Resolved: the committee noted the report.
Ashley O’Shaughnessy (Deputy Director of Primary Care, Lewisham CCG) and colleagues introduced the report. The following key points were noted
1.1 Three GP practice mergers have been approved in the past 12 months. Two were linked to retirement. GP retirement is a significant challenge in Lewisham and across the country. Practice mergers can help to provide continuity of service to patients by allowing GPs to stagger their retirement and provide a reduced number of sessions.
1.2 One member of the committee asked whether an equality impact assessment was carried out for the Hilly Fields and Brockley Road GP merger and how patients will be engaged now the merger has been agreed.
1.3 The full business case for the Hilly Fields and Brockley Road GP merger, including an Equality Analysis Screening Tool assessment, was considered by the CCG and is available online. There will be ongoing engagement with patients through the merger, including targeted support for vulnerable patients.
1.4 Primary Care Networks (PCNs) in Lewisham are able to access funding to support the recruitment of additional roles in primary care, including physician associates and physiotherapists from 2020. Physician associates are a new kind of healthcare worker within primary care that will provide services, health checks and screening, for example, with the support of GPs and nurses.
1.5 The GP Extended Access Service, which provides additional bookable GP appointments from 8am-8pm, continues to deliver and offer an increasing number of appointments. The service has a utilisation rate of 80% against a national target of 75%. The service also has a 16% DNA (“did not attend”) rate, however, which is impacting on its ability to provide more direct patient care.
1.6 There are a disproportionate number of DNAs on the weekend, particularly Sundays. The CCG is analysing the data and considering whether there are any specific measures that can be taken, with practices and patients. It has also spoken to Healthwatch Lewisham.
1.7 One member of the committee noted that some people might be anxious about being able to get a GP appointment and booking appointments “just in case”. The member suggested that more frequent text message reminders, up to a few hours before the appointment, might help reduce DNAs.
1.8 Lewisham CCG continues to work with GP practices to support unregistered vulnerable patients. There was a learning event in 2018 for all practices to raise awareness of the issues people had faced with registration. The CCG has also commissioned the Lewisham Community Education Provider Network (CEPN) to visit all practices to undertake specific training on supporting vulnerable people to access primary care. Cards have been distributed to remind practice staff that people do not need a fixed address or ID to register.
1.9 According to Doctors of the World, the number of people who tried to register in Lewisham and who were not initially successful has recently reduced from 17% to 7%. Officers expect this rate to reduce further as a result of the ongoing work.
1.10 Two errors in the published report were highlighted as follows:
5.5.11 – As of November 2019, 16 Lewisham practices had signed up to the Safe surgeries scheme rather than Safe hubs scheme.
5.5.12 - OHL is also working with DOTW to develop mobile clinics in Lewisham to help vulnerable people to register with a GP and receive immediate care rather than OHL is also working with DOTW to develop 12 mobile clinics in Lewisham to help vulnerable people to register with a GP and receive immediate care.
1.11 Lewisham CCG recently carried out a review of the GP patient survey data and other primary care quality indicators and identified a list of GP practices in need of support. One of the main areas of support was to address the issue of getting through on the phone.
1.12 The identified practices have successfully applied for additional funding to support address the issues identified. The CCG will monitor the impact by speaking to patients with Healthwatch and continuing to monitor GP patient surveys data.
Resolved: the committee noted the report.