Agenda item

The Health Select Committee has asked to be kept informed on the work that NHS Brent is doing to improve access to GP services in the borough. NHS Brent has provided a report on this, which includes the results of the 1st and 2nd quarter GP access survey results for 2009/10. As of this year, satisfaction with GP access will be surveyed quarterly rather than annually.

Jo Ohlson (Director of Primary Care Commissioning, NHS Brent) introduced the report which provided the committee with an update on the work being carried out to improve access to GP services in the borough and the results of the 1^st and 2^nd quarter GP access survey results for 2009/2010.   It was noted that as of this year, NHS Brent had been asked by the committee to provide quarterly rather than annual updates.  Jo Ohlson began by explaining that whilst NHS Brent remained concerned and disappointed with the results for the 1^st and 2^nd quarter of 2009/2010, which were below both the national and London average, GP access continued to be a top priority for NHS Brent and featured in NHS Brent’s Annual Plan and 5 year plan. Jo Ohlson drew the committee’s attention to the 2009/2010 quarter results as shown in the report and explained that whilst the survey uptake had improved compared to the 2008/2009 results, the satisfaction scores, excluding the ‘ease of seeing a Practice Nurse’, had gone down compared to 2008/2009.  She stated that she hoped that the effects of more recent work in improving access, such as extended hours, would have a positive impact on the quarter 3 and 4 2009/2010 results.

Jo Ohlson made the committee aware of the 6 main components that NHS Brent were focusing on in order to improve the overall satisfaction with access across Brent, as highlighted on the graph on page 1 of the report.   She stated that one of the ways which NHS Brent had responded to the 2008/09 results, was by holding an ‘Improving Access discursive event’ on the 20 January 2010. This event, she explained, provided the GPs and practice staff, from across NHS Brent, with the opportunity to discuss the issue of improving access and the approach that their practices would like to take to improve access. She explained that the event had left NHS Brent looking to improve access for patients by implementing support modules for practices. She added that NHS Brent’s ‘Improving Access Steering Group’ was currently assessing the responses to the event. 

Jo Ohlson drew the committee’s attention to the list of proposed modules, shown on page 2 of the report, which if approved would be delivered to NHS Brent practices as part of an Improving Access Programme of Work.  She explained that one of the modules being proposed was to aid practices in carrying out demand and capacity surveys.  Demand and capacity surveys, she explained, enabled practices to gain an understanding as to when their services were in most demand, so that provision could be tailored to meet these demands.   Jo Ohlson concluded by setting out some of the next steps which NHS Brent would be taking to improve patient access, which included visiting practices to create and agree practices’ plans, delivering the modules, if approved, and providing support to identified practices.  She added that she hoped that they would start to see an improvement in results within the next 6 months.

In response to a query regarding the reward linked to the Quality and Outcomes Framework (QOF), Jo Ohlson explained that the QOF included an element of patient experience to it. She added that many practices did not earn as much as they could have and that these practices had been told that they could have done better.   A concern was raised that a small response rate could mean that the results become altered due to a small number of patients and that there was risk that a practice which received a reward one quarter could then not receive a reward for the second quarter due to a small number of patients. This reduction in funding could then have a negative effect on future survey responses. In response to this concern, Jo Ohlson noted that whilst the survey was now carried out quarterly, the reward was based on the performance for the year.  Furthermore, she explained that the reward was a small amount of money and was an additional bonus for practices.  She explained that the attainment of the reward did not affect a practice’s ability to carry out a good service as existing funding was sufficient.  When asked how much the reward amounted to, Jo Ohlson explained that she did not have this information with her and that whilst she thought it was around £5000, she would need to check this. She stated that she would contact Andrew Davies (Policy and Performance Officer) to inform him of the exact amount. 

When answering a question about whether there were any penalties for poor performance with regards to access, Jo Ohlson explained that the contracts which practices sign, state that there must be ‘reasonable access’.  She added that practices had been sent information which compared them to other practices.  Practices, she explained, were being given a red, amber or green status.  She added that any practice which was red that did not sign up to the Improving Access Programme of Work would be followed up. 

The Chair noted that the committee would continue to monitor GP access.  The Committee requested that Andrew Davies produces a scoping document for setting up a task group to investigate the issue of GP Access and how access can be improved.

RESOLVED:-

(i)         that the update be noted;

(ii)        Andrew Davies (Policy and Performance Officer) to produce a scoping document for setting up a task group to investigate the issue of GP Access and how access can be improved.