Agenda item

Sarah Barron, Interim Manager, Primary Care at NHS England & Cassie Williams, Assistant Director of Primary Care Quality and Development, gave a presentation to the Board on the interim findings from the Strategic Plan for Primary Care. Ms Barron emphasised that the findings were interim as the Strategic Plan was due for completion in April.

The key finding was identified as reinforcement of the shortfall in primary care capacity issue which had been previously identified by the Board in the area around Tottenham Hale, Tottenham Green and Bruce Grove. Ms Barron argued that although the issue had been raised previously, there was a lack of evidence of strategic need to take to the NHS Finance Committee. The findings of the report and the capacity analysis would be used to develop that strategic need. Ms Barron commented that the minutes of the Board in September, along with the Healthwatch report that was tabled was to be used as evidence to support an application for additional primary care capacity. The Board were invited to put forward any other items that may help evidence the strategic need.

Ms Barron advised that the data was complex and that a significant gap existed between the GP registered population in that area and the resident population. As a result, the Board was advised that it was difficult to make a commitment on exactly how much additional capacity was to be commissioned. However, Ms Barron estimated that, based on the figures in the Healthwatch report,  there was a shortfall of around 4500 patients which equated to roughly 3 GP’s. The capacity analysis would be taken to the Primary Care Decision Making group next which would recommend a commissioning option; either an additional primary care practice procured, or a new premises would be commissioned and an existing practice moved in to that premises. After having been through the primary care decision making group, the decision would then be taken forward to the NHS finance committee for approval. The Board noted that the process was likely to take 2-3 months. The second option to commission a new premises and then move a new existing practice into that site was identified as problematic due to the deficit in primary care capacity identified in the area.

Ms Barron noted that details of the Primary Care Infrastructure fund of around £1B over four years had been released since the last meeting. Bids from across London had been assessed under the scheme, however it was noted that the results were not available until 27^th March. The Board noted that seven bids in Haringey had been approved subject to significant clarification, 5 of which were in east Haringey. It was noted that some of these bids might be in a position to support capacity in the area. These bids would be developed further in April in conjunction with the commissioning plans described earlier to ensure that a solution was found in the next three months.

Ms Barron stated that a piece of work was being undertaken which involved a detailed investigation of the primary care needs over the next five to ten years. A baseline of Haringey GP capacity identified that further investigation was required in the following areas;

•      Noel Park

•      Green Lanes

•      Tottenham Hale

•      Northumberland Park

Ms. Barron identified that NHS England had taken contractual action with underperforming practices in the areas concerned and would continue to do so given the capacity deficit that existed. 

Nicky Hopkins of North London Estate Partnerships gave an update to the Board on the strategic premises development planning process.

The Board noted that two stakeholder meetings had been held at which an options appraisal was undertaken for immediate/short term options for Tottenham Hale, and a set of valuation criteria was agreed. The valuation criteria was used to asses a number of temporary options including at Tamar Way, Hale Village and Board Lane. These sites were to be developed further. In addition, the Welbourne Centre scored quite highly as a more longer term solution 

The Board noted the following timescales for completion of the project:

Complete:

•      Stage 1- Creating a baseline: stakeholder engagement & analysis of data. Identify urgent needs.

In progress:

•      Stage 2- Developing a solution: gap analysis & identification of options, develop options assessment criteria. Identify short term solutions.

•      Stage 3 – Options appraisal; assess & prioritise the options.

To do:

•      Stage 4 – Sign off & agree next steps. (Mid-April 2015)

NHS England approval process (May/June 2015 for temporary solution and July 2015 for full report)

The Chair welcomed the engagement from NHS England on this issue and thanked the presenters for their contribution. The following questions and comments were noted.

Sir Paul outlined that the current shortage of GP capacity provided a real and present danger to the child protection measures that were available in the borough. The families that were having the greatest difficulty in accessing primary care services were the ones most likely to present child protection risks. Sir Paul gave an example of a recently published Serious Case Review in which one of the factors was difficulties in relation to GP provision. A lack of GP capacity impeded the ability to take corrective measures when working with a very vulnerable family.

Cllr Kober commented positively on the inclusivity, and on the overall progress that had been made and fed back similar comments from one of the Ward Councillors for Tottenham Hale. The Board noted that what was crucial was that this was now pushed on through the further stages to fruition.

Ms Grant welcomed the evidence that had been collected and reiterated the fact that there were residents that were unable to get appointments. The example of the impact of late cancer diagnosis on recovery rates was given.

The Chair welcomed the engagement from NHS England throughout the process and expressed a desire that NHS England would continue to engage with the Board going forward.

It was:

RESOLVED:

I). That the progress by the Task and Finish Group against the key aims be noted.