Agenda item

Jacqui Tuffnell, Rotherham CCG, to present

Further to Minute No. 80 of the meeting of the Health Select Commission held on 2nd March, 2017, Jacqui Tuffnell (Rotherham Clinical Commissioning Group) gave the following presentation on improving access to General Practice (doctors):-

 

We said:

We would introduce telehealth across Rotherham – We have:

-          Implemented Memory Jogger (Mjog) across Rotherham practices

-          Small number were using to enable patients to report results

-          30 practices were using to message patients e.g. flu campaign appointment reminders

-          1,400 appointments per month were released back from patients advising they are no longer attending and these were available for booking within fifteen minutes.

 

We said:

Access would be a significant element of our Quality Contract – We have:

-          Access improvement was a significant element of our quality contract and a requirement of all 31 practices from 1^st April 2017.  Spot checks had confirmed compliance as per self-declaration to date

-          Now implemented 3 weekend hubs for extended access:

Dinnington – Saturdays

Broom Lane – Saturday, Sundays and 6.30-8.00 p.m. Monday-Fridays

From July, 2018 the CCG would be funded for providing extended access

-          Utilisation was improving

 

We will:

-          Increase the extended hours offer to meet demand on Monday-Fridays

-          Implement nurse appointments

-          Implement e-consultation

-          Implement NHS 111 online

-          Implement an “App” for patients that could ultimately lead to a telephone consultation or face-to-face appointment

-          Implement a capacity and demand tool when NHSE make it available

 

We have:

-          Patient online numbers have significantly improved over the last year.  The CCG and NHS England were working with practices who were struggling with their uptake of patient online

-          We continue to look at ways of raising the profile of the availability by workshops to support new users

-          Facilitated all practices to undertake the productive general practice programme

-          Facilitated additional resilience monies to 10 practices

-          Facilitated the creation of a GP Federation – Connecthealthcare Rotherham – including medical and nursing leadership

-          We have funded the Federation to recruit 11 HCA Apprentices for practices to increase this workforce

-          We have funded nurse training and development, nurse educator roles and development roles from other sectors into primary care

-          Provided funding for locality based workforce

-          Commenced work with Rotherham Foundation Trust on joint roles for Associate Physicians and Associate Nurses

-          Implemented care navigation into 18 practices

-          6 services patients could be referred to without needing to see a GP:

Physiotherapy

Pharmacy

Smoking Cessation

Maternity

IAPT (Improving Access to Psychological Therapies)

Sexual health

-          We were working to develop the following services for care navigation:

Audiology

Single point of contact – RMBC

Minor eye conditions

 

Annual Patient Survey

-          Overall experience of GP

Rotherham CCG score if 86% (good/very good) compared to national average of 85%.  This was in line with the past 4 years

-          Ease of getting through on the phone

69% rated this easy or very easy and was in line with national figures and previous years.  Across Rotherham there were huge variation – Wickersley (29%) was considerably lower than other practices.  Other outliers were Treeton, Blyth Road, High Street, Dinnington, Brinsworth, who had all taken steps to improve their telephony.  Magna achieved 96% with Broom Valley, Village and Brookfield as close comparators

-          Helpful receptionists

RCCG score was 86%.  This was in line with the national average and previous years

-          Getting an appointment

RCCG score was 86% the same as previous years and the national average.  At 97% Mage Group was a high outlier.  The lowest rate was 69% (Wickersley) with Greasbrough another low outlier

-          Appointment convenience

RCCG score was 92% the same as the previous year and national average.  Variation in Rotherham was low; there were 3 low outliers at around 83% (Parkgate, Wickersley, Broom Lane).  Magna achieved 100%

-          What patients did when unable to get an appointment/offered an inconvenient appointment

All local paths were very similar to national data.  Over 1/3 of people went to the appointment offered, 4% weren’t to A&E, 2% saw a pharmacist, however, almost 1/3 (27%) did not see or speak to anyone or thought they might contact the surgery later

-          Overall experience of making an appointment

RCCG score was 71% the same as the previous 2 years and just under the national average of 73%

-          Waiting times in surgery

RCCG score was 61% similar to previous years and slightly higher than the national average of 58%

-          Satisfaction with opening hours

RCCG score was 76% the same as previous year and national average

 

The following issues were highlighted during discussion:-

 

: 1.5 million appointments per year in GP practices in the Rotherham Borough area;

 

: quality standards, eg: same-day appointments for medical emergencies and routine appointments with a GP within five days of the patient making the request;

 

: the availability of GP surgeries at weekends, for all patients (the locations of these surgeries are Broom Lane, Dinnington and Kimberworth);

 

: the planned extension of the availability of GP surgeries in the evenings (Monday to Friday);

 

: the ‘intelligent appointment’ system being piloted in Birmingham;

 

: the possible use of other modern systems (eg: Facetime) for patients’ medical appointments;

 

: the skills mix changes in general practice and the focus on care closer to home;

 

: the success of care navigators in freeing-up GP time – 39 hours per week;

 

: the recruitment of apprentices and associate nurses into Health care roles and the possible use of associate physicians, a system which has operated for many years in the USA;

 

: pressure on specific GP practices (eg: Clifton; Wickersley);

 

: the reliability of surveys of patients because of the apparent reluctance of some patients to be critical of GP surgeries and services;

 

: the re-modelling of the Integrated Wellness Service (including the ‘quit smoking’ initiative) with effect from April 2018 and ensuring that there are no gaps in service provision;

 

: through MJOG, 100,000 messages had been sent, although letters were still used as there was patient choice for preferred means of communication

 

: 78% of Rotherham people had the use of smartphones and apps;

 

: it was hoped to see the impact of the continuing improvements reflected in future annual patients’ survey results.

 

Recommended:-  (1) That the report and presentation be received and their contents noted.

 

(2) That every endeavour should be made to increase the amount of information and publicity made available to the general public about the opening of certain GP surgeries in the Rotherham Borough area on Saturdays and Sundays.

 

(3) That, in order to make best use of modern technology and means of communication, the GP practices be encouraged to have discussions with RMBC Library and Information Services about the possible benefits of the technology being used by the Council for customer services also being available for patients of GP surgeries.

 

(Councillor Ellis declared a personal interest in the above as a registered patient at one of the GP surgeries listed within the submitted report. Having declared that interest, Councillor Ellis remained in the meeting and participated in the discussion on this item)