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Dr Richard Evans had been appointed as ABMU Medical Director in November 2019 having previously worked in Cardiff and Vale Health Board for 15 years as an Infectious Diseases Physician. He said it had been refreshing to come into a different organisation which provided the opportunity to focus his experience in developing pathways between secondary and primary care and forge links between the Health Board and all professional disciplines.
Richard touched on the ABMU Clinical Services Plan, an ambitious 10 year strategy which would take care closer to patients’ homes He believed that priority issues for improvement included Discharge summaries , Antibiotic prescribing and the Heart Failure pathway. In the main he wanted to listen to issues from a GP perspective and opened the floor to members queries.
There followed some discussion around the following issues.
Antibiotics – prescribing in ABMU was not good and Richard asked how better use could be encouraged.
He said inappropriate prescribing of the 4 ‘Cs’ had to be tackled– there were good guidelines but ABMU was an outlier and the use of these was a major contributor. He asked if adequate information was being provided. The message from members was that they believed that the guidelines were being followed and it may be that there were ‘pockets’ of poor prescribing that needed to be investigated. Members also highlighted that no information was received about secondary care prescribing and it was often there that prescribing of the 4Cs was initiated.
Discharge Summaries:
Richard was asked what he would do differently about the quality and quantity of discharge summaries as performance improvement had dropped off recently and this was an area where improvement would buy an enormous amount of good will. Richard advised that he had asked Alastair Roeves to take this forward, building on what had happened before and believing that safe care required good communication. He pointed out that if it was easy it would have been done by now. Workload issues required review and space and time found to do it. He took on board members comments but knew that the solution would not be easy or straightforward.
OutPatient Waiting times
A query was raised about the length of some OP waiting times with GPs not being told about delays. This often resulted in patients being admitted. Richard could not comment on the position but confirmed that the importance of secretarial staff was recognised in relation to the completion of timely reports. He believed that other means of administrative support could be looked at such as voice controlled technology for completion of notes scans etc.
Clusters
The problem around ongoing HB support for cluster projects was acknowledged as an issue but as all 8 clusters in the new HB had been successful in transformation fund bids it would now be possible to look at moving resources from secondary to primary care. ARo advised that no other HB in wales had total cluster involvement. Richard wanted to develop closer links with individual secondary care clinical colleagues working in Primary Care. Individual clusters would be selected to work on certain projects such as COPD and heart failure to iron out problems so that these could then be rolled out once the benefits were seen.
IH thanked Richard
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GUEST SPEAKER 2:
Professor Malcolm Lewis spoke to members about the GP State Backed Indemnity Scheme which would commence on 1st April 2019 and would be operated by the Legal and Risk Service of the Shared Services Partnership. A mail shot was being produced and would go out to all GPs within the next few days. ARo agreed to arrange for a copy to be sent to Practice Managers. Cover would be included at present for locums but negotiations were still ongoing with Welsh Government. In addition to the MPL a wider locum register was being considered by WG.
IH thanked Malcolm who would be happy to come back if further information / discussion was required.
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