Agenda and minutes

Venue: Havering Town Hall

Contact: Anthony Clements 01708 433065  Email: anthony.clements@oneSource.co.uk

Items
No. Item

1.

ANNOUNCEMENTS

Details of the arrangements in case of fire or other events that might require the meeting room or building’s evacuation will be announced.

Minutes:

The clerk to the Sub-Committee gave details of the procedure to be followed in case of fire or other event that may require the evacuation of the meeting room.

2.

APOLOGIES FOR ABSENCE AND ANNOUNCEMENT OF SUBSTITUTE MEMBERS

(if any) – receive.

Minutes:

There were apologies for absence.

 

The revised membership of the Sub-Committee was noted and the Chairman welcomed Councillors Hawthorn and Smith to their first meeting.

3.

DISCLOSURE OF PECUNIARY INTERESTS

Members are invited to disclose any interests in any of the items on the agenda at this point of the meeting. Members may still declare an interest in an item at any time prior to the consideration of the matter.

Minutes:

There were no disclosures of pecuniary interests.

4.

MINUTES pdf icon PDF 138 KB

To agree as a correct record the minutes of the meeting held on 28 April 2015 (attached) and to authorise the Chairman to sign them.

Minutes:

The minutes of the meeting of the Sub-Committee held on 28 April 2015 were agreed as correct record and signed by the Chairman.

5.

PRIMARY CARE STRATEGY

To receive a presentation from the Primary Care Improvement Director, BHR Clinical Commissioning Groups on the Primary Care Strategy and GP workforce issues in Havering.

Minutes:

The Director of Primary Care Improvement – BHR CCGs explained that a Programme Board was working in conjunction with Barking, Havering and Redbridge University Hospitals’ NHS Trust and health and social care directorates across the three boroughs. Each borough however had its own primary care strategy.

 

There were a number of key drivers around the primary care landscape. These included the ageing population, more patients with multiple long-term conditions, IT issues, information sharing, the NHS estate and workforce issues. The Royal College of GPs had also recently issued a blueprint for new GP arrangements. The College wished to have 8,000 more GPs working nationally. It also wanted GPs to be allowed to innovate, have better premises and to have increased time with patients.

 

There was a total of 47 GP practices in Havering which were now commissioned locally by the CCG. Representatives of the Health and Wellbeing Board and Healthwatch Havering sat on the Commissioning Committee in order to avoid any conflicts of interest. It was clarified that pharmacists, optometrists and NHS dentists were still commissioned by NHS England. The Urgent Care Centre at Queen’s hospital was now managed by the three local GP Federations.

 

The GP list size in Havering (5,383 patients) was lower than the national average but Havering was also below the national average for the numbers of GPs and Practice Nurses per patient. These combined figures totalled 0.67 medical staff per 1,000 patients compared to a national average of 0.85 staff per 1,000 patients.   

 

It was accepted that it was difficult to recruit GPs in Havering. Around 20% of Havering GPs were aged over 60 and this was expected to rise to 27% in the next 10 years (higher than the national average).

 

A new GP contract needed to be negotiated nationally which would allow professional barriers to be broken down and GPs to work more closely with Social Care. The GP Federation could be used to provide some services differently and a Programme Board of stakeholders had been established to improve primary care provision. A programme of stakeholder engagement was also under way with regard to this and clinicians, patient groups and pharmacists had been asked to give their input. The CCGs were keen to have further patient and public engagement with regards to primary care provision.

 

A review of how local NHS properties and estates were being used was in progress and the CCGs wished to ensure that existing spaces were used as effectively as possible. There was a possible £1 billion NHS England investment in premises available nationally over the next four years but it was important that this linked with the CCG Estates Strategy. The Director would confirm when the review of local NHS premises was due to concluded and hence when the Estates Strategy would be available for scrutiny.

 

The Chair of the Havering GP Federation felt that difficulties in recruiting GPs locally were due to a number of issues. These were mainly related to working conditions and expectations of being  ...  view the full minutes text for item 5.

6.

HAVERING ACCESS HUBS AND WEEKEND GP PROVISION

Dr Dan Weaver, Chair, Havering GP Federation will update the Sub-Committee on out of hours and weekend GP provision in Havering.

Minutes:

The Chair of the Havering GP Federation reported that there was direct access available for patients to hub appointments. This was via a new phone number – 020 3770 1888. Access was also still available via the NHS 111 service.

