Agenda item

This report provides the Board with an update on the work of the Medway Clinical Commissioning Group (CCG) Primary Care Commissioning Committee.

Discussion:

The Chief Operating Officer, NHS Medway Clinical Commissioning Group (CCG) provided the Board with an update on the work of the CCG Primary Care Commissioning Committee. The key functions of the Committee and a summary of key decisions over the last year were set out in Appendix 1 to the report. In particular, the Board was advised that an Improved Access Service to extend out of hours provision in Primary Care had been commissioned. This had resulted in an additional 600 appointments a week at Medway’s Healthy Living Centres. In addition, it was noted that approval, by the Committee, of additional investment in a number of services, such as a GP led Care Homes Service and a locum employment software, had enhanced GP cover and improved access for patients.

In response to concerns expressed in relation to the shortage of GPs in Medway, the Board was advised that the NHS Medway CCG had taken a number actions, including:

·         improving access for patients, ensuring that they could attend the increased number of appointments in place across Medway;

·         strengthening the walk in centre at Medway Hospital as part of the CCG’s work within Urgent Care, which was now treating circa. 100 patients a day, with much shorter waiting times; and

·         working with practices around the locum position to maximise capacity within the system.

A Member commented that a comprehensive plan detailing what services were available and how to access them was required.

It was noted that recruitment and retention of GPs was a national issue and was not limited to GPs but also the wider Primary Care workforce, including nurses. It was recognised that in comparison to the national picture, Medway had a below average number of GPs per population and with regards to expenditure on Primary Care, whilst equitable to the national average across the whole of Kent and Medway, it was explained that within the area there was some variation.

In order to address the workforce issues, it was explained that the Kent and Medway Sustainability and Transformation Partnership (STP) were developing proactive solutions to workforce issues. In addition, it was anticipated that the development of the medical school would draw prospective GPs to the area and improve retention. In the interim, Medway NHS CCG were already working with local universities to enable students to experience working in Primary Care as part of their training, which historically they would not have received. It was also anticipated that the new GP contract would bring more resource and allied health professionals which should improve retention.

In response to a question in relation to whether GPs were dawn to more affluent areas, the Board was advised that there was some evidence to support this. However, it was noted that the proximity of Kent and Medway to London was also a contributory factor in the shortage of local GPs. It was explained that Kent and Medway had not managed to attract funding from the national schemes because trainee posts in the locality were filled with relative ease, but often, the trainees had come from London where the trainee posts were full and these GPs would work in London once their studies were completed, thereby skewing the overall picture.

Owing to the insight and support elected Members could provide, clarification was sought on whether Councillors were able be appointed as members of the CCG Primary Care Committee. In response, it was explained that Councillors were disqualified from holding any seat on the Committee by law. However, it was explained that the Committee meets in public for discussions on general practice and subsequent decisions in order to ensure transparency. It was added that the Health and Wellbeing Board and the Health and Adult Social Care Overview and Scrutiny Committee offered a forum for discussion and scrutiny on these matters.

Members commented that the Council had undertaken a lot of work to promote Medway and increase its offer and welcomed the opportunity to engage with the NHS Medway CCG further to understand the drivers preventing GPs, and others, from locating in Medway and to provide practical assistance where possible. A request was also made to involve Councillors in decision making at early stage.

The need to work collaboratively was recognised and it was suggested that a development session be held to:

·         provide a briefing on the NHS Long Term Plan and specifically the components related to Primary Care, as well as, the new 5 year GP Contract and understand what could be expected from the system;

·         provide further information on the complexities of commissioning Primary Care Services. It was noted that pharmacy contracts were still contracted through NHS England directly.

·         consider how partners can work together to join up work to deliver the NHS Long Term Plan.

It was suggested that Members of the CCG Governing Body be invited to attend.

Decision:

The Health and Wellbeing Board:

a)    noted the update provided; and

b)    requested that a development session be held to consider how partners jointly work together to deliver the ambitions of the NHS England Long Term Plan in the context of Medway.