Attendees

Graham Hall (Chair), David Owen-Smith, David Burn, Richard May, Dr Kerrin Masterman (For first part of the meeting), Douglas Dalrymple, Emily Norton, Kim Morgan, Gene Webb

Apologies

Dr Rob Russ, Marcus Lapthorn

1. Welcome

2. Minutes of Previous Meeting

Minutes of previous minutes were accepted and signed off by GH

3. Practice and PCN Related 

3.1 PCN update from Dr Kerrin Masterman

• Baseline legal agreements are in place. Building of trust between the two Practices is going well
• Agreement for the internal sharing of patient data is being worked on. The object is to achieve a consistent basis for accessibility, while keeping each Practice’s records separate, i.e. not merging the record for the whole PCN. Data workshop planned for next week
• Workforce agreements between the two Practices are already in place
• It is expected that patient awareness of our A420-based PCN will become progressively apparent after about one year from now
• It will probably take 12-18 months for patients to notice real practical differences, due to the way the availability of funding staggers the recruitment process
• The creation of an Intranet facility is planned for the sharing of Practice policies and procedures

Two new PCN posts have been funded for this year, on a shared cost basis:

• Clinical pharmacist - hard to find, so initially, may need an agency recruit
• Social prescriber – to further the integration of wider social care with medical care. Maybe some occasional home visits but is not the same service as district nursing

New posts planned for 2020:

• Physician associate
• Diagnostic physiotherapist

Likely Future Developments Under Discussion

Currently, there are 19 PCNs to serve Oxfordshire and there are moves to divide the delivery of large-scale services (e.g. out of hours, extended hours, district nursing) into three regions - North, City and South, each with about 250k population. Each of these regions would have 6 or 7 PCNs. Above these may sit the Oxfordshire Care Alliance (OCA) which may be made up of Oxford Health and the Federations. These would then sit under the Bucks/Oxon/Berks Integrated Care System (BOB ICS). This should be thought of as an amalgamation of the three counties’ CCGs. This is certainly not yet set in stone and there is a lot of ongoing negotiation about the matter. If enacted, it would see the end of CCGs and Localities. Nevertheless, ICS is definitely coming and is the new model to which the NHS is working, with the aim of integrating Health and Social Care on a larger scale than individual CCGs.

Having completed his presentation, Dr Masterman left the meeting, as had previously been arranged.

[Kerrin has since provided a hypothetical schematic diagram of how the Integration of Primary & Community Care in Oxfordshire, might look. It is attached to these Minutes. GH]

WHMP Practice Related Matters

3.2 GH to arrange a meeting with the Botley PPG. Before that, he will have an initial meeting with Sylvia Buckingham, their Chair. The purpose of both meetings is to enable the two PPGs to get know one another, to exchange details of their present activities, and to develop trust and understanding between them.

3.3 Angela Sammut will be Practice Manager (Admin), starting early October. She is ex-RAF, having been a practice manager at a helicopter base and more recently, serving at Brize Norton.

Recruitment is underway for a Finance Assistant. Possible candidate is at present Finance Manager in an Oxford-based charity.

Ann Sadler will remain in post for handover to Angela and to perform the Finance task until separate appointment has been made. D O-S expressed his thanks for her help and expertise in practice management. D O-S emphasised the need to maintain a clear accounting distinction between the responsibility for money in and money out.

Recruitment for additional reception staff is in progress.

Team leaders for each section are being put in place. Team Leaders will meet regularly with the Practice management and relay news and developments to their respective teams. Likewise, Team Leaders will gather the concerns of their team members and feed them back up the line.

3.4  No new housing developments.

VWHDC, now in LibDem control, has not adopted the Local Plan Part II. Implications of this and for Part I, are as yet unclear.

4

4.1 CT Pet Scan

• SW locality have formally lodged a protest about the plans
• GPs and Drs have written individually to Ed Vaizey, MP. SWOLF Chair has also written letters.

4.2 Flu Vaccinations

• Appointments can be made now for 28/09/18 only by Over 65s
• Announcements will be made when the vaccine is available for other groups

4.3 NHS App, EMIS plan for patients’ access to their own medical records

Currently, there is insufficient information to understand NHS App uses.

Rob Russ advised via DO-S, that he had recently attended a conference in Oxford by the South West Commissioning Support Unit (SWCSU) and NHS Digital Thames Valley. There are clearly lots of ideas about how access to technology might improve patient access to, and quality of, the healthcare they receive. There were few details given and it will be a long process. There was a lack of clear direction although lots of ambition. It was recognised that a significant barrier to change is the very dated IT equipment in primary care in Oxfordshire, which was worse than any other in the region. WHMP have, for example, at least 4 PCs in the building and in use, which are out of warranty at present (it may be more). The update to Windows 10 has been delayed to 2021! Until this is solved, we are doing our best but struggling somewhat. There is also the issue of the need for a common coding system (hospitals and GPs currently use different medical coding systems). This may change soon but was scheduled to have been unified 2 years ago! Few of the disparate NHS systems communicate in way that easily allows a thirdparty’s software to collate and compare information.

