South somerset healthcare federation

South Somerset Healthcare Federation
Minutes of Federation meeting held at Queen Camel Surgery
15 October 2013 at 7:00pm

In attendance
Dr Orla Dunn
Consultant in Public Health, Somerset County Council
Dr Iain Phillips (Chair)
Apologies: Dr Lindsay Smith, Margaret Gulliver
Dr Orla Dunn gave a presentation detailing the health profile of Somerset as a whole, South Somerset Healthcare Federation and individual practices. A copy of this presentation is attached with these minutes. Respiratory disease – especially asthma (adults) Obesity – children in particular Alcohol and drug related admissions (some practices) Increasing numbers of patients dying in their own home Self-harm/mental health Health checks in most deprived areas LW will find out if the alcohol pathway is on the navigator app.

Dr Orla Dunn left the meeting
Health Forum - It was noted that the Diabetes event was poorly attended by
members of the public. The next event (Asthma) will be held in January. It was
agreed that the time of the event should be changed to the day time to encourage
greater attendance, particularly considering the time of year. It was also
suggested that invitations should be sent to specific patients rather than a
newspaper advert.
LW will ask informatics team to help identify patients that have been admitted with
asthma related problems.
QP update on materials – The leaflets will be distributed shortly. LW is waiting
for a proof of the shared decision making cards. Funding has been agreed for
10,000 cards.
The Read code for provision of Shared Decision Making information is 8CL. URGENT CARE REPORT ACTION PLAN
The next step in reducing inappropriate A&E attendance is for practices to help
A&E to redirect patients back to primary care. IP asked if practices would be
willing to see patients referred by A&E Triage Nurse if they have attended
inappropriately. All practices present agreed to support this. IP will look further into
the detail.
Escalation planning -PS offered to share a sample practice escalation plan and suggested all practices might like to write/review an escalation plan for themselves ahead of the winter. SYMPHONY
JL thanked practices for responding and confirmed that all 17 practices have agreed to support the principle of the project. Practical support is now required to help get the project off the ground. It was suggested that a regular locum that can regularly back fill a GP would be helpful and might include more than is done by an ad hoc sessional GP. AR would be able to help with this in the New Year to allow the GP protected time. It was noted that practice manager time would also be valuable. JL asked for
support at a meeting on 7 November at the Yeovil Innovations Centre. IP, LB, RM
and IB volunteered to attend this meeting with JL.
Details have been sent to practices via email. The principle is similar to PGP with
the focus on quality and safety. There is £10k of funding for SSHF which will
enable a couple of practices to be involved. Attendance at meetings will be
required, one day per month for five months and must include a nurse, GP and
administrative member of staff. Changes will need to be put in place following the
meetings that will demonstrate an improvement in quality and safety. Information
must then be fed back to the rest of the federation. Langport, Martock and
Milborne Port expressed an interest. LW will ask if there is a rough idea of how
much time will be required to implement the changes.
Footcare pathway - IB will email practices with information to see how practices
want to take this forward.
Local diabetic sessions – IB attended a meeting with Su Down & Diabetes UK
where he was able to make contacts which may facilitate the development of
support groups for diabetic patients. The next step is to identify venues outside of
Yeovil suitable for these sessions.
AS has spoken with Kate Brookman who is keen to meet up to discuss the perception of problems with admissions. It would be useful if practices could look at weekly/daily data for admissions for 1 day or less that are linked to COPD or other respiratory problems. LW suggested looking into whether the patients have rescue medication actually in their home that is ready to use. CANCER LEAD UPDATE

10.1 Nurse pilot - One nurse has dropped out so there is now a space available. AR
asked any interested parties to contact her as soon as possible as there is a meeting on Thursday afternoon. The course is due to start in January. 10.2 Part of the nurse pilot education will involve patients that can talk to the nurses about their experience with cancer. If any doctors identify patients that may be suitable for this please would they find out if they would be willing to help; 8 patients will be required to cover all of the sessions, ideally including a terminally ill cancer patient.
10.3 Significant event pilot - £125 back fill is available for GP’s willing to attend a
meeting with YDH in order to gain feedback from both perspectives. Any interested GPs should contact AR. Practices may also be approached by AR as YDH have also been asked to identify suitable patients for the pilot. PRESCRIBING INCENTIVE FROM 2012/13
11.1 PAM – If there are any queries regarding the budget your practice has been set 11.2 Somerton, Langport, Westlake (Cox), Preston Grove and Abbey Manor are all at the top end of the Cephalosporin prescribing table which we should be trying to reduce to avoid C Difficile infections. 11.3 There have been concerns over the nasal flu vaccine containing pork gelatine ingredients. Use of this substance in vaccines has been approved by representatives of the Muslim and also the Jewish communities. 11.4 Practices need to order in Fluenz for at risk children from the ages of 4- 17. Practices are able to claim for broken boxes of Fluenz vaccines up to a maximum of 9 doses should this be necessary. 11.5 Shingles vaccine – please do not give this to anyone outside of the age 11.6 Practices should be aware that solicitors are targeting patients that may have been given the wrong medication in hope of a compensation claim. 11.7 Catheter formulary – after a patient has been discharged, if a request is received for a retrospective script, do not process this as it should have been requested before the product was delivered. This applies to dressings also.
11.8 MH will email practices with an updated list.
11.9 Applications need to be in by the end of December to spend the prescribing
incentive. The federation has £44k to spend. It was suggested and agreed by
those present that this should be invested in the Symphony project. JL will contact
Paul Goodwin about this.

12.1 JW reported on the year to date financial position of the Federation.
12.2 JW requested that invoices are submitted no later than two months from the
incurred costs. It has been strongly suggested that we will not be allowed to carry funds forward and quarterly progress reports are required to show how funds are being spent. If funds are not being used as planned, the Federation may seek agreement from CCG re-allocate in year, if not spent they may have to be returned. ANY OTHER BUSINESS
13.1 Please would practices read through the musculoskeletal physiotherapy pilot proposal provided and feedback their thoughts to LW? 13.2 A Local Choices event has been organised and is due to be held on 6 November 6-9pm at Huish Episcopi Academy in Langport. The event aims to share information on local services. IP, LW and JW will attend. 13.3 There were concerns that district nurses are only going to provide flu vaccinations for patients they see regularly and it would not be clear who has or has not received their vaccination. LW will seek further information on this from Bernie Edwards. UPDATE: LW has emailed practices with a response from Mary Martin stating that district nurses have been asked to print off their case loads and discuss with the GP which patients will/will not be vaccinated by the district nurses. DATES OF MEETINGS

3 December 2013 – Wincanton Health Centre (includes CCG governing body visit)


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