Agenda item

(To receive a report from the Lincolnshire Sustainability and Transformation Partnership, which provides the Committee with information on the development of the GP Forward View as part of the Lincolnshire Sustainability and Transformation Partnership)

The Chairman welcomed to the meeting Martin Kay, Head of Commissioning, NHS Lincolnshire West CCG and Dr Sunil Hindocha, Chief Clinical Officer, Lincolnshire West Clinical Commissioning Group.

Consideration was given to a report from the Lincolnshire Sustainability and Transformation Partnership (STP), which provided information on the development of GP Forward View as part of the Lincolnshire STP.  It was noted that the GP Forward View was one of the four current priorities in the Lincolnshire Sustainability and Transformation Partnership, which the Committee had decided to look at in more detail.

It was reported that Lincolnshire CCGs were accountable for the delivery of the GP Forward View Programme of work.  It was highlighted that the Primary Care Programme was influenced by the General Practice Five Year Forward View (GPFV), which brought together GP Federations, practices, CCGs and the Lincolnshire Local Medical Committee.

The Committee was advised that in addition to local initiatives, Lincolnshire had through the Local Medical Committee been successful in recruiting 26 GPs from abroad; and a second bid had been successful for a further 39 international recruits, which would enable Lincolnshire to reach its required target.  As well as the recruitment Lincolnshire was also working with NHS England and others to achieve greater working flexibility to retain current GPs.  Lincolnshire also had a target to increase the number of other staff in primary care, the target was to recruit a further 53 additional posts by 2020.

Paragraph 2.2 (1) and (2) of the report provided information as to the Primary Care Workload and Redesign.  Particular reference was made to ensuring that existing capacity was being used appropriately; a number of initiatives being developed in primary care were shown on page 46 of the report presented; and to the fact that GPs were key contributors to the development of integrated neighbourhood working. 

The Committee noted that significant change was required across general practice; and page 47 of the report identified 10 High Impact Actions, which included active signposting; developing practice teams; partnership working and developing self-care support.

The Committee noted further that with the workforce working differently in different areas would mean that improved infrastructure support would be required to enable them to be effective.  This would be achieved by changes to information management and technology.  Also, as services changed, some buildings would also need to change so that services could be delivered in a more appropriate environment.  It was highlighted co-locating services would provide synergy and benefits for patients and staff; and that this factor would be particularly significant with the development of Neighbourhood Teams.

It was reported that many general practices were now working as part of federations or super practices, but some practices still remained independent.

In conclusion, the Committee was invited to provide feedback on the GP Forward View Update.

Note: Councillor K Cook advised the Committee that she was a Lincolnshire Partnership NHS Foundation Trust Governor; and a Lincolnshire NHS Foundation Trust service user.

During discussion, the Committee raised the following points:-

·         The need to ensure that GPs continued to see patients in the first instance, to prevent conditions being missed.  Reassurance was given that a patient would always been seen by an appropriate professional.  Some members expressed their concerns regarding the national evidence that identified that 25% of appointments for GPs were avoidable.  Reassurance was given that a number of pilots were being undertaken, one of which was Care Navigation Training, which would help practice staff signpost patients to the relevant health professional; and also help practice staff provide a better service.  One member enquired as to whether mental health was part of the Care Navigation training and this was confirmed;

·         Some concern was expressed to the number of people not attending scheduled appointments;

·         A concern was raised regarding repeat prescriptions; and to the fact that prescriptions could only be collected by the patient, or their spouse;

·         One member enquired as to why no consultation had been undertaken on the proposed changes implemented.  The Committee was advised that engagement was ongoing relating to the changes, and that any significant change to a service would be subject to consultation;

·         Increase in capacity – It was highlighted that practices working together provided increased capacity to patients.  It was highlighted that the Sleaford Medical Group were extending their opening hours from October 2018; which would enable patients to be seen in their locality;

·         One member requested information relating to GP practices with extended hours; and a question was asked as to whether pharmacies were extending their opening times as well.  A further observation made was that GP practices had not been included in the Pharmaceutical Needs Assessment;

·         Staff retention – The Committee was advised that there were a number of schemes operating to help retain staff, such as career breaks and part-time working.  One member enquired as to whether medical insurance was something still provided to GPs; and

·         A comment was made on the GP Forward View Update and the Integrated Neighbourhood Working as two separate items, as they were both very closely linked.

RESOLVED

That the Lincolnshire Sustainability and Transformation Partnership – GP Forward View Update be received and that a further progress report be received at a future meeting of the Committee.