Agenda item

The Integrated Care Board (ICB) submits a report providing an overview of the NHSE Primary Care Recovery Plan (PCARP) and commitment to patients.

The Deputy Chief Medical Officer and Head of Transformation presented the item, and it was noted that:

·       Integrated care boards across the country are required to develop system-level access improvement plans for primary care.

·       The main commitments in the LLR Plan includes addressing the 8am rush, continuity of care and reducing bureaucracy between primary and secondary care.

·       General Practices across LLR provided over 360k additional appointments in 2022/23 than the previous year. The plan intends to ensure additional appointments are maintained by increasing the workforce and creating multidisciplinary teams to meet the needs of the community.

·       LLR practices exceeded the 70% target of face-to-face appointments, but feedback has been received that patients would like more. There is a national push to move towards digital appointments but face-to-face will not be eliminated.

·       Understanding and improving patient experience is a focus and whilst a national survey is undertaken further information will be collected through a local patient experience survey, due to launch in 2024.

·       Variability will inevitably exist across practices to identify and meet the needs of the population. The ICB are aiming to promote some consistency however in relation to cloud based telephony, using a wider workforce to ensure patients can be seen appropriately and working with community pharmacies for better access.

·       Over the winter period primary care networks are enabling additional appointments to support patients in the community, particularly focussing on acute respiratory conditions.

In response to questions and comments from Members, it was noted that:

·       Demand inevitably outstrips capacity as primary care is the initial contact of healthcare system. As part of the system level framework, general practices are looking to identify demand and build capacity to be flexible to the needs of communities through training, creating multi-disciplinary teams with varied roles and building relationships with community pharmacies.

·       The national feedback survey has limitations in information it asks and the rate of response from Leicester has been low previously. A local survey is due to launch in 2024 to enable further data to be collected.

·       There is variation between GP practices on access to services, but incremental changes are visible, and many practices are utilising features of the NHS App to improve patient experience. The local feedback survey will enable further work to be undertaken.

·       Uptake of the NHS App across LLR is 54% of patients registered although functionalities vary but work is underway to increase.

·       Communication teams across the health system and the local authority are promoting the NHS App although the features enabled by each GP practice currently varies. The local authority also utilises the Your Leicester newsletter to share health information.

·       Recruitment has been lower in the city compared with the wider LLR area but there has been a good uptake for the GP fellowship scheme.

·       It was agreed additional information would be shared with the Commission regarding increasing staff in GP surgeries and the number of GPs across the city compared with previous years.

·       A robust programme is in place to ensure resilience and support GP practices that have limited partners that may be nearing retirement to ensure patients other practices can support with patients and prevent contracts being handed back to the ICB. It was agreed further information would be shared on the number of GP practices operated by one or two partners who are nearing retirement in the city.

·       GP Practices are required to create health inequality plans which includes identifying support for elderly patients and proactive outbound work for prevention.

·       There are various pathways that enable patients to access services without GP referrals, including mental health and musculoskeletal. It was agreed that information would be shared on all pathways available for self-referral.

·       The judgement of a clinical practitioner will determine the urgency of a health case. Care navigator will use a flowchart agreed by the clinical team but if there is doubt staff should seek clinical guidance. 

As part of discussions the Chair invited Healthwatch and youth representatives to make comments and it was noted that:

·       Appointments are being made available for patients to book online, although the number of appointments will vary between practices. Some practices in the city are also interacting with patients online to determine whether advice can be provided without needing an appointment.

·       Primary Care Networks are making a difference and providing resilience to enhancing GP access to patients with practices working together and providing additional appointments including evening and weekend.

The Chair invited Cllr Haq from the public gallery to ask a question in which it was it was noted that:

·       Further information in relation to the breakdown of NHS App users across LLR, particularly the uptake in the city will be reviewed and shared if available. 

·       Various plans are in place and workstreams underway to support patients in the community and prevent additional pressures on local hospitals over winter.

The Deputy City Mayor for Social Care, Health and Community Safety noted that whilst A&E has started to see pressures, the recent situation was better than the previous year. Cllr Russell also shared a tweet with the Commission by an A&E Doctor, not from University Hospitals of Leicester, to highlight that health workers are doing all they can in light of challenges.

It was further noted that ICB funding is being utilised by the local authority to alleviate fuel poverty and prevent admissions, particularly relating to respiratory conditions.

AGREED:

·       The Commission noted the report.

·       Members comments and concerns be noted by health partners.

·       Additional information requested be circulated.

·       The Commission receive a report in 2024 regarding the results of the local satisfaction survey and health inequalities plan.