March 2018: Welcomed by Karin to the 9 participants.
Matters arising: covered in the rest of the Agenda.
New Care Home Contract
starts on the 1st April and is cluster based (Jubilee with Kensington Road [Dr Cotterill], Forrest, Woodside medical, Limbrick Wood and Dr Kukreja in Tile Hill Lane). The care homes which Jubilee is currently responsible for are Westminster Road, the Knowles and Avalon Court (Avalon is shared 50/50 with Woodside). It is most sensible to register the patient with the practice and the doctor that look after that care home (e.g. Dr Wiggins always looks after The Knowles), but patient choice is paramount (A patient should in theory be covered by anyone in the cluster.)
In Jubilee’s care homes Donna does the Initial Assessment and checks that the medications will last until the first GP visit.
The lease is due for renewal on 31st May 2019. There is no change from the Minutes report from 25 January. (KB: “same shenanigans for the last 9 years”) The situation falls outside the Landlords and Tenants Act. KB can’t start negotiating until 6 months before the lease is up. NHS England claims there is enough spare capacity in neighbouring practices to cover patients.
One Patient One Problem
There are now posters to say this new policy is being implemented to try to shorten waiting times (which have occasioned complaints), but so far there appears to be no improvement. Patients have complex needs, often don’t know how to prioritise or articulate their problems and it’s difficult to curtail the time.
HIV Testing with New Patients
HIV is a growing problem, Coventry is a hotspot (1 in 20 people have HIV, large transient population near Westminster Road, African post graduates), and the onus is on the doctor rather than the patient to discover and treat it. Do we agree with the new strategy: when registering the prospective patient the receptionist will offer HIV testing among all the other routine tests. (The patient is within his/her rights to refuse it.) Answer: yes.
New Nurse Sharon left last Friday after being denied her request regarding very flexible working. A Practice Nurse from Birmingham has been interviewed and offered the post. The practice will also try to recruit a trainee HCA and Donna will be further trained to deal with COPD.
Dr Beth Sanders is leaving in April (expecting twins) and Dr Jagadeesan is leaving end May / beginning June to go to New Zealand. The Practice has interviewed a previous Registrar who will be joining in Mid July, Dr Ellie Newbold.
NHS 5-year Forward Plan
Practice staff are to have additional training in document management. Staff filter out incoming mail which doctors don’t need to see: e.g. just information or DNAs (except for children which needs following up). Some then goes to Reception with a task, others straight to a GP. Our surgery has already demonstrated that the number of missed actions is greatly reduced and coding information is greatly improved.
There is an electronic register of ancillary services and support / interest groups. KB wants to send all staff on a 6-week course to understand what is offered and how to access it. If a member of staff is employed by our cluster to signpost patients, then each practice could refer patients to the signposter who would then send the patient to the most appropriate service or provider to help with the problem.
Most of these are charity and third sector referrals. They would then notify the practice of where the patient had been referred to. This would also potentially save doctor time as quite a few appointments are for more social reasons.
Potential for fraud
A pharmacy has been asking for repeat dispensing to be printed rather than done electronically.
Loophole in prescribing procedure
GPs who have left have not been removed from the system, so they appear to be continuing to prescribe. Amendments were done immediately this was noted.
Next meeting date: 17th May 2018, same time, same venue.