SEDERUNT

Drs Donald Blackwood, Colin Brown, Malcolm Brown, Brian Clegg, Douglas Colville, Jane Connelly, John Dudgeon, David Gaffney, Gary Hamilton, John Ip, Robert Jamieson, Susan Langridge, Stewart McCormick, Alan McDevitt, Chris McHugh, Keith McIntyre, Kathryn McLachlan, John McLauchlan, John Nugent, Jim O’Neil, Nigel Pexton, Iain Robertson, Paul Ryan, Petra Sambale, Maureen Smith, Ian Struthers, Alastair Taylor, Andrew Townsley, Barbara West, Peter Wiggins and Raymund White.

CHAIRMAN

Dr Paul Ryan, Chairman of the Committee chaired the meeting.

APOLOGIES

Apologies for absence were received from Drs Barry Adams-Strump, Dallas Brodie, William Doak, Norrie Gaw, Stephen Goldberg, Ian Gordon, Richard Groden, Kevin Hanretty, Jouda Jheeta, Derek Logan, Gerry Lynas, Neil Mackay, Murray Macpherson, Andrew McCall, Robert Mair, Michael Mutch, Andrew Power, James Ward, and Professors Murray and Watt.

ATTENDING

Mrs Mary Fingland, Secretary of the Committee.

REVISED AGENDA

The Committee received the Revised Agenda. 

MINUTES 08/058

The Committee received the Minutes of the meeting held on 21st January 2008.

The Minutes of the 21st January 2008 were approved and signed by the Chairman.

BUSINESS ARISING

08/059

(a)          SCI Store

The Committee was told the SCI Store development team was currently working on new software to allow practitioners in South Glasgow to access the system. 

(b)          Integrated Services for Older People and Adults with Physical Impairment

Given the implications for current District Nursing Services highlighted in the GP Subcommittee response to the document “Towards a Community Based Rehabilitation and Enablement Service for Older People; Older People with Mental Health Problems; Adults with a Physical Impairment” it was agreed the response should be emailed to every GP practice in Greater Glasgow and Clyde to make them aware of the apparent desire to remove District Nursing Services away from their practice attachments.  Dr Smith voiced her concern that proposed changes to current community service provision in Inverclyde were social work not health led. 

Action: Email the GP Subcommittee response to all practices. 

(c)           Camglen

Dr Colville had been invited to attend a meeting between North Lanarkshire CHP and GP Practices from the Stepps Corridor, to discuss the proposed transfer of nGMS contract management to North Lanarkshire CHP.  The meeting had established GP Contracts whilst remaining with GG&C, would be ‘babysat’ by North Lanarkshire CHP on behalf of GG&C. Practices were given assurances that access to Glasgow’s current Enhanced and Support Services would continue.  Traditional patient flows into Glasgow’s acute and community services would also remain. 

Members were told the Board had been advised the consultation process on the transfer of management of Camglen (and North Lanarkshire) nGMS contracts was now at an end and the implementation process started.  The Committee heard serious concerns remained that there may be a push to actually transfer the actual nGMS contracts in these areas, from one Board to another.  Members were told advice on this issue was being sought nationally from both SGPC and the BMA in London.  Dr Smith asked about future enhanced services and heard they could not be guaranteed for any area.  Dr West also noted that the consultation process with GP practices had consisted of only one week, and warranted challenging as it was clearly not a realistic consultation exercise. 

IM&T 08/060

(a)      Note of the IM&T meeting held on Thursday 17th January 2008

The Committee received a note of the IM&T Committee meeting held on Thursday 17th January 2008, copies of were emailed and tabled.

(b)      Oral Report of the IM&T meeting held on Thursday 21st February 2008

The Committee received an oral report of the IM&T Committee meeting held on Thursday 21st February 2008.

Generic Clinical Mailbox

Members heard guidance and advice for the clinical mailbox was now available for GPs.  Dr McDevitt told members practices may need to change their current business practice to ensure the safe transfer of patient data.  It has been suggested that the guidance and advice is rolled out on a CHCP area basis. 

Laptop Security

Members heard practice laptops currently in use do not meet new security guidelines and it would cost £36,000 to fix and bring them up to date.  The Committee was told no further laptops were being purchased at the moment as the usefulness of the current ones was still being assessed.

