[ Contents | Search | Post | Reply | Next | Previous | Up ]
Name: HARLOW PCG
Date: 28 Sep 2000
Time: 17:57:05
HARLOW PRIMARY CARE GROUP
OPEN PUBLIC BOARD MEETING
THURSDAY 7 SEPTEMBER 2000 MINUTES OF THE OPEN PUBLIC BOARD MEETING HELD IN THE COUNCIL CHAMBERS, HARLOW COUNCIL, TOWN HALL
Chairperson: Dr Cliff Bishop
Present: Dr Cliff Bishop Sally Gorham Peter Pearson Dr Arvind Chhibber Rita Cutts John Wright Irene Jein Dr Rob Gerlis Dr Mukesh Rajani Dr Hassan Khimji Matthew White Dr Trevor George Apologies: Cll. Roy Collyer Fiona Gilmour Dr John Portelly In Attendance: Dr Kate Tully Alan Cudmore Carol Sizeland Pam Hicks Dawn Poon Anne Reeder Paul Wrighter Jan Dixon
ACTION 77/00 THE HARLOW MACMILLAN GP FACILITATOR PROJECT Rita Cutts presented the draft proposal which is aimed at developing cancer and palliative care provision by recruiting a GP Facilitator funded by Macmillan (2 sessions a week) on a three year fixed contract for the Harlow locality. The proposal has been developed by Dr Kate Tully and Rita Cutts following discussions between the PCG and Jane Loughlin, Macmillan Service Development Manager. Dr Rob Gerlis raised concern about the level of funding when the role is a administrative role and not clinically lead. It was agreed that this should be considered when the job description is prepared. Rita Cutts confirmed that at the end of the 3 year period there was no expectation that the PCG/T would be required to pick up the cost of the post although if effective this is something which the PCG/T may wish to consider at that time. Members agreed to formally support the proposal. 78/00 MINUTES OF THE MEETING HELD ON THURSDAY 6 JULY 2000 The minutes were agreed as correct record subject to the following amendments: Walk-in Centre: page three, first paragraph, last sentence, Should read ‘It was noted that systems were in place through Centramax to confirm that patients understood the advice given to them. It was also agreed that further work in this area was required.’ Make a Difference to Harlow Event, last sentence,Should read ‘ healthy eating’ Verbal Declaration of Interests By Board Members It was formally noted that Matthew White was present at the meeting and had provided a verbal declaration, as detailed in the document attached to the previous minutes. 79/00 MATTERS ARISING 62/00 Winter Plan Anne Reeder reported that the first draft document had been submitted to the Health Authority for approval by the Regional Office. 58/00 Walk-in Centre The official Ministerial opening has been postponed. No alternative dates have been provided at this stage. Anne Reeder reported that following the recent recruitment process one nursing post has been filled, however the centre is still under staffed and more posts will be advertised to ensure that the right calibre of staff are appointed to the centre. Following the opening, the nurses have identified additional training they will require i.e. ear syringe. They have also asked to shadow professionals in Primary Care. Dr Arvind Chhibber informed members that as part of the Walk-in Centre reporting process the PCG/T will be carrying out a detailed audit on patients attending the centre and requiring a referral for further treatment within primary or secondary care. AC/AR Dr Hassan Khimji was concerned about the number of patients attending his surgery requesting urgent appointments following a visit at the Walk-in Centre. Dr Cliff Bishop explained that the nurses have a policy that for all patients requiring to see their GP urgently the Walk-in Centre Receptionist will contact the surgery directly to arrange an appointment. Anne Reeder to ensure policy is being enforced by staff at the Walk-in Centre. AR 69/00 Declaration of Interests and Hospitality Members not present at the previous meeting were asked to make a written declaration, which was attached to the minutes of the previous meeting. 10/00 Response from Mental Health Medical Staffing Consultation Following the consultation period the PCG has received a formal response from Essex and Herts Community Trust. As a consequence of the consultation, a number of improvements to the proposal have been made, which include: The appointment of two full time consultant posts for Harlow. This will provide additional clinical sessions for Harlow. The proposal indicated that Junior Staff problems are resolved within the plan by having a Herts and Essex based SHO working with Professor Katona. Dr Hassan Khimji was concerned as to whether Professor Katona would be able to support this role, however Dr Mukesh Rajani stressed that this proposal had been considered in great detail and appropriate support would be provided. 80/00 WAITING LIST PERFORMANCE FUND Sally Gorham reported that all practices in the Town had formally written to the PCG confirming their agreement to participate in the initiative. 81/00 ADDITIONAL FUNDS FOR WINTER/INTERMEDIATE CARE West Essex has been successful in its application for additional funds for Winter/intermediate Care. West Essex has received a considerable amount of available funds, which have been targeted in the following areas: · Transfer of resources to Social Services to top payments for both residential placements and domiciliary services.· Creation of additional assessment capacity to overcome recruitment difficulties for Essex Social Services.