Agenda item

Purpose: To consider a report on access to Primary Care in West Berkshire.

Dr Heike Veldtman (Clinical lead for Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board (BOB ICB)) presented the report on access to primary care.

During the presentation the following key points were raised:

·       There was variation between practices in the patient survey.

·       It was important to ensure the most appropriate consultation type was offered and there would be consideration for how ongoing care would be delivered.

·       Berkshire West was fairing fairly well with 81% of appointments within two weeks, given the short period of time this measure had been in place. It was noted that if routine appointments were managed right, they would get fewer urgent appointment requests.

·       It was highlighted that appointment data was triangulated with patient feedback and what was heard on the ground, taking into account changes within the practice.

·       It was important to align national campaigns with local communications and engagement.

·       The ICB and Primary Care were in discussions around new developments and planning policies.

·       Learning how to live well with long term conditions was a key message. Local authorities and the voluntary sector were working on prevention and addressing inequalities to ensure health and the NHS were sustainable in the future.

The following points were noted during the Committee’s discussion:

·       It was confirmed that the friends and family feedback had a low response rate, and they were working to increase the response rate in future. The national patient survey had a larger response rate and was targeted at people who had recently attended the surgery.

·       It was advised that the variations in feedback between practices was multifactorial. It included differences between rural and town practices, deprivation levels, and demographics which affected health and access to support.

·       It was highlighted that Covid brought about change regarding telephone triage and online consultations. Some surgeries embraced this, and others were slower to embed it. There was good feedback on the new telephony system as patients became used to it.

·       It was confirmed that there was ICB-level support for primary care networks to work together and to share best practice particularly with methods of contact.

·       In the discussion regarding empowering patients, concern was raised regarding the role of community pharmacy, increased demand and how practices worked together with pharmacies. It was noted the Health and Wellbeing Board was responsible for the Pharmaceutical Needs Assessment. The benefits of online pharmacy were highlighted to enable pharmacies to deliver health checks and health promotion.

·       Pharmacies were commissioned by the ICB and they were working with colleagues to support and build resilience in community pharmacy. Concerns regarding a recent closure of a Newbury pharmacy were noted.

·       The advantages of the NHS App were promoted but concern was raised regarding access and digital exclusion. It was confirmed that digital inclusion and exclusion were always considered. Patient Participation Groups were involved and there were courses to help people to use the NHS App. The overall benefit of the NHS App helped all to have better access.

·       It was noted that they wanted to increase the response rate for the local survey and so they would be working with Healthwatch and Patient Participation Groups.

·       There was discussion around the information available to patients on the new ways of working. The ICB confirmed that work had been ongoing to tie up communication teams to get messages out to the public.

·       A query was raised regarding the messages to patients regarding the role of and upskilling of receptionists to care navigators. It was noted that the role of care navigation had provided an opportunity for training and career development. Messages were getting out there about how this role would help waiting times by ensuring appointments were seen at the most appropriate time. There was a challenge in how to get that message out even more.

·       Healthwatch had been commissioned to do a project into GP access and the public understanding of additional roles. This would inform future communications and engagement.

·       It was advised that triage could have been through online consultation as well as by phone.

·       There was a pilot in some surgeries for patients to call at 11am rather than 8am for routine appointments. If it was successful, the good practice would be shared. It was advised that there had been positive feedback so far.

·       A community wellness outreach service was being developed. This would be to complete health checks and have wellness conversations in the community. This would be joint with the Local Authority through the Local Integration Board. The focus would be to reduce health inequalities through targeted outreach.

·       Concern shared by the Learning Disability Partnership Board was highlighted. This was around ensuring access and that reasonable adjustments were being provided. It was advised that the clinical lead for Learning Disabilities and Mental Health shared training with practices to help to ensure people were not left needing to navigate a difficult process.

·       It was highlighted that chronic conditions could be well controlled with lifestyle changes and medications to help patients to feel better.

·       The GP contract negotiations were ongoing. It would be reasonable to assume that much would continue with some changes. For example, the diversified workforce model and emphasis on access would remain. Practices would need to continue to collaborate.

Action: Primary Care Access to be added to the Work Programme for an annual update. A Pharmacy update to be scheduled sooner.