Report and presentation attached.
Officers representing the BHR CCGs that a primary care strategy had been introduced for North East London that sought to establish more integration between health providers and between the health and social care sectors. It was accepted that recruiting and retaining the GP workforce remained important to the success of the strategy.
Governance of primary care transformation included the establishment of a BHR primary care transformation programme board, chaired by a Cabinet Member from Essex. The most significant area of work was the development of Primary Care Networks and 40% of GP practice income would in future be derived via collaborative working.
There would be six Primary Care Networks in Barking & Dagenham, five in Redbridge and four in Havering. Each Network had a local GP who acted as clinical director. Paid roles in the Networks could include a social prescriber (for which 100% of the cost would be reimbursed this year) and a local pharmacist (for which 75% pf the cost would be reimbursed. From April 2020, a workforce budget would be allocated to each Primary Care Networks for the Network to spend as it preferred on roles such as physician associates or paramedics. A total of £1.6m would be invested in Primary Care Networks in Redbridge alone.
Work was in progress to increase the availability of GP appointments that could be booked on line. On line consultations could be accessed by 60% of Redbridge residents, 42% in Barking & Dagenham but only 23% in Havering. It was also noted that the new GP contract would require practices to open from 8 am to 6.30 pm. There remained significant numbers of patients who booked appointments but did not attend or cancel these. A new text messaging reminder service had been introduced in order to address this.
There were 46 vacant GP posts across the BHR area. This was better than the London average but slightly worse than the national average. A scheme had been introduced to match GPs to potential vacancies and efforts were also being made to address workload issues by establishing more part time GP posts. Only four GPs had this far been recruited via the international recruitment programme.
There were a total of 122 GP practices in the BHR area and the CCGs aimed to have GP practices care in a more collaborative way. It was accepted that satisfaction rates for GP services were too low (with Redbridge recording the lowest figures locally) but it was difficult to increase these ratings in the short term.
It was clarified that a capacity plan for all three boroughs was being developed and the CCGs were working with Councils on this. Consideration was being given to the level of health facilities that would be needed for new developments such as those at Rainham and the former Victoria Hospital site in Havering and Barking Town Centre and Baking Riverside in Barking & Dagenham. Efforts were being made to find a different model of health facilities for these new developments and work with Council officers was ongoing on this.
Officers accepted that it was sometimes difficult to persuade GPs top move from converted houses into more modern premises. It was agreed that work undertaken in Redbridge on how the location of GPs is decided should be shared with the Joint Committee for information.
It was an overall priority of the CCGs to move more care out of the hospital environment. This depended however on workforce issues being sufficiently resolved. Good work undertaken by local GPs in areas such as diabetes and atrial fibrillation had already reduced pressure on hospitals in these areas.
The Joint Committee noted the update.