 

There were now two GP hubs available in Havering – at the North Street Medical Centre and at the Rosewood Medical Centre in Abbs Cross Lane. The new service had received a lot of publicity support with Practice posters being produced and Practices being asked to mention the hub appointments on their answerphone messages. Members suggested that libraries, community centres and Facebook could be also used to advertise the service.  The GP Federation Chair agreed that more advertising was required. Living Magazine and the Council e-mail database could also potentially be used.

 

In September 2014, around 300 out of hours appointments per month had been provided. By May 2015, with the opening of the second hub, this had risen to approximately 5,000 appointments per month. Some 42% of people who used the service had indicated they would otherwise have gone to A&E so this had produced a financial saving for the local healthcare economy. The hub services had received good feedback for areas such as access and quality of staff. There was no peak time for the service as all patients were booked by appointment. There had been a lot of compliments received that people were able to obtain weekend GP appointments very quickly via the service.

 

Some 90% of weekday hub appointments in Havering had been used but this dropped to 41% at weekends. The weekend figures were in line with experience in other areas where demand for weekend appointments had been lower than anticipated. The originally planned 8 am – 8 pm weekend service was not therefore needed and appointments were available 12-5 pm on Saturdays and 12-4 pm on Sundays. It was clarified that there were no plans to close the weekend GP service in Havering.

 

The GP Federation, known as Havering Health, represented 38 of the 47 GP practices in Havering. As regards sharing of medical records, any IT issues had been resolved but data sharing protocols still needed to be agreed. This was a local issue that needed to be resolved between the commissioners and providers involved.

 

The Director of Healthwatch Havering reported that around half of Havering GP surgeries did not display a recent Healthwatch survey on GP access and only very poor responses had been received from most other practices. Responses that were received however had been very supportive of the hub and of the sharing of patient records. Many GP receptionists still did not appear to be aware of the hub and its out of hours services. The Federation Chairman expressed disappointment t this and would report this back to a practice managers’ meeting.

 

The GP Federation wished to run the full triage service at Queen’s A&E but this was not however consistent and the Federation only currently undertook the  ...  view the full minutes text for item 6.

7.

JOINT HEALTH OVERVIEW AND SCRUTINY COMMITTEE NOMINATIONS pdf icon PDF 84 KB

Report attached.

Minutes:

It was AGREED without division that Councillors Dodin, Ford and Patel should be the Sub-Committee’s representatives on the Outer North East London Joint Health Overview and Scrutiny Committee for the 2015/16 municipal year.

 

It was AGREED without division that Councillor Dodin should be the Sub-Committee’s representative at any pan-London health scrutiny meetings that may be required during the 2015/16 municipal year.

8.

APPOINTMENTS CANCELLATION TOPIC GROUP pdf icon PDF 259 KB

Members are invited to discuss what areas they would like to cover at the next meeting of the appointments cancellation topic group, scheduled for Tuesday 28 July at 6 pm. Data from Barking, Havering and Redbridge University Hospitals NHS Trust is attached as an aid to discussions.

Minutes:

The Chairman reminded the Sub-Committee that the next meeting of the topic group looking at appointments cancellation was scheduled for Tuesday 28 July at 6.30 pm.

 

The Chairman reported a number of issues he had been advised of concerning appointments at BHRUT. There had been incidents reported of where an appointment not was not available within 12 weeks, patients not being put on the system and being asked to telephone every day to check availability. This was of course impractical for many people. Other issues included chose and book appointments made direct by patients then being cancelled by the Trust and continuing delays at the call centre in answering calls.

 

It was felt it would be useful if the BHRUT Assistant Chief Executive could attend the next meeting of the topic group to explain the administration process and how problems were being resolved. This would include the large reduction in the variety of appointment letter types that had previously been sent by the Trust.

 

It was AGREED that the clerk to the Sub-Committee would circulate to Members the notes of the previous meeting of the topic group. Members would then decide on which issues they wished to discuss during the topic group meeting.

9.

COMMITTEE'S FUTURE WORK PROGRAMME pdf icon PDF 65 KB

Draft work programme attached for discussion and amendment.

Minutes:

In addition to the draft workplan circulated with the agenda papers, the Sub-Committee AGREED that the following items should be added to its workplan for the 2015/16 municipal year:

 

Joint Health and Wellbeing Strategy

Joint Strategic Needs Assessment

CCG Estates Strategy/Property Review

 

The clerk to the Committee would circulate to Members a revised version of the workplan for information.

10.

URGENT BUSINESS

To consider any items in respect of which the Chairman is of the opinion, by means of special circumstances which shall be specified in the minutes, that the item should be considered as a matter of urgency.

Minutes:

There was no urgent business raised.