Agenda

No

Note

1

Welcome and Introductions

Interim Chair, Eddy Shallcross, welcomed everyone to the meeting and thanked such a large number for attending.

2

Minutes from last meeting

The minutes taken at the last meeting of the Wirral GPCC Patient Council, held on 10^th December 2010, were agreed as a true and accurate record.

3

Matters arising

111 Call Centres – Following a recent headline in a national newspaper, there have been queries around the implementation of a single point of access for all appointments on the Wirral.  Dr Mantgani explained that the Wirral will not be a pilot site, as this scheme is not currently in line with the ethos of this Consortium.

Pathfinder – this Consortium is one of 9 sites in the Northwest that has been approved as a pathfinder.  This means that we will be able to start influencing policy and will be able to take on more responsibility prior to 2013.  Dr Mantgani, Dr Oates and Paul Edwards were recently invited to a reception at Downing Street for Pathfinder Consortia, where the Prime Minister was very positive about the opportunities that lay ahead.  It was very encouraging to note that this Consortium was the only one present that had already developed a Consortium Patient Group – all other Pathfinders were only in the very initial stages of developing a group. Dr Mantgani confirmed that one of the ideas behind the Pathfinder programme is to enable these groups to share good practice, and so this Consortium will be able to benefit from learning in other areas.

It was explained that the Wirral GPCC has no current plans to join with other Consortia, but that we will work together on the Wirral where it is appropriate to do so.  Our patient demographics are different to other areas of the Wirral, and we will need services that reflect what our patients need.

Portfolios – Dr Mantgani thanked so many members for returning their portfolios.  There have been many common themes for areas to improve – access to mental health, communication with patients between appointments etc.  It is important to bear in mind that some of the areas patients most want to change are not in the hands of the Consortium to do so, for instance, access to routine GP and Nurse appointments.  However, any suggestions and comments made at the Council can be fed back to GP colleagues and the body that will in the future be responsible for GP Practices (this will be the National Commissioning Board, and not GP Consortia).  Dr Mantgani explained that the local provider of counselling has been served notice on its contract, which gives this Consortium the opportunity to design the service that it wants from scratch, in line with the needs of its patients.  The decision to serve notice was taken because the provider was not able to meet the terms of its contract, and so patients were not receiving an adequate service.  Patients will be given opportunity to provide input into the development of the new service.

4

Consultation on the Public Health White Paper

Fiona Johnstone, Director of Public Health, gave a presentation on the government’s proposals for the Public Health strategy.  This presentation is enclosed with these minutes.  Key points are:

-          Public Health will become part of the Local Authority and will have a wide remit ranging from emergency planning, immunisation, health for 0 – 5 year olds and health promotion, such as stop smoking services

-          There will be a Health and Wellbeing Board, which will be a statutory body.  This will be led by Local Councillors, Social Services, Consortia and Healthwatch.  These will not come into full force until 2013 but we would like to implement this as soon as possible.  This will monitor how public money is being spent, and all will be accountable to this board.  The board will work with providers such as the 3^rd sector.  GPs will be on the board to ensure that any decisions taken are in the interest of Consortium patients as far as possible

-          The funding for public health will be ringfenced within the Local Authority until at least 2013. 

-          The Director of Public Health will provide professional leadership and will be held accountable by the board.  Fiona is a Wirral resident with a passion to improve healthcare locally.  Fiona will also be on the Wirral GPCC Executive Board to ensure that anything that the GPCC develops is in line with Public Health strategy – it is very important that we work together to ensure no duplication.

-          The board will be committed to reducing inequalities – this includes those that have a learning or physical disability.

-          The Board will be committed to openness and accountability

Patients may feed into this consultation by going onto the NHS Wirral website.  Fiona agreed to explore putting the consultation documents into One Stop Shops for those who cannot access the internet.

5

Prescribing of Gluten-free Foods

Helen Dingle, Prescribing Advisor, NHS Wirral explained the remit of Medicines Management: help practices to stay within their prescribing budgets (budgets have remained static whilst the cost of drugs has risen); advise practices on medications that cost less, but are more effective; help practices to identify patients that no longer need to be taking certain medication, ie where there is wastage.

One area for savings that has been identified is the prescription of gluten-free foods.  Patients that have Coeliac disease cannot tolerate gluten and can access gluten-free foods on prescription.  Currently around £250k is spent on these foods on prescription per annum on Wirral (across around 500 patients), and the amount prescribed per patient varies enormously.  NHS Wirral is currently proposing to standardise the amount available per patient, and to restrict the prescription of items such as pizza, cakes and biscuits.  The prescription of fresh loaves incurs a carriage fee of £30 per delivery to pharmacies, and this charge is passed onto the practice.  It has been suggested that this money could be best spent elsewhere.  Medicines Management is out to consultation on the following:

-          stop prescription of fresh loaves

-          restrict prescription of cakes, biscuits pizza to a standardised level per patient

One patient suggested that fresh loaves could just be obtained from the supermarket rather than pharmacies, using a voucher system, to cut out the delivery charge.  Helen explained that this approach was taken in Northampton PCT, where it required a significant administrative resource to manage.  However, Helen agreed that the PCT would look into this option.

Several queries were raised in relation to medicines management and it was agreed that the agenda of the next meeting would be dedicated to this topic.

6

Commissioning of Homeopathy

Dr John Oates gave a brief presentation to the Patient Council Members explaining that there was a requirement to consult with the community on the recommendation by NHS Wirral PEC not to re-commission a contract for homeopathic therapies. He explained  that NHS Wirral have been able to refer to a block contract with Liverpool NHS costing £37, 270, but that this would no longer continue beyond the existing contract lifetime, ie it wouldn’t be re-commissioned. This recommendation had been made because there was overwhelming support by GPs on Wirral that this therapy was not effective and that this was evidenced further by the BMA who questioned the benefits of this therapy, citing that Homeopathy only provided a ‘placebo’ effect. Abhi Mantgani at this point stated, ‘’£37,200 is a fly in the ointment compared to the overall budget, but that its not a question of cost, it is a question of whether it was effective’’. It was further suggested that the House of Commons had challenged PCTs to look into the effectiveness of Homeopathy as they felt the ‘placebo benefits’ were not effective enough to warrant continued funding.

At this point there were a number of comments from the floor where members of the Patient Council questioned this decision and personally validated the effectiveness of Homeopathy with references to the benefits some members of their family experienced. Dr Oates read out various articles that he had researched which supported the case against Homeopathy.

Although some patients requested figures on the total number of patients that use this service, and the benefits to these patients, the overwhelming support seemed to be to accept the recommendation not to re-commission.  Patients were advised that they can provide further feedback through the NHS Wirral Have Your Say mechanism.

7

Elections and Future Meetings

It was discussed at the last meeting that this Council will meet 3 – 4 times per year, but that there will also be a Patient Council Executive Committee that meets bi-monthly and is more of a decision-making group that sets the direction for the Council, and is the direct link with the GPCC Executive Board.  There will be around 8 – 10 members on this group, and Council members were asked to nominate themselves for these positions, by completing an application form (this is attached).   James Kay, Chair of NHS Wirral, will support the Executive Board in selecting the Board members.

8

Any Other Business

There was no other business.

9.

Date and Time of Next Meeting

The next meeting will take place on Wednesday 4^th May 2011, 6.30pm, Birkenhead Medical Building.