Agenda and minutes

In accordance with the Council’s Constitution, Members are asked to declare any interest they may have in any matter which is to be considered at this meeting.

Councillor Chris Rice stated that he was a member of North East London Foundation Trust’s Governing Body.

The minutes of the meeting held on 18 December 2018 were agreed.

The Barking and Dagenham, Havering and Redbridge Clinical Commissioning Groups’ (BHR CCGs) Deputy Director for Primary Care Transformation (DDPCT), and Primary Care Improvement Lead (PCIL) delivered a presentation to update the Health Scrutiny Committee on the challenges and activity happening in primary care. The presentation included the following areas:

·  Results of Care Quality Commission (CQC) inspections, practices rated ‘inadequate’/ ‘requires improvement’ and overview of the themes occurring;

·  Support provided by the CCGs to practices;

·  Challenges in primary care including workforce numbers and what the CCG was doing to address them;

·  Other workforce initiatives and workforce transformation;

·  The focus for 2019/20;

·  Improving practice sustainability;

·  The work of the GP Federation;

·  Improving care for patients with diabetes and stroke prevention;

·  Referral schemes;

·  Community urgent care update; and

·  Personal Medical Services (PMS) and the local review of PMS contracts.

In response to questions, the DDPCT and PCIL stated that:

·  Resilience funding was provided by NHS England (NHSE) and the CCGs topped this up with their own funding. This funding was used to support sustainability and workforce optimisation. Examples of this was training for front desk receptionists at general practices to signpost people to the most appropriate service for their condition, and the creation of a bank of GPs and nurses to provide consistent support to practices;

·  The CCGs did provide support to practices before they were inspected by the CQC on a daily and regular basis across the network. They used a ‘quality surveillance tool’ which gave an early indication of any practices which appeared to be declining. The tool had ten indicators including estate, vacancies and information from the local Healthwatch organisation, which helped do this.

·  The issue of safeguarding appearing as a theme in relation to CQC inspection outcomes was not about staff awareness of safeguarding matters. It related to practices not having updated their written policies and procedures around safeguarding. Another issue that had emerged was around practices meeting their responsibilities under the General Data Protection Regulation;

·  There were three Primary Care Improvement Leads in Barking and Dagenham CCG who looked after a network of practices each. They undertook regular visits to practices and used information from these to develop plans to support them; and

·  There was a huge challenge around the GP to patient ratio in this borough, which could not be addressed through money. NHSE appreciated that there were localities in the country where GPs were scarce in comparison to others. However, it was hoped that the current workforce model would help address these challenges.

Councillor Freeborn stated that she was the Member Champion for Care and Quality. In response to questions from her, the DDPCT stated that:

·  Practice managers did have a role in ensuring that their practice’s policies were appropriate and up to date, as well as ensuring other aspects of the practice were adequate such as estate, number of staff, training and, implementing CQC inspection recommendations. However, practices were independent businesses which meant that the role of practice manager could vary from practice  ...  view the full minutes text for item 18.

The Committee noted the report.