Issue - meetings

Presentation by Lynette Daws, Assistant Director of Commissioning - Primary Care, NHS Nottingham City Clinical Commissioning Group

Lynette Daws, Assistant Director of Commissioning, Primary Care NHS Nottingham City Clinical Commissioning Group (CCG), delivered a presentation regarding access to GP services within Area 1.

In addition to the information provided in the presentation of the following points were made:

(a)  Bulwell and Bulwell Forest have more than the City average of older citizens, the highest proportion of residents with poor mental health, and the highest proportion of residents within the City who smoke and are overweight;

(b)  the mystery shopper survey can only be considered as a snapshot as it was carried out by HealthWatch Nottingham with two calls made to 8 surgeries, requesting appointments over two days. Where surgeries were unable to provide either a routine appointment within one week or same-day urgent appointment, this has been investigated further;

(c)  within Area One there are 17 whole-time equivalent GPs providing 550 GP sessions each per week;

(d)  it has been a struggle to get trainee GPs to work in Nottingham as generally trainees tend to stay in the area in which they trained. As a result, 30% of available training posts were not filled in the last year;

(e)  newly trained GPs do not generally want partnerships and prefer initially to remain either salaried or work as locums. This impacts on the cost of providing locum or agency cover to an extent which is not sustainable for some practices; one practice within Bulwell held a GP vacancy for one year even though the vacancy had been advertised nationally throughout that period;

(f)  many practices are working to use clinical staff more effectively and promote the advice available from pharmacy staff;

(g)  suggestions regarding how appointments are booked and cancellations made include text messages to remind patients of their appointment, but which also offer a facility to cancel the appointment;

(h)  the ‘Physio First’ pilot enables patients to make appointments directly with the Physio Service instead of requiring referrals from a GP;

(i)  the new ‘Self-Help’ pilot operating within Bulwell will provide one central point which citizens can access to find self-help facilities such as referrals. The information will be kept up-to-date on a weekly basis;

(j)  the City Council’s Health Scrutiny Committee is considering the quality of GP practices in Nottingham and the information gathered so far can be found here: http://committee.nottinghamcity.gov.uk/ieListMeetings.aspx?CId=614&Year=0 ;

(k)  ideally, all surgeries would be able to offer a same day urgent appointment or a three-day routine appointment.

Lynette responded to the Committee’s questions as follows:

(l)  there are five practices within Bulwell which operate extended hours beyond the contractual requirements;

(m)  there is no specific CCG policy regarding patients making, but not attending, appointments. This is a waste of resources but more importantly, it wastes an appointment which may be used by another patient. Some practices do have their own policies where if patients do not attend (DNA) a set number of appointments, they are removed from the surgery’s register. However, this can just move a problem to a different practice so  ...  view the full minutes text for item 33