Agenda item

This report provides an update regarding developments in Primary Care.  It describes the strategic direction of primary care including work around estates, access and prevention.  This item will also consider how this work links to Haringey Council’s Priority 2:  Outstanding for All: Enable all adults to live healthy, long and fulfilling lives with control over what is important to them.

Cassie Williams, Assistant Director, Primary Care Quality and Development, Haringey Clinical Commissioning Group (CCG), provided an update on developments in Primary Care.

The Panel was informed the CCG was working with NHS England and local practices to ensure high quality general practice in Haringey. It was noted Haringey CCG was Co-commissioning at Level 2 i.e. working in collaboration with NHS England to commission primary care and making decisions about how national priorities should be focused for the local community.

In response to questions, Ms Williams provided information on the following issues: 

-       The Primary Care Strategy that had been developed across North Central London.

-       Accessible care and at scale working, including the development of a pan-Haringey federation to enable practices to provide an equitable offer to all patients across the borough for evening and weekend appointments and the ongoing work to improve the use of technology to support better access.

-       National guidelines in terms of GP surgery accessibility for disabled people, including the accessibility of the building and accessibility of services offered. It was suggested GP surgery accessibility in Haringey might be an area for further investigation, possibly by Healthwatch, during 2016/17.   

-       GP provision in Seven Sisters.  

-       Coordinated Care. It was noted that work was continuing to enable care to be coordinated around individuals. For example, the Better Care Fund, which coordinated work between health and social care, supporting the development of multidisciplinary Locality Teams who provided joined up care for those most in need, including those with long term conditions and those most at risk of admission to hospital.

-       The future role of pharmacists in primary care.

-       Proactive Care. The Panel was informed that in 2015-16 a new local incentive scheme had been developed to support increased case finding of those most at risk. It was noted that this was a key area of focus in relation to Priority 2 of the Council’s Corporate Plan (2015-18). It was explained that Haringey had higher than expected numbers of strokes occurring within its population with lower than expected identified cases of atrial fibrillation (irregular heart beat) and hypertension (high blood pressure), two medical conditions known to be risk factors for stroke. Various issues, and schemes, in relation to atrial fibrillation and hypertension were discussed.

The arrangements for early supported discharge after stroke, across North Central London, were discussed, along with the scrutiny of such arrangements that had been carried out by the Joint Health Overview and Scrutiny Committee. It was agreed this was an issue for further consideration when developing the future scrutiny work programme.    

In terms of workforce development, the Panel was informed that the CCG worked closely with health providers and adult social care in a network called the Community Education Provider Network (CEPN). It was noted that the CCG was looking to work with the council, and other partners, to support the development of the workforce across the borough; considering how quality staff could be attracted and retained.

Ms Williams concluded her presentation by providing an update on the Primary Care Estates Strategy. It was noted that the strategy, previously considered by the Panel, had identified the following areas as needing additional GP capacity: Green Lanes, Noel Park/Wood Green, Northumberland Park and Tottenham Hale.

The Panel was informed Tottenham Hale had particular need and agreement had been achieved from NHS England to establish a new GP practice in the area. Ms Williams explained that a temporary site was in development in Hale Village and would be able to take up to 7,00 patients while a permanent site was built. It was explained the new site was due to open during April 2016 although there was a risk that work to re-specify the demountable may result in a small delay. Ms Williams advised the permanent site/s for the new GP practice had yet to be confirmed. However, it was explained a number of locations were being considered as part of a feasibility study for the area and that this would be completed in March 2016.

In response to questions, Ms Williams advised that the Wellbourne Centre could be a primary care site in the future with the potential to accommodate at least 20,000 patients. It was noted that other areas, across the borough, had also been identified as long term building solutions. It was explained that in order to minimise the potentially significant uplift in rate and rents reimbursements that the CCG would be liable for when developments completed, work was ongoing to bid for Primary Care Transformation Fund money. The Panel was asked to note that this could potentially release capital to support building new premises which could then be used as GP practices at affordable rents.  

AGREED:

(a)  That the updates regarding developments in Primary Care be noted.

(b)   That an item on the arrangements for early supported discharge (after stroke) across North Central London be considered for inclusion in the Panel’s work programme for 2016/17.