SCI Gateway

Members heard guidance was being developed on the level of information required on SCI referrals.  Once drafted the new guidance would be shared with the GP Sub-Committee before final approval and dissemination to general practice. 

Members were told of concerns from an officer of the information commission about unsuspecting GPs possibly breaking data protection laws through the use of SCI electronic referrals.  Members heard there was a real possibility of legal action being taken on inappropriate information, for example a history of sexual abuse, being retrieved by and sent with the SCI Gateway referral if it was not relevant to the referral.   Members felt GP IT systems should have a mechanism by which individual pieces of data could easily be identified as confidential and not for transmission.  Members heard GPs could face a hefty fine if found to be in breach of the Data Protection Act.  Dr McCormick told members he had found it simple to remove excess information from the SCI referral letter before it was sent.  However, members agreed this was also a training issue and highlighted the problem of new software constantly being rolled out to general practice with insufficient training in its subsequent use.  Dr Nugent suggested the LMC should also remind colleagues to remove patient identifiable information from items of communication that did not require this data. 

Dr McDevitt told members he had recently met with Richard Copeland, Head of GG&C IT and he had been informed SCI Gateway was due a revamp and, as part of this process; drafts would be drawn up on how to control the amount of information being retrieved from IT Systems by SCI Gateway.    However, given the pressure on GPs to use the Gateway system as the preferred method of referral, members thought many colleagues were unaware of the risks involved and wondered whether colleagues should be advised to revert to paper referrals given the problems highlighted.  Members were also concerned it was difficult to identify who was a member of the SCI Gateway user group and if membership included GP representation.  Members heard that in Glasgow there appeared to be no GP representation and the group consisted mainly of SCI developers.  It was thought, given the implications for GPs, this issue should be referred nationally through SGPC.   

Dr McDevitt told members another meeting with Mr Copeland had been arranged and he would take forward the points raised.

IPACC

Members heard the IPACC process might move forward but only in relation to GP IT Systems.  However, given the uncertainty, Glasgow was now focussing on what system it would require in two to three years.

NOTES AND REPORTS OF MEETINGS (FOR INFO) 08/061

(a)      Minutes of the Area Medical Committee meeting held on Friday  18th January 2008

The Committee received the minutes of the Area Medical Committee meeting  held on 18th January 2008, copies of which were emailed and tabled.

(b)      Oral Report of the Area Medical Committee meeting held on Friday 22nd February 2008 

The Committee received an oral report of the Area Medical Committee meeting held on Friday 22nd February 2008.

Members heard the meeting mainly focussed on a presentation by Helen Byrne, GG&C HB, which gave an outline view of the new hospital in the Southside.  AMC members had found this very interesting. 

Health Visitor Review

Members were told there discussions were ongoing.

Workforce Planning

Members heard there were still problems with MMC.

(c)       Report of the Cervical Screening Steering Group meeting held on Tuesday 12th February 2008

The Committee received a report on the Cervical Screening Steering Group meeting held on Tuesday 12th February 2008, copies of which were emailed and tabled.

Same Day Smear Result Corrections

Dr West highlighted her concerns about ‘same day corrections’  Members were told should a smear result be altered within twenty four hours of being uploaded onto SCCRS, GPs would not see the new report.  This was a major worry and dangerous for both patient and GP. 

Action: Raise with SGPC.

Encouraging Use of Electronic Submissions

Members were told the laboratories were becoming more stringent on accepting smear requests which had not been electronically submitted.   

Leaking Pots and Labels Dissolving

Members heard the problems with dissolving labels remained. However, although the cause of the problem had been identified and hospitals had been issued with new improved labels, it had been thought too difficult to furnish GPs with the new labels and instead discussion had focussed on how to close the pot lids properly. 

Change Requests

Dr Smith asked about progress on items previously highlighted as problematic such as a ‘not malignant’ category and heard that to adapt SCCRS required a ‘change request’ to be submitted to a national committee for approval before work could commence.  Unfortunately, this process took time.

SCCRS User Groups

Dr Taylor wondered if there were any GP representatives on the current user groups.  Dr West undertook to get an update on the membership.

