| Meeting | PPG Meeting |
| Date and Time | 3rd February 2021 12pm |
| Location | Zoom |
Members Present
| Name | Site/Organisation |
| Dr Ujjal Sarkar | PCN Clinical Director & MHP Lincoln Road Medical Practice Partner |
| Dr Anita Shah | PCN Clinical Director & Cockfosters Medical Centre Partner |
| Sarah-Jane Hope | Enfield Unity PCN Operations Support Officer |
| Janice Downing | Medicus Health Partner Chair |
| June Armitt | Nightingale House Surgery Chair |
| Colleen Sterling | Nightingale House Surgery Chair |
| Susie Shaw | Cockfoster Medical Centre Chair |
| Elena Fiora | Oakwood Medical Centre Chair |
| Nevin Kaleli | Oakwood Medical Centre Chair |
| Rohinton Khajotia | Oakwood Medical Centre Chair |
| Monty Meth | Oakwood Medical Centre Chair |
| Stephanie Jacobs | Oakwood Medical Centre Chair |
| Thomas Devine | Oakwood Medical Centre Chair |
| Suzanne Truttero | Curzon Avenue Surgery Chair |
| Martyn Axon | Curzon Avenue Surgery Chair |
| Christine Williams | Connaught Surgery Chair |
Apologies
| Name | Site/Organisation |
| Maria Christoforou | Lincoln Road Medical Practice Chair |
| Item | |
| 1. Welcome | Ujjal Sarkar opens and everyone introduces themselves. Enfield Unity PCN is the second largest primary care in the county, covering a 160,000 patients. Which is more than half the London borough of Enfield. |
| 2. Covid Vaccine | Q: What are the plans for the over 80’s to have their second jab? Ujjal: We started giving patients the second vaccine but due to the national policy they changed it. From the 12th January we were instructed to stop giving the second dose. The second dose will be given from 10/11 weeks from the first. Q: Will we be contacted or do we contact our practice regarding the second dose? Ujjal: We are work out the call and recall program for patients for the second dose at the 10/11-week mark. Vaccination data is entered on a national software called Pinnacle and we extract that data and call you for your second dose. A text will be sent and a central team will be working to contact people who aren’t digitally able. Susie: How does the government justify the time between the first and second dose? Ujjal: We are GP’s and are following the national guidance. Nevin: What about Pfizer? A lot of people say you should have it after 4 weeks while others say 12 weeks. Ujjal: This is a national policy to reduces deaths, to give as many people the first dose, especially the most vulnerable. Astra Zeneca has data to show patients are protected for 12 weeks, but no data for Pfizer so far. Nevin: How effective is the first vaccine? Ujjal: It is above 50%. Vaccines went live on the 15th December. Evergreen are sending the texts on behalf of the whole of Enfield with the option of Carlton House, Evergreen or Winchmore Hill. A central team are phoning patients who don’t have mobiles. Staff are working 8 – 8 7 days a week. Monday to Friday we vaccinate 750 people each day, 1000 Saturday and 1000 Sunday. Carlton House has 70 vaccinators and 40 administrators we are able to do that as Medicus Health Partners because we have over 300 staff over 15 GP sites. We have zero vaccine wastage. We work with North Middlesex Hospital, North London Hospice and other healthcare provides who are on the list for vaccines if there are any cancelations. We have vaccinated but 3 care homes due to an outbreak by 17th January. We have started vaccinating house bound patients, it was difficult before because of moving the vaccine from place to place. Martyn: Does the problem with the postal service in Enfield means letters aren’t being sent? Ujjal: We are not sending letters, instead we are sending text messages and calling patients. Patients can call their surgery to be booked in for the vaccine. Nevin: Does the first dose have to be the same as the second dose? US: They haven’t told us we can mix and match yet. We are telling patients they will have the same second dose as the first. Nevin: When will this all end? Ujjal: We will be vaccinating most of this year. Hands, face and mask won’t change. Even with vaccination there is still 5% chance of getting Covid. Martyn: What are the chances of getting to see your GP? Ujjal: Surgeries are open 8 – 18.30 Mon – Fri also 4 Extended Hours Hub services 7 days a week. Lots of patients were coming in for problems that didn’t need an assessment. Patients that need face to face will be able to come in and everything else can be done digitally. Susie: With it being done remotely are there more GP appointments? Ujjal: We had to recruit more staff. Pre pandemic we use to provide 80 appointments per 1000 patients per week, in December we were providing 110 appointments per 1000 patients per week. Digital poverty is something we are trying to address. Anita: I am Dr Anita Shah; I am a Partner at Cockfosters Medical Centre and the new Clinical Director for Enfield Unity PCN. Patients are seeing the benefits of being able to have appointments by video or being able to send pictures. There is also eConsult which has a quicker response time. Ujjal: There is a divide between East and West Enfield, people from deprived backgrounds or where English is not their first language are struggling with the digital platform. Martyn: Mental health has become a problem; will technology be able to boost mental wellbeing compared to seeing a doctor? Ujjal: Human touch regarding mental health is very important. Patient who needs to be seen face to face will be seen. Martyn: Can referrals be done digitally? Ujjal: Referrals take several weeks plus chasing it up. We use Consultant Connect which connects us to a specialist almost instantly and you can speak to them and get the help you need much quicker. Anita: For dermatology problems