Agenda item

(To receive an update on GP Provision in Lincolnshire from Dr Reid Baker, Medical Director of the Lincolnshire Local Medical Committee and Sarah-Jane Mills, Director of Primary Care, Community and Social Value, NHS Lincolnshire Integrated Care Board)

Consideration was given to reports from the Lincolnshire Local Medical Committee and the Lincolnshire Integrated Care Board, which provided an update on general practice provision.

The Chairman invited Dr Reid Baker, the Local Medical Committee’s Director, Sarah-Jane Mills, Director of Primary Care, Community and Social Value and Nick Blake, Acting Programme Director Integrated Primary Care and Communities, to present their reports to the Committee.

It was reported that general practice was under ongoing pressure due to multiple factors including inflationary, and cost of living pressures.  Despite this, GPs continued to work hard to meet the needs of patients, providing new services and more appointments.  It was highlighted that there had been a 43% increase in appointments in general practice since August 2019.   It was reported that in the last year the number of appointments provided by GPs had increased by 14.5%, and that in the last year GPs in Lincolnshire had provided 4,954,959 appointments.

It was noted that GP provision in the County was good, with appointment availability being above the national average.  It was reported that there were 81 practices across Lincolnshire, and that these practices worked together as Primary Care Networks (15 in Lincolnshire) to provide a range of services for leir local population.

It was reported that the key elements of the NHS delivery plan for recovering access to primary care reflected the challenges faced across Lincolnshire and provided a framework for expediting the development of modern primary care provision.

It was highlighted that there would be challenges, but the Primary Care Networks (PCNs) would provide the vehicle for further strengthening the partnership working across GP surgeries and with other agencies.  

In conclusion, the Committee noted that the ICB was committed to working in partnership with people living in Lincolnshire to ensure that the further development of service provision met the needs of the local community.

Note: Councillor Mrs L Hagues left the meeting at 12.43pm.

During consideration of this item, some of the following comments were noted:

·       Personal experiences of some members using ‘Ask my GP’ and accessing the practices by telephone.  The Committee noted that when there was increasing demand and there was insufficient capacity to meet that demand, to ensure that clinical safety was maintained, access through this application was on occasions was switched off, to ensure that urgent requests were not lost.  It was noted that as part of the recovery plan there was additional support for practices to improve their internal processes with reference being made to the 8.00am appointment rush.    In Lincolnshire it was noted that several practices had been working on such issues, prior to the government directive.  It was noted further that general practice was a national contract and therefore GPs were nationally governed.  Reassurance was given that once the digital system was turned off, a receptionist would take down details of any urgent requests and these would be put on the system for a GP to look at and allocate; 

·       The need for better access to primary care for residents and for better publicity/communication explaining how primary care could be expected to be accessed. There was recognition that there was a message to be delivered to residents in this regard;

·       Some concern was expressed to four Care Quality Commission (CQC) reports from October 2022 last year, which had identified one practice as being good, two needing further improvements and one being deemed as being inadequate. Reassurance was given that the ICB Quality Team did visit and work with practices where issues had been identified. In all instances mentioned, the Quality Team had already been working with the practices, prior to the CQC inspection.  The Committee noted that other than the four practices highlighted, the ICB was currently working closely with two further practices;

Note Cllr R J Cleaver left the meeting 1.00pm.

·       It was noted that practices were proactive in assisting vulnerable groups, from information gathered on the local population;

Note: Cllr S R Parkin left the meeting at 13.02pm.

·       From members personal experience, there were suggestions that the current system was not working as well as it could do.  It was noted that there was a need to educate patients that the GP model had changed, and that multi-disciplinary teams were now available to help take off the pressure off GPs, to allow them to be able to see the more vulnerable patients with complex needs.  There was recognition that more work still needed to be done to understand the concerns and views of the service user;

·       The Committee noted that increased costs were having an impact on practices and that the ICB were supporting practices in this regard, i.e. making sure that they were in receipt of funding where appropriate, and adopting more efficient practices etc; and

·       That information relating to the number of face-to-face appointments conducted by GPs, as opposed to other healthcare staff in 2019 would be made available in the next report to the Committee on this topic.   

RESOLVED

1.      That thanks be extended to representatives from the Lincolnshire Local Medical Committee and the NHS Lincolnshire Integrated Care Board for their presentations.

2.      That the increase of 43 percent in the number of appointments in GP practice between 2019 and 2023 be welcomed and that support be given to support further measures to enhance access to GP services, such as improved recruitment and retention, and access to funding for additional roles in GP practices.

3.      That a further update be received in six months’ time.