Issue - meetings

Elizabeth Manero will provide an independent assessment of the Haringey Primary Care Strategy.

Elizabeth Manero, Chair of Health-Link,

Elizabeth Manero was appointed to act as independent adviser to the Panel.  The Panel was addressed by Ms Manero.  A summary of some of the key points made within this presentation are described below. A full copy of a presentation given by the Elizabeth Manero to the Panel is attached for information. 

·        Health-Link is an independent, not for profit social enterprise which explores new ways to improve health and health services, with patients and the public. 

·        The consultation for the Darzi review of London NHS services is explicitly concerned with models of care and delivery models only.  Further national and local consultation will be necessary for the application of models e.g. where polyclinics/ super health centres might be located.  Further clarification may be necessary from NHS London concerning the consultation process for the London NHS Strategy (A Framework for Action) and possible implications that this may have locally.

·        To assess what impact proposals set out in the strategy may have on health inequalities, an explicit formula needed to be developed.  A template of such a formula was presented to the Panel.

·        As GPs are independent contractors, PCTs and the NHS more generally have limited powers to direct their work.  The Primary Care Strategy does however appear to strengthen local commissioning arrangements which may be beneficial in helping to achieve change locally.

·        Haringey may be in a stronger position than other PCTs to deliver change given the number of salaried GPs working within the locality.  This may further help to reconfigure primary care services.

·        The way in which the Haringey Primary Care Strategy is applied will be of critical importance, particularly in the way that planned developments (super health centres) acknowledge and respond to local health needs.  

·        The PCT should provide further clarification of the costs of the Primary Care Strategy.  There were some inconsistencies in financial planning, such as the presumption of staff costs to be neutral despite the intention to extend and develop services.

·        There was a need for further detail and clarification on some aspects of the Primary Care Strategy, in particular, what services will be offered from super health centres and whether all super health centres will offer similar services.

·        A number of gaps in the strategy were identified including the views of the Local Medical Committee, the views of local Practice Based Commissioning Groups, the effectiveness of local Practice based Commissioning and the willingness of local GPs to re-locate and financial implications for GPs.

·        There was a need for the Primary Care Strategy to include a community based monitoring system, so that the impact of planned developments can be assessed as the plans are implemented.  Similarly, the PCT should establish a baseline health position from which to assess future impact of planned changes.