Agenda item

Dr Catherine Fines, GP Partner at Tower Family Healthcare and Associate Medical Director at the Greater Manchester Integrated Care Board, joined Zoe Alderson, Head of Primary Care in Bury, to present an update on the GP Strategy. The presentation outlined five strategic goals aimed at improving access, quality, and integration of primary care services across the borough. A visual summary of the strategy was shared with the committee, illustrating the ambitions and direction of travel for general practice in Bury.

Dr Fines and Ms Alderson began by addressing the ongoing pressures on A&E departments and the need for primary care services to operate differently to alleviate this strain. They highlighted the expansion of advanced access to GP services, noting that practices across Bury are now offering appointments seven days a week, including evenings and weekends. This enhanced availability is being delivered with a focus on maintaining continuity and quality of care, even out of hours.

To illustrate the scale of current provision, Dr Fines shared data from Tower Family Healthcare, which had offered 503 appointments on the previous day alone. Across Bury, approximately 4,000 appointments were made available, supported by a workforce of around 800 nurses and advanced nurse practitioners. Despite this, she acknowledged that demand continues to outstrip supply and that further expansion of availability is needed.

Councillor Staples Jones queried why public perception of GP services remains negative despite the apparent improvements. Dr Fines responded by emphasising the importance of better communication and public awareness, noting that duplication of appointments and system inefficiencies contribute to frustration. She invited councillors to help disseminate accurate information to residents.

Councillor Ryder echoed concerns about delays in securing appointments, suggesting that some residents feel let down by the system. Dr Fines acknowledged these concerns and discussed the challenges posed by digital platforms such as AskMyGP, which had not worked well for all patients. She confirmed that work is underway to improve online booking systems and ensure more consistent access across practices.

Councillor Fitzgerald noted that while online booking options exist, implementation varies between practices. Councillor Simpson raised the issue of acute respiratory hubs, particularly their role in supporting elderly patients during winter. Dr Fines confirmed that these hubs operate annually in Bury and stressed the importance of ensuring patients are aware of their location and purpose, especially when travel is involved.

Councillor McBriar highlighted the need for better data sharing with elected members and asked what measures are in place to address missed appointments. Dr Fines explained that practices are using SMS reminders and promoting the NHS App to help patients manage their bookings. She also noted that data on appointment attendance and cancellations is being published on practice websites to improve transparency.

Ms Alderson added that there has been a 50% increase in prescription requests via the NHS App, indicating growing engagement with digital tools. Dr Fines concluded by outlining the rollout of cloud-based digital telephony systems across all practices, which are helping to manage high call volumes and improve responsiveness. She also spoke about the development of care navigation roles and the integration of first contact practitioners, such as physiotherapists, to ensure patients are directed to the most appropriate services from the outset.

The presentation continued with a summary of the slides, which outlined key developments and strategic priorities in primary care across Bury. It was confirmed that all 25 GP practices now offer online registration, enabling patients to change practices quickly through GP-to-GP transfers. This was highlighted as a significant step in improving patient flexibility and access.

Councillor McBriar raised a question regarding the volume of calls received by practices and how many of those result in patients being seen.

Dr Fines responded by explaining that under the national contract, GPs are required to see patients who are ill or perceive themselves to be ill. However, it is not always possible to determine from call data how many contacts require clinical treatment. She emphasised the need to better support patients in navigating services and suggested this was an area for further exploration.

Councillor Duncalfe asked about access to medical records and whether some practices operate separate systems. Dr Fines clarified that from 2023, all patients should be able to access their records digitally. Councillor Simpson queried whether NHS systems include military records, to which Dr Fines responded that she was unsure but noted that the long-term plan is to move from analogue to fully digital systems.

Councillor Fitzgerald raised concerns about the shift away from paper-based systems, suggesting that some patients prefer traditional methods. Zoe Alderson responded by highlighting the expansion of seven clinical pathways designed to streamline referrals and reduce pressure on services, while still offering a wide range of care options.

Dr Fines discussed the importance of care navigation, ensuring that patients who contact their GP are directed to the most appropriate service or professional. Zoe Alderson added that building a resilient workforce is central to the strategy, with a focus on developing a sustainable pipeline of practice nurses. Dr Fines noted that recruitment to these roles is challenging, but Bury has a strong foundation of training practices and is working to create clear career pathways to support long-term sustainability.

The next section of the presentation focused on strengthening relationships between provider partners across the Bury system. Dr Fines acknowledged that previous attempts at GP collective action had not always been positive, but there is now a more collaborative approach between primary and secondary care. Bury’s four Primary Care Networks Prestwich, Whitefield, Bury, and Horizon are geographically scattered but work closely together to deliver integrated care.

Councillor Duncalfe asked for clarification on the difference between the MyGP app and the NHS App. Zoe Alderson advised that the NHS App is the preferred platform, with ongoing updates and enhanced functionality.

Councillor Hussain raised concerns about bureaucracy and the role of the medical examiner.

Dr Fines explained that the medical examiner service supports families during bereavement and ensures the timely and lawful provision of death certificates. The service has been rolled out nationally and is operating effectively in Bury, including over weekends something not available in many other areas. Councillor Tariq emphasised the importance of this service, particularly in relation to faith communities and legal compliance. He requested data on delays in issuing death certificates, and it was agreed that this would be brought back to the committee via the ongoing working group.

The final slides of the presentation covered incentive programmes and performance indicators across neighbourhoods. It was noted that there has been mild to moderate improvement in both baseline and overall achievement. Councillor McBriar asked about the relationship between COPD and annual health checks, and Zoe Alderson confirmed that improvements have been seen in the uptake of annual reviews.

Councillor Boles asked about GP involvement in neighbourhood strategies. Will Blandamer responded by outlining the integrated approach being taken, with GP leadership embedded in each of the five neighbourhoods. This work is aimed at reducing hospital admissions and developing integrated neighbourhood teams, supported by Pennine Care and wider public service teams. He confirmed that Bury is well-positioned both strategically and operationally.

The committee also discussed the development of family hubs and the NHS’s role in neighbourhood working. There was recognition of the strong public health drive, particularly around improving uptake of the MMR vaccine.

It Was Agreed:

·       The report be noted 

·       Councillor Fitzgerald proposed that elected members receive training to help promote these developments. Councillor McBriar suggested the use of graphics and infographics to support communication with constituents. Councillor Duncalfe added that basic training for councillors would be helpful, particularly around underused services.