Agenda item

The Select Committee will receive an update from the Clinical Commissioning Group (CCG) on current issues.

Dr Ruth Grabham addressed the Select Committee, a summary of the update is set out below.

·  Update on A&E performance

Between the months of March to December 2015, an average 89.3% of patients were seen in A&E at the Royal United Hospitals Bath NHS Foundation Trust (RUH) within four hours.  In December this percentage dropped to 86.6% against a national target of 95%. 

The System Resilience Group (SRG) continues to oversee implementation of a four-hour recovery plan to strengthen urgent care performance and ensure patients receive the highest quality care. The SRG brings together partners from across the local health and care system to plan urgent care services, reduce admissions via A&E (by ensuring non-life threatening emergency needs are met in or close to people’s homes), improve patient flow through hospital and ensure appropriate after care and support at home or in the community.

·  Health and care partners work together to get patients ‘Home for Christmas’

‘Home for Christmas’ was a system-wide initiative to increase patient flow through the RUH, ensure people benefited from a timely, effective and safe discharge and ease pressure on beds over the Christmas period by creating some additional capacity. Monitor had asked the RUH to create a 20% reduction in bed occupancy (118 beds) by Christmas Eve to help the system cope with the anticipated increased demand during the rest of the month and New Year period.

The event was led by the CCG with the support of the SRG. Representatives across our different organisations met daily as part of a tactical coordinating group to assess and put in place the right package of care for those patients who were sufficiently well to be discharged to move home or into the community.  By midnight on Christmas Eve just over 30% of beds were unoccupied at the RUH. 

·  Results of GP survey

A recent patient survey has highlighted high levels of satisfaction with GP services locally.  The GP Patient Survey is an England-wide survey conducted by Ipsos MORI on behalf of NHS England.  3,139 patients completed the survey in Bath and North East Somerset during spring and summer 2015. 92% rated their experience of their GP surgery as good (compared to a national average of 85%), 90% were able to get the appointment they needed (national average was 85%) and 87% said it was easy to get through to practice staff on the telephone (national average of 70%). Satisfaction with out of hours’ services was lower at 73% but this was still higher than the national average of 67%. The survey results are being shared and discussed within practices to further improve patient experience.

·  New Genomic Medicine Centre planned

A new Genomic Medicine Centre, based in Bristol, is to open by February 2016 as part of a three-year project to transform diagnosis and treatment for patients with cancer and rare diseases.

The CCG is member of a partnership called the West of England NHS Genomic Medicine Centre which includes NHS providers and commissioners, universities, patient organisations and the West of England Academic Health Science Network.

Across the UK, clinicians will be collecting and decoding 100,000 human genomes – complete sets of people’s genes – that will enable scientists and doctors to understand more about specific conditions. It could allow personalisation of drugs and other treatments to specific genetic variants. Patients choosing to be involved will take part in a test which will then be processed in a lab at Southmead Hospital, before being sent nationally for sequencing.

Addressing the statement made by Pam Richards, Dr Grabham spoke of how GP vacancies were on the increase and that one of the main causes was the early retirement of older GP’s. She added that the partner option at a surgery was now not so attractive. She said that she had been at her surgery for 25 years and had noticed an increase in the level of bureaucracy and administration required.

She informed them that an opportunity to investigate different ways of working was available through the Vanguard Project. The project would look at how practices can work more together.

She said that the guidance relating to seven day working was not explicit and that it was hoped they could define this locally. She added that every surgery has a Patient Participation Group and they will be consulted as part of the process.

Councillor Paul May stated that it was good to see the levels of patient positivity from the survey. He added that in his view care for the elderly would benefit from a seven day service.

Dr Grabham replied that there was already a specific service in place in addition to the out of hours service that provided continuity for elderly patients over the course of a weekend if they have just been prescribed a new course of medication.

Councillor Eleanor Jackson asked if seven day working would be more of an issue for female GP’s who are more likely at some point to have care responsibilities.

Dr Grabham replied that currently most GP’s that qualify are female. She said that a full time GP would work 8 sessions which was the equivalent of 4 days and that there was no expectation for a GP to work all seven days. She added that further engagement was required on the matter and that an application to the Transformation Fund was due.

Councillor Eleanor Jackson if she possibly knew why new residents in Writhlington were being asked to register with practices in Frome.

Dr Grabham said that she was unsure as to why the practise would have made that decision.

The Cabinet Member for Adult Social Care & Health, Councillor Vic Pritchard said that he was awaiting a response to the matter raised by Councillor Jackson.

Councillor Lin Patterson asked if she could explain why she felt that there were increasing levels of bureaucracy within the role of a GP.

Dr Grabham replied that alongside an increasing range of complex patient needs that there is a rise in the number of records that need to be kept, especially relating to quality of service.

Councillor Brian Organ asked if there was an increased pressure on the 111 service and if GP liaison within it could be improved.

Dr Grabham replied that a good range of services are provided through the 111 service, but reminded the Select Committee that the telephone operators are not clinically trained. She said that the questions they ask are generated electronically. She added that in the case of the young child highlighted in the media this week he had already been seen six times previously by a doctor.

She stated that there was a clinical oversight of all 111 cases locally and that additional training will now be provided for operators.

The Chair thanked her for her update on behalf of the Select Committee.