Agenda item

To consider the findings and recommendations of the Health Select Commission spotlight review into access to primary care.

The Senior Governance Advisor introduced the report, summarising the findings and recommendations of the Health Select Commission spotlight review into access to primary care. The review was prompted by insight provided by Healthwatch Rotherham, regarding continued enquiries from residents who were having difficulty accessing GP appointments.

The report seeks approval for the recommendations to be submitted to NHS South Yorkshire / Rotherham Place Board for consideration and response.

The Vice-Chair welcomed the Cabinet Member for Adult Social Care and Health and the Director of Public Health to the meeting.

The Vice-Chair invited questions from Members of the Board and a discussion on the following points ensued:

Further details were sought on how the Commission had arrived at its recommendations. In the absence of the Commission’s Chair, a request for was made for further details to be shared.

The Cabinet Member was asked for his views on the review and findings. He highlighted that the review reflected a national problem in access to primary care. He noted that services in Rotherham compared well regionally although improvements were still required. It was outlined that the Place Board and NHS South Yorkshire were part of the Health and Well-Being Board and in his role, would recommend that partners gave consideration to the recommendations.

The Director of Public Health observed that the focus of the review was access to GP services rather than the broad of primary care. However, he noted that GP practices were working collaboratively to drive improvements.

Examples were given of difficulties to access GP surgeries and questions were asked about the definition of reasonable waiting times. It was suggested that patients may present to emergency care if they were unable to secure an appointment, which may exacerbate pressures on those services.

It was noted that the key recommendations of the report referenced national issues and longstanding structural problems with GP contracts. A view was expressed that the deprivation formula for funding acted as a disincentive for practices to work in communities often with more complex health needs. It was also noted that demand for services had increased significantly since 2017. An example was given of a practice in a neighbouring borough doubling its number of GPs however, there were still pressures on available appointments. It was suggested that a structural change was required to encourage more people to work into primary change and retain existing staff. It was also highlighted that recent changes to the GP contract to offer same-day appointments may increase additional pressures on primary care.

The Chief Executive outlined in her role as co-chair of the Place Board, that it was recognised that national change was required and this would be raised through this forum and the Integrated Care Board. However, it was reiterated that unless change was affected at a national policy level, there was limited influence that could be exercised locally.

Resolved:

1.    Cabinet notes the following recommendations and considers its response.

2.    Cabinet approves the submission of the recommendations to NHS South Yorkshire / Rotherham Place Board for consideration and response.

a)    That the principle be agreed that responsibility for patient access to primary care is shared between the primary care practices and their patients.

b)    That consideration be given to how all Place Partners demonstrate responsibility to communicate honest wait times, where this information is available, for all health and care services system-wide.

c)    That any trend connecting a practice or GP with excessive delays or Urgent and Emergency Care Centre attendances be analysed, and appropriate action taken.

d)    That consideration be given to how to increase general understanding of how to recognise symptoms as needing medical attention, where to seek help, and within what timeframe.

e)    That Place partners, including the Primary Care Networks (PCNs), consider how to expand general understanding of the wider options when seeking medical advice, with a view to expediting consultation with the most appropriate professional or service to be able to address their need.

f)      That NHS South Yorkshire/Rotherham Place Board give due consideration to enhanced safety-netting to mitigate risks associated with an increasingly patient-led model of care initiation and follow up.

g)    That NHS South Yorkshire/Rotherham Place Board consider how messaging and communications will figure in managing patient expectations around waits in the evolving model of care.

h)    That consideration be given to how Councillors may play an expanded role in signposting and managing expectations among Rotherham residents, as the sector works toward a new model of care which takes account of ongoing resource pressures on health services.

i)        Whereas recruitment remains a limiting factor for expansion of social prescribing, that recruitment to social prescribing roles be prioritised, and consideration given to how to make participation in social prescribing in Rotherham more attractive to professionals.