Agenda item

For the Health and Wellbeing Board to receive an update on primary care in Brent.

Fana Hussain (Borough Lead Director – Brent, NWL CCG) introduced the report, which detailed the priorities for primary care going forward, as defined by national, regional, North West London, and local priorities. It was recognised that during the pandemic years, when many services moved to remote, patients may not have come forward for a number of services provided by GP practices, and some services that the GP may have previously provided may not have been accessible. As a result, a priority was reaching those patients who may not have had contact with their GP for some time now that services were fully open. In particular, cervical smear tests and childhood immunisations continued to be a priority. SMI health checks for those with learning disabilities or mental health diagnoses was also a priority going forward. The paper detailed the work being done to recruit to the Additional Role Reimbursement Scheme (ARRS) to support Primary Care Networks (PCNs).

The Chair thanked Fana Hussain for her update, adding that they were also using ARRS to support patients with their medication, following 6 years of clinical training. He invited comments and questions, with the following issues raised:

• In relation to face to face services, the Board were advised that access to primary care existed whether virtual or face to face, and if patients wanted face to face that should be made available to them. The Integrated Care Partnership (ICP) had written to all practices and asked them to open their doors while maintaining infection control measures. The ICP had also commissioned Saturday morning clinics from a number of GP practices across all PCNs, with a focus on face to face in particular. Dr Haidar added that there was work to do alongside community services and the Brent Health Matters team to educate patients on which services to attend to best meet their needs, for example to avoid patients going to their GPs when their pharmacist was better equipped to provide a service. Brent Health Matters had been doing a lot of publicity around winter access including leaflets, social media campaigns and promoting the hours and telephone numbers of primary care services. Specifically in relation to group therapies, the Board were advised that CLCH were offering all their services face to face, or hybrid for families who preferred digital, as well as ensuring home services were offered face to face, with the exception of group sessions. Officers were working with the Medical Officer to understand the guidance and risk assessments to get groups running again.

• In relation to the commissioning of ARRS by PCNs, the Board were advised that the role of ARRS was to help in the reduction of variation across primary care services and standardise care across the patch. They were available to all GP practices in a particular PCN but may be focused on one specific practice. For example, in one PCN there may be 4 GP practices varying between good, middle or poor standards, and so the additional resource from the ARRS may be placed in the practice with poorer standards to level that practice up. It was highlighted that Brent was suffering with recruitment and retention issues for the ARRS. For example, the inner/outer London weighting impacted where staff wanted to work, and a priority for the ICP was to improve that recruitment so that ARRS staff were consistently available to every practice and every person within a PCN. Recruitment was an issue across the whole of the 8 NWL boroughs rather than a Brent specific issue.

• In relation to how those ARRS specialists could be supported with their continued professional development in order to encourage them to work and remain in North West London, the Board were advised there was an Educational Training Hub. They were told no request for training was refused, and nurses were actively encouraged to take on additional training, with an allocation per nurse set aside. The balance that the ICP struggled with was that if a nurse was not working and was on a training course then they were not earning, and the ICP needed to look at encouraging GP practices to release nurses to do education training on a paid basis. This would benefit GP practices as well. Dr Haidar added that across 51 GP practices there were now certain practices which were training practices, including his own.

• A pilot was being trialled at Northwick Park Hospital, where a GP and nurse had been placed in the Urgent Treatment Centre to triage patients turning up there in order to support easy access to medical services. They had been managing over 1,000 patients a month and 3,000 patients had been managed either on site, received self-care advice, been seen by the GP, or had been booked in for an appointment. Other boroughs were now adopting the project due to its success.

RESOLVED: to note the information provided in the paper.