Meeting documents

Purpose:

This item will provide the Committee with an overview of the current GP provision in Bucks, including the challenges and opportunities in advance of a more in-depth look at this issue later in the year.

Attendees:

Ms L Patten, Accountable Officer, Bucks Clinical Commissioning Group

Ms H Delaitre, Associate Director of Primary Care

Papers:

Power point presentation attached

Intended outcomes:

For Members to gain a greater understanding of current GP provision across the County.

The Chairman welcomed Ms L Patten, Accountable Officer, Bucks Clinical Commissioning Group and Ms H Delaitre, Associate Director of Primary Care to the meeting.

The Chairman advised that the item would be coming back to the Committee in September for a fuller discussion.  Ms Delaitre ran through the presentation and highlighted the following points:

• Primary care consisted of GPs, dentists, opticians and community pharmacies.
• There were 3 types of GP contract; the General Medical Services (GMS); Personal Services Medical (PMS); Alternative Provider Medical Services (APMS).
• The contract holders were small independent businesses and were monitored on their service delivery of the contract.
• There were 51 general practices serving 528,000 patients from 72 buildings.
• Primary Care Commissioning Committee meetings were held in public.
• GPs received a core services payment and could opt in or out of providing certain services.
• There would be a growing pressure of housing growth in the next 15-20 years and the CCG was liaising with the District Councils with reference to the impact on primary care
• Population demographics – there was an ageing population and an increase in the prevalence of long term conditions.
• Fewer GPs were choosing primary care as a profession.
• Work was being carried out to encourage GPs to work in Buckinghamshire.
• Most GP surgeries were full; support was needed for the GP practices. 
• Primary Care was part of the Buckinghamshire One Public Estate initiative and the Integrated Care System (ICS).

In response to questions the following points were discussed.

• The GPs would be encouraged to work together to share opportunities and best practice and support the emerging community model.
• The problem of persuading some GPs to move out of their existing accommodation and into new rented accommodation in order to create modern facility was acknowledged but it was the GP’s decision as an independent business. 
• People needed to be directed to the right place via 111 to avoid unnecessary visits to the A&E departments.
• It was confirmed that GPs did not gain financially for referring fewer patients but evidence suggested that GPs should refer a patient to see a specialist only when all other options had been explored first.
• The GPs funding allocation was weighted for deprived populations and areas with an older population. 
• The community hubs would take into consideration the forthcoming demographic changes. 
• The future strategy would be to co-locate GP practices with other services wherever possible.
• The commissioners were responsible for making sure the correct level of services was available to the patients.
• It was likely there would be a move to appointments being available from 8.00 am to 8.00 pm.
• Bookable appointments between 8am and 8pm weekdays would be available for all patients in Buckinghamshire by the end of 2018.
• It was acknowledged that there was a challenge with GP appointment availability.
• The definition of a GP cluster was more than one GP practice working together. 
• It had been an incentive for GPs to work together in clusters with 30,000-50,000 registered patients as there was value in close working with nurses, physio therapists and other healthcare professionals.
• The planning for the new housing developments taking place now happened a few years ago and the Section 106 discussions in many cases did not include health provision so there was no funding coming from the developers; therefore the NHS was bidding for capital funding, against their peers within the STP, from NHS England. 

RESOLVED:  The Committee gained a greater understanding of the current GP provision across the County.