Agenda item

NHS Brent has provided a report on GP access satisfaction results for 2010/11, as requested by the Health Partnerships Overview and Scrutiny Committee. When members last looked at this issue in April 2011, members were keen to see that improvements would be made in GP satisfaction measures by quarter 4, as NHS Brent felt that the Access, Choice and Experience (ACE) programme should be delivering improved satisfaction by the end of 2010/11.

Jo Ohlson introduced the report which provided information requested by the committee at the previous meeting to see what improvements had been made in GP satisfaction measures for quarter four of 2010/11.  She reported that overall there had been improvements with regard to the access indicator, whilst although overall satisfaction indicators had dropped in respect of patient experience, the reduction was less than that reported nationally.  Jo Ohlson added that “the clean, comfortable, friendly place to be in” indicator had improved slightly overall.  It was felt that the improvements recorded could be partly attributed to the Access, Choice and Experience (ACE) programme.  Jo Ohlson acknowledged that more work could be undertaken to provide a summary of performance by practice, however she informed Members that the ACE team’s resources to undertake performance analysis had been diminished.

Prior to the committee discussing this item, Councillor R Moher (Lead Member for Adults and Health) was invited to comment.  Councillor R Moher asked for an explanation as to why Kingsbury Consortia had performed worse in all indicators with regard to experience and what action was being taken to remedy this. 

In reply, Jo Ohlson commented that the better performing consortia tended to show greater enthusiasm to ACE’s initiatives and this had not been the experience at Kingsbury.  However, all consortia were expected to consider ways to improve patient satisfaction and experience.  Sarah Basham (Clinical Director, Willesden Clinical Commissioning Group) added that ACE had focused on embedding systems last year and this year would focus on standardisation, whilst a process of peer reviews whereby local practices made comparisons with neighbouring ones to see how they can improve would continue.

During Members’ discussion, Councillor Hunter enquired when the results per practice would be available and in a user friendly format.  In respect of large performance differences between practices, she queried whether some consortia performances was being compromised because of one particular practice performing well below the others.  Councillor Hunter also expressed concern that the more detailed information previously requested and the performance improvement anticipated had not materialised to date and sought assurances in respect of these.  Councillor Daly commented that almost half the patients were not satisfied in respect of the clean, comfortable, friendly place to be indicator and asked what was being done to address this.  She suggested that a more helpful way of presenting the data would be to list the ten best and ten worst performing practices, as this would be particularly useful for patients.  Councillor Daly felt that the customer satisfaction levels recorded overall indicated that the level of service currently being provided was not acceptable and that a more robust approach focusing on ensuring customer satisfaction needed to be taken. 

Councillor Colwill commented that he personally had been content over access and experience in a recent visit to a health facility.  However, he sought reasons as to why the Kingsbury and Willesden consortiums were performing below others.  Councillor Cheese enquired what measures were in place to ensure that staff behaved in an acceptable way.  In respect of peer reviews, he suggested that not all neighbouring practices enjoyed good relationships and he felt that a different approach to improving practices needed to be taken.

The Chair emphasised that providing best quality of service was the highest priority and she sought details of what measures were being taken to ensure this.  In respect of GPs taking responsibility to improve access to services, she enquired what support they were given to achieve this.

In reply to the issues raised by Members, Jo Ohlson confirmed that the performance results were publically accessible through the NHS Choices website.  The results were compiled by consortia, however Jo Ohlson agreed to look into how to make the information more user friendly.  Members were advised that practices were obliged to register and comply with the Care Quality Commission’s (CQC) premises standards by April 2012.  The ACE programme also encouraged staff to provide more customer support and have a friendlier approach.  In the meantime, staff had contractual obligations that they were required to meet and consortia were required to provide a declaration in respect of this.  From April 2012, the CQC would be checking to see if the declaration was sufficient as well as reviewing patient feedback.  Each consortia was required to provide information on how it was addressing areas that were in need of improvement.  Jo Ohlson advised that there was not always a direct correlation between high quality care and high patient satisfaction levels.  Consideration of how to provide appropriate weight to each indicator also needed to be given, however Members heard that a traffic light system of highlighting performance results would continue to be provided.  However, it was not anticipated that the measures put in place by the ACE programme would show significant improvements until quarters three and four.  Jo Ohlson explained that GPs now had more support to help them improve in areas of service since the ACE programme had been launched as well as receiving advice and support from peers and neighbouring practices. 

Rob Larkman (Chief Executive, NHS Brent and Harrow) added that practices across the borough would have their performances scrutinised and those performing below satisfactory levels would be challenged to raise their standards.

The Chair requested that a report providing performance information of both individual practices and the consortia be provided at a future meeting of the committee.