we can take a picture, send it to a Dermatologist and get a reply in 24 hours. They can then give guidance on how to deal with it. Patients that need referrals are referred but hospitals have a back log from last year so it is taking longer to be seen. Ujjal: Enfield has community diagnosis, which is based Lincoln Road Medical Practice. It is 7 days a week. Anita: Patients have said they prefer Lincoln Road InHealth rather than hospital as there is less risk of catching something. Nevin: Do we need another vaccine to prevent the new variants? Ujjal: My opinion is public health and scientists will decide what is the most prevalent Covid strain for the season, and a yearly vaccine will be given to combat it. Cas: Has the pandemic halted the development of the Commissioning Hub with Enfield, Islington, Camden, Haringey and Barnet? Ujjal: That was formed in April 2020 the 5 boroughs merged together. That has happened and hasn’t stopped. Monty: I think NHS England is using the Covid crisis to create new integrated care systems. Previously patients had a say in the Enfield CCG but no say with the 5 Bourgh CCG and less with the integrated care system. Ujjal: I share your concern; with Enfield CCG we were accountable to our stake holders the patients. I don’t think the pandemic has been used as cover to bring in integrated care systems, it was planned pre pandemic. Cas: On the management board at North Middlesex Hospital what opportunities are there for the patients voice to be heard? June: I sit at the patient board at North Mid. Due to the pandemic we can’t go to the hospital, but we are still well informed. The Patient Representative Forum is a strong forum. There will always be a patient voice there because a lot of us are dedicated to our hospital and community. Thomas: When I attended phlebotomy at Barnet, I arrive 10 min early and had to wait 15 before being call. I was in a waiting room with 20 people which made me very uncomfortable. Ujjal: We were able to secure practice base phlebotomy from August. Anita: Most practice should have in house phlebotomy. Young patients who need routine bloods we send to hospital. In house phlebotomy is reserved for older patients, patients on anticoagulant or patients with conditions like diabetes. There is a wait time though for in house phlebotomy. Stephanie: Why are certain practices vaccinating and other are not? Ujjal: The government wanted 1 practice in each Primary Care Networks to provide a vaccination site. Enfield has 4 PCN’s. Enfield Unity PCN has Carlton House Surgery as their site, Enfield Care Network has Evergreen and West Enfield Collaborative has Winchmore Hill. The fourth doesn’t vaccinate because they don’t have the workforce. It takes a lot of resource and manpower. We are doing it pan Enfield so no one is excluded. Martyn: Is more money given to practices in Enfield and is it to deal with the pandemic? Ujjal: Carlton House has vaccinated over 20,000 patients; we have not been funded yet but it should be coming in. 90% of the work in the NHS is done in primary care and 10% of fund comes into General Practice. Some of the income has been protected but no sizable difference funding. Monty: I want to pay tribute to the staff in Enfield for the great work with vaccinating. I wear the hat for the Over 50 Forum and the people I have spoken to are full of praise. Enfield CCG was severely underfunded; we were told we would be better off with the 5 CCG’s but there is no sign of more money coming in. We have not seen how the money will be allocated for integrated care systems. Ujjal: Thank you and the Over 50’s Forum for their kinds word. If the Over 50’s would like to do a statement of thanks we could circulate to all staff to boost morale. I don’t have a role in the ICS. Enfield has done better than the other 4 boroughs, not just with the vaccine but also in areas like diabetes. That has meant that the commissioners at the NCL realise they are getting more value out of Enfield primary care. Cas: Why are some communities not coming forward to take the vaccine and if the site is only offering Pfizer can patients go elsewhere if they want Astra Zeneca? Ujjal: Anyone who can reach out to all parts community especially the BAME community to raise awareness and to encourage them to take the vaccine, please do that. We try to give patients choice, but it depends on the time of the day. We can’t open new vial at the end of the day as the rest will be wasted. We ask those patients to come back in the morning so we have the rest of the day to use the whole vial. Cas: Where can we get access to the data surrounding the spread of Covid in the borough. Is it fair to assume the spread of Covid is more in the east than the west? Ujjal: Public health has that data. Medicus uses a single clinical system, we are seeing that more positive test are coming back from the east. Public health will have more accurate data. Martyn: To second Monty. My wife and I had the vaccine late in the day and we knew that a lot of the staff work long days, they greeted and treated us with great kindness. Ujjal: Everyone is making a lot of personal sacrifices and those comments are really appreciated. Janice: Yes on behalf of everybody I would like to say how much we appreciate the work being done. June: I would like to add I have heard glowing reports from family, friends and practices across the borough about how brilliant the Carlton House service has been. Thank you very much. Susie: With the combining of the 5 boroughs, are Enfield subsidising the other boroughs. Ujjal: It is the other way round. Enfield is being under funded so merging with the other borough that are over funded means there is a more even financial playing field. |