Discussion with representatives from the Havering GP Federation – Havering Health Ltd.
Minutes:
The Interim Chair of the local GP Federation – Havering Health explained that the Federation was a group of local GPs working together. The aim of the Federation was to ensure a well-resourced, high quality local health service. Thirty-nine o the fifty-eight GP practices in Havering had joined the Federation and this represented around 84% of patients at Havering GPs. Those practices who had not joined the Federation would also be engaged with.
The Federation was closely regulated by the Assurance Panel of the Care Quality Commission as well as by the existing GP regulations enforced by NHS England and other organisations. The Federation had also engaged with Healthwatch Havering.
GP Federations were being encouraged by the London Health Commission in the light of declining funding for GP services. There were also increasing demands on GPs due to the ageing population and higher disease prevalence and complexity of care. GP Federations were now operating in a number of areas including Barking & Dagenham, Hackney and Tower Hamlets. The Federation wished to work with the Sub-Committee to improve the quality of care for Havering patients.
While there was a fee of £1,000 to join the Federation, it was not felt that this was the main reason why some GP Practices had declined to join the Federation. One practice had declined to join as it disagreed with the general philosophy of Federations.
The GP Federation had provided access via a hub to appointments from 6.30 – 10 pm, Monday to Friday. The level of expertise in the Federation meant it could for example help GP practices improve their rates of smoking cessation. Work would be undertaken with the Barking & Dagenham and Redbridge Federations to develop training for GPs. Recruitment would also be addressed by the Federation.
It was hoped to extend opening of the hub to include weekend GP appointments although CCG had also commissioned weekend service. This was however planned to cease operating at the end of March. The hub was a pilot scheme for two years at the end of which it was planned to procure a permanent provider.
The demand for the Federation’s out of hours services had increased recently with 28 appointments offered each evening. Weekend appointments were not available as yet. The Federation was keen to increase referrals to the service from Queen’s Hospital and the polyclinic at Harold Wood. No referrals had however been received as yet from A & E and the possibility of having the out of hours service present on site at A & E was being investigated.
The emphasis would also be placed on reducing attendances at A & E and the ‘Don’t go to A & E’ campaign was being updated with the launch of a phone app. Referrals to the out of hours hub from NHS 111 and via GPs had now commenced.
It was accepted that there was a lack of information about the out of hours service in GP surgeries that this was intentional at this stage. All Havering GP surgeries were aware of the hub and were able to make referrals to it. It was not possible for patients to self-refer as the pilot was looking at current need and the Federation did not wish to generate any additional demand at this stage. The CCG would however look at how GP surgeries were promoting the out of hours services. It was confirmed that NHS England had also asked that information about NHS 111 should be on Practice answering machines.