Agenda item

Henry Clay, representing the Primary Care Foundation gave a presentation to the Committee.

During the discussion the following points were made –

·         Locum issues were relevant when considering the data on GP performance.

·         As part of the review process the Committee should look at how the CCG were helping practices to change the performance statistics as required.

·         There were draft access standards being prepared for London but they were not yet in place.

·         It had been difficult to find threads of consistency across high and low performing practices.

·         There was an expectation on practices that they would provide online access to patients from next year but there needed to be a balance of methods of access.

·         Support had to be given to receptionist teams to help with managing patients with English as a second language. There were existing translation services in place but the take up of these was low and did not seem to work well. Many patients chose to bring a family member or friend with them to translate.

·         Although there was data on GP performance nationally there was no one solution for GP performance that would work for all practices.

·         When practices told patients to call back again at the same time tomorrow they were often perpetuating the pressure on phone lines at busy times of day.

·         Resourcing on any given day could be an issue but there could also be more complicated underlying issues.

·         Repeat appointments was a larger issue for availability. If patients were coming back seven times rather than five times then the practice needed to consider why the extra appointments were needed.

·         The widespread variation between practices was a big challenge.

·         DNAs (did not attend) appointments were often higher when appointments were booked further in advance as the illness had improved by the time the appointment came around. If surgeries made better use of nursing staff so patients could be seen sooner the levels of DNA appointments could improve.

·         Patients unable to get through to the surgery by phone to access appointments was a major issues. Aiming for targets of 90% of calls being answered in 30 seconds would often diminish complaints.

·         Occasionally reception staff felt that the surveys were invasive and it was important that practice managers explained how the surveys would help improve systems for the patients of the practice.

·         Walk in appointments could help with providing easier access to appointments, particularly to those with English as a second language but it was just one way of service delivery.

·         There was a drive towards extending access to primary care including into weekends. The shift was inevitable but it was possible that by working with other practices new service models could be developed. The difficulty with this was how to provide continuity of care as a patient’s notes and clinical record would need to be accessible.

·         Continuity and having management plans in place that would explain what would happen when a situation arose were vital.

·         The Committee had heard evidence of many GPs performing a social support function and undertaking a significant amount of work on benefits assessments, housing applications and sick notes. It was suggested that giving other clinicians access to the system centrally would enable these patients to be seen elsewhere.

·         As practices grew they would need more resources. Allowing some staff to move round practices and out of hours services to gain experience could be beneficial.

·         Caution should be exercised to not look at just one model of service.

The Chair thanked Henry Clay for attending.