Agenda item

The Board is invited to (1) note both the national and local context for Primary Care GP Services in B&nes; and (2) consider any other issues that should inform the Emerging Primary Care Strategy in B&nes

The Chief Officer, B&NES CCG gave a presentation to the Board relating to this item. A brief summary is set out below and a copy of it will be available online as an appendix to these minutes.

Context

Challenges facing Primary Care in terms of:

•  Contracts, viability & sustainability

•  Provision in areas with greatest recruitment problems, resource challenges and health need

•  Need for a stronger population focus and an expanded workforce

Context (2) - BMA Survey 2015

More than nine in ten GPs (93%) state their heavy workload had negatively impacted on the quality of patient services.

•  Over three in five GPs (62%) support maintaining the model of GPs being able to own their surgery

•  Over a third (37%) of GPs say that their practice has joined with a network or federation.

•  More than four in five (82%) GPs support maintaining the option of independent contractor status for GPs.

The most mentioned factor essential for general practice was continuity of care.

Context (3) – Patient Survey, July 2015

Overall experience of GP surgery (Good) – 85% (National) / 91% (B&NES CCG)

Ease of getting through to GP surgery on the phone (Easy) – 71% (National) / 86% (B&NES CCG)

The last time you wanted to see or speak to a GP or nurse, were you able to get an appointment / see / speak to someone?  (Yes) – 85% (National) / 91% (B&NES CCG)

Overall experience of making an appointment (Good) – 73% (National) / 85% (B&NES CCG)

Key Activities

•  Co-Commissioning - Joint working with NHS England on decisions affecting Primary Care (Medical)

•  Funding, PMS Reviews- NHS England, LMC and CCG review of existing PMS ‘premium’ and re-investment into General Practice

•  Primary Care Strategy Development

Primary Care Strategy Development

Themes arising:

•  Build services around the needs of patients and carers, not organisations

•  Benefits for practices working together ‘at scale’

•  All out of hospital care could be grouped together

•  Many practice premises require investment, concerns around housing development and expansion

•  GP practice appointments access perceived as variable, often complicated and difficult to book

Primary Care Funding & Investment

PMS Reviews – approx. £1m to be recovered and reinvested into Primary Care system on a recurrent basis  (not necessarily to practices on a like for like basis) over next 5 yrs. Process running during 2015/16, with national principles for reinvestment:

•  Secures services or outcomes that go beyond core general practice

•  Helps reduce health inequalities

•  Offers equality of opportunity for GP practices in each locality

•  Supports fairer distribution of funding at a locality level

£5 per Head – approx. £1m to be utilised for schemes care of the >75s

(Nursing Homes, Urgent Care Escalation, Community Cluster MDT schemes).

Transformation Fund – £200k (non-recurrent in 2015/16) to support practice schemes aligned to national and local priorities, 4 schemes to be selected.

Next Steps

Continue Joint Co-Commissioning approach with NHS England - Consider options for future Primary Care Commissioning in 2016/17

Completion of PMS Review process - Practices required to agree ‘indicative’ net position of PMS review impact by 31 March 2016

Councillor Michael Evans asked where the money comes from with regard to the PMS funding for primary care.

The Chief Officer, B&NES CCG replied that this would come from NHS England as part of their baseline for Primary Care Services.

Councillor Michael Evans asked how this would be allocated to differing populations.

The Chief Officer, B&NES CCG replied that some practices have said that their population require special consideration due to inequalities, high levels of students etc.

The Chairman said that he was encouraged by how good our local statistics were.

Dr Ian Orpen commented that a good summary of the general mood of practices would be that they are fragile due to the pressure of workload and increased pressure on services.

The Board agreed to note both the national and local context for Primary Care GP services in B&NES.