· Financial support for the existing Harlow Crisis Intervention Team· Increase the overall capacity for domiciliary care schemes through the NHS employing Home Care Assistants.· To set up a transitional unit for delay discharge patients who are likely to need residential care whilst the assessment is completed.· To spot purchase temporary residential care places when the Transitional beds are full. Dr Mukesh Rajani asked whether Essex Social Services would consider differential rates for Nursing homes, were it is apparent there is higher costs associated to running the home. Peter Pearson was concerned that this would lead to increase charges overall across Essex. PP 82/00 PCT PROGRESS REPORT Announcement on the appointment of PCT Chair and the appointment of non-executives is expected shortly. The Management Team has established a working group to manage the processes required for establishing the Trust. Dr Rob Gerlis asked whether consideration had been taken on the process of appointing the five GPs to the Executive Committee. Sally Gorham explained that a paper was being prepared for the PCG Board away day, which outlined the process to be followed. The process can not take place until the Minister has appointed the Chair. The Board will have three professional members, one who would be the appointed Executive Chair, of the three it is expected that there will be both a nurse and a GP SG 83/00 FUTURE MANAGEMENT OF SPECIALIST SERVICES Following a meeting of the Transitional Leadership Group it has been agreed that the management of Specialist Services would transfer to Epping Forest Primary Care Trust from April 2001. The decision was taken following consultation with Staff and their preference towards Epping Forest. 84/00 SECRETARY OF STATE’S APPROVAL TO CREATION OF SINGLE MENTAL HEALTH TRUST FOR NORTH ESSEX Approval has been agreed for the Trust to be established and the region is currently in the process of appointing the Chair and lay members. 85/00 PERSONAL MEDICAL SERVICES (PMS) One practice has declared an interest in becoming a PMS from April 2001. 86/00 PUBLIC HEALTH PROVISION TO PCG/Ts The Health Authority have now taken the view that PCG/Ts will access public health expertise from a central resource which will be based at North Essex Health Authority. This will include medical consultant, other public health/clinical expertise and a full range health information from the Health Intelligence Unit. Each PCG/T will also have a link person allocated who will ensure a full service is provided. Pam Fenner will provide the links for Harlow Primary Care Group with immediate affect. Sally Gorham confirmed that Keyvan Zahir would remain with the PCG until such time that all posts within the Directorate had been recruited to. Members felt that the PCT would need to monitor this to ensure that provision was provided, as historical Harlow has not received appropriate support from the Authority. SG 87/00 CONSULTATION DOCUMENTS Sally Gorham circulated two consultation documents for members comments. Draft responses to be considered by the Board at the next meeting:· Age Matters, consultation on services for older people Public meeting to be held on Monday 11 September 2000.· Future Provision of Cancer ServicesConsultation starts today, with a public meeting on 12 October 2000. There would also be an opportunity for stakeholders to meet with the proposed Management teams. ARRC Sally Gorham proposed that the Board do not take any formal view on the cancer document until after the public meetings to ensure public views are addressed in our responses. Members agreed this. AR/RC 88/00 PRIMARY CARE TUTOR The Primary Care Group have successfully appointed Margaret Hutt to the post through partnership with Anglia University. Her appointment will be a joint post between Harlow and Chelmsford PCG. Dr Mukesh Rajani and Dr Rob Gerlis raised concern that she was not a grass route General Practitioner and would not necessarily understand the needs of GPs. Rita Cutts and Sally Gorham reassured members that Margaret had a great deal of experience of working with GPs and that had demonstrated that she had the skills and experience to meet the requirements of the post. Rita Cutts advised members that the PCG were in discussion with the Post Graduate Deans office about using the half year under spend in their budget to access additional time for the remaining 6 months of the year. Sally Gorham assured members that the joint appointment would not disadvantage Harlow despite the fact that Chelmsford has better facilities. 89/00 CLINICAL GOVERNANCE REPORT The Risk Assessment Toolkit, which was developed in partnership with HRRI and three practices, will be rolled out to all the remaining practices by the end of September with the evaluation being completed by October. In preparation for trust status a ‘risk management group’ as a sub group of the clinical governance committee is to be established using the expertise of individuals within the community trust and the PCG to bring together the issues relating to risk assessment for both primary and community care. RC The newly formed ‘Education, Training and Development Forum’ recently met for the first time. The aim of this group is to provide an opportunity for key personnel from PAHT and Harlow PCG to meet together to consider the potential of joint working in relation to this area. The TEC Training suite is near completion with the first group of staff enrolling on the course. This has also been extended