Agenda item

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

Dr Ian Orpen addressed the Select Committee. A copy of the update can be found on their Minute Book and as an online appendix to these minutes, a summary of the update is set out below.

A&E performance

Local system performance against the A&E waiting time target (95 per cent of attendees to be seen within four hours) was 76.9 per cent in December. Across England there has been extremely high demand and this is putting local health and care services under significant pressure.

Some non-urgent hospital appointments and operations have been postponed in line with national guidance to help hospitals deal with the sustained pressure. 

Proposals to restrict access to three non-urgent services

We have extended our consultation on proposals to restrict access to fertility treatment, vasectomies and female sterilisations. The consultation will now run until 31 January 2018.

This decision is in response to feedback at a public meeting held on Monday 8 January where people raised concerns that the CCG had not allowed sufficient time for the consultation and had not taken into account the Christmas break when people would be too busy to respond to the proposals.

National plans to further restrict access to over-the-counter medicines

We are raising awareness of a national survey from NHS England and NHS Clinical Commissioners.

Locally the NHS spends approximately £935,000 on prescriptions for medicines which can be purchased over the counter from a pharmacy and other outlets such as supermarkets. These prescriptions include items for self-limiting, minor health conditions which will often clear up of their own accord or that the patient can treat themselves by buying over-the-counter medicines, sometimes at a lower cost than that which would be incurred by the NHS.

The survey asks for feedback about medications used to treat 33 minor, self-limiting health conditions. These medications have been selected as they may be considered low priority for NHS funding and it is proposed that they should not be routinely prescribed in GP practices. Products included as part of the consultation include treatments for head lice, infant colic, mouth ulcers, cold sores, mild cystitis and nappy rash.

In Bath and North East Somerset we have already reviewed our prescribing policy for two types over-the-counter medicines (painkillers and hay fever medicines) when they are used to treat short-term minor ailments. Following consultation, we are advising GPs not to prescribe these medicines – when used for short-term, minor ailments such as mild hay fever, headaches, coughs and colds.

We are encouraging everyone to feed back on the national survey by following this link here (Please note the national consultation closes on 14 March 2018).

Councillor Tim Ball queried the practise of not prescribing certain medications.

Dr Orpen replied that the duty for GPs to prescribe remains, but they also have a duty to make best use of resources. He added that, as part of this, new guidance on vulnerable patients so as not to disadvantage patients will be made available. He stated that some medications however are cheaper without prescription.

Councillor Eleanor Jackson commented that the cost of a GP appointment in both time and money was significant and hoped members of the public would recognise that and only attend when necessary.

She said she had been informed that 19 patients on stretchers had been observed through the RUH over the Christmas period. She asked how can staffing levels be increased and retained.

Dr Orpen replied that he was aware that morale locally was low, but acknowledged that staff across the area work incredibly hard. He spoke of how the pressure had unfortunately been building for a number of years and it has reached new levels this year.

He said that to have those numbers of patients on stretchers was obviously not a good situation, but that on 3 visits to the Emergency department in the last 3 weeks by the CCG Director of Nursing, we had been assured of the good care patients received despite the pressures on the service. He also wished to point out that the hospital does have excellent figures in terms of patients not waiting in ambulances once they arrive.

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