Agenda item

5.1

The Committee received a report from Nicki Doherty, Director of Delivery, Care Out of Hospital, NHS Sheffield Clinical Commissioning Group (CCG) which provided an update on the progress to date and future plans to achieve the priorities identified in the Sheffield Place Based Plan and GP Transformation Plan.

5.2

Also present for this item were Abby Tebbs, Maggie Sherlock, Jane Harriman (NHS Sheffield CCG) and Dr. Mark Durling (Vice Chair, Local Medical Committee).

5.3

Nicki Doherty gave a short presentation outlining three key approaches in achieving the priorities for the delivery of high quality, sustainable care as described in the transformation plan for GP services across Sheffield.  The first approach was to ensure a consistent quality offer to patients through investment, listening to what people had to say and working closely with GP practices. Secondly, to develop a new way of working through neighbourhoods to support efficient use of professionals, ensuring that their time was spent in the right places, understanding what people need and tackling inequalities in those services provided.  Thirdly, enhanced communication and information sharing for more effective ways of working, care navigation and communication with patients and partners.  Nicki Doherty added that the aim was for a broad range of professionals to be working within neighbourhood practices and that there was equality of investment to deliver services to meet the particular needs of different populations across the city.  She said that there was a role for Healthwatch and other sources who provided feedback, through patient surveys, which assisted in identifying practices where patients had reported issues such as access to GP services.

5.4

Jane Harriman referred to the next report on the agenda, which provided an Overview of Sheffield General Practice and stated that over the past two years, the Care Quality Commission (CQC) had carried out inspections at Sheffield based GP practices and there had been a 7% increase in improvement in ratings, and she added that the overall satisfaction with practices throughout the city was very close to the national average.  She said that the Quality Framework for Primary Care which had been approved in May, 2018, aimed to provide a consistent and equitable approach to managing practice quality and performance across practices in Sheffield and give support to areas of weakness.

5.5

Dr. Mark Durling stated that, nationally, the NHS was struggling to recruit and retain GPs nationally, and although Sheffield was a popular place to work there was an ageing workforce with workload pressures and this needed to be addressed.  He said that the ageing population had more complex needs, and there had been a 15% rise in consultation rates.

5.6

Members made various comments and asked a number of questions, to which  responses were provided as follows:-

·                     It was stated that Neighbourhoods were emerging and most areas had committed GPs.  Development was needed around the concept of working more efficiently.

·                     With regard to where money was coming from for investing in primary care, it was stated that the Government had announced a ring-fenced pot for primary care within its recently published NHS Long Term Plan.  There was also a need, however, to use existing resources more efficiently.

·                     The integration of commissioning between clinicians, healthcare professionals, patients and the public, to deliver high quality, efficient and cost effective healthcare services for people across the whole of Sheffield, was needed to work towards the prevention strategy as set out by the NHS.

·                     Not all Neighbourhoods are developing at the same rate.  There was an emphasis on giving support to those neighbourhoods that were struggling, by offering support and training by developing receptionists’ knowledge, the introduction of new IT systems and forming stronger partnerships with other service providers.

·                     The neighbourhood model helps to share information and raise standards of care.

·                     Work was being done towards Practice Nurses being more clinically trained in diabetes care, and if successful, the same approach could be rolled out across other conditions.

·                     A question was asked on whether fewer, bigger GP Practices was a solution to some of the current problems. The response was given that many people prefer the “cradle to the grave” type of medical practice, and want to keep their link with a local practice. The advantage of the neighbourhood model was that it has the potential to offer a wider range of services than can be provided at practice level i.e. from Community Nurses, Mental Health Workers, Physiotherapists, First Responders, Specialist Nurses.

·                     A series of workshops will be held during the coming year to see what needs to be changed within Neighbourhoods.

·                     In response to a question about whether GP practices have enough time and capacity to give to neighbourhood development, the response was given that all Neighbourhoods have a Clinical Lead and a Project Manager to oversee and give support to practices.  There wasn’t a “quick-win” solution, but the aim was to take the pressure off GPs, to enable them to spend more time with their patients.

·                     There was city-wide commitment to Neighbourhoods from pharmacies, the voluntary sector, community services, mental health teams and the police, with the aim of building relationships over the long term. Currently, Neighbourhoods are at differing levels of maturity.

·                     A Workforce Group had been established within the Accountable Care Partnership to look at different roles, training, Practice Nurse development; and to look at ways of retaining professionals.

·                     It was stated that it takes 10 years to train a GP, and a further number of years for them to become accomplished in general practice.  It was further stated that there was a serious problem with investment in General Practice and there needed to be a way to make General Practice more attractive to recruit to, and to create posts that were versatile. Reforms in inspection and licensing have been good for improving quality in General Practice, however, they had also added to the pressures GPs face.

·                     With regard to the variation in gaps in funding, there was a need to target resources to practices that were struggling.

·                     All the results of the primary care survey can be found on the CCG website by accessing each practice.

·                     It was recognised that work needed to be done on how to link Councillors in to the Neighbourhood model.

5.7

RESOLVED: That the Committee:-

(a)       notes the information reported and thanks those attending for their contribution to the meeting; and

(b)       requests that the CCG keep the Committee updated on progress and brings an update report in Autumn 2019.