to the Harlow Community Trust Staff. DP All practices have now had their GPnet connection upgraded to the North Essex wide project. In the first phase this provides each practice will a standalone PC that will supply access to staff who has completed a half-day security course. The course provides basic training on email and NHS internet use and a clear understanding of their responsibilities to the practice code of connection when using the system. Because GPs will also be required to attend this course Dawn Poon will arrange for local staff to be trained to provide these sessions within Practices. DP Phase two of the project will enable connection of the standalone machines to practice clinical systems providing email and NHS internet access to every desktop on the LAN. It is anticipated that work on phase two of the project will commence around October of this year. Dr Trevor George asked whether this meant their clinical systems would be vulnerable to hacking. Dr Rob Gerlis reassured members that the GPNet was a secure environment protected by a ‘firewall’ and there was more chance of the system being hacked into via a modem. Dawn Poon advised members that this was an important issue that practices need to be fully aware of and she had already been in contact with practice managers to arrange a visit to discuss a number of IT issues, which this will include. Dr Trevor George asked whether it would be possible for a detailed briefing paper explaining how GPnet will work and further information about the security of clinical data is produced. It was agreed that Dawn Poon would try and obtain this information and circulate in preparation of the meeting. DP A request has been received for the PCG to support the funding of the ‘Emergency bag scheme’ which was originally established by the Health Authority. Currently it is down to the Practice to maintain and purchase supplies as required. It was agreed that the medicine management committee should review this further. AR 90/00 ANNUAL ACCOUNTABILITY AGREEMENT – QUARTER ONE Members formally note the report. 91/00 FINANCE REPORT The July finance report was noted. Sally Gorham explained that we had now received the final out-turn on prescribing for 1999/2000, which was considerably higher than originally anticipated, this has therefore had a significant impacted on this years financial position. The actual overspend rose sharply in the final month leading to a cumulative overspend of £485K, £118K greater than originally anticipated. The consequences of this requires that the PCG:· Immediately identify funding to cover the £118K unplanned overspend on a non-recurring basis. · Put further measures in place to tighten control on prescribing costs within 2000/2001· Identify further measures to fund the now inevitable overspend in this financial year. Sally Gorham then explained how the budgets had originally been allocated and the level of expenditure and variances to date. From this the PCG will need to determine the level of virement from internal and external budgets. Sally Gorham then went on to explain how the final overspend affects this and future year prescribing budgets. She explained that the final overspend on last year means that the 12.1% increase on last years budget reduces to 2.3%. If the actual drug costs increase by 8% this year as is anticipated this will lead to a £406K overspend which will have to be carried forward into next year. Dr Rob Gerlis felt Harlow PCGs financial problems were because the Health Authority had made no provision for the level of private referrals across North Essex. Dr Cliff Bishop explained that this argument was a long-standing issue that could not be resolved at this meeting. The immediate problem was how the Board resolves the financial position for this year, in light of the final prescribing overspend for 1999/2000 and to agree the measures required for tighter control on this years budgets. Sally Gorham explained the proposals set out in the papers to address the overspend from last year and to make a small step in increasing this years prescribing budget. Dr Mukesh Rajani asked whether the PCG would receive any growth monies. Dr Cliff Bishop explained that we had only received our share of the 80% as 20% has was allocated as discretionary growth monies which we are not entitled to as the PCG was 9% above distance from target. Dr Trevor George was concerned that Harlow had one of the highest generic rates in North Essex, which has been significantly affected by the recent price increases despite government intervention. Both Matthew White and John Wright felt that the Board had no option but to address the problems otherwise we were at risk of external intervention. Mukesh Rajani felt that the Board could not expect practices to decrease prescribing costs whilst knowledge that the budget is unachievable. Matthew White queried the £118K figure. Sally Gorham explained that this was not the actual overspend but the difference between the planned and actual overspend. Dr Rob Gerlis felt that the Board should monitor the quality of service provided by practice, i.e. waiting lists and referral levels and patient care as well as the financial position across the Town. As he felt that just because a practice is overspend it does not mean they are a poorly managed practice and other factors need to be taken into account. Sally Gorham acknowledged the concerns and