Agenda item

The Committee considered a report of Leicester, Leicestershire and Rutland Clinical Commissioning Groups (CCGs) which provided an overview of Primary Medical Care in Leicestershire including the current priorities, issues and challenges. A copy of the report, marked ‘Agenda Item 11’, is filed with these minutes.

 

The Committee welcomed to the meeting for this item Yasmin Sidyot, Deputy Director Integration & Transformation (City), and Fay Bayliss, Deputy Director of Integration and Transformation, Leicester, Leicestershire and Rutland CCGs.

 

Arising from discussions the following points were noted:

 

(i)          Concerns were raised by members that the plans for Primary Care were focused on how the workload of doctors could be reduced rather than how the experience of patients could be improved. Some members were of the view that as doctors were working from home they were distancing themselves from patients, and overall GP’s were less accessible than they had been in previous years. In response the concerns were acknowledged by the CCG and reassurance was given that it was not intended that doctors carry out less work but it was more about ensuring their time was spent carrying out work that GPs were intended to do. The way GP Practices operated had to change because there were currently less doctors available than previously and there would be less in the future so the best use of doctors’ time had to be made. Therefore there was a move away from GP Practices being focused on the doctor towards making use of a wider healthcare team. Patients were living longer and had more long term conditions which required a broader range of health professionals to deal with them. In response to a suggestion from a member it was confirmed that a document would be produced which explained to patients the roles of all the healthcare professionals at GP Practices and how they fitted together.  One of the new staff roles in Primary Care Networks would be paramedics to help triage patients and treat minor injuries.

 

(ii)         Particular concerns were raised about Care Home residents who were unable to see a GP and the CCG agreed that this should not be the case and agreed to look into it further.

 

(iii)       There had been recent media coverage regarding greater use being made of chemists to make referrals for medical appointments and a member raised concerns about privacy at chemists, but it was noted that most chemists had a private consulting room. Other members were of the view that chemists should be utilised more.

 

(iv)       Where the report referred to ‘appointments’ this referred to a consultation with either a GP or another Healthcare professional and this could be either in person face to face, via a video call or a telephone call and included appointments booked in advance or on the same day. Currently in the County 68.3% of all appointments delivered were face to face i.e the patient was in the same room as the practitioner.

 

(v)        In response to concerns raised by members about the difficulties in obtaining an appointment with a GP Practice it was explained that various options were being considered to improve the process of booking an appointment. Cloud based telephony was being introduced but this would not help where delays were being caused by a lack of call handlers. Therefore, trials were taking place where admin staff across GP Practices worked collectively and answered calls for more than one Practice. Consideration was also being given to releasing appointments gradually throughout the day rather than making them all available for booking early in the morning. All GP Practices had the facility for appointments to be booked online but not all practices had resumed using this facility since the Covid-19 pandemic and work was taking place to encourage all GP Practices to offer this facility.

 

(vi)       A member suggested that Facebook and other social media were useful tools for GP Practices to get messages to patients such as when the practice was closed or phone lines were not working.

 

(vii)      Members were of the view that patients would have more confidence with a video appointment than a telephone appointment and GP Practices should invest in the technology required for video appointments. In response it was explained that GP Practices began providing video appointments during the Covid-19 pandemic but the implementation was piecemeal due to the urgency at the time. Going forward consideration was being given to how video technology could be implemented in a more joined up manner across GP Practices. Though it was noted that one style of offering video appointments would not suit all practices and there would have to be some bespoke procedures in place.

 

(viii)    Leicestershire County GP Practices delivered 388,894 appointments in March 2022 and in response to questions from members it was agreed that further information would be provided after the meeting regarding the number of GP appointments where the patient failed to attend including telephone and videocalls, and the breakdown of whether the appointments were with a GP, nurse or other health professional.

 

(ix)       Every single GP Practice was part of a Primary Care Network (PCN) and in response to a request from a member it was agreed to provide details of the Lutterworth PCN after the meeting.

 

(x)        A member raised concerns about poor people skills shown by staff at GP Practices in the Harborough area.

 

(xi)       Reassurance was given that quality assessments of GP Practices took place and work was ongoing to reduce variation in the way practices delivered services. The LLR CCGs had commissioned a support programme for all LLR Practices from the Royal College of General Practitioners.

 

(xii)      There were 7 County GP practices with active Care Quality Commission and/or Risk improvement plans in place. It was agreed to provide information to members after the meeting on the percentage of GP Practices across Leicestershire that were on the improvement list.

 

(xiii)    GP Practices were using Care Navigators to signpost patients to the most appropriate source of advice and support and the care navigators were working together with the Local Area Co-ordinators (LACs) as part of Integrated Neighbourhood Teams rather than duplicating the roles of LACs.

 

(xiv)    In response to a request from members the CCG agreed to provide a report to the Committee for later in the year regarding the actions being taken to improve Primary Care and timescales, who was responsible for carrying out the actions and how success would be monitored. It was also agreed that this report would cover the Next Steps for Improving Primary Care: Fuller Stocktake report.

 

RESOLVED:

 

(a)        That the overview of Primary Medical Care in Leicestershire including the current priorities, issues and challenges be noted with concern;

 

(b)        That officers be requested to provide a further report regarding Primary Care for a future meeting later in the year.