Agenda item

To receive a presentation on the transformation of primary care with respect to GPs and Primary Care Networks and the resulting implications for patients.

Consideration was given to a presentation by the Rotherham CCG in respect of changes to GP and Primary Care Networks. The new long-term plan included the transformation of the Primary Care Networks—six of which are in Rotherham. Practices had been working together in terms of telephone systems, hot and cold site visiting, etc. These strong relationships also strengthened multidisciplinary working across all the networks. Funding had been received to recruit for 48 more posts added since this time last year. Care navigations had therefore been streamlined so that patients received their care appointments quickly. None of the extended access had been utilised since March, so this had been converted into hot and cold services. Population needs had been assessed by geographical area, to try to identify and meet better the needs of the patient population on a more granular level. With these arrangements, clinicians could support their practices even if they were self-isolating at home. Funding had also been put in place to look at the conditions most affected by COVID.

The update further showed that COVID had accelerated progress with telephone triage. Most people prefered video consultation, which was also supported by the Rotherham Health App. It was noted that the information was also recorded efficiently. The login and the triage processes had also been streamlined to minimise the impact on clinicians. If there were particular issues, the Primary Care Network had been able to mobilise to respond.

A new home visiting service had also been deployed since July. This service also supported care homes. The entirety of this service had been moved to hot visiting, while the GPs continued to do cold visiting. It was noted that the entire place has responded powerfully to the demanding circumstances. Details were presented as to measures in place to prevent transmission and to maintain safety. Tele-dermatology was a further area of innovation. Ophthalmology had also been adapted to continue to provide services to people throughout COVID. Details were provided as to the measures in place to ensure high quality care is provided to care homes during COVID.

Details were provided as to progress with Clinical Thresholds. The priorities had included provision of rapid access to smoking cessation, weight management, etc., for patients who needed to have surgery but were not quite fit enough to have that surgery. It was noted that some invasive procedures, especially in trauma and orthopaedic areas, were able to be avoided because when the patients lost weight, they no longer needed the procedures. The new practice, with positive results so far, was to schedule people for surgery and health optimise at the same time, instead of deferring scheduling until health optimisation had taken place.

In discussion, Members requested clarification as to how it was that one practice belongs to the PCN associated with a different geographical area of the Borough. The response illustrated that this association reflected the relationships of the branch sites and reflects the contracts. Assurances were provided that there was no impact on the service provided at the practice.

Members also asked if the Rotherham Health App would eventually expand to become a universal gateway to health services. The response suggested that several expansions were in progress. The challenge was that TRFT have quite a complex system, so the question became whether this system could be integrated with the app.

Clarification was requested around how many practices were using the Rotherham Health App. The response emphasised that all practices had access to the Rotherham Health App. They also had access to AccuRx, which was preferred by some clinicians. Numbers were not currently captured as to the uptake of the App among practices. Numbers were available showing how many appointments are face to face versus technology mediated, but it was not possible to know how many had been conducted by telephone versus video.

Clarification was requested around how many people are using the app? The response indicated that 10% of the Rotherham patient population were using the app, which is high in comparison to Birmingham, which remained at 6% after more than a year since the service was rolled out.

Assurances were requested that health checks could be conducted even where the presence of autism or disability presents challenges to communication. The response identified inclusion as an important area of work. Clinicians strove to have flexibility built in so that if there were a carer available, that person would be invited to join in the consultation, although this practice otherwise would be  discouraged generally in accordance with the current practice of limiting face to face appointments. For some patients, it was important to have phone consultations available.

Resolved:-

1.    That the report be noted.