Agenda item

Alison Blair and Martin Machray, Islington CCG, was present and outlined the report to the Committee.

During consideration of the report the following main points were made –

·         It was proposed to adopt model 2 – joint decision making - in the first instance, with a shadow arrangement starting in April, which will give an time to test out arrangements for decision making and membership, as well as determine the resources needed

·         Some areas still needed to be worked through in particular Governance and conflicts of interest

·         The NCL Primary Care Strategy underpins the development of co-commissioning and gives the CCG oversight of primary care development and contributes to forwarding local strategic change, leads to more integrated decision making, greater consistency of outcomes and incentives and a more collaborative approach to infrastructure developments

·         In response to a question it was stated that it was not felt appropriate to adopt model 3 at the current time

·         At present there were 36 GP practices in the borough and a number of these were now taking on part time roles and in addition there was an ageing profile for practice nurses and managers. There was a need for this to be addressed and to build capacity for the future

·         In response to a question as to the re-commissioning of the 111 service it was stated that whilst this would be looked at by NCL and any decision would need agreement by the 5 individual boroughs

·         NHS England have a 5 year forward view that focused on the need for high quality sustainable primary care

·         It was hoped that co-commissioning will develop a more co-ordinated approach

·         Reference was made to recruitment problems and that there were variations in contracts in the NHS and work was going on with GP’s to create a federation to promote and build skills

·         The Chair stated that the GP Appointments scrutiny review report would be considered by the Executive on 15 January and that following this he intended to write to all GP’s in the borough and other relevant organisations to draw attention to the recommendations and hope that a collaborative approach could be undertaken to implement these and a follow up exercise undertaken in the future

·         It was noted that it was not intended to share financial resources across the 5 boroughs

·         Reference was made to the provision of mental health and that the new model of dealing with mental health problems involved more joined up working across the NCL sector with primary care to improve outcomes and CCG’s had been told to invest more in mental health

·         The Committee then received a written (copy interleaved) and verbal submission from residents in relation to the re-commissioning of the 111 service during which the following main points were made -

There should be support given to local GP’s to enable them to bid for the service in order to provide the best possible service for residents and provide continuity of care

It was noted that in L.B.Hackney the 111 service contract had been won by local Hackney G.P.’s

The public consultation meetings arranged by the CCG were in their view not in adequately sized premises for the number of residents who would be likely to attend

The Chair stated that a number of issues had been raised in the laid round document from residents and that consideration of this matter should be deferred until the next meeting of the Committee, when the CCG would have had an opportunity to consider the points raised and be able to respond.

RESOLVED:

(a)  That the residents submission be noted and that a further discussion on the 111 service take place at the next meeting of the Committee

(b)  That the report and comments of the Committee be noted and that the preferred adoption of level 2 seems a sensible proposal to the Committee at this stage