Upton Group Practice

                   

DRAFT MINUTES OF Wirral GPCC Patient Council Meeting

Tuesday 13th September 2011, 6pm

Nightingale Room, Old Market House

 

Agenda No

Note

1

Welcome and Introductions

Interim Chair, Eddy Shallcross, welcomed everyone to the meeting.

 

2

Minutes from last meeting

The minutes taken at the last meeting of the Wirral GPCC Patient Council, held on 4th May 2011, were agreed as a true and accurate record.

 

3

Matters arising 

HSJ Awards – This Consortium has been shortlisted for an award with the Health Service Journal.  We are one of six in the country to be nominated for Commissioning Organisation of the Year, which is a fantastic achievement and one for which we would like to thank our members and stakeholders.  The application was based on our commitment to engagement with our patients and practice members. A judging panel will be coming to meet us before the awards ceremony in November, and we would very much appreciate the involvement from our patient council members.

 

Meeting Dates – Since the last meeting, several comments had been received around the frequency of meetings.  It was approved by the Patient Council Executive Board that meetings will be held on a bi-monthly, rather than a quarterly, basis, with immediate effect.  A revised schedule of dates has been drawn up and will be issued to members.

 Action:  Christine to circulate meeting schedule.

 

Safety of Surgical Implements – The Patient Council Executive Board had written to Wirral Hospital Trust to seek reassurance around the safety of surgical implements, following a BBC Panorama programme raising concerns on this issue.  No written response had been received, but a representative from the Trust had rang the Consortium earlier that day to ask if the Council would like a representative to attend a future meeting.  It was agreed that a written report providing details of the safety measures in place would suffice, and that any further queries would be channelled back to the Trust through Christine.

 Action:  Christine to ask Trust to provide letter of reassurance around safety of surgical implements.

 

Physiotherapy and Podiatry

Dr Mantgani explained that currently physiotherapy and podiatry are paid for through a block contract, mainly with Wirral Community Trust, but also with Wirral Hospital Trust.  There have been some concerns around waiting times and whether block contracts provide value for money.  This has led to the Consortium commissioning services from another local provider to ensure that patients are not disadvantaged by access difficulties.  This is not viable in the long-term, and something needs to be done to address access issues as soon as possible.   Service specifications need reviewing to ensure that there are tighter controls around waiting times, and it is possible to monitor providers more robustly.  Latest guidance from the Department of Health suggests that these services can be provided on a cost-per-case basis, so that the money follows the patient.  This is called an Any Qualified Provider (AQP) process.  It means that, as long as a provider meets a set of standards set by the commissioners, and work to a standard service specification, they will be able to provide services to our patients.  Patients will have the choice at the point of referral as to which provider they would like to see.  Each provider will work to an agreed service specification and will charge the same tariff.  This will enable the commissioners to achieve better value for money, for patients to have more choice, and for new providers to enter the marketplace, at their own risk.

 

The following questions were raised:

 

Q:  will staff working for the providers have to meet particular standards?

A:  yes, we’ll specify the staff competencies in our service specification – ie providers cannot just use lower grade staff in order to save money.  In many cases there are national standards dictating the core competencies of particular staff members, and those that are required to undertaken particular procedures, and we would ensure that providers and their staff comply with these.  The Care Quality Commission also requires providers to meet minimum standards in terms of their buildings, policies, procedures etc.

 

Q:  is this being done just to save money?

A:  this is being done to spend money in a better, more cost-effective way.  That is, by not committing to block contracts, we are not paying for overheads and the provider takes all the risk in offering the service.  By paying for individual patients/ sessions, rather than a block contract, we can be assured that we are getting value for money. 

 

Q:  who will administrate all of these contract changes, as surely the GPs won’t have time / expertise? 

A:  the Consortium itself comprises a very small team who, along with the Executive Board and GP Practices, set the direction for the Consortium.  The remaining PCT staff provide the ‘back office’ support to enable us to take our plans forward – this includes support such as Finance, HR, Governance, Contracting etc

 

It was agreed that a diagram would be useful to show how the Consortium core team fits into the wider picture with the health economy.

 Action:  Christine to provide organisational chart for next Patient Council meeting

 

The service specifications for physiotherapy and podiatry still aren’t complete, and it would be very useful to gain the insight from any patients with experience in these fields, or who may like to provide input.

 Action:  Patients to contact Christine should they wish to get involved in designing these service specifications.

 

It was confirmed that the Patient Council is in favour of this direction of travel for Physiotherapy and Podiatry.

