Agenda item

Purpose:   To discuss the proposed changes to GP commissioning arrangements and how this will affect services in the east of the District.  Evidence will be received from Janet Fitzgerald (Transition Director of the GP Commissioning Consortia), Dr Iain Rock (Mortimer Surgery) and Dr John Winchester (Theale Medical Practice).

(Councillor Carol Jackson-Doerge declared a personal interest in Agenda item 6 by virtue of the fact that she was a patient of the Mortimer Surgery. Councillor Alan Macro declared a personal interest as a patient of the Theale Surgery.  Councillor Tony Linden as a patient of the Burghfield Surgery and Councillor Quentin Webb as a member of the Chapel Row Patient Panel. As their interests were personal and not prejudicial they were permitted to take part in the debate and vote on the matter).

The Panel considered a presentation by Janet Fitzgerald (Transition Director for the Clinical Commissioning Groups) (Agenda Item 6) and described the proposed configuration of the Clinical Commissioning Groups (CCGs) across Berkshire.

Mrs Fitzgerald introduced the doctors that were present as Dr Iain Rock (Mortimer Surgery), Dr John Winchester (Theale Surgery) and Dr Rupert Woolley (Pangbourne Surgery).

Mrs Fitzgerald described how the establishment of CCGs were part of the wider health reforms of the NHS. These groups would need to be established by April 2013 to replace Primary Care Trusts as the statutory bodies for healthcare commissioning. 

She described how there would be a National Commissioning Board established for highly specialised services, e.g. organ transplants, as well as  retaining the statutory responsibility for Primary Care commissioning.  It was described that without such an overarching Board, General Practitioners (GPs) would have a conflict of interest in commissioning Primary Care Services.  GPs would commission community health services such as nursing, midwifery, mental health and acute hospital services, accident and emergency and ambulance services.

Mrs Fitzgerald described the proposals for seven Clinical Commissioning Groups across Berkshire with four covering the Berkshire West area.

Mrs Fitzgerald described the similar sized populations covered by the Newbury and District CCG (113,000 weighted population) and the North and West Reading CCG (106,000 weighted population). She described that often a Practice’s registered patient numbers did not always align with political geographical boundaries.  It was described how, for example, some patients that attended the Pangbourne Surgery actually lived in South Oxfordshire and not West Berkshire.

Mrs Fitzgerald described how the proposal was for CCGs to be in place by October 2012 and operational by the official final deadline date of April 2013.

Mrs Fitzgerald mentioned how CCGs needed to demonstrate competence to pass the Department of Health (DoH) approval process. All CCGs needed to show strong clinical and professional focus along with proper patient and community engagement. Credible plans needed to be established alongside clear governance structures. She described the links with the West Berkshire Health and Wellbeing Task Group and the consultation that would take place to ensure the CCGs were fully formed and fit for purpose.

The Department of Health (DoH) was responsible for considering the size and the boundaries for the CCGs and ensuring risk assessments were undertaken. Approval was sought from the Local Authority in relation to the proposed boundaries.

Mrs Fitzgerald described the strong endorsement from each of the member GP Practices and approval from the PCT for the current model.  She described how the Practices of Pangbourne, Theale and Mortimer wished to remain within the North and West Reading CCG as opposed to aligning with the West Berkshire Council Local Authority boundary. 

Dr Iain Rock (Mortimer Surgery) described the strong working relationships which had been established in recent years and the good background of fund holding and commissioning of services which had developed with the other GP Surgeries in the Reading area.  He described how the Mortimer, Theale and Pangbourne Practices tended to sit more naturally with the North and West Reading CCG.

Mrs Searle (Director of Partnerships and Joint Commissioning, Berkshire PCT) added that CCG leads were working alongside the Directors of the outgoing Primary Care Trusts in these federation discussions.  She described how there were no patient concerns and the doctors were fully engaged with the Health and Wellbeing Working Group.

Mrs Fitzgerald continued by explaining how the DoH authorisation process was due to begin and this would validate the Organisational Development Plans for the CCGs. A more detailed consultation document on the proposed CCGs would be circulated in the next five weeks.   

The Chairman asked about the impact on patients of practices joining different CCGs. Dr Rock (Mortimer Surgery) replied by explaining that there would not be any noticeable difference to the patient in their direct experience of accessing and receiving GP services. 

Councillor Jackson-Doerge asked about how the system would impact on the wider health and social care economy. It was described how the commissioning decisions would still be required to reflect the local need and that the overarching responsibility for meeting the strategic health needs would be overseen by the Health and Wellbeing Boards.  

RESOLVED that

(i)      The Panel supported the proposed configurations for Clinical Commissioning Groups and the inclusion of the Theale, Mortimer and Pangbourne Surgeries within the North and West Reading Clinical Commissioning Group.

(ii)     The slides of the presentation were to be circulated to all Members of the Health Scrutiny Panel.