Agenda item

Jacqui Tuffnell, Head of Commissioning, Rotherham CCG, to present

Jacqui Tuffnell, Head of Commissioning, Rotherham CCG, gave the following powerpoint presentation:-

                                                                                         

National and local demand continues to rise

Year                Rotherham GP activity

2015               1,093,753 appointments

2016               1,180,601 appointments

2017               1,549,034 appointments

2018               1,604,853 appointments

 

We have

-          Now implemented 3 weekend hubs for extended access:-

Dinnington – Saturdays

Magna – Saturdays

Broom Lane – Saturday, Sunday and 6.30-8.00 p.m. Monday-Friday

-          Since October 2018 we have been providing an extra 132 hours per week (from 22 hours per week) – over 430 additional appointments

-          Utilisation is improving on average now over 60% and some weeks as high as 80% but DNAs are increasing – there are posters in all practices advertising the access hubs, patient feedback is very positive from those attending – part of winter communications

Saturdays were now at nearly 100% but there was spare capacity on Sundays yet at the UECC the busiest days were at the wekends

-          Increased the extended hours offer to meet demand on Monday-Friday

-          Implemented Nurse, Physio, Pharmacist and Healthcare Assistant appointment

-          Enabled 111 and Rotherham Hospital to be able to book directly into the hubs after triage although some patients will still choose to wait

-          Started to roll-out the Rotherham ’App’ for patients that could ultimately lead to a telephone consultation or face-to-face appointment – it will also be feasible to book directly into the extended access hubs – full cover April 2019 on a phased basis

-          Communications – practice notices, MJoG messaging, leafleting, winter campaign

-          Implementing a capacity and demand tool to help GPs manage their workload and have the right resources

-          Waverley GP service has been procured – The Gateway – delays in building commencement, however, backstop of October 2020

-          Implementing teledermatology – rollout commencing April

 

GP Patient Survey 2018

Q No.	Question	RCCG Results % good	National Results % good
Q31	Overall how would you describe your experience of your GP Practice?	84%	84%
Q1	Generally how easy is it to get through to someone at your GP practice on the phone?	71%	70%
Q2	How helpful do you find the receptionist at your GP practice?	88%	90%
Q6	How easy is it to use your practice website to look for information or access services	78%	78%
Q16	Being offered a choice of appointment	60%	62%
Q17	Satisfaction with type of appointment	73%	74%
Q22	Overall experience of making an appointment	67%	69%
Q27	Health professional recognising Mental Health needs	89%	89%
Q38	Support to manage LTC	81%	79%
Q8	Satisfaction with available appointment times	64%	66%

 

It was hoped that the responses to several of these question would improve over time with the introduction of the Rotherham App and patients having more control.  Further training with receptionists was planned.

 

The world is changing

-          NHS Long Term Plan and new GP contract

-          Primary care networks

30-50,000 population

Integrating community care

Funding additional roles

Extended access

Population health management

Joining up Urgent Care Services

Using digital technology

Service developments

 

Members were reminded of keys issues that had previous been covered in terms of managing demand from patients

-          Alternative workforce models

-          Retaining and attracting GPs

-          Care navigators

-          Patients still wanting to see a particular GP at a particular time and being prepared tow ait

-          Patients saying they struggle to get through to get an appointment

-          Management of the worried well and self-care, no need for a GP

-          Work to do on patient education

 

More detail was provided on the Rotherham App and leaflets were shared with Members.  People would be able to access their medical record, make changes to their medication, book appointments and use a symptom checker to help decide if they could self-care or needed an appointment.  To get full functionality patients needed to register formally with their practice first for security reasons.

 

Discussion ensued with the following issues raised/clarified:-

 

·           Mobile App – carers would be able to access the app via proxy by the person they cared for

 

·           Computer/smart phone – it had been surprising that the more mature residents had embraced the new technology, however, it was acknowledged that everyone did not have access to a computer/smart phone.  The surgery telephone lines that were currently busy would hopefully start to be less so when more utilised the digital technology to make their medical arrangements

 

Last year it was also agreed to link with the Council on training around the App following a recommendation from this Commission.  The project manager had been discussing groups and downloading the app and they utilised it

 

·           Offered the option for appointment at a hub – the doctor’s receptionist was required to offer you an alternative venue

 

Members were encouraged to feed back any issues or concerns about an individual practice to Jacqui

 

·           Medical Records – a patient had to go to their surgery and request access to their medical records.  Once that authority had been given you would be able to access it via the app.  It was a massive job for the practice as they had to go through every patient’s individual medical record, however, they had to do it

 

·           Wider Services - discussions were taking place with the Foundation Trust with regard to making hospital appointments and eventually hoped it would include the Single Point of Access and all services across Rotherham

 

·           GP Patients Survey 2018 – it was felt that the satisfaction rate would increase due to the additional workforce that was going into practices giving the ability to divert patients to services and receive the care they required within a short time rather than having to wait for weeks.  Responses could be broken down by practice.  Working together in the new primary care networks would have a positive effect

 

·           Logging in for appointments – encourage patients to use the log-in screens at their practice rather than queueing to inform reception of their arrival

 

·           Hubs – why not include a holding message about access to a hub when people were waiting to speak to a doctor’s receptionist? This idea was welcomed and would be followed up

 

·           Appointment at a Hub – due to the contract set up by NHS England, appointments were not allowed to be used for urgent care so there had to be a booked appointment system rather than patients just turning up

 

·           Waverley – the building of a surgery at Waverley was connected to the creation of the Waverley Centre, a shopping centre that was being created.  There had been planning issues and issues with grants.  Rotherham CCG was unable to hold any lease and had to appoint a GP provider, Gateway, who would sign the lease.  The CCG’s cut off date was now June, 2019 for it to be built by 2020

 

·           Patient Participation Group view of ease of access – it was mixed.  Some parts of the population thought it was okay to receive adequate care and access but by participating in a PPG made them realise they should be getting more and helped improve the access arrangements

 

Jacqui was thanked for her presentation.

 

Resolved:-  That the report be noted.