Agenda item - GP Sustainability

19.1    This item was introduced by Murray King, Interim Associate Director Primary Care, Brighton & Hove CCG. Due to administrative error, the CCG report accompanying this item that should have been tabled at the meeting was not available. There was therefore no report for the meeting. The report has subsequently been added to the committee papers on the council’s website and circulated to members. Several members noted their dissatisfaction with the absence of a report.

19.2    Mr King told members that there were some local positives: 36 city GP practices are rated ‘good’ and Brighton & Hove GP Patient sSurvey results are above average. However, there are also significant problems, particularly in the east of the city where a number of practices are vulnerable.

19.3    Commissioners have developed tools to identify the most vulnerable practices. Four city practices have been identified as being particularly vulnerable, and are receiving additional support. Commissioners are also focusing on single-handed practices due to their inherent vulnerabilities.

19.4    There has also been investment in a telephone service which can augment capacity in practices under pressure. The practices using this service supply a list of their most vulnerable patients who will then not be routed to the telephone service. Clinical call-handlers  have full access to patient records. In time it is hoped that many call-handlers will be local GPs and practice nurses  with a good understanding of the city. The CCG believes that there is an un-tapped market of local clinicians with the appropriate clinical skills and experience.

19.5    It needs to be recognised, however, that there is a national and indeed an international shortage of GPs and that it is important to think about the skill mix of primary care clinicians – i.e. using physicians’ assistants, practice nurses, pharmacists etc. where appropriate and ensuring that GPs only see patients who need to see them.

19.6    Mr King also explained the situation at Ardingly Court, where the practice has decided effectively to split in two. This follows the practice taking on a number of new patients following the recent closure of city GP surgeries run by The Practice Group. The CCG will tender for a new, Whitehawk-based practice, and four of the GPs currently at Ardingly Court will resign in order to bid for the new contract.

19.7    In response to a question from Cllr Morris on practices closing their lists, Mr King told the committee that practices could apply to commissioners to ‘cap’ (temporarily close) their lists where it was unsafe to register new patients. There are currently five practices with capped lists in the city. This is largely due to practices having to manage the impact of the closure of the Ridgeway surgery and should be a temporary issue. A capped list is not wholly closed; it must still accept some new patients – for example babies born to existing patients on the list.

19.8    The Chair thanked Mr King for his presentation.