difficulties practices faced and the good record that Harlow GPs have in the area of prescribing however stressed the importance of dealing with the prescribing deficit from last year and the knock on effect into this year. Dr Mukesh Rajani felt that there was an opportunity to justify funds from the winter plan monies as patients who are managed in the community will require a level of prescribing from practices. Sally Gorham stressed that this money has already been allocated. However we may be able to consider this for any other new monies. The Board formally approved the virements required in-year and agreed that the PCG should explore the possibilities of additional funding discussing prescribing patterns with practices again and ensure that the PCG average rate is compared to both North Essex and National figures. PW Dr Rob Gerlis stated that the formulary is currently being integrated into the system and hopefully will improve the prescribing budget, however it is important that work is undertaken by the Medicine Management committee to ensure that the formulary is updated on a regular basis. Anne Reeder confirmed that a work group is to be established to manage the updating of the formulary. AR 92/00 WAITING LISTS/WAITING TIMES The PCG is still waiting for quarter one activity data from Princess Alexandra NHS Trust. The delay is due to internal validation as the Trust is concerned as to the accuracy of the figures. These will be circulated on receipt. PW 93/00 NHS PLAN Sally Gorham introduced a summary of the NHS Plan with a brief description of the actions already underway in Harlow. Dr Arvind Chhibber raised concern about the level of GPs required locally and how we can manage the potential recruitment problems. Sally Gorham explained that from information available we were predicting that 1 to 5 GPs will be required to replace retiring PGs over the next four years and a further 1 to 2 additional GPs would be required to cope with the current planned population increase over the same period. Members agreed that this did not only affect GPs but also nursing staff, Dr Rob Gerlis reported that his practice were experiencing problems with recruiting a replacement nurse. He felt this problem would potentially increase in the introduction of government initiates like the walk-in centre. Dr Rob Gerlis also raised concern that internal modernisation’s at Osler House will need to funded by the Practice and will not be funded by HHCT who own the building. He felt that the building was below the red book standard and would therefore be eligible for additional funds through the NHS Plan. 94/00 HARLOW ECONOMIC DEVELOPMENT STRATEGY Members agreed to defer this item to the next meeting. 95/00 PRESCRIBING DRUGS ON NHS FOR PATIENTS RECEIVING TREATMENT IN THE PRIVATE SECTOR Anne Reeder asked members to consider the following proposal: ‘If a private consultation/treatment has resulted in a treatment regime, which is normally carried out in a primary care setting, then the GP should prescribe according to the Harlow PCG formulary. However, if consultation/treatment has resulted in a treatment regime that is normally managed and monitored in a secondary care setting, then the GP should not prescribe.’ Members felt that this was an acceptable proposal and formally agreed to adopt the policy with the provision, that GPs should not prescribe drugs that have been recommended by a Private consultant that would not normal be prescribed to NHS patients. Members also felt that patients should not be able to fast track the NHS waiting list by the use of the private sector. It was agreed that this should be monitored between the PCG and PAHT. AR/PW 96/00 DATE AND TIME OF NEXT MEETING Thursday 5 October 2000 to be held in the Council Chambers, Harlow Town Hall, Harlow.
Sign:………………………….. Date:…………………
Name: Leigh
Date: 28 Feb 2008
Time: 06:18:36
<a href= http://m.domaindlx.com/bigtimezone/log-splitters >hydraulic log splitters</a> [url=http://m.domaindlx.com/bigtimezone/log-splitters]hydraulic log splitters[/url] <a href= http://m.domaindlx.com/bigtimezone/turbo-tax >turbo tax</a> [url=http://m.domaindlx.com/bigtimezone/turbo-tax]turbo tax[/url]
Name: kisa
Date: 16 Jun 2008
Time: 00:34:44
<a href= http://index10.erbed.com >mp4 video downloads</a> <a href= http://index8.erbed.com >touched by an angel videos</a> <a href= http://index7.erbed.com >teen party ideas</a> <a href= http://index1.erbed.com >china gel analgesic</a> <a href= http://index2.erbed.com >world map outline blank template lakes landmasses</a> <a href= http://index4.erbed.com >grasshopper sounds</a> <a href= http://index3.erbed.com >nebraska counseling associations</a> <a href= http://index9.erbed.com >nasty videos</a> <a href= http://index6.erbed.com >easy chicken cassoroles</a> <a href= http://index5.erbed.com >holly hunter nude</a>
Name: Orgy Sex Parties
Date: 16 Jul 2008
Time: 22:46:34
Apologize so http://access.trannyhunt.com/track/MTAwMTMzNToyOjU/ nor http://www.realitykings.com/ma.htm?id=klucz and http://www.boobexamscam.com/?revid=51512 before http://www.teenybopperclub.com/?wm_login=cdoom
Name: tag heuer monaco replicand70
Date: 14 Sep 2008
Time: 20:32:29
Bgdlbs get http://replica-tag-heuer-watchstrap.theaxelounge.ca even if watch http://cellini-replica-rolex-watch.apex-qc.ca even if http://dubai-imitation-rolex-watch.austo.ca rather than rolex http://breitling-replica-watch.aviatorbirdsolutions.ca also.
