To receive a report from Dr Louise Payne, Clinical Director, Aldershot and Dr Alice Earl, Clinical Director, Farnborough which will cover local primary care services. The report will include the impacts of the pandemic, future working arrangements and how the Primary Care Networks and the Council are working together.
Minutes:
The Committee welcomed Dr Alice Earl and Dr Louise Payne,
Clinical Directors for Farnborough and Aldershot respectively, who were in attendance
to report on local primary care services, impacts of the pandemic, future
working arrangements and how the Primary Care Networks (PCN) and the Council
were working together.
Dr Payne, provided an overview on Primary Care Networks and
it was noted that a PCN was a group of doctors’ practices working together with
other healthcare providers and appropriate organisations to deliver integrated
services to residents. It was noted that the Aldershot PCN covered 48,000
patients and Farnborough PCN covered 60,000 patients.
In Aldershot, there were four practices involved in the PCN,
Princes Gardens Surgery, The Border Practice, The Cambridge Practice and The
Wellington Practice. The executive, and leadership and strategic management
structure included, the four Practice Managers alongside the Clinical Director
(Dr Payne) and a PCN Manager. Below that, additional roles within the structure
included medicine management, mental health and wellbeing, care co-ordination,
first contact physio and paramedic practitioners. These roles were provided
through the Additional Roles Reimbursement Scheme (ARRS) a fund established to
support GP practices to address the needs of their patients.
In response to the pandemic, it was noted that the PCNs had
had to suspend contracts on some services to ensure patients were supported
throughout. However, some services continued to be provided such as general
medical services to patients and screening/immunisation services. Collaborative
working had played a part in many responses to the pandemic, including the
setting up of the vaccination sites in both towns (99,323 vaccines administered
to date), working together across Aldershot and Farnborough PCN’s on addressing
mental health matters resulting in the recruitment of a care co-ordinator
funded through pooled resources, working with the Council and other partners
with the aim to reduce health inequalities across the Borough and forging and
building on relations within the community, in particular with the Nepali
community.
Dr Earl reported on the situation in Farnborough and it was
noted that, by offering more digital services throughout the pandemic, patient
appointments had risen by 20%. In addition, patients had got used to seeing
appropriate specialists under the additional roles scheme to address their
needs. With the return to business as usual, it was noted that the PCNs would
continue to develop on the experiences learnt during the height of the
pandemic. However, it was advised that “return to normal” would require an element
of catch up, through the management of patients whose care had been affected by
the pandemic. Priority cohorts would also be targeted, with a particular drive
around those with mental health issues and learning difficulties, hypertension
and diabetes, amongst others. The Committee also noted that each of the six
practices within the Farnborough PCN had a Mental Health Support Practitioner
working within the practice to help support and improve people’s mental health.
The care co-ordinator helped to guide people to who was best placed to support
their needs, freeing up the doctors to treat those with more complex issues.
The Committee discussed the presentation and raised a number
of issues. These included:
·
Face to face appointments – it was noted that
face to face appointments had not stopped during the pandemic. However, they
were not freely available to be booked by patients and were issued via a triage
system based on need/demand. Currently 60% of appointments were carried out
face to face compared to around 80% before the pandemic. Many patients had
embraced the virtual/telephone consultations on offer. Moving forward it was
noted that the PCN were using and would continue to use internet/phone-based
appointment systems to address capacity issues. Nevertheless, it was considered
important to offer choice to patients but not allow them to dictate/demand how
they would be seen.
·
Patient lists/demand – it was noted that demand
outweighed the provision across the Borough, but the PCNs were working with the
Clinical Commissioning Group (CCG) on the building and projected population
plans to address the issue and expand as required moving forward.
·
Care Homes – it was noted that care homes had
suffered during the height of the pandemic and during May 2020 a local GP had
stayed over, at a particular site, on a number of occasions, to address the
needs of extremely unwell patients. Once the vaccination programme had
commenced in January 2021, admissions to hospital had reduced and outbreaks had
become more contained.
·
Cancer patients – it was noted that there had
been no backlog in cancer care; throughout the pandemic cancer care had always
been a priority, with referral through to diagnosis/commencement of treatment
generally being achieved within a four week period.
·
Young peoples’ mental health – It was noted that
schools were starting to work jointly with Mental Health Integrated Care
Services to address mental health issues within the education setting. In
addition, through the additional roles opportunity, the local PCNs were looking
to employ mental health practitioners, but it was noted that there was
currently a national shortage of qualified practitioners to fill these roles.
From the Council’s perspective, Mr Colver advised that
health was now a very important part of the Council’s work and suggested that,
where the Council was adding value, was working with the PCNs and the CCG on
the wider determinants impacting on health.
The Chairman thanked Drs Earl and Payne for their presentation.