Issue - items at meetings - Update on GP Provision in the City

Presentation from NHS England (copy attached).

15.1    The Committee received a presentation from Sarah MacDonald, Director of Commissioning, NHS England South, and Kirsty Sibandze GP Contract Manager, Operational, NHS England South, , in relation to update on GP provision in the city.

15.2    Geraldine Hoban, Chief Executive, Clinical Commissioning Group for Brighton and Hove, explained to the Committee that the city had a high level of primary care need compared to other areas. This related to the significant number of people in the workforce nearing retirement, and the ongoing difficulty of recruiting new GPs. There was work underway to ‘cluster’ GP practices together geographically so that they could support one another if a practice was struggling and share resources and back office functions.

15.3    Ms Hoban also advised that all CCGs had been asked if they wanted to take on direct responsibility for commissioning GPs, but Brighton & Hove CCG had not taken up the opportunity at this stage. This may change in the future.

15.4    The NHS England representatives explained that NHS England and the Care Quality Commission (CQC) worked alongside each other; as they have  different roles between NHS England, the CQC and the regulator, with NHS England being the contract managers; any action that they take has to be linked to contractual issues,. She highlighted that NHS England and the CQC had monthly meetings to discuss possible issues that needed improvement.

15.5    With regard to Goodwood Court, NHS England had met with the practice on a number of occasions in 2014 to raise concerns and had been assured that action would be taken. Information came to light in June 2015 that had not been known before, which meant that a different course of action had to be taken and led to the closure of the practice.

15.6    The Committee expressed concerns that a similar situation could arise in other GPs surgeries in the city. To provide assurance Ms Hoban offered to update the Committee at a future meeting with the criteria considered by NHS England in relation to the oversight and monitoring of GPs surgeries. It was also agreed that Officers could work alongside NHS England and the CCG to bring this information in the appropriate format to the Committee.

15.7    Nicky Cambridge, Healthwatch Brighton and Hove representative, expressed concern about patients being temporarily registered for Charter Medical Centre and said that there were a number of lessons and challenges for NHS England to take forward about communication. Healthwatch Brighton and Hove had been contacted by very distressed patients from Goodwood Court, some of whom still did not feel that they had a permanent GP placement, Ms Cambridge suggested that the local CCG might be better placed to cascade information urgently.

NHS England acknowledged they needed to communicate more with patients, and were looking into using social media more.

15.8    Ms MacDonald confirmed patients had been informed the arrangements were temporary, and work was being progressed to arrange an engagement session in September which would brief them on the next steps.

15.9    In response to the Committee, the Practice Manager and one of the partners from Charter Medical Centre explained that since Goodwood Court had closed, Charter medical centre were working towards continuity in the quality of service. They were looking into opening on Saturdays and holding additional clinical surgeries. Charter had retained one member of the Goodwood Court staff which had been very helpful in building knowledge of vulnerable patients on the Goodwood Court lists.

The Chair thanked the staff of Charter Medical Centre on behalf of the committee, for their work in taking on the additional patients so speedily and successfully.

15.10  In response to the Chair, Ms MacDonald provided assurance to the Committee that, at this time, there were no any other GPs practices in the city with the same level of concerns as had been identified at Goodwood Court.

15.11  Ms Cambridge commented that Healthwatch Brighton and Hove had been carrying out a number of Enter and View visits to GPs in the city and would be happy to share this data when results were known.

15.12  Following a question from Councillor Deane, Ms Hoban stated that the GPs who worked at Goodwood Court were still practicing but they were currently the subject of investigation from the General Medical Council (GMC).

15.13  Members said that they felt were a number of issues outstanding with regard to their concerns about GP provision in the city. It was agreed to continue the discussion at a later stage.

15.14  RESOLVED – That the Committee note the contents of the presentation and the response to their questions.