Agenda item

1. Title of Item/Report

 

Scrutiny Review of Access to GPs and Primary Medical Care - Final Report of the Adult Social Care and Health Select Committee.

           

2. Record of the Decision

 

Consideration was given to a report of the Adult Social Care and Health Select Committee’s review of Access to GPs and Primary Medical Care.

 

It was explained that accessing the help and advice of General Practitioners (GPs) and other professionals, working in primary care general medical practices, within the UK, had long elicited a range of experiences and, indeed, opinions. Exacerbated by the recent COVID-19 pandemic and its subsequent knock-on effect to all health and care providers, the ability to make contact with and then use such services in the context of changed systems, working practices and workforce capacity had further sharpened views on this topic.

 

Conscious of the ongoing debate around these existing challenges, the Government released a new plan, in May 2023, to make it easier for patients to see their GP and, in collaboration with the NHS, had announced a major new primary care access recovery plan which aimed to facilitate faster, more convenient care. Regionally, the North East and North Cumbria Integrated Care Board (NENC ICB) publicised a three-year programme bringing together the NHS and Councils with voluntary, community and social enterprise (VCSE) organisations to tackle long-standing inequalities and poor health, an investment which included extra support for the 'Deep End' network of GP practices in the region's most deprived communities, and steps to attract and retain more GPs to work in deprived areas, with extra training and support to encourage trainee doctors to build their careers in these practices.

 

Locally, this scrutiny topic had been proposed, back in February 2022 (though was unable to be undertaken during the 2022-2023 municipal year due to competing work programme demands). At that point, several related concerns were highlighted around processes involved in accessing general practice, including call wait times, the need to complete online questionnaires, and the initial requirement to tell call-handlers of very personal issues before receiving an appointment. Whilst it was acknowledged that work would have taken place in relation to this topic since early-2022, national and regional announcements regarding primary care (general practice) access demonstrated the ongoing high-profile nature of what was a key frontline health service.

 

 

The aim of the review was to:

• Understand the existing local ‘access to GPs’ landscape in the context of national / regional developments around this ongoing issue.

• Ascertain systems for accessing general practice services, the communication of these to the public, and how effective they were (including any variations across the Borough’s providers).

• Determine any areas which may assist in improving the experience of the local population, and practices themselves, when individuals wished to contact and / or access general practice services.

• Share any identified good practice within the Borough’s Primary Care Networks (PCNs).

 

Cabinet noted that the Committee had taken evidence from several relevant health bodies including the North East and North Cumbria Integrated Care Board (NENC ICB), Cleveland Local Medical Committee (LMC), Hartlepool & Stockton Health (H&SH) GP Federation, and the Borough’s four Primary Care Networks (PCNs). To ascertain experiences of contacting / accessing local practices, public / patient views were sought and considered from a variety of sources including the Care Quality Commission (CQC), NENC ICB, Healthwatch Stockton-on-Tees, and Patient Participation Groups (PPGs) from the Borough’s general practices. GP patient survey data was also reflected upon.

 

Cabinet also requested that the report be shared with Tees Valley Integrated Care Partnership.

 

RESOLVED that:-

 

General

 

1) All relevant health bodies (NENC ICB, Cleveland LMC, H&SH, NHS Trusts, and general practices) engage regularly and constructively around the issues raised as part of this review to ensure that patients were approached/ received care from the most appropriate services, based on need.

 

Communications

 

2) All relevant health bodies continue efforts to increase public / patient understanding about accessing the most appropriate services (including in the context of the Pharmacy First initiative), using all available communication mechanisms (both print and digital) and links through local community networks (e.g. community partnerships), to ensure key messages were reinforced.

 

3) Councillors and local MPs be supported in helping with these communication messages as leaders in their communities (as well as their role in raising concerns expressed by the community), and encourage positive feedback as well as concerns (to help share and spread learning and best practice).

 

4) The value and importance of all general practice roles be highlighted and publicised by health bodies and practices themselves.

 

5) Local practices be recognised for continuing to deliver primary medical care services safely in Stockton-on-Tees despite the ongoing challenges raised during this review.

 

Operational

6) All general practices move towards providing the full use of digital telephony capabilities (including call-back functionality), with appropriate staff in place to support these arrangements.

 

7) All general practices be encouraged to review and refresh care navigation processes, ensuring adequate training was in place to support implementation to ensure both staff and patients were comfortable with the approach.

 

8) To ensure appropriate workforce capacity was in place to maximise the local general practice offer:

 

a) NENC ICB continue to support / encourage uptake of the ARRS scheme, particularly amongst those PCNs which had not accessed this initiative.

b) All relevant health bodies continue to explore further and develop options to increase GP recruitment and retention in the Borough.

c) Options to increase nursing numbers (including strengthening training offers and uptake) be explored further.

 

9) The Borough’s four PCNs be encouraged and supported to work together collaboratively to share and adopt good practice.

 

Public / patient feedback

 

10) Relevant health stakeholders be proactive in encouraging involvement of patients in practice Patient Participation Groups (PPGs), aim to ensure these are representative of a practice’s patient list demographic, and consider fostering links between the Borough’s PPGs to assist in identifying / addressing any access issues.

 

11) NENC ICB consider its complaint / compliment reporting mechanisms so future data could be provided at a local general practice level.

 

 

Dissemination of report

 

12) The report is shared with the Tees Valley Integrated Care Partnership.

 

3. Reasons for the Decision

 

This topic was included on the Scrutiny Work Programme for 2023-2024. The review was now complete, and the recommendations had been endorsed by the Adult Social Care and Health Select Committee, for submission to Cabinet.