Name: Anna Castries
Date: 16 Sep 2008
Time: 02:55:02
Very pretty design! Keep working. Go on! http://autumn-design.co.uk/forward/forward_images/uploaded/extra/viagranoprescriptionls.htm# <a href=http://autumn-design.co.uk/forward/forward_images/uploaded/extra/viagranoprescriptionls.htm# >viagra no prescription excitements</a> [url=http://autumn-design.co.uk/forward/forward_images/uploaded/extra/viagranoprescriptionls.htm# ]viagra no prescription deliberation[/url] http://seize-music.com/private/temp/withdrawalfromzoloftuk.htm# <a href=http://seize-music.com/private/temp/withdrawalfromzoloftuk.htm# >withdrawal from zoloft forbearance</a> [url=http://seize-music.com/private/temp/withdrawalfromzoloftuk.htm# ]withdrawal from zoloft lithographs[/url] http://meriauto.com/_c_tpls/extra/amoxicillininfoad.htm# <a href=http://meriauto.com/_c_tpls/extra/amoxicillininfoad.htm# >amoxicillin info obsequiousness</a> [url=http://meriauto.com/_c_tpls/extra/amoxicillininfoad.htm# ]amoxicillin info apologizing[/url] http://mongiteenbourgogne.be/setup/icones/big/phenterminebluewhite375mghc.htm# <a href=http://mongiteenbourgogne.be/setup/icones/big/phenterminebluewhite375mghc.htm# >phentermine blue white 37.5mg discharging</a> [url=http://mongiteenbourgogne.be/setup/icones/big/phenterminebluewhite375mghc.htm# ]phentermine blue white 37.5mg considerable[/url] http://funnyoutube.com/data/scroller/tmp/viagralowcostxy.htm# <a href=http://funnyoutube.com/data/scroller/tmp/viagralowcostxy.htm# >viagra low cost inattentive</a> [url=http://funnyoutube.com/data/scroller/tmp/viagralowcostxy.htm# ]viagra low cost ungraciously[/url] http://lasnuevasalora.com/Gallery/thumbnails/extra/allegrarssfeedfr.htm# <a href=http://lasnuevasalora.com/Gallery/thumbnails/extra/allegrarssfeedfr.htm# >allegra rss feed sensitiveness</a> [url=http://lasnuevasalora.com/Gallery/thumbnails/extra/allegrarssfeedfr.htm# ]allegra rss feed interspersed[/url] http://montsaintroch.be/setup/icones/big/prednisonehalflifezv.htm# <a href=http://montsaintroch.be/setup/icones/big/prednisonehalflifezv.htm# >prednisone half life congratulatory</a> [url=http://montsaintroch.be/setup/icones/big/prednisonehalflifezv.htm# ]prednisone half life commissioned[/url] http://fabricaz.co.uk/acatalog/DD/more/celebrexattorneytexasdl.htm# <a href=http://fabricaz.co.uk/acatalog/DD/more/celebrexattorneytexasdl.htm# >celebrex attorney texas undertaking</a> [url=http://fabricaz.co.uk/acatalog/DD/more/celebrexattorneytexasdl.htm# ]celebrex attorney texas undoubtedly[/url] http://montsaintroch.be/setup/icones/big/antibioticzithromaxnb.htm# <a href=http://montsaintroch.be/setup/icones/big/antibioticzithromaxnb.htm# >antibiotic zithromax fictitiously</a> [url=http://montsaintroch.be/setup/icones/big/antibioticzithromaxnb.htm# ]antibiotic zithromax physiognomy[/url] http://vinceweb.co.uk/bingo/temp/noprescriptionneededvicodinbi.htm# <a href=http://vinceweb.co.uk/bingo/temp/noprescriptionneededvicodinbi.htm# >no prescription needed vicodin predecessor</a> [url=http://vinceweb.co.uk/bingo/temp/noprescriptionneededvicodinbi.htm# ]no prescription needed vicodin physiologists[/url]