Agenda item

The Board received a presentation by Anthony Fitzgerald, Director of Strategy & Delivery, Doncaster CCG outlining the local and national plans for improving access for patients and supporting General Practice.  Anthony was accompanied by Carolyn Ogle, Associate Director Primary Care and Commissioning, and Dr Dean Eggitt, CEO of Doncaster Local Medical Committee.

In particular, the presentation summarised the following key points:-

• Information was provided on the Primary Care structure in Doncaster, including a map showing locations of the General Practices across the Borough.  It was noted that there was variation across Doncaster in terms of people’s access to services.
• The Primary Care response to Covid-19 was outlined, highlighting that Primary Care had been crucial to the rollout of the vaccination programme.
• The headline trends from Capacity and Demand data showed that General Practices remained very busy, with pressures remaining high in relation to Practice call volumes, appointment availability and workforce pressures.
• A National Plan for Improving Primary Care Access had been produced in October, resulting in a £250 million Winter Access Fund being made available (with £1.3 million anticipated for Doncaster).  Doncaster’s Winter Access Fund Plan describing how its share of the Fund would be utilised was included in the agenda pack for this meeting for the Board’s information.  The proposed key actions set out in the Plan were outlined to the Board, according to the main themes which comprised:-

o   Increase and Optimise Capacity;

o   Address Variation and Encourage Good Practice; and

o   Zero Tolerance of Abuse and Public Communiciations

• Dr Dean Eggitt gave a frontline view of the current situation in General Practice.  He explained that the future of General Practice was Primary Care, and that a shift was needed towards viewing Primary Care units operating in a similar way as the former cottage hospital industry, with GPs acting as consultants of Primary Care leading teams of health care professionals to see a whole range of conditions that would not naturally be thought of as being about Primary Care in the past.

During subsequent discussion, Board members asked questions and made comments on a range of issues highlighted by the presentation, including:-

• Jackie Pederson explained that there would be a need to work across the whole sector as a team in future, with all providers and voluntary sector organisations around the table, to ensure there was greater integration in the delivery of services.  The challenge of dealing with the long term (planned care) health conditions of patients while also providing care for the urgent cases was also recognised, and this applied equally to Primary Care and not just in hospitals.
• Councillors Andrea Robinson and Nigel Ball advised that they were aware from their constituents and local communities that people were experiencing difficulties in accessing some general practices, both in person and by telephone and sought assurances that steps were being taken to improve the situation at those practices where there were issues.  It was also suggested that the Plan should include actions/measures via communications to make it easier for people to submit complaints when they wished to.
• It was suggested that it would also be beneficial to highlight those General Practices that were performing well, and look at how Primary Care could work with the wider community organisations to support and meet local people’s needs.
• The Board welcomed the proposed actions in the Plan, but also recognised the importance of being able to measure the outcomes for local people.
• Members noted that in many ways hospitals and General Practices had experienced the same challenges during the pandemic in terms of reduced capacity, be it in the form of reduced bed space or not being able to see as many people in face to face appointments in surgeries due to social distancing restrictions.  There was a need to ensure that a clear message went out to the public as regards service expectations in the future, so that they understood that normal now was not the normal of old, while Covid-19 continued to circulate.
• The Chair stressed that a radical approach was needed to look at how services communicated with people, as not everyone had access to social media and the Internet.  She also welcomed the partnership approach to delivery of services in the future, and felt that Doncaster was already in a strong position when it came to working on a collaborative basis across organisations, as the necessary framework was already in place in terms of Localities, the Health and Social Care Forum and Team Doncaster.  She also suggested that the Board revisit this agenda item in 6 months’ time to check on progress.

After the Chair had thanked all General Practice and Primary Care staff on behalf of the Board for their amazing efforts and hard work during the pandemic in continuing to deliver services for patients in challenging circumstances, it was

RESOLVED to note the local and national work being undertaken in improving access for patients and supporting General Practice and receive a progress report in 6 months’ time.