Report of the Corporate Director of Resources, Durham County Council and the Director of Commissioning, Strategy and Development (Primary Care), NHS County Durham Clinical Commissioning Group.
The Board received a joint report of the Corporate Director of Resources and Director of Commissioning Strategy and Development (Primary Care) in relation to progress against review recommendations from the Adults Wellbeing and Health Overview and Scrutiny Committee Review of GP Services in County Durham (for copy see file of minutes).
Councillor R Bell noted that it had been around 10 years since former Health Secretary Andrew Lansley had brought in reforms that created the CCGs to give primary care a larger voice within the NHS and asked as regards the impact on GPs would be in moving to the new ICS and whether it would be to the benefit or detriment of primary care.
The Director of Commissioning Strategy and Development (Primary Care) noted there were a lot of unknowns and noted that if one were to ask Durham GPs, they would note they had been fully supportive of the CCGs over the last nine years in helping to benefit their patient populations and the ongoing development of general practice. GPs were hoping that the benefits of CCGs in County Durham, in terms of local influence, decision-making and financial control is retained via place-based arrangements under the ICS.
The Vice-Chair, Dr Stewart Findlay noted that the Lansley changes had not been universally popular, however, for primary care they had worked well, in particular in Durham. He explained that there had been good support for primary care and noted the integration agenda had been advanced more than ever before, working closely with the Local Authority, Mental Health Trusts and Acute Trusts. He noted the development of joint pathways and the movement of a lot of work from secondary care to primary care, closer to patients’ homes and often more cost effective. He added there was the ability to react quickly, evidenced by the successful vaccination programme, being able to mobilise within a matter of weeks. Dr Stewart Findlay noted the importance of retaining that clinical engagement going forward. He noted that, as with any change, there would be some embedding as people reorganised, and noted the importance of all working together.
The Director of Integrated Community Services noted that, operationally, due to the influence of GPs, CCGs had commissioned the Community Services Contract, nearly £80 million of services. He explained using the example of the Richardson Community Hospital which had influence from the social work team that was collocated and had input from local GPs, with that leading to better outcomes for patients.
The Chair asked as regards struggling to obtain a timely GP appointment, noting services such as 111, pharmacies and mobile apps which could help in terms of alleviating pressures. The Director of Commissioning Strategy and Development (Primary Care) noted he would encourage the use of technology in terms of reordering repeat prescriptions or to received test results in order to prevent multiple calls through GP telephone lines. He noted ongoing work in relation to GP telephone systems, following Government comments in relation to patient frustrations in contacting GPs.
He explained that GPs, as businesses, had often purchased their own telephone systems and noted some had moved to cloud bases systems, enabling their staff to be able to work from home, providing additional flexibility. Digital access was now part of the complement of services from GPs in order to meet the expectations of patients and provide choice during covid and moving forward.
Dr Stewart Findlay noted the ratio of reception staff to clinical staff may need to increase in order to deal with the number of calls. He noted that primary care was busier than ever before across the country, since recording began, and was significantly higher in the North East. He added Durham GPs were seeing more contacts that any other region, with more face to face consultation and more home visits, with less GPs as the number of GPs had fallen. He concluded by emphasising the good performance of GPs in Durham.
(a) To consider and comment on the progress made against the recommendations made within the OSC Committee’s Review report into GP Services in County Durham;
(b) To Receive the report of the Director of Commissioning Strategy and
Development (Primary Care), NHS County Durham in respect of NHS England guidance entitled “Improving Access for patients to Primary Care and Supporting General Practice and the associated winter access fund”;
(c) To consider and comment on the guidance and offer any insight that
will inform the County Durham response;
(d) To receive further reports and dialogue that respond to NHS England expectations.