Questions are invited from members of the public present at the meeting on any matters for which this Committee is responsible.
Minutes:
Luise Fitzwalter raised a number of concerns with regards to the proposals which included; lack of detail, availability of the extended hours GP service for Ramsbottom residents, dual running of services including staffing issues, problems with recruitment to GP positions.
In response to these concerns, the CCG representatives reported that a wound care service had been introduced in six different locations including Ramsbottom.
Dr Patel reported that the GP extended hours service has not been as well utilised by patients in the Tottington and Ramsbottom areas. Every GP Practice within the CCG can now access the same IT system. The Virtual Clinical Hub has been operational for several weeks and this service will eventually be rolled out across Greater Manchester. Dr Patel reported that 75% of the patients who accessed the virtual hub have been triaged without the need to refer on to A&E.
Dr Patel reported that a primary aim of the urgent care redesign is to encourage and enable patients to self care. It is hoped a less fragmented service, as proposed, with entice GPs currently working as Locum doctors to work as permanent members of staff in more integrated multi-disciplinary teams.
The Chief Operating Officer reported that the CCG are in discussions with Pennine Care NHS Trust, the provider of the walk-in centre service, with a view to potentially extending the contract at the Town Centre venue.
Richard Coates, a member of the public raised concerns in respect of plans in Oxfordshire and elsewhere, for GPs to set up private companies to charge for primary care service that are no longer provided by the NHS, including urgent weekend and evening care and some minor surgery. Mr. Coates sought assurances from representatives of the CCG, that the closure of the urgent treatment centres will not be a step towards privatisation and charging for treatment.
Responding to these concerns, representatives from the CCG reported that Bury CCG does not intend to introduce payments for these primary care services. Statutory guidance dictates that certain services must be procured. Previous governments have encouraged competition from the private sector through the establishment of Independent Treatment Centres (2008/9) and the Any Qualified Provider Scheme. Dr Patel reported that he had spoken to the Local Medical Committee and they have confirmed that they have no plans to provide these schemes privately.
Dr Patel reported that the purpose of the urgent care redesign is to streamline the service and encourage patients to self care and not to privatise the service.
Paul Gerrard, a Member of the Public expressed concerns that the plans put too much emphasis on the 111 telephone triage service, a service that has been shown to be inadequate. He also raised concerns in respect of additional pressure on already over-stretched A&E departments as well as the decision making process.
With regards to the 111 telephone service, Dr. Patel reported that there had been some concerns raised in respect of the service and in particular the use of computer algorithms to triage patients. The CCG has engaged with the providers of the 111 service to try and address some of these issues. Dr Patel reported that telephone triage is used regularly by GP to assess a patient’s condition.
The Chief Operating Officer reported the 111 telephone service is now provided by North-west Ambulance service, NWAS have a large amount of experience in triage patients via the telephone.
Andy Walker, a Member of the Public reported that the already undertaken engagement exercise identified that 83% of respondents were opposed to the closure of the walk-in-centre and expressed concern that the consultation will finish a week before the proposed closure date of the Town Centre, Walk-in centre.
The Chief Operating Officer reported that a number of facilities will continue to be provided across the Borough including, the wound service and the extended out of hours service. The urgent care redesign will not be a cost saving exercise; the plans will result in the most appropriate service being delivered at the right location.
In response to a question from Jane Deesdale, the Chief Operating Officer reported that if the service is to be successful then the message in respect of urgent care needs to be simplified; dial 111 for non-emergency queries and 999 for all emergency calls. Dr Patel reported that the 111 service will provide access to translation services.
Andrew Lyones, a member of the public reported that there were a number of unfilled posts within the walk-in centres as a result of the job insecurity. In response the Chief Operating Officer reported that the CCG are working with the current provider, Pennine Care to ensure that there continues to be safe staffing levels within the service.
Other members of the public raised concerns with regarding the accessibility of the 111 service for those most vulnerable, the recent CQC NWAS report and closures of walk-in centres elsewhere, as well as transport concerns.
Responding to the concerns raised, the Chief Operating Officer reported that in areas where a front end primary care service has been introduced there has been a dramatic reduction in the numbers of patients attending A&E. Where walk-in centres have closed there has not been an increase in the number of attendances at A&E. The new virtual hub will not be provided by a private company and BARDOC will provide the front end service at FGH.
The Chief Operating Officer reported that the CQC inspection rated the 111 telephone service provided by NWAS as “Good.”
Dr Patel reported that the CCG has recently developed a new initiative that allows GPs to provide additional support to vulnerable adults. The initiative would encourage GPs to check on patients at risk prior to the weekend and ascertain if any preventative action is needed.