Agenda item

Pam Richards has registered to make a statement to the Select Committee.

Pam Richards representing Protect Our NHS Bath and North East Somerset addressed the Select Committee. She explained that the group consisted of public and patient groups and they had conducted a survey in September 2015 of all GP practices in B&NES, receiving 51 replies, a response rate of 34.5%.

A copy of the survey will be available online as an appendix to these minutes and placed on the Select Committee’s Minute Book, summary is set out below.

Almost all said they had increasing workloads, with added pressures from both community and secondary care and from increasing patient demand.

92% of those who responded said they were concerned about the ability of their practice to deliver a comprehensive service, including out of hours services, on the basis of current resources. They said that net practice income is currently inadequate and/or falling, and mentioned the high and rising costs for locum and agency staff. Many said their practice was financially unsustainable, and the new funding formula was seen as hitting practices in the most deprived areas. They spoke of lack of staff and serious problems with recruitment, especially replacing senior GPs and partners who are retiring.

96% of respondents said that the government’s planned funding of the NHS over the next 5 years is not adequate to deliver the government’s plans for nationwide 7-day healthcare. They said the level and timing of this funding was unclear but the indications are that funding will not be enough.

Several felt that patients did not actually want 7-day GP access and pointed out that what exactly was meant by 7 day healthcare was not clear. Others were worried that routine care by practices cannot be delivered over the weekend unless weekday services are cut, and unless GPs have access to 7-day diagnostic, therapy and social care services. A substantial number said in their view this proposal had not been properly thought through.

98% of GPs who responded said their patients had experienced delayed hospital discharge due to difficulties in organising social care in the community. They said this is now a regular occurrence and is getting worse. They detailed the missing services, complex processes and lack of placements, and noted that the problem was worse for patients with complex needs, and for those funding their own care. They pointed out that insufficient provision of timely social care in the community also leads to many more patients being admitted to hospital in the first place.

When asked about their views on the increasing role of private healthcare companies in providing NHS clinical care, 91% of those who responded had a range of serious concerns. Many said that private healthcare is moving money out of the NHS and will drive up costs in healthcare. The same number saw the profit motive in private healthcare as damaging the quality of care offered to patients.

Finally, when asked if they had any concerns about the future of the NHS as a publicly resourced service, free for all at the point of delivery, 94% of respondents said they had, and these ranged from the quite worried to the seriously desperate and disillusioned. Almost all said current funding levels were a major concern, and many mentioned the ever-increasing levels of patient needs, demands and expectations.

Councillor Lin Patterson asked if she knew the extent of GP vacancies in the area.

Pam Richards replied that she did not have that information to hand, but that it would be good to find out. She added that she was aware that some surgeries across the country had closed due to a lack of staff.

Councillor Lin Patterson asked if she had any evidence that seven day healthcare provision was required within B&NES.

Pam Richards replied that locally some surgeries were accessible on Saturday mornings and in the evenings. She added that anecdotally she had heard that it was not necessary and that there was concern that it would affect the funding of the five day service.

Councillor Paul May asked how Protect Our NHS Bath and North East Somerset were funded.

Pam Richards replied that it was a voluntary group of around 250 people that was funded by the members of the group.

Councillor Paul May commented that the relationship between the Council and the NHS was important. He added that he supported the proposal for a seven day service as he felt it would provide more opportunities for patients.

Councillor Eleanor Jackson offered her compliments on the number of responses generated by the survey, but said that she would have liked to see further information from the BS31 area. She said that the issue of delayed discharge had first come to light during the Homecare Survey carried out by the Council in 2010/11 and that this was something that would require further analysis when the review was due to take place in 2017.

She also highlighted the lack of dementia beds and her concerns over the levels of recruitment.

The Director for Adult Care and Health Commissioning reminded the Select Committee that they were due to receive a report regarding Domiciliary Care at their May meeting which would address capacity and any potential gaps in the service.

Councillor Tim Ball commented that if a similar survey was carried out in the future he would like to see a more positive line of questioning.

Pam Richards replied that the survey was designed to be short on this occasion to gain responses and that the comments received should be seen as more important as they provide a level of detail.

The Chair said that the comments raised during debate and the survey results would be taken on board during future work on this matter.