Agenda item

Councillor West, the Lead Member for the GP Services Scrutiny Panel, introduced the report.  She made the following comments:

• in the very limited timeframe, the Panel covered a wide range of GP services,

• the recommendations set out in the report are to ensure that an improved GP service is delivered to residents,

• the Panel was mindful that the public looks on NHS services as a whole and expects efficient, high quality, conveniently available services, irrespective of what borough the GP’s building is located or who monitors the services delivered by the GP,

• a belief that, recommendation 9 – to  implement cross-borough billing as soon as possible for the benefit of our residents – will bring an end to our residents being sent for tests or treatment to the other side of the borough, when a neighbouring borough delivers the same facility for patients in the neighbourhood also contributing to equality of services across boroughs,

• highlighted recommendation 10 which is to improve access to GP services for our young people,

• the recommendations also include issues in respect of staff employment and training and the need for a health publication setting out services, including where and when they are available, to be delivered to every household in the borough,

• the appointment system and the multi-agency receptions at Walk-In Centres and large medical centres are worthy of further investigation,

• thanks to the Panel for their work over a very short timeframe in producing this report and, in particular, the two co-opted members, Jim Camp, a Barking and Dagenham LINKs Member and Alison Moorton, a local GP Practice Manager, for volunteering their time to assist in undertaking this very important scrutiny,

• with more health consultations to improve the delivery of services currently being scrutinised on a local and across London basis, the delivery of health services and social care will be changing and it is important that scrutiny is active to ensure getting the best services for our local residents, and,

• if adopted by the Assembly, the report will then be sent to NHS Barking and Dagenham for a formal response and action plan.  This plan will be monitored by the Health Scrutiny Panel.

There then followed a debate on the report with the majority of contributions supporting the review and its findings, as well as congratulations to Councillor West and colleagues for completing such an in-depth review.  Members were particularly impressed with the level of public engagement and the depth of information and analysis undertaken that led to the recommendations in the report.

In response to a councillor’s question, Matthew Cole,Director of Health Improvement Barking and Dagenham NHS, indicated that the polyclinic model had been well received by the medical profession and that there was only one dissenting voice coming from a GP in the borough.  He also stated that the PCT, alongside the strategic health authority, had agreed a hub and spoke model for the borough. However, he reported that the emerging development in Barking Riverside did propose the building of polyclinics in its scheme.

In making her closing remarks, Councillor West reserved particular praise for Matthew Cole and Pat Brown, Senior Democratic Services Officer, for their invaluable contributions to the review.

Agreed the following recommendations:

1. NHS Barking and Dagenham investigate ways to encourage GPs to provide Saturday morning surgeries, on an appointment only basis.  To avoid wasting resources and in order to promote a healthy work life balance, the Panel suggests that NHS Barking and Dagenham look at a range of models including a rotation system. The Panel notes that, under such a system, patients requiring a Saturday morning appointments would be required to give permission for their records to be shared with the GP on duty.

2. NHS Barking and Dagenham actively and widely consult patients and health professionals regarding the Hub and Spoke model proposed for the delivery of GP services. If the consultation response is favourable, it is recommended that the model be implemented at the earliest possible time, and that regular updates be provided to local residents informing them of progress and services available throughout the Borough.

3. The Panel supports the proactive approach currently being taken to recruiting health professionals, and notes the importance of achieving the target of one hundred and one full time equivalent GPs by March 2009. The Panel recommends that NHS Barking and Dagenham be mindful of the importance of prioritising specialist services and achieving gender balance when recruiting new GPs, in order to meet the needs of our local multicultural community.

4. NHS Barking and Dagenham ensure that all GP premises meet the requirements of the Disability Discrimination Act 2005 and provide reasonable access for patients of all disabilities, including adequate access for patients who require aids for mobility problems.

5. NHS Barking and Dagenham encourage sufficient car parking and access for ambulance transport at new medical centres and, where possible, ensure that existing GP surgery parking facilities are upgraded.

6. NHS Barking and Dagenham pursue the ring-fencing of GP funding for ongoing staff training.

7. NHS Barking and Dagenham develop and distribute guidance on the following training standards for practice staff, and promote and monitor the implementation of these standards:

1.  That mandatory accredited induction training, including customer care, should be identified for all new reception and administrative staff and included as part of their terms and conditions of employment and job descriptions.

2.  That new Practice Managers should be required to undertake accredited training, funded from the GP training budget, as part of the terms and conditions of employment and job description.

3.  That all Practice Nurses attend refresher courses and development training.

8. GP surgeries within the same local area should provide the blood testing service on a rota basis, to achieve less and later pick-ups for the courier service.

9. NHS Barking and Dagenham take the lead in negotiating with all neighbouring boroughs to implement cross-boundary billing as soon as possible, as is already in place for acute services and Hospital Trusts and community services through the ‘Choose and Book’ system.

10. NHS Barking and Dagenham work with GP services to put in place the following measures to improve access for young people:

1.  On reaching 16 years of age, all young people should be invited by their GPS to a confidential consultation without their parents to discuss any health related issues.

2.  GP sessions (a mixture of drop-in and appointment-based) should be offered at a central location in Dagenham and in schools at the end of the school day (for example, between 3.30pm and 5.00pm).

3.  A website for young people to ask questions on line about health related issues should be developed in consultation with young people.

11. NHS Barking and Dagenham continue to work with local pharmacists to further publicise the services they provide and the availability of confidential consultation facilities.

12. NHS Barking and Dagenham encourage the use by GPs and Patients of the process by which GPs can issue six prescriptions of one month’s supply of medication to be held by a local pharmacist, nominated by the patient. The Panel suggests that the pharmacy should assume responsibility to monitor the correct use of the medication.

13. NHS Barking and Dagenham should attempt, where possible, to ensure that a pharmacist is located within medical centres or in very close proximity to GP services when planning services at new surgeries and medical centres.

14. NHS Barking and Dagenham develop and put in place procedures for the safe disposal of unused end of life medication by agencies in partnership with the patient’s relatives.

15. NHS Barking and Dagenham work with the Public Health Network to develop a joint protocol to publicise health messages, changes of policy and consultations.

16. NHS Barking and Dagenham develop a customer access strategy and improve the marketing of services to all residents, including, once the new medical centres are constructed and operational, the distribution to all properties in the Borough a concise health directory booklet, outlining specialist services available, opening times and locations.  The publication should be vibrant and headline text carefully worded to encourage its use and retention by residents. The Panel believes this will greatly assist residents to locate the most appropriate health service to meet their needs.

17. NHS Barking Dagenham investigate and / or lobby to ensure that staff working in privately built clinics (such as the Broad Street Medical Centre) that are specifically employed to deliver NHS services are able to continue their membership of the NHS pension scheme.

18. In line with the GP’s Code of Conduct and their professional duty, NHS Barking and Dagenham should strongly advise local GPs to assess and engage locums and salaried GPs with appropriate communication skills for all segments of the community.