There is some progress. WHMP has signed up to a local trial in November with new software to help better use, understanding, and hopefully to influence the development of patient diagnosis and treatment pathways, in secondary care. We are the only SWOL Practice to do so.

In the interim, Rob Russ could personally use some feedback from patients. Can the PPG consider asking patients to try the NHS App, and let us know what they think? He would like to know what patients think WHMP might be able to do through the App that could help them. This should help focus resources towards relevant solutions, not solutions for solutions’ sake.

EMIS controls patient information system for Oxon and it is not currently possible to change this.

As mentioned above, Rob would like feedback from anyone re: NHS App.

There is an outstanding issue regarding the merging of the former Fernhill patient data with those of WHMP. This is to be investigated, because it restricts full WHMP patients’ access to their own medical records. N.B. The above notes in black were made at the meeting. The information in red was provided later by Rob Russ to DO-S and then inserted by GH.

4.4 WHMP Website

Noted that increasingly, people do look at websites. However, there are no current plans for changes. DO-S emphasised the importance of ‘getting the words right’. He would like a unified approach to be developed, which would include all marketing aspects. Maybe we will work with Botley on this, in the future.

4.5 Recent of planned WHMP service changes

No recent or planned changes to patient services. Becky Eyre will be Team leader for the Practice nurses. Alyson Lee will be Team leader for the salaried GPs. The Team leader for the Patient Services team is Holly Green. The Team leader for the Receptionists and Admin staff is yet to be appointed.

4.6 Dispensary Issue

There was some discussion of the issue raised by Paul Eddy. The matter is being dealt with by the Practice.

5 Team Updates

5.1 NAPP

Conference Report was circulated. EN and RM enthusiastic about some of the initiatives which other PPGs are pursuing.

5.2 NAPP monthly Bulletin

PPG members confirmed they would each like to receive the monthly NAPP Bulletins. It was agreed that each issue should be circulated by the Practice, as before. [Since the meeting, EN advised user name and password to access the Bulletin are: ppgwhitehorse@yahoo.com This is for the use of PPG members only. EN email of 04/09/2019 refers.]

5.3 SWOLF

Draft Minutes of the last meeting were circulated at the end of July

5.4 Dementia

Following Age UK’s widening of the remit of the group and renaming it as ‘Dementia Support Group’, EN reported that there had been no increase in its membership, as a result. There are 7 couples who attend on a regular basis. EN will press for the reinstatement of the original name, i.e. Memory Support Group.

Douglas Dalrymple mentioned the Dementia Adventure Charity and would provide more details to EN.

5.5 Mental Health

Nothing to report.

5.6 Living Wills

GH circulated a sample of a Living Will/Advance Decision and a set of explanatory notes on them. DO-S and the Practice recommend that the Health and Wellbeing version of a Lasting Power of Attorney (LPA) should be used. In their view, Living Wills were not legal. However, the NHS site indicates they are legal - no doubt subject to their having been drafted according to relevant legal precedents and properly witnessed, as are those which GH circulated. See https://www.nhs.uk/conditions/end-of-lifecare/advance-decision-to-refuse-treatment/

GH said that the Advance Decision he circulated had been drafted by the Society of Will Writers and is one of three versions currently in use by their will writers to cater for differing medical needs. However, it seems that until personal medical records are accessible by any accredited medic or organisation, especially in the case of need for emergency treatment, the provisions of any Advance Decision or LPA will be of limited usefulness.

Living Wills/Advance Decisions are to be mentioned in the Autumn issue of Healthy Times (page 6).

5.7 Healthy Times

• To be issued 13/9/19
• DB to arrange for named bundles to be prepared and made available for distributors to collect from the Practice
• Web versions to be published after 13/9
• Spring 2020 issue will be available around 12/4/2020, in time for Easter

5.8 The Nasio Trust

• No clinicians have yet volunteered to serve in Nasio’s Medical Centre at Musanda, in Western Kenya. WHMP would need locum staff at the same cost to cover absences. WHMP’s status as a Training Practice might widen the source for volunteers.
• ‘In date’ medication can be taken to the Dispensary, who will decide whether it is suitable for use by Nasio. A Nasio trustee will collect them periodically and arrange for them to be forwarded to its Medical Centre, in Musanda, Kenya. Nasio will provide the person carrying them with appropriate documentation for Kenyan Customs.

6 AOB

The Oxford City PPG Forum is holding a meeting from 12:00 noon to 15:30 on 17 September, at the West Oxford Community Centre, Botley Road, OX2 0BT entitled, ‘Winter Is Coming: Is Your Primary Care Network Ready?’ [ I was informed at the SWOLF meeting on 17/09 that this meeting had been cancelled because of lack of support. – GH]

7 Next Meeting

The next meeting will be 18:30 on Tuesday, 3 December 2019. 2020 dates are: 03/03/2020, 02/06/2020, 01/09/2020, and 01/12/2020