Agenda item

To consider a report from the Head of Governance and Scrutiny Support that introduces a further update from Leeds Clinical Commissioning Groups Partnership regarding the delivery of GP services in Leeds.

The Head of Governance and Scrutiny Support submitted a report that introduced an update from Leeds Clinical Commissioning Groups Partnership regarding the delivery of GP services across Leeds.

The report specifically highlighted matters associated with provision of services at Radshan Medical Centre in Kippax where, in October 2017, the provider of services had presented their formal resignation without prior warning.

In attendance at the meeting presenting the report were:-

·  Dr Simon Stockill, Medical Director, NHS Leeds Clinical Commissioning Groups Partnership

·  Gaynor Connor, Associate Director: Primary Care Development, NHS Leeds Clinical Commissioning Groups Partnership.

Also in attendance at the meeting were local Ward Members for Kippax and Methley, Councillors Keith Wakefield, Mary Harland and James Lewis.

In introducing the item, the Medical Director outlined the overall role of Clinical Commissioning Groups (CCGs) in terms of commissioning local GP services within the context of nationally negotiated and agreed contract framework. 

It was also highlighted that CCGs were commissioning organisations and, as such, were not permitted to provide services directly – unlike Primary Care Trusts (PCTs) previously. 

The Medical Director also provided some additional national context around the GP Forward View and funding and workforce issues across general practice. 

The Medical Director outlined the details, including a brief background, associated with the circumstances leading to the imminent closure of the Radshan Medical Centre; and highlighted: 

·  Aspects of the CCG’s consultation and engagement activities could have been improved.

·  The provider’s decision to terminate the contractual relationship to provide services at Radshan Medical Centre had been unexpected.

·  The minimum notice period of 6-months had been submitted by the existing provider on 31 October 2017.

The Chair of the Scrutiny Board invited the local ward members to address the Scrutiny Board.  The issues highlighted included:

·  The CCG had been aware that the practice was to close from October 2017;

·  Most patients first received a letter concerning the closure in January 2018;

·  Communication had not been good for residents of Kippax or for patients of the Radshan;

·  The practice had formed part of the local community for over 70 years; and pre-dated the NHS.

·  The closure should be considered in the context of projected increases to the local population – largely as a result of new housing developments across the local area.

·  Inconsistencies in approach and length of notice when considering potential closures in local GP areas. 

·  The involvement and communication with local ward members.

·  General poor communication with patients / service users.

·  Local residents needed reassurance about access to appointment.

·  The impact of previous closures decisions on surrounding GP practices (including Garforth Clinic).

·  The potential impact of availability of local public transport services.

The Medical Director sought to address the concerns expressed by local Ward Members and highlighted some additional points, including:

·  The different needs, and therefore different type of relationships between patients and their GPs.

·  Earlier involvement of local ward members would often result in less certainty / assurance at that time.

·  The CCG had worked to prioritise higher risk patients to ensure re-registration and continuity of care.

·  The timing and complexity associated with the Radshan Medical Centre. 

The Scrutiny Board considered the details set out in the report and highlighted at the meeting and discussed a range of matters, including:

·  The addition of qualitative performance data in future reports, including average waiting times for appointment, missed appointments, vacancies and levels of funding.

·  The analysis of qualitative performance data, including patient experience, when considering the impact of GP closures in general and specifically in relation to the Radshan Medical Centre. 

·  The reporting of practice level surveillance group activity/ outcomes.

·  Transitional funding arrangements associated with GP closures and list dispersals.

·  The use and potential impact of technology in delivering GP services.

·  The potential impact of Brexit (across a range of health and care professions and roles).

·  CCG input, comment and impact analysis associated with development proposals.

·  The lack of any national system for capturing and reporting GP workforce and workload data for benchmarking purposes.

·  Matters associated with GP practices potentially ‘cherry picking’ patients.

In drawing the item to a close, the Chair thanked all those present for their attendance and contribution to the discussion. 

RESOLVED –

(a)  That the information outlined in the report and discussed at the meeting be noted.

(b)  That the Principal Scrutiny Adviser draft a brief statement summarising the main issues identified by the Scrutiny Board.

(NB The Kippax and Methley local Ward Members left the meeting at the end of discussions on the Radshan Medical Centre, as part of this item).