Members expressed concerns about the difficulty residents were experiencing in accessing GP appointments. Reference was made to residents having to wait for hours in making telephone appointments just to see a doctor, and some felt they had little choice but to resort to other means such as going to A&E direct or ringing 111 for assistance. Concern was also raised that these difficulties were deterring some residents from accessing primary care when they did need it. The issues were acknowledged however, it was explained that the number of GP face-to-face consultationsacross Medway and Kent in March 2021 was over 450,000, which was almost the same level as before the pandemic. For the same month, the number of telephone consultation was about 200,000 more than that in February 2020, therefore more consultations were being offered.
It was stated that it was necessary to have a better understanding of people’s preference in engaging with GP services. In general, the working population and younger age groups welcomed the use of e-consult, however, other members of the population found the system difficult to use. To cope with increasing demand for e-consult, hub arrangements were being explored to address the increasing demand in users of the service. While exploring ways to address the long-standing issues concerning GP appointments and services, it was advised that as an immediate response, the CCG was working closely with PCNs to address the significant backlogs and demands arising from the pandemic.
On differential pressures across primary care, reference was made to the work being done to encourage small practices to collaborate with other practices to ensure they were more robust and resilient. It was also confirmed that the number of patients presenting at A&E and Meddoc with primary care conditions was increasing.
Reference was made to current work being undertaken by the Integrated Care Partnership (ICP) to explore how primary care could be adapted to address immediate issues and how it should look in the future, including redesigning care pathways, to possibly allow direct access to specialist clinics for some conditions such as diabetes, without the need to go through GPs. In addition, GP recruitment and retention difficulties were recognised as a long-standing issue in Medway, compounded by other factors including housing growth and changing demands. The representative of the Medway and Swale ICP undertook to bring back an outline of the work being undertaken by the Medway and Swale ICP to the Board in the future.
A suggestion was made that a simpler and more effective system to manage the appointment calls to improve the access for patients making an appointment would be helpful. It was confirmed that commissioners had no direct influence on GP surgery telephony booking systems but were working with them to assist them in improving services in the context of customer service.
It was also suggested that residents should be encouraged to engage themselves in the process through serving in local Patient Participation Groups and have a positive influence into the development of health services in Medway. Equally, it was considered that Healthwatch Medway had a role to play in patient participation.
Whilst recognising this was a long-standing issue in Medway, it was also acknowledged that the COVID-19 pandemic had created additional pressures and difficulties, which were still present.
Recognition was made that the Health and Adult Social Care Overview and Scrutiny Committee was scrutinising this issue but that the Board had a clear role in terms of looking at how, collectively, pathways and the health and social care network as a whole could work differently to address issues.
The Health and Wellbeing Board agreed to receive a report on the Medway and Swale ICP Delivery Plan and outline of Primary Care Strategy at its next meeting on 2 September 2021.