Agenda item

Dr Kiran Patel, Chair of Bury Clinical Commissioning Group will report at the meeting.  Report attached.

Dr Patel, Chair Bury Clinical Commissioning Group attended the meeting to provided members with an overview of the Urgent care redesign proposals.  The presentation contained the following information:

The proposals build on national and Greater Manchester guidance and focus on the delivery of services with the locality and integrated hubs.  The proposals have been influenced by the previously undertaken engagement phase and will now include; the promotion of the GP telephone number, available 24 hours a day seven days a week; retained walk-in service and a new Urgent Treatment Centre.

The aim of the proposals will be to reduce the utilisation of emergency services, promote self-care and encourage initial phone contact.  As well as the development of integrated services at hubs, which will include multidisciplinary teams; staff at these centres will be able to access a patient’s medical records.

Dr Patel reported that the 6 week consultation will run from 29^th January until 11^th March 2018.  The CCG governing Body will meet on the 28^th March to consider the proposals.

Those present were invited to ask questions and the following issues were raised:

Responding to a Member’s question, Dr Patel reported that the proposed integrated hubs will be sustainable if NHS staff work differently. GPs do not want to work in the current system, the proposed new system it is hoped, will be an attractive alternative for them. 

Concerns were raised that the new system will put a great deal of emphasis on GPs (and their staff) staffing the Urgent Treatment Centre and the integrated hubs.  General Practice is stretched as it is and this will add to the pressures already faced in primary care.  Dr Patel reported that between 30% and 40% of patients he sees daily within GP, do not need to be seen by a GP and may be seen by another NHS professional freeing up his time to support the Integrated Hubs.

Dr Patel reported that a greater emphasis needs to be placed on self- care and prevention, as well as a consistent offer from Pharmacies in respect of the services they offer.  The CCG is working with partners in GM to develop a healthy living offer across the footprint.  Education is key in respect of the proposals.

With regards to the roll out and the addition of further Hubs, Dr Patel reported that this will be based on the outcomes within the initial facilities as well as also the local resource and the specific need in each area.

The Urgent Treatment Centre will be open for 12 hours a day, based at Fairfield hospital and will be clinically led by primary care staff including GPs and nurses.  Staff will have access to patients’ medical records to help with their care and will include pre-booked, same day appointments accessible by health care professionals as well as walk-in appointments for A&E streamed patients.  The centre will have access to diagnostic tests including x-ray facilities.  A similar facility will be available for residents in the South of the Borough at North Manchester General Hospital.

Members expressed concerns that there was no consistent offer across the Integrated Hubs and no clear timescales for the role out of the additional hubs.  Dr Patel reported that what services will be delivered and where will be dependent on how the LCO responds and also how as a Board the self-care agenda is supported.

It was agreed:

1.     That the Health and Wellbeing Board supports the Urgent Care Redesign proposals as presented.

2.     That at a future meeting of the Board information is considered in respect of:

a.     Timescales for the future roll out of the additional Integrated Health and Social Care Hubs

b.     The make-up and scope, including staffing, of all the Integrated Health and Social Care Hubs and the Urgent Care Treatment Centre, and

c.     Further information in respect of how the CCG in partnership with Public Health will develop and expand the self-care agenda.