Agenda item

Neil Roberts, Head of Primary Care NHS England (London Region, North Central and East), presented the report on the variation of primary care performance, and how it is identified and handled, together with details of the GP standards outcome and other key data. 

The details set out in the report also provided areas for consideration in relation to the Board’s due diligence role, particularly in regards to contracts offered to GPs and pharmacies that the local authority commissioned.  The value of the contract was £8bn and that GPs were independent contractors and not employees of the NHS.  Funding had been targeted at areas where performance has been poor and that had recently been other areas of London.  There was also a five year strategy, which included the establishment of a Primary Care Transformation Programme, and they were also looking at co-commissioning projects between the three CCG. 

Mr Roberts went on to inform the Board it had not proved possible to have a national standard, therefore, a London-wide standard had been developed.  They were also looking to further develop 17 aspirational standards at the moment. 

Matthew Cole asked how this work responds to the Francis recommendations and in regards to individual performance if they felt they had included the ‘Francis’ recommendations in relation to safeguarding and was advised that they had not done so as the GP contract is limited on safeguarding and there is more in CQC registration.  Mr Cole and Councillor Carpenter both asked if it was not more appropriate to suspend somebody accused of a serious allegation whilst they were being investigated.  Mr Roberts explained how they would investigate and if necessary suspend a specific person and how the statutory process is then followed.

Dr Mohi, Barking and Dagenham CCG, advised that there had been difficulties in regards to communication in the past but this had improved as of late.  The ability to obtain a GP surgery appointment was known to reduce the likelihood of a hospital A&E attendance so it was important that issues such as appointments and later opening need to be considered by NHS England when drawing up contracts or co–commissioning as this could have both a serious and long-term effect on the overall standards being provided. 

Anne Bristow, said there seemed to be little in the way of patients voice in the process.  Mrs Bristow indicated she had particular concern that NHS England had not taken the Francis recommendation to the core of their operation and stressed that investigation systems need to be in place, especially for vulnerable adults.  Mrs Bristow added that this may be an issue that the Board might wish to lobby on in future.

The Board:

(i)  Noted the report from NHS England;

(ii)   Expressed concern that the issues relating to GPs in the Francis Report had not been addressed by NHS England;

(iii)  Asked NHS England to revisit the arrangements with GPs in relation to Safeguarding issues as problems with accountability were still being encountered; and,

(iv)   Recognised the resource limitations for effective oversight of work done by GPs, but asked that NHS England consider what positive action might be taken to embed good practice as part of future commissioning and monitoring of contracts and report back to the Board in due course.