PPG Meeting February 2nd 2017 @ 10.00am
Attendees:
Gloria Twidal             Tabitha Koroma 
Sarah Flynn                Lynn Hardman 
Karen Andrew            Peter Hardman 

Apologies:

Tim Mason                   Janet Mason
Carol Lynch                  David Birks

Agenda :

1.	Practice Leaflet 
2.	Radio Streaming
3.	Telephone Triaging update 
4.	Tender 
5.	Wait for routine appointments 
6.	Patient Partner telephone triage system 
7.	Any other business 

Practice leaflet:  will defer until next meeting

Hospital details: permission was given by Mr Birks to track change of address information on the hospital system – all was changed accordingly 

Radio streaming:  radio license has being purchased; we are just awaiting support to get it up and running.  The screens will also have surgery information and these can be regularly updated – hopefully this will be sorted today.

Telephone triage:  this has been improved and is quicker 

Christmas jumper day:  £177.55 was raised for Save the Children 

Kath Howlett:  Nurse Kath will be starting with us officially on the 2nd March and will be with us two days a week Weds/Thurs.

Patient partner telephone triage programme:  We will be trialling a new telephone triage system for the next 12 months – this will run for 24/7 you are able to book appointments/ order prescriptions etc.

We will check how many appointments patients are able to make at the same time.

AOB:  Claire our clinical pharmacist came into the meeting to answer Tabitha’s questions regarding medications:

Medicine waste how does the surgery check the repeat prescriptions of patients against what they still need or no longer need?

Check: - Majority of patients order via community pharmacy, which has the following benefits:
-	Managed repeat system 
-	Healthcare staff at the pharmacy follow the pharmacies individual policy for managing repeats – White Paper 2008 – on delivering pharmacy, and the NHS England Best Practice Paper  “Pharmaceutical Waste Reduction in the NHS”

For the patients that do not order through a community pharmacy those over 65 and housebound patients are allowed to order over the phone, the reception staff are trained to order the medication requests and not to accept “everything”.  All other patients must order via the repeat slip that is in reception – patients are asked to fill this in with their medication request.  Reception staff then select the medication, if on repeat this is issued to the patient: repeat medications are authorised for 6 months.

Review:  After 6 months patients get an interim review, patients have a yearly medication review in house, although patients are brought in to discuss specific things in line with current guidelines or are contacted by the Clinical Pharmacist via the telephone.

Acute medication –this is done as a request by reception staff - the request is then actioned by the pharmacist/GPs.

Where a patient has been initiated on a new medication this is usually monitored (i.e. anti-hypertensives) and after checking an appointment has occurred and the medication is appropriate for the need of the patient,

Shared care medication – (see below) This medication is kept on a patient’s acute list – this is because these medications need close monitoring before reissuing to a patient. A number of checks happen before the prescription is generate which depends on the medication in question 

Past medication that the patient is no longer taking is assessed on a need basis upon patient request.
-	Short courses, with a request to book in for a review if no improvement i.e. eczema treatments: this allows for self-management of certain conditions

Interface is the phrase used between transfer between general practice and hospital and vice versa

Hospital Clinics
-	Letters are written following the clinic appointment
-	Clinic letter is checked against patient record
-	Discuss with patient anomalies
-	Urgent prescriptions are given by the hospital to be dispense at the outpatient pharmacy

Outpatient requests 
-	A treatment request to GP.
-	These are non-urgent (within 5-7 days)
-	Clinical Pharmacist adds on or discusses with GP if problematic

Discharge letters 
-	Clinical Pharmacist checks and updates medication changes
-	Then passed to GP to review hospital attendance 

Red drugs – Hospital supplied –practice is not always aware, add to hospital record on Emis as letters arrive – unfortunately this is reliant on hospital information

Amber – Shared care medication – initiated by hospital and request to GP to continue to prescribe and monitor patient – these items are kept on acute to allow for monitoring 

Interaction with pharmacy – I work closely with the four main local pharmacies Boots, Coop, Lloyds and ER. They call us with problems, few but dealt with appropriately – generally by admin or practice pharmacist depending on nature.

The practice uses optimise Rx – uses evidence based medication choices on best practice to guidelines and the cost.

Commissioning – Postcode – Not for our area – all patients are treated equally depending on clinical condition – all medications Joint HERPC Formulary across Hull and East Yorkshire. 

Traffic light system:
Red – Hospital only – consultant led
Amber – Shared Care – initiated in hospital, supplied by GP 
Blue – Guideline led 
Green – Any place of care.

Outside of this needs evidence – by NICE (National Institute for Health and Care Excellence) provides national guidance and advice to improve health and social care
-	‘TA’ Technical appraisals 
-	Drug approved 
-	Generally cancer meds – trial based 

NHS England commissioning request for individual funding from consultant, GP may not have input in this due to expertise.

Date of next meeting 16th March 10am