Agenda item

Actions and developments since November 2021 report to the Board on ‘Access to GPs (primary care)’ in Buckinghamshire and plans for development of primary care GP services linked to housing growth in Buckinghamshire.

Philippa Baker, Buckinghamshire Place Director, Buckinghamshire Oxfordshire and Berkshire West Integrated Care Board.

The Chairman advised that there were two parts to this item; a follow up on access to GPs which was discussed in November 2021 and the second part would be a focus on longer term plan and the strategy for access to GPs related to the population growth in Buckinghamshire.  The Chairman stated that she had received a letter from the Chairman of the Strategic Sites Committee who was concerned about build out of infrastructure alongside essential infrastructure such as primary care (PC) services.  Access to GPs was important to our residents and the Chairman was keen to understand how health was working alongside our planning colleagues as the five year plan was developed to ensure the correct provision for residents in the future.

Access to GPs - Philippa Baker, Buckinghamshire Place Director, stated that it was a challenging time nationally as GPs had never been busier and GP retention and recruitment was difficult.  Changes had been made to improve access and the direction of travel was to GPs at scale which meant opportunities for groups of GPs to work together, e.g., on the vaccination programme.  However, continuity of care would be part of the five year plan.  The Primary Care Networks (PCNs) were in place and federated GPs were working in Buckinghamshire.  New types of staff were being introduced in primary care involving, for example, pharmacies and social prescribing to improve access.  It was recognised that GPs were independent practitioners and that some variation was expected but it was important to challenge unwarranted variation in accessibility or patient experience.

The following key points were raised:

Healthwatch Bucks reported that GP access was one of top issues for residents and a short survey had been carried out to gauge whether the cost of living was impacting GP access.  20% of respondents were worried about being on hold when phoning a surgery and two thirds had been cut off whilst waiting. 

Simon Kearey, Head of PCN Delivery and Development, added that there was also currently the challenge of covid, flu and strep A resulting in high demand on GPs. Approximately two thirds of GPs had a new cloud based telephony system, and many people were using online access, video consultation and mobile phone apps.  A training programme on digital literacy was being rolled out which should make an improvement.

Gill Quinton, Corporate Director, Adults and Health reported she had seen complaints regarding access to GPs and asked whether any analysis was carried out.   Philippa advised that the ICB Place team were reviewing practices in the top and bottom quintiles and asked to be informed of any outliers in terms of complaints.

Dr Sian Roberts, GP and Clinical Director, Mental Health, Learning Disabilities and Dementia, explained the difference between GPs and primary care.  Primary care was the first point of contact which could be at a pharmacy, or an appointment with a nurse.  Not everyone needed to see a GP; GPs were an aspect of primary care.  Philippa added that primary care was changing but there was still an expectation of access to a GP and communications were needed to show the different ways to access primary care.

Michelle Evans-Riches, Programme Manager, Bedfordshire, Luton and Milton Keynes, ICB highlighted that they used a GP bulletin to send to elected members to help inform residents.  The Chairman asked for Michelle and Philippa to discuss the possibilities [for Buckinghamshire].

Action:  P Baker/M Evans-Riches

The longer term strategy – the Chairman stated that residents needed to understand that considerable thought was going into where PC provision was required in the future in Buckinghamshire.  Philippa added that there were three aspects to explore; the population growth, in particular the new developments and making sure that the PC services and estates were keeping pace with the growth in population; the second area was inequalities and making sure that the services were available to the population in areas of higher social deprivation, and thirdly, the changing types of care that PC was delivering.  It was possible that there would be a broader base model, with different kinds of consulting rooms/clinics and different services linking up with community hubs. It was a dynamic, complex picture.

Louise Smith reassured that they recognised the estates as one of the bigger areas of PC and were recruiting a senior manager to oversee the PC estates and to understand the workforce and digital require requirement.

In summary, the NHS were engaged with the five year plan and the Section 106 and Community Infrastructure Levies.  Philippa stressed that the ICB was keen to work with the Council, partner organisations and residents, to ensure they understood what was driving and informing the decision making.

The Chairman thanked everyone for their contributions and stated that an item on ‘Primary Care’ should be brought to the HWB in a year’s time.

Action:  J Boosey