Agenda item

Terri Roche, Director of Public Health, and Jacqui Tuffnell, Head of Co-Commissioning, Rotherham Clinical Commissioning Group

Terri Roche, Director of Public Health, and Jacqui Tuffnell, Head of Co-Commissioning, provided an update of the action being taken for each of the Scrutiny Review’s twelve recommendations.

The Review had taken place between September, 2013 and March, 2014, with the aims being:-

-          Establish the respective roles and responsibilities of NHS England and GP practices with regard to access to GPs

-          Ascertain how NHS England oversees and monitors access to GPs

-          Identify national and local pressures that impact on access to GPs – current and future

-          Determine how GP practices manage appointments and promote access for all patients

-          Identify how NHS England will be responding to changes nationally

-          Consider patient satisfaction data on a practice by practice basis and to compare Rotherham with the national picture

-          Identify areas for improvement in current access to GPs (locally and nationally)

Further scrutiny of the initial response from partner agencies had been carried out in January, 2015 and a mini survey with GP Practice Managers undertaken at their Forum meeting in May, 2015.

The majority of the actions in response to the twelve recommendations fell to the Rotherham Clinical Commissioning Group (CCG) and NHS England.  Many had now been either completed or included within the Interim GP Strategy. There was also a workforce strategy.

Three were aimed at the Health and Wellbeing Board and, although it was clear the Board would not lead specifically on any campaigns, it had a role in bringing partners together to ensure consistent messages were delivered.  One of the ways in which this would happen would be through a revamped website, due to be completed by the end of May, 2016, and a Twitter account now set up to keep the public and stakeholders updated on partners’ activity and health and wellbeing initiatives.

Consideration was given to Appendix 1 which contained the Cabinet response to the recommendations.  Discussion ensued with the following issues raised/highlighted:-

·           Improvements in telephone systems were taking place, for example informing people where they were in the telephone queue and additional capacity at busy times such as 8.00-9:30a.m.

·           Efforts should be made to gain the support of the large number of private sector employers within the Borough to encourage their employees to keep their GP appointments as part of the prevention and care agenda

Prevention formed part of the quality contract and work took place with Public Health in terms of an element of associated funding which was increasing the number of Healthchecks that took place.  Public Health could work with NHS England to make sure members of the public took up the national Health Screening Programme.  Primary Care needed to be supported in the wider sense and may be work with voluntary and community sector who worked with particular groups

·           Are you now confident that all practices were engaging effectively with their patients?  Are there any hotspots around?  Any issues within any individual GP practices?

There were some contracts that had struggled with Patient Participation Groups and a lot of work had taken place in connecting them with the more successful ones.  Healthwatch Rotherham was also helping to support them

·           Although recommendation 5 was originally rejected had it been revisited given the national specification has not yet been developed?

The Service was in place but the national specification awaited from NHS England

·           The Winter Communication Plan was updated and produced annually

·           The comments associated with the recommendations would be helped greatly if they contained numerical information and clearly defined data that supported the comments

·           Would there be an analysis of data regarding trends in the “do not attends” and the evaluation of the impact of the campaigns?

Linking to the Quality Contract, the sharing of the Key Performance Indicators with the Commission would pick up this point.  Also the GP lead for quality in every practice would meet monthly at the CCG with the CCG Clinical lead.  The practices were being clustered based on their demographics and they would be expected to be progressing.  It was only recently that all the data had been pulled together to show where each practice was on the map.  The cluster information would be shared at the Primary Care meeting in terms of KPIs which would include non-attendance, A&E attendance, workforce and how they were doing with regard to the Quality Outcome Framework.  All the information was in the public domain but there was only Rotherham pulling it altogether in one map so a comparison could be made between practices

·           Do you ever envisage returning to “sit and wait”

There had been a lot of discussion and public engagement with regard to “sit and wait”.  There were pockets of the public that would like it but the majority wanted to be seen at an appropriate time and within 5 minutes.  There was a very stretched workforce within Primary Care and there were examples of where no-one had turned up for “sit and wait” so was problematic in managing capacity.  From an efficiency point of view,  appointments were a more efficient way of managing a practice

·           Repeat prescriptions included review dates which were often missed.  Whose responsibility was it to ensure the review was undertaken?

       Work was taking place with practices currently.  There were a number of services which were reliant on review dates and reliant on the patients returning for blood pressure checks etc. Work was taking place with regard to having the technology in place for the bring forward systems

·           Consideration within the Strategy as to how to reward good practice or recognise good practice amongst employers

There was a balance between what the employees would want to share and how that could be recorded versus being able to record it.   It was a good idea to make sure that all the campaigns were better distributed and provide evidence on the importance of allowing people the time to attend their appointments and screening.  The awarding of good practice was by trying to get more people involved in the Workplace Health Charter and looking at the health and wellbeing of their workforce in the broader sense – from policies, access to healthier options in the canteen and getting the workforce to own it 

The report was noted and requested that a future update be submitted once the Strategy had started to embed.