 

4

Update on NHS Reforms

 

Paul gave an update on the NHS reforms, explaining that the Health and Social Care Bill had been subject to some amendments following the ‘pause’, but that this didn’t radically alter anything for this Consortium, as most of the requirements are already in place.  For instance, the Consortium already has a Nurse member and lay members on its Board.  The Consortium is now working towards ‘authorisation’: there are certain standards and criteria that a Consortium needs to meet to demonstrate that it is ready to function as an independent organisation; many of these are concerned with demonstrating governance and accountability.  We will keep patients updated as to our progress, and as and when any amendments or further guidance is received from the government.

 

5

Community Equipment Service

 

Jane Hayes-Green gave a presentation to the members on potential service redesign of the Community Equipment Service, which is provided by Wirral Community Trust.

 

Currently there is excellent feedback in relation to the service, but it is consistently overspent and does not provide value for money.  For instance, there is no tracking system for the equipment, and there are significant overheads within a block contract. 

Suggestions made by / agreed by the Council were as follows:

 

-          the service should only deliver bulky items / to patients who have mobility difficulties or lack of transport – equipment should be collected by the user wherever possible

-          all equipment should be labelled with the name of the service and a telephone number, to encourage returns

-          used / unwanted equipment could be returned to one-stop shops

-          nursing / residential homes should be fined for not returning equipment

-          choice of items should be limited to a few options only for each item (at the moment there is a vast catalogue of choice)

-          the service could send a letter to the user each year to see if they still need the equipment, and ask for it to be returned if not

-          a tracking system needs to be introduced as a matter of urgency, perhaps by barcoding the equipment

-          there should be no means-testing, and no minimum limit on the cost of equipment supplied (eg we should not ask patients to buy equipment that costs less than £50)

-          all orders over £1k should be approved by a senior member of staff (the service specification would set timeframes for approval to prevent this delaying supply of equipment)

-          if a patient moves out of area for a specific period of time (ie a child going to university), the service should not supply a duplicate set of equipment (this should be supplied by the health authority in the new area).  Duplicate equipment should only be purchased if the child lives predictably between two homes, eg if parents are divorced.

 

Dr Mantgani explained that a similar process of redesign is taking place for the Surgical Appliances service within the Hospital, and we are proposing to commission this in a different way in order to achieve better value for money.

 

The Members were thanked for their contributions, and Jane advised that she will come back to update the members and also to present further items of service redesign.

 

6

Personalisation

Peter Tomlin, Principal Manager for Birkenhead Locality, Department of Adult Social Services, gave a presentation on personal budgets. 

 

The following points were raised:

 

-          the main aim of personalisation is to offer more choice and control to patients as to how social care funding is utilised; the coalition government is committed to the principles of personalisation, and there are intentions to roll this out to health budgets, too

-          the Council sets the criteria for how personal budgets may be spent; patients will carry out a directed self-assessment, rather than applications being assessed by the Council along

-          if someone does not have the capacity to manage / spend their budget, or does not wish to, then someone will be identified to safeguard the budget.  If the money is not used appropriately, the money will be reclaimed by the Council

-          there are proposals for introducing pre-payment cards so that expenditure may be more easily monitored, and to reduce bureaucracy as no invoices will need to be submitted / approved

-          if there are any concerns as to how a nominated advocate is using the money on a patient’s behalf, someone independent will be introduced to the process

-          if money is not used, for example if someone is in hospital, this would be monitored through the pre-payment card and any money not spent will be clawed back

-          there are two nominated brokers who offer a brokerage service for the Council, and these are both funded through voluntary grants

-          money is allocated through a means-testing system, initially through filling out a form, then through a visit

-          there is no legal obligation to insist that all providers are CRB checked (as there is a worry that this will preclude family members from carrying out care); however, the Council strongly advises that any external providers selected have a number of quality standards in place, including CRB checks

-          The Council needs to do more to support users regarding budget management – this is being developed

 

Any further queries in relation to personalised budgets should be directed to Christine who will pass these to Peter.

 

7

Any Other Business

Mr Parsonage asked for patients’ views on providing patients with a printed summary of their GP consultation, in order to ensure they understand and comply with the information given.  It was agreed that whilst this is a good idea, it would prove too costly and time-consuming, and equipment would be needed to do this instantly, eg digital Dictaphones that could e-mail a copy of the consultation to the patient.  However, there may be governance issues associated with this if the transcript is not accurate.

 

Patients asked for an update on the proposal to relocate oncology (cancer) services to Liverpool, and also on the proposed vascular review.  Members would want to take part in any consultation taking place on this issue.

Action:  Paul to find further information on this consultation process and send to members as soon as possible.

 

8

Date and Time of Next Meeting

The next meeting is due to take place on the 22nd November 2011,6.30pm, Old Market House.

 

 
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Last modified: 30/01/2012