1. What’s New Doc? "Aiming to, provide high quality care and continuity, look after self and each other, value contributions from team, play to strengths" Tim Walter

2. Staff changes 1 Dr P Brooke left to work as Clinical Lead, in Solihull Care Trust Dr C Chandler leaving next week to enjoy time with her family, and possibly move to USA Sally Sutton left to move closer to family Christine (PN) left practice last month

3. Staff 2 Dr Angus Tallini joined a fortnight ago to replace and extend sessions of Dr Brooke Dr Sarah Hall joining in 2 weeks time to replace and extend sessions of Dr Chandler Emma Macpherson joined as practice manager 2 months ago Dr Yasmin Al-Sam joined as GPR 2 months ago for 1 yr Kate Ronaldson joined 1 month ago as GPN trainee

4. Staff 3 Net effect is that we expect to have expanded our appointments by about 3 sessions (half days) per week when all changes made Wait to see effect on appointments

5. Our aims for 2008-9 We recognise there is a lot of change happening within the practice so although we continue to strive towards future development, part of our aim is to consolidate our current position to enable us to have a stable platform to move forward in the future.

6. Access 1 Continue to develop the Advanced Access system. We have recently implemented a joint GP and Nurse practitioner service in the morning every day. This successfully provides AM (and PM) access for any urgent care, as well as an overflow for people unable/unwilling to wait for routine appts. We recognise this is part of the solution only (and stressful for us as it stands)

7. Access 2 Duty doctor is freed to do early phone calls and emergency visits before starting surgery More appointments coming on stream with doctor replacements Plan to review this at Practice Evening meeting next month

8. Develop as a Learning Organisation Medical Student day in July Comments Patient involvement Plans Plan/implement GPN training Kate Early pilot for all GPN Training Exciting development for us and region

9. Leg Ulcers Agree initial assessment protocol for new leg ulcer patients Invite Tissue Viability Nurse for talk to PHCT Audit Initial assessment protocol implementation and agree co-ordinated Rx approach.

10. CDM Monitoring Aimed at people who don’t normally attend Initiated blood test monitoring protocol triggered by prescription issue Ideally redundant Safety net

11. COPD PBC initiative To improve care and prevent admissions Treatment packs Early response Physio Staff education

12. Nursing Homes Argyles Paradoxically neglected population Consolidate care with regular ward rounds Pro-active rather than reactive

13. Signposting Agreed with PPG the need for more and clearer signposting for patients. Initially external signposting to MIU 14-21 etc in PPG newsletter Later - Consider internal signposting to services Later - Consider further disease specific information packs

14. Elderly Care NECAAP Newbury Elderly Care Admission Avoidance Plan Financially driven But Care Focussed Dedicated Community Elderly Care Consultant Regular Group Meetings Co-ordinated Approach

15. Screening Alcohol consumption Weight management (continuing the “Greenham Project”)

16. Gifts (from patients via PPG) Fetal Dopplers Height measures Scales Portable Spirometer

17. Text Messages Currently trial to see effect and cost Issues about confidentiality etc Text sent direct to your mobile before Appt Initially plan to test it with pts on methadone (approximately 600-700 appts/yr)

18. New Staff Review their skills and interests to integrate into the team Important to recognise there is a huge workload starting in practice They bring both skills and enthusiasm Refresh our knowledge stills and attitudes

19. Summary Busy year so far Consolidation Moving forward Thankyou