Agenda item
Scrutiny task group on Access to extended GP services and primary care in Brent
Brent Clinical Commisisoning Group (CCG) and London North West Healthcare NHS Trust are changing the way healthcare is provided in Brent. The Scrutiny Task Group was established to review the primary care element of Brent CCG’s transformation programme and assess the extent of the changes and investment made in the Brent GP networks and primary care services for the effective implementation of the changes to the acute sector set out within Shaping a Healthier Future (SaHF).
Minutes:
The committee received the report of the task group that had been established to review the primary care element of Brent CCG's transformation programme and assess the extent of the changes and investment made in the Brent GP networks and primary care services. Members of the task group, Councillors Conneelly and Hector were also present.
The Chair welcomed to the meeting Ian Niven(Chair, Healthwatch Brent) and
Julie Pal (Healthwatch Brent).
Councillor Daly gave the chair of the task group, Councillor Colwill's, apologies that he could not be present to introduce the report. She thanked the officers who had supported the work of the task group. She also thanked the large number of GPs who gave their time to support the work of the task group. Councillor Conneelly stated that the task group was very concerned at the wide range and extensive lack of communication at all levels in the health service shown by the task group's finding that almost half of Brent residents were not aware of their access to out of hours services. Councillor Daly added a concern of the task group that whilst GP Access Hubs had been established to provide access to GPs in times of need the hubs had somehow evolved into permanent fixtures without consultation and, it was suggested, without a full equalities impact being carried out on these changes to the primary care offer to residents. Given the way they had been commissioned their coverage of the borough was patchy. The task group had also found a lack of local planning to promote the provision of preventative services. It was recognised that Brent is meeting nationally set targets for health screening but the task group felt that the targets for delivering health screening for older people were not ambitious enough. The task group was concerned that the total number of GPs had reduced and that many were over 65 years of age and may be approaching retirement. The recruitment and retention of district nursing was raised as an issue during the review and the task group were concerned about a lack of planning for the recruitment of additional district nurses. It was felt that given the poor level of communication and awareness of local services, Healthwatch Brent needed to play a more robust role in representing the voice of local residents and take on a stronger advocacy role.
In addressing how the number of those registered with a GP could be higher than the population of the area, it was explained that people could register across borough boundaries and those that moved abroad did not always take themselves off the register. This was a situation governed by legislation and individual GPs decided whether they could continue to deliver care to those that had moved away. Ian Niven acknowledged that Healthwatch Brent had not been as vocal as it should have been during the last two years. The service had been retendered and it was now time to review its role within the resources it had at its disposal. Julie Pal outlined the reconfigured service and expressed confidence in being able to deliver on the recommendations from the task group directed at Healthwatch Brent.
In answering questions from members of the committee the task group members explained that they had not been able to look into the optimum size for a practice but it was clear that there was a range of varied opening hours and gaps in service during lunch hours and Wednesday and Thursday afternoons. It was the decision of the GP on hours of service and the task group had not been able to obtain full information on what out of hours service there was. Members expressed surprise that communication plans were not integral to the delivery of services. Sarah Mansuralli pointed out that the NHS was a very complex organisation comprising a multitude of providers. Everybody needed to work to the same ends and computer systems needed to support this. She agreed that GP hubs had been introduced as pilots and that the time was right to review them. The CCG worked closely with NHS England to meet the primary care needs of local people. She commented that experience had shown that people did not want to see a practice nurse at a GP Access Hub rather than a doctor and that different types of workforce arrangements were being tried.
It was the understanding of the task group members that the CCG would consider the recommendations of the task group and make a formal response. The task group would meet again in six months time to consider the response of the CCG and progress with implementation of their recommendations.
RESOLVED:
(i) that the recommendations made by the task group be approved and an action plan developed across partner organisations to take them forward;
(ii) that a progress report on implementation of the recommendations be submitted to the committee in six months time.
Supporting documents:
- Covering Report_Health Scrutiny Task Group, item 7. PDF 123 KB
- Access to Extended GP Services FINAL REPORT, item 7. PDF 1 MB
- Appendix 1 - Growth rates by Brent GP Practice 2014-2015, item 7. PDF 52 KB
- Appendix 2 - Numbers of Patients Registered at a GP Practice, item 7. PDF 50 KB
- Appendix 3 - Location of services in Brent, item 7. PDF 61 KB
- Appendix 4 - Healthwatch Brent Report docx, item 7. PDF 386 KB
- Appendix 5 - Primary Care Workforce Profile Jul15, item 7. PDF 57 KB