Agenda item

Interim scrutiny survey results were circulated with the main agenda. The survey has been produced by scrutiny to provide additional evidence for the review: Access to Health Services in Southwark. The survey is still live and can be accessed here:

http://www.surveygizmo.com/s3/1463361/Access-to-Health-Services

Healthwatch have provided papers on focus group feedback to support the review into Access to Health Services in Southwark.

6.1  The chair explained that items 6 & 7, on the scrutiny survey and the GP Patient Survey would be taken together. The scrutiny project manager, Julie Timbrell,  commented that the scrutiny survey sample was much smaller so the results could only be indicative, however many of the questions were similar to  those asked by the GP Patient Survey , so the results could be cross referenced with the GP Patient Survey data , which could be interpreted with a high level of confidence in the results as it survey a large population sample. The scrutiny survey also offered an opportunity for people to comment on difficulties in open text responses, unlike the GP Patient Survey, where the questions were all closed.

6.2  Jill Webb, Deputy Head of Primary Care (South London) NHS England added that the GP Patient Survey had a population sample of 10,000 and was done by MORI and so the results could be relied on. She noted that when she came and presented the results of the last survey 74% of patients were satisfied that they could get a convenient appointment; this has now gone down slightly to 72%, whereas the interim scrutiny survey results indicated that 49% of respondents were satisfied with their appointment.

6.3  The Deputy Head of Primary Care commented that there is a review of contracting to get better results and a move towards more local contracting. A fund as been set up to enable practices to applying for extra money to look at improved access.

6.4  The chair commented that a number of people had spoken about visiting their doctor in connection with  a long term condition and asked if this was the right place to access care. The Deputy Head of Primary Care responded that GPs are supposed to be gateway to care - but there is a team approach.  Tamsin Hooton, Director of Service Redesign, SCCG, commented that doctors offer the core services for people with long term conditions. She commented that the SCCG has been encouraging people to get better at self management of long term conditions, for example there is register and improved care on diabetes and COPD. These is also a community based multiple disciplinary approach which emphasizes a tiered approach to accessing care. People with a long term conditions should be getting a continuity of care from their GP - rather than going to acute care.

6.5  A member referred to a former plan for poly clinics, and asked if there are still plans for extended GPs,  where people could have access to more extensive primary care for conditions such as diabetes. The Director of Service Redesign referred to the paper on Commissioning Urgent access to Primary Care strategy, circulated as a late item (14). She said that the terminology is now community hubs , but the model is very similar to poly clinics, and confirmed that this would allow for better community health care for people with long term conditions . The Deputy Head of Primary Careadded that she thought their was more appetite for this model now.

6.6  The Director of Service Redesignwent on to comment that the paper on Urgent Primary Care Access identified that there are problems with the booking system and inequitable access. The CCG have been considering the Lister Centre; the CCG preferred option is encouraging practices to come together in locality to offer extended access clinics.

6.7   A member commented that a quite a few of the practices have a link nurses who work with older people, and asked the Director of Service Redesign if she thought there was a role for more specialized nurses. She responded that there is an integrated nurse the role; and these practitioners work with people with a high level of risk.

6.8  Alvin Kinch from Healthwatch commented that they are planning to do rolling focus groups and they have already done two with the Latin American and deaf community, who both identified similar issues. Healthwatch will be taking some of the recommendations forward: for example on sexual health.

6.1  A member asked if there was sufficient capacity for people wanting appointments outside of work hours. The Director of Service Redesign responded that the capacity survey of G.Ps showed the CCG that there is capacity but it is not always mapped well to demand - for example too little Monday and Friday. The CCG are providing money to encourage doctors to work together to better match resources to demand. She added that the CCG do think they need to add more capacity to primary care and also make some improvements around telephone systems. The Deputy Head of Primary Care said there are some GP Practices that are outliers. She explained that more can be done with the GP Patient Survey data now as NHS England have been  using the same questions for two years now. NHS England will be looking at data - and looking at practices with cause for concern, whether complaints, or access, or diabetic care.