 

4. Alternative Options Considered and Rejected

 

None

 

5. Declared (Cabinet Member) Conflicts of Interest

 

None

 

6. Details of any Dispensations

 

None

 

7. Date and Time by which Call In must be executed

 

Midnight Tuesday, 25 June 2024

 

 

 

Proper Officer

 

Consideration was given to a report of the Adult Social Care and Health Select Committee’s review of Access to GPs and Primary Medical Care.

 

It was explained that accessing the help and advice of General Practitioners (GPs) and other professionals, working in primary care general medical practices, within the UK, had long elicited a range of experiences and, indeed, opinions. Exacerbated by the recent COVID-19 pandemic and its subsequent knock-on effect to all health and care providers, the ability to make contact with and then use such services in the context of changed systems, working practices and workforce capacity had further sharpened views on this topic.

 

Conscious of the ongoing debate around these existing challenges, the Government released a new plan, in May 2023, to make it easier for patients to see their GP and, in collaboration with the NHS, had announced a major new primary care access recovery plan which aimed to facilitate faster, more convenient care. Regionally, the North East and North Cumbria Integrated Care Board (NENC ICB) publicised a three-year programme bringing together the NHS and Councils with voluntary, community and social enterprise (VCSE) organisations to tackle long-standing inequalities and poor health, an investment which included extra support for the 'Deep End' network of GP practices in the region's most deprived communities, and steps to attract and retain more GPs to work in deprived areas, with extra training and support to encourage trainee doctors to build their careers in these practices.

 

Locally, this scrutiny topic had been proposed, back in February 2022 (though was unable to be undertaken during the 2022-2023 municipal year due to competing work programme demands). At that point, several related concerns were highlighted around processes involved in accessing general practice, including call wait times, the need to complete online questionnaires, and the initial requirement to tell call-handlers of very personal issues before receiving an appointment. Whilst it was acknowledged that work would have taken place in relation to this topic since early-2022, national and regional announcements regarding primary care (general practice) access demonstrated the ongoing high-profile nature of what was a key frontline health service.

 

 

The aim of the review was to:

• Understand the existing local ‘access to GPs’ landscape in the context of national / regional developments around this ongoing issue.

• Ascertain systems for accessing general practice services, the communication of these to the public, and how effective they were (including any variations across the Borough’s providers).

• Determine any areas which may assist in improving the experience of the local population, and practices themselves, when individuals wished to contact and / or access general practice services.

• Share any identified good practice within the Borough’s Primary Care Networks (PCNs).

 

Cabinet noted that the Committee had taken evidence from several relevant health bodies including the North East and North Cumbria Integrated Care Board (NENC ICB), Cleveland Local Medical Committee (LMC), Hartlepool & Stockton Health (H&SH) GP Federation, and the Borough’s four Primary Care Networks (PCNs). To ascertain experiences of contacting / accessing local practices, public / patient views were sought and considered from a variety of sources including the Care Quality Commission (CQC), NENC ICB, Healthwatch Stockton-on-Tees, and Patient Participation Groups (PPGs) from the Borough’s general practices. GP patient survey data was also reflected upon.

 

Cabinet also requested that the report be shared with Tees Valley Integrated Care Partnership.

 

RESOLVED that:-

 

General

 

1) All relevant health bodies (NENC ICB, Cleveland LMC, H&SH, NHS Trusts, and general practices) engage regularly and constructively around the issues raised as part of this review to ensure that patients were approached/ received care from the most appropriate services, based on need.

 

Communications

 

2) All relevant health bodies continue efforts to increase public / patient understanding about accessing the most appropriate services (including in the context of the Pharmacy First initiative), using all available communication mechanisms (both print and digital) and links through local community networks (e.g. community partnerships), to ensure key messages were reinforced.

 

3) Councillors and local MPs be supported in helping with these communication messages as leaders in their communities (as well as their role in raising concerns expressed by the community), and encourage positive feedback as well as concerns (to help share and spread learning and best practice).

 

4) The value and importance of all general practice roles be highlighted and publicised by health bodies and practices themselves.

 

5) Local practices be recognised for continuing to deliver primary medical care services safely in Stockton-on-Tees despite the ongoing challenges raised during this review.

 

Operational

6) All general practices move towards providing the full use of digital telephony capabilities (including call-back functionality), with appropriate staff in place to support these arrangements.

 

7) All general practices be encouraged to review and refresh care navigation processes, ensuring adequate training was in place to support implementation to ensure both staff and patients were comfortable with the approach.

 

8) To ensure appropriate workforce capacity was in place to maximise the local general practice offer:

 

a) NENC ICB continue to support / encourage uptake of the ARRS scheme, particularly amongst those PCNs which had not accessed this initiative.

b) All relevant health bodies continue to explore further and develop options to increase GP recruitment and retention in the Borough.

c) Options to increase nursing numbers (including strengthening training offers and uptake) be explored further.

 

9) The Borough’s four PCNs be encouraged and supported to work together collaboratively to share and adopt good practice.

 

Public / patient feedback

 

10) Relevant health stakeholders be proactive in encouraging involvement of patients in practice Patient Participation Groups (PPGs), aim to ensure these are representative of a practice’s patient list demographic, and consider fostering links between the Borough’s PPGs to assist in identifying / addressing any access issues.

 

11) NENC ICB consider its complaint / compliment reporting mechanisms so future data could be provided at a local general practice level.

 

Dissemination of report

 

12) The report is shared with the Tees Valley Integrated Care Partnership.