Report of the Integrated Care System
Minutes:
The Director of Primary Care and Medicines Staffordshire and Stoke on Trent ICB provided a report and presentation which provided context and key drivers to the current situation regarding general practice access in Staffordshire and Stoke-on-Trent.
Committee noted a summary of completed actions and achievements relating to public communications, digital, and quality variance and resilience, training, and development work. The Director outlined the seven-point action plan for July 2022 to consider matters relating to communications, access improvement programme (Accelerator Programme); record keeping; digital solution; quality, variation, and resilience; training and development and workload initiatives.
Committee noted the following comments and responses to questions:
· Concerns were raised about communication to the public about transformation and process change coming out of the pandemic. Members were assured that work was ongoing to address concerns and get messages out to people about new roles and ways to access services.
· There continued to be increased demand for appointments, with 65% of appointments face to face.There was a significant amount of telephone appointments, however this did not create additional capacity, it was a more convenient way for some people to access the GP, but not a way of seeing more patients.
· Different ways of using telephony with a move to cloud-based telephone systems to book appointments was being rolled out over 12 months. The cloud-based telephony system tripped in when lines were busy, callers were able to leave their number and would be phoned back, without losing their place in the queue.
· Digital solutions, including blood pressure monitoring from home, had been introduced in practices. Online information and support, including ‘Know your Gp Staffordshire’ live website and an access support package was also available.
· For practices not performing well targeted support and training was available, including workload initiatives, directing people to the right service, working with the wider primary care and NHS England. There were twelve domains of work, each with a metric. The data being collated would inform the wider KPI dashboard being developed by the Health and Care Overview and Scrutiny Committee.
· Additional support for staff was available and advice for those who had concerns about financial wellbeing.
· Patient Participation Groups (PPGs) enable patient engagement with practice staff, the Primary Care Network (PCN) were strengthening PPGs and agreed to provide a list of PPG vacancies to the District and Borough Councillors to get involved. PPGs were not currently part of the Primary Care Access Plan but as a result of the discussion today would be considered for inclusion.
· Members highlighted that some people rarely contacted a GP surgery and would need to be informed about what was available in their community and of new ways to access alternative solutions. The ICS was looking at different mechanisms to inform and educate the public, looking at lessons learned during the roll out of vaccines in the pandemic, targeting different age groups in different ways.
· Members highlighted the move to preventative agenda and that there was a need to look at the pathways to early advice and support. Assurance was given that this would be part of the strategy going forward.
· In relation to making GP appointments on the APPS there was not currently a consistent approach across Staffordshire practices, but this was being worked on.
· ‘Did Not Attend’ (DNA) appointments was not a metric currently being used. Members felt that visibility of DNA appointments online should be considered in the range of metrics collated.
· GP Access had been a challenge before the pandemic but in terms of the backlog arising from the pandemic the largest group had a long-term condition. To accelerate the backlog before the winter period they were frontloading the Quality Assessment framework.
· 167 practices had reduced to 144 to optimise the footprint for resilience, practices were working together and had developed the universal offer - fifteen services commissioned across 100% of the practice population offering equal access to services. There was a need for the ICB to refresh the strategy, practices need to establish their own strategy and a primary care collaborative has been established consisting of senior leaders across the area to shape the strategy. Within the strategy, workforce was an issue to address with a 7% reduction in GPs in the area, a workforce plan would be part of the strategy.
The Chairman thanked the Director for the presentation and for the work they were doing.
Resolved:
1) That Health and Care Overview and Scrutiny Committee note the progress report and include a further update in the Work Programme to review the Primary Care Access Plan in 3-4 months’ time.
Supporting documents: