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Opting out of NHS Central Databases

Meeting of Swanton Morley Surgery Patients’ Participation Group

Tuesday 23^rd September 2008, 7.00pm at Lincoln House

Present:  Gina Eames,  Dr. Simon Hibberd,  Rosemary Northall, Ted Peachment,  Karen Purchase, Maggie Richards, Fran Sampson, Jan Turner , Judith Wood

AGENDA

Ted Peachment, Chairman, welcomed everyone, introducing a new member, Gina Eames and noting with pleasure the presence of Dr Hibberd. He announced that Karen Purchase wished to stand down as Secretary and that Rosemary Northall had agreed to take on the task. Maggie Richards had offered to assist. Warm thanks were expressed to Karen for her hard work as Secretary since this Group began in September 2004.

1. Apologies:   Apologies were received from Jean Purchase, Anne Sadler and Jean Walden

2. Minutes of meeting held on 8^th July to be accepted: Since these were available only in draft form, acceptance and signing were deferred until the next meeting.

3. Matters arising: Judith Wood, Commissioning Manager, answered a series of queries raised by members at the last meeting, under Item 5, “Swanton Morley Surgery Matters”.

a) North Elmham Surgery It was confirmed that Elmham Surgery is the correct title, the word “North” no longer being included.

b) A glossary of abbreviations and acronyms being used will be produced for the convenience of members.

c) Regarding the NHS Database proposed by the Government, concerns have been expressed that there could be problems with breaches of confidentiality. In the first instance a summary care record would be uploaded onto the NHS spine, detailing patients’ current prescriptions and any allergies. Detailed care record information would be submitted later. Forms are provided at the surgeries for patients who wish to opt out of the system and a register will be completed well in advance of a national spine being established. All patients will be informed beforehand and given the opportunity to opt out. No information will be uploaded before a full consultation process has been completed.

d) Surgery newsletters: These are produced quarterly and include information about both surgeries and are available in the surgery waiting rooms. Gina’s offer to arrange for the autumn issue to be distributed to every household in Swanton Morley was gratefully accepted The surgeries are not allowed to advertise but may give details about the facilities offered. Updated information, news items and letters can also be found on the website: elmhamsurgery.com

e) Multiple enquiries within one appointment: It was confirmed that Doctors are happy to deal with more than one health problem during the same consultation, since they are often inter-related. Time constraints might mean that, in some instances, a second appointment would have to be sought.

f) Emergency Appointments: The terms “urgent” or “emergency” are no longer used and appointments now fall into one of two categories

i) Routine appointments – can usually be made up to 6 weeks in advance, with a Doctor, Nurse Practitioner or Practice Nurse of the patient’s choice. Two popular Doctors are often booked up well in advance.

The early morning appointments from 7.30am on Mondays and Tuesdays still continue, mainly for patients at work but others may use them if slots are available.

ii) Same day appointments - these are not necessarily for urgent matters but, if a patient wishes to be seen that same day, this will always be possible, even if this has to be at the end of a list. The patient may be offered any of the medical practitioners available and may have little choice but, it is guaranteed that they will receive attention that same day. Patients ringing during a morning will be offered sometime that day and will no longer be asked to phone back at 2.00pm. Any problems should always be reported to Judith for investigation.

g) Dispensary problems: In the interests of simplicity, safety and efficiency, efforts are being made to reduce and rationalise the variety of drugs being prescribed. Over 20,000 items are prescribed by the two surgeries each month, with 1600 different medication products. Drugs are ordered twice daily and there are two deliveries each day to try to ensure they are available on time. Patients are now being asked to give two working days notice between ordering and collecting, not 48 hours, as previously. Sometimes, due to problems procuring a particular drug, there may be an unavoidable delay in receiving it on time. It was noted that for a variety of reasons, some repeat medication is never collected. Since it has not left the surgery, it can still be used in future.

h)      Choice of GP surgery: The Practice covers an extensive, rural area, stretching from the northern outskirts of Dereham to Swanton Novers and from Tittleshall in the west to beyond Bawdeswell in the east. It is divided into four segments, with a Doctor assigned to each one for the purpose of visiting patients at home. The boundaries are governed mainly by practical considerations to ensure it is feasible for a Doctor to travel those distances to reach particular patients, within a time schedule.

4) Update on Swanton Morley Surgery matters

Judith reported that Dr. Chilenge was now doing clinics at Swanton Morley.

Ultra-sound services continued to be provided and would extend to obstetrics in about a year’s time. Health visitors hope to hold clinics soon.

“Disabilities Rights Norfolk”, led by Tricia Hyde, is being hosted at Elmham Surgery. Help and advice is given on matters such as benefit claims, disabled living allowances, applications for blue badges and people can be visited in their own homes, if necessary. Patients should contact either surgery for contact details.

Flu clinics: Patients are being contacted by phone and offered vaccinations at either Elmham Surgery on Saturday 11^th or 18^th October or, at Swanton Morley Surgery on Friday 10^th or 17^th October. Representatives from Age Concern will be on hand on both days at Elmham Surgery to offer practical advice on matters such as staying safe and warm in the home, lighting and security.

It might be possible also for Breckland Council staff to attend to offer similar advice, if there would be room in the car park for their large vehicle.

5. Input from PPG members, including patients’ comments

0845 Phone numbers: These cost callers more money than the usual phonelines. While some income could be generated for the surgeries, it was felt not to be best practice and it was confirmed that this system would not be adopted here. It was noted that Elmham Surgery receives about 700 phone calls early on Monday mornings and patients are encouraged to wait until later in the day if their problems are not urgent.

The Government’s consultation process regarding G.P.’s running dispensaries: While it was felt there was some logic in not allowing G.P.’s to dispense medicines if there were pharmacy provisions nearby, as in towns, members felt strongly that in rural areas it was essential to continue to offer this service for the benefit of the patients. Owing to transport problems, inconvenience, hardship, and delay in obtaining vital medication could result if patients had to obtain their prescriptions elsewhere.

Out of hours care: A member highlighted the difficulties of trying to procure a carer or a Doctor or, to obtain transport to take a chronically ill neighbour into hospital during the night. Despite being unwell herself, she felt she had been made to feel obliged to remain with the patient for an indefinite time until professional medical help could be provided. There is an acute shortage of out of hours carers and it is hoped that a new care system will be established in the practice to alleviate the problem.

Leaflet giving updated information about Swanton Morley Surgery: It was reported that the Parish Council was willing to arrange distribution of leaflets to every household, along with their quarterly Mardler newsletter. It was agreed that Judith would organise an updated leaflet to be produced to coincide with the publication of the Mardler, next March.

6. Any Other Business

A request was made that the list on display in Swanton Morley Surgery detailing the items purchased by the Friends of Elmham Surgery Charitable Trust should be updated to include more recent acquisitions.

7. Date of next Meeting

It was agreed that the next meeting should be held on Tuesday 18^th November, at 7.00pm.