Action: Dr West to obtain an update on the make-up and membership of the SCCRS User Groups.

(d)      Oral Report of the Area Drug and Therapeutics Committee meeting held on Monday 18th February 2008 

The Committee received an oral report of the Area Drug and Therapeutics Committee meeting held on Monday 18th February 2008.

Members heard of GP concerns about drugs being recommended which have not been approved by the SMC.  Members were also advised new Asthma guidelines would be coming to the GP Subcommittee for comment.  There was concern at the apparent lack or loss of ‘shared care’ protocols for many of these drugs including those for ADHD.  Members heard that prescribing for ADHD was carried out at the GPs own choice but only if sufficiently competent and informed to do so.

Dr McHugh raised the issue of Warfarin prescribing and the lack of INR reports from the GAS service.  Members heard he had sought MDDUS advice on this issue and MDDUS had recommended GPs not prescribe the drug if the INR was unknown.  Members heard it had been felt the GAS service should be able to input INR results to SCI Store but this was not possible with the current software.  Dr Colville told members he attended GAS meetings as GP representative and would raise this issue at the next meeting.

Members wondered whether stating on the prescription “take as directed by the GAS service and if you have not attended the service do not take this medication” would suffice but heard probably not.  It was questioned whether Clyde GPs would be willing to move to the GAS service in light of these concerns and it was felt they would prefer to remain in control of these patients.  Dr McDevitt also thought the service needed to make their reports more easily readable.  Dr Struthers pointed out it was not just INR results GPs needed but also information on changes in the patients’ warfarin dosage.

Members also raised the issue of being asked to prescribe specialist drugs for patients who had undergone transplants and were told LMC advice was that GPs should not be doing this prescribing and the hospital should be able to issue a repeat prescription for specialist drugs.

(e)      Oral Report of the Child Health Strategy Group meeting held on Tuesday 19th February 2008

The Committee received an oral report of the Child Health Strategy Group meeting held on Tuesday 19th February 2008.

Members heard there may be difficulties between the Women and Children’s Directorate and CH(C)Ps, whose workload appeared to be preventing them from being able to fully commit to partnership working on services for children.  Members were advised that Catriona Renfrew had been seconded as Director of West CH(C)P and would take up post at the end of Mr Findlay’s resignation period.  

Members expressed concern about the loss of the Enuresis clinic in the South East.  Members were also told the East had lost a school nurse and a rota system was in place to cover the schools involved however, there was concern about who would pick up any work that was missed.

(f)        Oral Report of the Clinical Subgroup of the Sexual Health PIG  meeting held on Thursday 21st February 2008

The Committee received an oral report of the Clinical Subgroup of the Sexual Health PIG Group meeting held on Thursday 21st February 2008.

Members heard Dr Bigrigg was pleased the LES Sexual Health had been offered to practices.

HPV Vaccine

Procurement decisions were still awaited.

Syphilis and Herpes

The presence of these could now be detected by a simple test which was being piloted.

LARC

Members heard a lot of this work was being carried out in the Sandyford clinic who had targets to meet.

Pharmacy Walk-in Services

Members heard these were being developed in Boot’s Pharmacies located in the Braehead Centre and Glasgow Central Train Station.  The Sexual Health PIG had been asked to approve the new service but could not as there were no proper systems in place as yet.  Dr Nugent told members this was a Scottish Government initiative which had required a pharmacy led bid for the service.  There were a number of issues such as:-

·    Would the service see asymptomatic patients only?

·    The need for an examination table and proper consulting room – would one be available?

·    Patient confidentiality and the need for patient identifiable information for verification purposes.  Board employees are covered by the Board’s confidentiality policy but this would not apply to Boot’s employees. 

Dr Nugent told members there was a briefing paper which outlined proposals for the service, which he would forward to members.

Subsequent to the meeting Mr David Thomson, Director of Pharmacy forwarded proposals for the new service and indicated he would be happy to speak to the Committee if need be.

AOCB 08/062

There was no further competent business.

DATE OF NEXT MEETING

The date of the next meeting of the GP Subcommittee will be Monday 17th March 2008.