Patient Group Meeting Wednesday 22nd March 2017

Agenda Minutes from last meeting- Sept 2016 Operational Brocklebank Issues Engagement of a clinical pharmacist- discussion of how we can implement Handling of results at Brocklebank- St Georges Hospital issues CQC results for BGP -areas for improvement CCG budgets 17/18 how to manage funding constraints AOB

Operational issues Huge increases of patients attending A&E Huge increases in patients consulting with GP Lack of GP candidates being trained Increased numbers of older GPs retiring Nurse availability issues General environment is under stress and constant scrutiny Consider options to spread workload to try and free up GP time/nurse time

Clinical Pharmacist NHSE announced funding scheme to support practices to work in groups to employ clinical pharmacist/s to help deal with issues around medication We put in a bid for two part time pharmacists to cover the patients of BGP, St Paul’s Cottage, Earlsfield Practice, Haider Practice Approximately 40,000 patients NHSE have approved in principle for a three year period after which funding disappears BGP will be the employing practice

Issues Once all appointments for a day are taken, all patients who requested an appointment are put on a list where the GP will call them back to assess their clinical need Our practice is now to ask the patient why they are wanting the GP to call back >30% of all requests to speak to a GP on the phone are about medication Some patients refuse to say why they want a call (its private, its my right, its none of your business) A clinical pharmacist has far more training in medications than a GP and moving calls to them would be a major time sparing move for GPs allowing them to concentrate on other stuff

Handling results Patients a very frequently given diagnostic tests by a GP These can be anything from simple bloods to complex scans Results come back at different times depending on what they are for Easy to see if results are back with online access to patient record If all results are back and all are normal, reception staff are allowed to tell patients the results are normal If results require further action/discussion we have been sending texts to patients asking them to arrange either telephone call or appointment with nurse/GP As soon as patients receive texts they ring and ask for a telcon that day The GP who requested the tests is in the best position to discuss results We propose now sending text to patient telling them when the GP is next in and that the GP will call them to discuss results If any results were urgent, the on call GP would be handling them immediately Patient resistance?

St Georges Hospital Our major supplier of secondary care CQC report recently stated requires improvement Mainly estates issues- not unsafe Waiting time record is poor >18 weeks Recent press about quality is resulting in a review of 2 million pathways Two serious incidents discovered in the first days Robust work ongoing New Chair and CEO appointed

CQC Brocklebank Result was pleasing The process was very stressful The CQC team Next visit probably 5 years We need to think about what we can improve Specific feedback on Initiating contact with the surgery What happens after a consultation

CCG Board meeting today FY 17/18 a great concern Ideas being considered Transform a service to deliver care in a different way eg Diabetes Reduce activity or change thresholds for treatment eg Infertility Stop commissioning some services eg Infant formulae, gluten free foods

AOB?