Agenda item
Planning and Primary Health Care Infrastructure
The Health Scrutiny Sub - Committee is recommended to:
|
1. Note the contents of the presentation to help gain a greater understanding of:
|
Minutes:
Jenny Cooke, Deputy Director for Primary and Urgent Care at Tower Hamlets Clinical Commissioning Group (CCG) jointly presented her report with Chris Banks and Tracey Connell from Tower Hamlets GP Care Group as well as Tim Madelin, Senior Public Health Strategist at Tower Hamlets Council.
The presentation gave an in-depth analysis of the issues facing the health economy in Tower Hamlets due to increased demand and population growth, coupled with funding restraints Commissioners was experiencing. In light of this the CCG was working with General Practices to improve access, streamline procedures using technology in innovative ways to ensure patients are signposted correctly.
Jenny acknowledged recruitment and retention of staff in primary care faced an unprecedented challenge however the CCG was working with GP practices to ensure change was occurring. She said the CCG had piloted their GP support programme over eight months and had seen impressive results. For example it had assisted one surgery to improve their telephone access with a drop in complaints by 40-60% and helped to reduce Did Not Attend (DNA) rates. The CCG was helping GP practices to think through their processes and to be more customer focussed, in order to help embed learning from the pilot.
Tracey Connell and Chris Banks informed Members about the GP Care Group. Chris explained how the GP Care Group came into existence with GP practices being grouped together and working in a network. It is a not-for-profit ‘Community Interest Company’ (CIC) which aims to support GP’s and their patients. This has allowed Tower Hamlets to be ‘ahead of the curve’ in terms of consolidating the primary care offer.
The GP Care Group had successfully tendered for the Prime Ministers Access Fund (known as the GP Access fund), which exists to support provision outside of core hours and has created four hubs in Tower Hamlets where patients can access 350 appointments p/w in primary care out of normal hour’s.
Evening and weekend appointments were available to patients and the hubs were staffed with a range of professionals – GP’s, pharmacists, nurses and healthcare assistants. Patient footfall during the week and Saturday showed demand for an extended service (although Sunday take-up has been low) with an average of 290 appointments p/w. For example, the hubs had assisted with the BCG vaccinations by offering new parents additional appointments.
The GP Care group had built good relations with pharmacies and with additional funding next year hoped it could align services with the Urgent Care and Walk in centres.
Jenny added patient feedback indicated satisfaction with the standard of clinical care, but there was frustration with the process of getting an appointment. She also added that the GP workforce was also changing. In the past the profession was male dominated and GP practices were stand-alone businesses however more GPs are salaried staff and more are female. Hence with this change GP’s are looking to work in federations and networks and there needs to be a strong local offer to attract GPs and retain them in Tower Hamlets. The CCG has developed their ‘open doors’ and ‘physician associates’ scheme in order to support career development and the skill mix of practitioners.
Tim Madelin, Senior Public Health Strategist stated the Public Health Team worked closely with Health professionals and the Local Plan set out the 15 year planning policy, subsequent design, scale and location of development. The Plan had identified and safeguarded potential sites for infrastructure development and considered how infrastructure could be funded.
Tim explained the difference between S106 agreements which were replaced with the Community Infrastructure Levy (CIL) in April 2015. He said that whereas the S106 agreements could specify what the monies should be used for – e.g. health centre, the CIL was a collective tax and the priority of allocating CIL monies were decisions made by the Mayor and Cabinet. CIL money is only likely to meet up to 20% of the cost required for infrastructure.
Tim informed Members the ‘Ageing Well’ Strategy was being developed with a view to ensure older people could live independently in their own homes for longer. Cllr Whitelock-Gibbs clarified the local authority was considering to build more extra-care sheltered housing in addition to supporting residents who require residential care or those with complex needs.
This was followed by questions and comments from Members, who stated:
· Impressed with the plans in place to analyse population increases and demand on health infrastructure however it’s also about physical space in a given locality. Some parts of the borough have been over developed and there may not be the physical space for infrastructure buildings.
· What is being done to tackle overcrowding and can CIL monies be used to improve existing homes?
· What support is provided to vulnerable tenants in their own homes?
· S106 specified the project to be developed but how can we ensure CIL money is spent on health priorities?
· Will there be nurse-led surgeries similar to midwife led birthing centres?
· Improvement of Primary care focusses on GP’s however attention should also be given to Dental Care and access to Dental practices.
· Would welcome the centralisation of processes – such as online registrations and appointments, telephone systems.
· Recruitment and retention has been highlighted as an issue; what is being done to link up with the councils objective of providing homes for key workers and how can we integrate health and housing need especially for those with Mental Health issues?
The Chair thanked everyone for their input.
The Sub-Committee RESOLVED to NOTE:
The contents of the presentation to help gain a greater understanding of:
· The challenges facing general practice and the plans in place to address them.
· Planning of healthcare infrastructure to account for population increases,
· The links between planning and health infrastructure and how this is implemented in LBTH.
· How the housing needs of elderly residents will be addressed.
Supporting documents:
- 161024 HSP Planning and primary care infrastructure cover 2 0 (2), item 3.1 PDF 102 KB
- Presentation, item 3.1 PDF 730 KB