Welcome by Karin to 11 attendees
Matters arising from the MinutesGroup Consultations
A government trial to pool resources and save money. On 13th December Jubilee Healthcare did a diabetes group consultation as described in the minutes of 22nd November 2018.
The 15 patients (known only by EMIS numbers) who turned up were very pleased with the event. They received help and information in one session which might have required several visits to clinicians. Although there was some local extra funding, it did not cover the hours of work needed, not to mention the unpaid overtime offered by a few. For example, the initial phone call to each patient required 30 minutes of explanation.
The overall cost to the practice outweighed the costs of seeing the patients separately for their needs, but there were benefits such as the possibility of self-help groups being formed. (An HBAIC number indicates the sugar level in blood over the previous 6 months.) To be reviewed
Dementia diagnosis plan
This is a year-long project which appears to be a big improvement over the previous system: a much quicker response to and diagnosis of the onset of symptoms than before. GPs are picking up extra training. Tests go straight to Dr Newbold and medication starts in the practice. The possibility of referring to hospital services (e.g. memory clinic) remains.
Releasing clinical capacity
A limited audit of doctors’ analyses of problems which patients present with concluded that 40% of their problems could have been solved by a nurse, clinical pharmacist or other health care professional, i.e. the doctor’s time could have been better spent on other issues.
However, most patients prefer to see a doctor and not all practices have a full primary care team.The practice is just starting to address the time-consuming problem of doctors signing prescriptions off (electronically) far too frequently, as mentioned in the previous minutes. However, controlled drugs cannot be issued electronically, so time must be set aside for issuing / renewing those.
Nurse Loretta Spain and training
Loretta is being trained from scratch over two years to be a practice nurse and every different skill (e.g. giving vaccinations, doing smear tests) is outsourced to a registered training provider which is very costly to the surgery.
However, she is a good “all-rounder”, patients are pleased with her attitude and efficiency, and she never steps out of her strictly defined role within the practice.
Flood drainage issues at Westminster Road
KB explained calmly what is a scenario out of a farce and could be funny if it weren’t so serious and potentially cripplingly expensive. Incompetent workmen after an initial flood in the practice cellar disconnected the water suction pump and removed the water-tight membrane around the cellar, thus prompting another even worse flood.
In addition, there appeared to be no exit drain into mains sewerage of the water once removed. We (and the owners of the practice) await the sequel to the saga with some trepidation.
New child protection working with patient contract
Coventry is starting a new patient contract for “looked-after children”, i.e. children in care. The Looked after children in the practice will have dedicated doctors who will have to prioritise their care even if they already have a full timetable of other patient needs. One doctor in Coventry wants to include “vulnerable adults” in this which KB regards as totally impractical at the present time for a number of reasons.
Current Registrars: i) Dr Asma Abbas (f) leaving in 2 months; ii) Dr Abu Islam (m), iii) Dr Hira Hassan (f), the “technical” replacement for Dr Abbas, although working out how their respective hours complement each other is very complicated. Appointments with registrars last 20 minutes rather than 10 because the registrars work more slowly than the experienced doctors.
Ambulatory Blood Pressure Monitor
This is the ideal way to measure with great accuracy a patient’s average blood pressure over 24 hours. The frequent readings are stored in the monitor. Its cost, however, (£1800 plus VAT) is an invitation to theft, the practice might join forces with other practices to source these to drive down the prices. The monitor has to be recalibrated every two months.
Any other business
All in response to member queries:
- The Reverse Advent Calendar was a box in which every member of staff and some patients at the practice put food which would be distributed to the needy over Christmas through Queens Road Baptist Church’s Open Christmas, a very worthwhile and well run cause.
- Patients finding very limited access to appointments through EMIS were probably accessing it at a time when staff hadn’t updated it so there was far less information and choice than usual.
- The best audiology service outside the NHS but working with the NHS is Spec Savers. A New NHS audiology service is coming to Coventry, details TBA.
- Men (and women?) over 50 can self-refer for an ultrasound aortic aneurism check.
Next meeting: 14 March same time, same place.