Agenda item

Members to receive a report updating on the current priorities and opportunities in Primary Medical Care across Leicester, Leicestershire and Rutland as well as a summary on the Primary Care Network (PCN) Enhanced Access services delivered by Primary Care Networks across Leicester, Leicestershire and Rutland.

Members received an update reporting on the current priorities and opportunities in Primary Medical Care across Leicester, Leicestershire and Rutland as well as a summary on the Primary Care Network (PCN) Enhanced Access services delivered by Primary Care Networks across Leicester, Leicestershire and Rutland.

Yasmin Sidyot introduced the report and drew attention to the LLR Primary Care Plan update which concentrated on four key points:- Access, Workforce, Quality, and Delivery on key Long-Term Conditions.

It was noted that:

·         In terms of Access, more appointments were now being delivered across 132 practices compared to April 2019 and there had been sustained increase in face to face appointments being given across LLR from January to October 2022.

·         Enhanced access had been implemented and that came online 1^st October 2022, this meant primary care networks were delivering additional appointment capacity to that stated above, this additional provision was available Mon – Fri 6.30 pm to 8.30pm and on Saturdays  9am to 5pm

·         Outcomes of data showed some areas of significant improvements, such as the percentage of patients being treated on anti-coagulation treatment; hypertension patients being detected and treated earlier, although there was still some inequity across PCN’s with areas of further requirement to improve such as diabetic and respiratory patients but overall seeing shift towards better service provision.

·         Workforce continued to be challenging in general practice, and there was discrepancy between what workforce growth looks like across LLR. Improvements were being seen in the uptake of additional roles brought in through primary care networks such as social prescribers, pharmacists etc and there was growth in those but that was overlaid with the challenges to recruit and retain GP’s, nurses, and an administrative work force too.

The Chair invited members to comment on the report which included the following:

·         PCN contracts  were a concern, although overall things looked to be going well underneath there were still serious issues such as around recruitment and retention of appropriate staff to general practices.

·         OPEL status report was about the operating pressures and escalation level, this reporting was introduced with General Practices this year (2022-23) and is a very operational process that provides good intelligence of what GPs are facing.

·         The OPEL status report showed a deterioration from November 2022 to December 2022 of the number of GP practices at Level 3, this was because of increasing winter pressures  and the visible reporting enabled additional support to be put into acute respiratory services in January 2023, as well as enabling specific targeted work with practices.

·         In terms of patient groups there were currently 51 active participation groups and officers were working with them to ensure consistency in how they operate and also to connect with each other and work more collaboratively around patient experiences. General Practices were also being engaged to re-establish and refresh patient groups that had stopped.

Members raised concerns about the inaccessibility of phone systems that most general practices still used and the huge variation of quality of messages within those systems. Members were informed that telephone contracts had been discussed, these were individual contracts between the GP’s and phone companies, however steps had been taken to provide communication toolkits to GP’s,  but this took time to implement and embed, especially with practices that had issues in terms of culture and how they operate, and where there was a rapid turnover of workforce that also brings challenges to the communications and telephony.

As far as patients being offered appointments at different hubs and having to travel to those it was acknowledged there was a challenge in terms of what could be delivered through the network hub and what had to be delivered through local general practice and they were working with the patient population to try and reflect on that better.

The data presented in Tables 4 and 5 was queried in so far as it related to Rutland. In response it was advised that officers had been working with 4 practices across Rutland who had turned to the ICB in June, there had been different reporting methods in place, and this data had been amalgamated but officers would check that data and look to extract the Rutland data and share with members outside this meeting.

It was noted that officers were actively working on issues raised about access to GP’s in Rutland and there was a collaborative focus on specific elements and how to actively try to support a face led solution, it was also noted that border hopping was taking place and that mires the data too.

Members raised concern about the rise in private practice and the negative impact that brought upon the NHS for patient, and it was queried whether a 2 tier system and services were making it less attractive for GPs to work in NHS funded practices and what was being done to prevent general practice becoming an issue like dentistry. In reply it was noted that this had not been raised from the GP fraternity in LLR as a concern. Work was taking place nationally to ensure GP services and make it attractive and viable and there was local input to that.

The Chair thanked officers for the report. The Chair indicated that an update report should be provided to a future meeting and that it would also be helpful to provide an update specific to each of the local authority’s scrutiny committees during the 2023/24 municipal year to enable them to delve into the data for their areas.

AGREED:

1.    That the contents of the report be noted,

2.      That a report detailing progress made and containing a review of data from the early months of 2023 be brought to a future meeting of the committee.