Agenda item

(To receive a report from Sarah-Jane Mills, Chief Operating Officer, Lincolnshire West Clinical Commissioning Group, which provides an update on the progress in implementing plans to enhance primary care services and its public awareness campaign as to the alternative provisions to the Lincoln Walk-in Centre; and invites the Committee to review and comment on these plans) 

The Chairman welcomed to the meeting Dr Sunil Hindocha, Chief Clinical Officer, Lincolnshire West Clinical Commissioning Group (LWCCG), Sarah-Jane Mills, Chief Operating Officer LWCCG and Wendy Martin, Executive Lead Nurse and Midwife – Quality and Governance LWCCG.

The Chief Clinical Officer, LWCCG advised the Committee that a Push Doctor App had been promoting its online 'walk-in centre' services to patients in the Lincoln area.  Confirmation was given that this was not a service that had been commissioned by LWCCG; and that LWCCG had had no interaction or conversations with the company behind the App.  The Committee noted that a statement to this effect had been released.

During their joint presentation, Officers from the Lincolnshire West Clinical Commissioning Group updated the Committee on the following issues:-

·         Background – The Committee was reminded that on 12 June 2017, the Lincolnshire West Clinical Commissioning Group (LWCCG) had launched a public consultation on the future of the Walk-in Centre, this had concluded on 18 August 2017.  Then, at the Governing Body meeting held on 27 September 2017, a decision had been taken to keep the Walk-in-Centre open over the winter period; and close only when the governing body was satisfied with the evidence based reviews.  The first evidence based review had been presented to the Governing Body on 29 November 2017; and a further review was due to be presented to the Governing Body meeting on 24 January 2018.  It was highlighted that the ten week public consultation had been extensive and had engaged patients, the general public; public bodies, key stakeholders including health care partners and the third sector; 

·         It was reported that attendance to the Walk-in-Centre had significantly reduced, and that October 2017 had seen a reduction of 26.8% from the previous year; and that the September attendances had been the lowest monthly attendances at the Walk-in-Centre for over two and a half years.  The LWCCG had supported a targeted communications and engagement initiative by the University practice, during freshers' week to encourage students to register with a GP.  As a result of the initiative, the Committee was advised that the University practice had seen a net increase in registrations of 3,150 students;

·         Alternative provision – Page 22 of the report presented provided the Committee with a list of ongoing plans to strengthen alternative provisions in six key areas; and Appendix A to the report provided details of the status of the alternative provision plans.  Other alternative provisions mentioned included GP same day access, arrangements for urgent need; skype access at the University practice; additional community pharmacists; GP Out of Hours; 111 supplemented by Lincolnshire Clinical Assessment Service; Neighbourhood Team implementation progression (Gainsborough and the South of Lincoln areas).  The Committee was also advised that GP practices had confirmed that arrangements were in place to support any potential increase in demand.  It was noted that on average there was approximately 3 - 10 additional appointments per practice per day.  The Committee noted that as a result of concerns raised from the consultation, the LWCCG had a Communication Plan in place, a copy of which was detailed at Appendix C; and a Communications Initiatives Description was detailed at Appendix D for the Committees consideration; and Appendix E to the report provided the Committee with the LWCCGs Alternative Provisions Engagement Plan;

·         A & E Attendances – The Committee was advised that the attendances to A & E were being kept under review.  It was highlighted that communication reiterates that patients should only present themselves to A & E when it was an emergency; and if they were unsure, they should contact 111; 

·         Children's Hubs – It was reported that to enhance care for new parents and children the first of eight children's hubs had opened in Birchwood in the Lincoln City area.  The children's hubs would be another source of advice and guidance for parents with children under five; and would also include health visitor advice and other appointments; and 

·         Transition Planning – The Committee was advised that the LWCCG had been working in partnership with the Lincolnshire Community Health Service (LCHS) who provided the Walk-in-Centre Services, to ensure that there was an effective plan for transition.  It was noted that the transition plan incorporated the introduction of triage as a method to direct members of the public to the appropriate provision for them and provide education as to the alternative provision available.  Appendix B to the report provided the Committee with a description of the alternative provisions.

In conclusion, the Committee was advised that progress would be ongoing relating to alternative provision plans as approved by the governing body, details of which were shown on page 25 of the report.

The Committee was invited to make any comments on the progress made and to highlight any areas where the Committee felt further information was required; comment on whether the Committee considered the communication and engagement plan addressed the issues highlighted in the consultation; and whether the Committee wished to have a one-off meeting with the LWCCG to discuss matters in further detail.

During discussion, the following points were raised:-

·         Same day access to GPs for children under 12 – The Committee noted that if a same day appointment was not available then the parent should ring 111, as additional advisors had had extensive training regarding NHS and clinical matters and that pathways were already in place;

·         A question was asked as to whether the University practice was solely for students.  The Committee was advised that the practice was primarily for the university; but that other people could register at the practice.  It was highlighted that attendance at the practice was monitored, and the practice mainly focussed on the needs of young people, with input from the Student Union.  Reference was made for the need for better communication in relation to the practice;

·         City Centre Practice Provision – The Committee was advised that one GP practice had been identified as struggling to match local demand and service capacity; and as a result the LWCCG was currently working with the practice to support them, and exploring ways of increasing their capacity;

·         Children's Hubs – Confirmation was given that a lot of parents with young children had been attending the Walk-in-Centre for help and advice.  The provision of children's hubs would provide an alternative route for parents to take when needing advice.  The Committee was advised that the proposal was for eight children's hubs in total, which would be spread across Lincolnshire.  LWCCG representatives agreed to let the Committee have details as to their localities;

·         A question was asked relating to whether there was any evidence as to why there had been a reduction in attendance to the Walk-in-Centre.  The Committee was advised that better provision at the University practice; and better clinical advice services had been instrumental in reducing the numbers visiting the Walk-in-Centre;

·         Clarification was given that alongside the consultation, there had been extensive drop-in sessions, at which members of the public had had their say, the responses received had then informed the direction of travel going forward.  Some concern was expressed as to whether the GP practices would have the capacity to meet the demand.  Assurance was given that this matter was being reviewed on a monthly basis; but so far there had not been any adverse impact due to the increased lists for GPs.  The Committee requested that an evidence based report detailing activity should be received at the February 2018 meeting;

·         Homelessness provision – Confirmation was given that provision would stay as it was; and that this provision would be monitored closely; and

·         Copies of leaflets concerning alternative provision.  Some concern was raised that there was still a need to promote further; as not all residents had access to social media.  A further suggestion was made that easy to follow picture based leaflets would help get the message of alternative provision out to the general public.

RESOLVED

1.    That the Committee's satisfaction with the progress made regarding improved access to GPs, the development of alternative provisions and the communication and engagement plans of the Lincolnshire West Clinical Commissioning Group (LWCCG) be recorded.

2.    That a request be made for further evidence to be presented to the 21 February 2018 meeting, to substantiate the progress made on all areas of activity, including an analysis of the usage of the Walk-in-Centre on an hourly basis.

3.    That the Chairman be authorised to meet with the LWCCG to discuss the initiatives and communication plans in more detail.

Note:

Councillors J Kirk, P Gleeson, R B Parker and M A Whittington abstained from voting on the resolution set out in 1 above.