MINUTES

Drs I Harris (Chair) (IH), S Hlaing (SH), A Rayani (AR), N Shah (NS), H Dean (HD), S Karupiah (SK), R Thomas (RT), Mrs M Liddell (Executive officer) (ML), Mrs E Harris (Secretarial assistant) (EH)
IH welcomed Helen Dean, Shanti Karupiah and Richard Thomas to the meeting.

None received

One received

• LMC Executive Committee meeting – Tuesday 12th March 2019: the Minutes were approved and signed by the Chair.

ML to forward Cwm Taf paper to NS

Following the meeting Helen, Shanti and Richard confirmed that they would join the Executive Committee Team for the remainder of the current term. This was warmly welcomed by the Exec members.

The Exec agreed that a change in structure seemed inevitable following the impact of the recent Health Board Boundary change and the views of constituents would now be sought. ML would draft a survey document. The original options paper which was considered by Bro Taf and Morgannwg LMCs in early 2018 when a ‘no change’ option was agreed for 12 months would be re-circulated to the Exec team. A meeting would be arranged with Bro Taf LMC in September 2019 to agree the way ahead. The final decision would be based on what was best for all constituents.

A summary of expenditure to 31st May 2019 was tabled and discussed. The Statutory and Voluntary levies for 2019-20 had been received from SBUHB and CTMUHB.

The Draft minutes and action log had been circulated. The action log was reviewed.

LMC representation at cluster meetings was discussed and agreed that the LMC was visible in the Swansea and NPT clusters either through the attendance of an LMC rep at meetings or there being an LMC member in the cluster. The exception to this was the Upper Valleys cluster and the LMC would ensure that GPs in the cluster were specifically targeted when surveying them for their views about representation. Representation at Bridgend clusters was good with attendance being confirmed at most meetings during the year.

Attended by IH who summarised some of the issues discussed including the transformation fund projects which had been rolled out in Cwmtawe and Neath Clusters. He highlighted the recruitment problems being experienced. Ongoing sustainability remained an issue and some cluster leads felt they were not being involved at an early stage in the development and roll out of the transformation funding plans.
It was agreed that Hannah Evans, the SBUHB Transformation Director would be invited to the LMC meeting on 10th September 2019.

The draft minutes had been circulated. IH attended and was very positive in his feedback about the Health Board’s approach to finding solutions to problems. This was evident in their agreement to look at establishing a transfusion pathway.
IH had raised a concern at the meeting about the setting up of email inboxes by NWIS for the transfer of clinical information. He had advised Bridgend practices to put an ‘out of office’ message on as MLMC continued to hold the view that clinical information should only be transferred via WCCG (or via fax/post if WCCG not available).

Negotiations for the 2019-20 contract remained ongoing and a response from WG was believed to be imminent.

No update reported. Practices were being encouraged to use the tool and provide feedback.

SK expressed disappointment that there was little Primary care involvement in discussions about the development of the CSP. This would remain on the agenda for updating.

A meeting had been arranged on 9th July 2019 to review the basket of Enhanced services and negotiate an uplift.

A number of practices were still declining to sign up to the DES (Gateway Module) which was a pre-requisite to being able to sign up to the 3 NES modules. Alternative service arrangements would be required for patients not covered by the DES/NES.
SH had received a letter about a cluster based Diabetes Transformation Project and would request confirmation about the funding source which could not be from the ES ‘pot’.
DPDG: AR had attended the SBUHB Diabetes Planning and Delivery Group meeting on 24th May 2019

The spec for housebound patients was still awaited. Richard Tristham was looking at ways of educating practices in the management of patients perceived to be ‘too difficult’. eg those with heart valves.

Following the MLMC meeting on 14th May 2019 SBUHB had proposed the following to help address the concerns of the LMC members;
a) that a member of the LMC attend the next Unscheduled Care Board ( cross agency meeting chaired by Chris White)
b) That an LMC representative joined the Keep me at home workstream
c) That Chris White and Richard Evans were invited to attend the next full LMC evening meeting to share progress to date.
IH had agreed and welcomed the above.

IH asked that any unhelpful or confusing automated generated messages received from secondary care should be forwarded to James.chess@wales.nhs.uk.
The actioning of urgent messages received via WCCG would be raised at the Liaison meeting in July 2019. This followed a report from a constituent that a message to admit a patient, received late on a Friday afternoon, was missed.

A Swansea constituent had raised a query about the non-acceptance by Radiology of patients not seen face-to-face by the GP. The Exec agreed that a comprehensive assessment made by telephone should be acceptable as a referral and SH would seek further guidance from Derrian Markham, Consultant Radiologist.

The security arrangements for patients when seen in an OOH setting differed from when seen in-hours. HD would feed back concerns to the OOH Clinical Director as the pathway should flag up in the SPN (Special Patient Notes).

IH had discussed the management of results with Andar Gunneberg who had supported the LMC view that the Lab should contact the requesting specialty both in and out-of-hours instead of defaulting to the GP. This would reflect the current arrangements for oncology and renal patients. This was being taken forward by Dr Gunneberg.

IH reported that the partners in a Bridgend Practice had confirmed their intention to hand back their Contract and the practice was being supported through the process.

WELSH LMC CONFERENCE – Saturday 9th November 2019: The Conference would be held in
St Georges Hotel, Llandudno. Accommodation and travel arrangements for attendees would be arranged by the LMC to facilitate the GPDF invoicing process.

• LMC full Meeting: Tuesday 9th July 2019 – Mercure Hotel Swansea
• LMC Executive Committee Meeting: Tuesday 13th August 2019 – venue tbc