full time doctor we will delay meeting the doctors until August.
Action: CK/All
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8.
SURVEYS
Forty were completed in January and Ian issued a summary report giving the results. The overall findings are that the practice continues to provide a very high standard of service. Ian congratulated the doctors and staff on the quality of care and the services provided and this sent to all patients with Learning Disabilities with a SAE.
Action: IG - All Members was endorsed by the Group. Ian distributed the survey he has developed with the Learning
Disabilities team and the Group thought this was very good and authorised its use. It will be
9.
PROJECTS
 PPG Publicity - no report this month as the team members have family commitments.
 Virtual PPG - the re-scoped document was sent to all members, some further input is available in a recent email received by Lucie. We will incorporate this and reissue the document. When members have signed off the document Sam and Ken will then design the pages and Dr Neep will identify about 20 patients who we could invite. Sam has some patients who have enquired via the website and we will look at those.
Action - Amend & Reissue Project Document - KD. Design Pages - SA KD
10.
PRACTICE REPORT
 The new patient call system is now being accepted by patients who seem to like it!
There are only limited changes that can be made to the automated voice system and these have been implemented
 There were no complaints on clinical practice last month.
 The doctors and staff are concerned about some aspect of the 111 service. Recent changes have increased the administrative work for the practice staff. Sam will show
Ian how these changes have adversely affected the practice and Ian will take these to the 111 executive to get the processes improved if possible. If required RN can supply
IG with anonymised reports from the 111 service as examples of poor reporting
 Action - SA IG RN
 Lucie reported on the Healthwatch 'survey' of Year 11 students. These seem to be from a very small and sporadic base. Lucie and Richard reported on the response given to
Healthwatch and the Group supported that response. We can provide evidence from our own surveys on the views of patients in that age group.
 We can investigate ways of increasing our surveys of young people.
 The practice has advertised for another full time doctor. Dr Manwal and Dr Thorne will end their temporary contracts in the next few months. Dr Rash will return at the end of
July and will become a partner.
 Nick raised the reissue of Passwords for online access. It is a system and procedural requirement that patients attend the surgery to get new or reissued passwords
11.
LOCALITY GROUP AND THE CCG
No specific meeting. The Joined Up Care / Community Hub programme will continue to form a critical part of the Locality Group focus.
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12.
ANY OTHER BUSINESS
 As a separate item after the meeting Katy raised the possibility of establishing a
Bereavement Group and that she would be keen to set this up. Katy and Ken will refer this to the Group and could speak to Anne who has bereavement support as one of the care functions for the Community Matrons.
13.
DATE AND TIME OF NEXT MEETING
TH
Anne has spent her professional life providing care to the chronically sick and currently spends two days a week as Community Matron for the Practice.
The job of the community matrons and staff is to provide care to the long term chronically sick patients who are assessed as high risk based on the numbers of hospitalisations / A&E attendances and the number of GP visits.
Anne is supported by a nurse and a care co-ordinator, currently the nurse has been seconded to another practice which is affecting the service our practice can provide.
All patients falling into the chronically sick category as described are scored and assessed by
Anne and the relevant doctors. Anne visits the patient and carer and completes a 'top to toe' examination including assessment of medicines and the needs for social and health care and agrees a plan with the patient and with social services to make sure the patient gets access to relevant allowances and carers.
This plan is kept with the out of hours records in case the patient calls that service.
Anne will visit patients in hospital and agree discharge arrangement with the patient and hospital.
The maximum number of patients that Anne and her team can support is 20, there are currently 17 on her books. All relevant patients are assessed by the 'Multi-Disciplinary Team' of the practice doctors and nurses, Occupational Health and other care professionals at the fortnightly meeting.
The total number of patients on the at risk register is 250.
In the ensuing discussion it was felt by the PPG that Anne and her team along with the doctors and nurses provide the 'Joined Up Care' service that the CCG is trying to develop and implement. There were a number of concerns expressed by Anne and Dr Neep that Nick and
Ken will take to the Project Meetings and push for answers on. This includes how we maintain the excellent working relationship that the Community Matrons have with the Practice.
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