Agenda item

primary care estates update

The Board received a report which was included in the agenda pack at page 21. The paper provided an update to the Board on primary care and described the progress which had been made during the year in meeting capacity demands. The report was introduced by Cassie Williams, Assistant Director of Primary Care Quality and Development – Haringey CCG. Following the introduction of the report, the Board discussed its findings.

The Board noted the opening of the new zero list practice at Hale Village in August 2016. In addition, the Board was advised that Haringey CCG had been provisionally awarded £11.6m for three estate developments in areas previously identified as having particular capacity needs; Tottenham Hale, Wood Green and Green Lanes. There was still a significant process involved in accessing these funds but the award was highlighted as being very significant, given that the total amount of funding available to London was £67m.

The Assistant Director of Primary Care Quality and Development advised the Board that 7 bids for improvement grants had been submitted to support some of the smaller scale work that was required in some of the smaller sized practices. Examples of the bids included; improved infection control, hearing loops and improved disability access. The Board was advised that notification on the outcome of the bids was expected in a month’s time. The Assistant Director of Primary Care Quality and Development also drew the Board’s attention to appendix 2 of the report which contained a draft of the guiding principles for future commissioning of premises; setting out a vision for larger premises, with a high number of clinicians and providing a high level of care. The Board’s views were sought on the governing principles and it was noted that there would also be also be a consultation process with the public.

The Leader advised that she attended a meeting the night before in Seven Sisters and that there was still significant concerns from residents around the quality of buildings and accessibility of the service, with residents still reporting difficulties in getting appointments. The Leader suggested that there was still a perception issue around primary care in the borough and that the Board needed to continue monitoring the issue.

The Chief Executive of the Bridge Renewal Trust sought clarification on how support was being offered to GP’s in commissioning excellent clinical facilities. The Assistant Director of Primary Care Quality and Development advised that following the failed Estates and Technology Transformation Fund (ETTF) bids for three premises, partners were looking at options and the financial availability to see how those schemes could be progressed without the initial capital investment from the ETTF fund. It was noted that there may be another round of bids available after 2019.

The Deputy Chief Executive commented that it was really useful having all of the information presented in the report to the Board and stated that it was important to recognise that there had been significant progress in some areas.

In response to a query about how the estates work linked in with the potential for co-location of community and health and social care services, the Assistant Director of Primary Care Quality and Development acknowledged that potential site for co-location was being considered. The Assistant Director of Primary Care Quality and Development  advised that a lot of the work done to establish the bids considered flexible use of space and that this was part of the reason why large scale premises in key locations had been prioritised. The Welbourne centre was noted as an example of a facility where there were plans to have a range of co-located services but the Board was advised that there was still work to be done to understand how community services might work alongside health and social care services.

The Chair of Haringey CCG welcomed the opportunities afforded through having bigger hubs offering wider array of services and hopefully attracting health care professionals with a variety of skills to live and work in the area. The Chair of Haringey CCG also commented that there was an increasing blurring of the lines between primary and secondary care that was being driven by the STP process.

The Cabinet Member for Children & Finance commented that the report highlighted that most of the current practices were assessed to have high or significant rate of statutory non-compliance. The Cabinet Member also queried how quickly the purpose built hubs needed to be put in place and also where the key locations would be. In response The Assistant Director of Primary Care Quality and Development advised that proposals for integrated networks was based on a population level of 50k-80k and that this would likely involve a number of smaller practices and a key aspect would be to have enough purpose built buildings in place.

The Board noted that there had been a number of smaller purpose built practices leaving the system recently due to retirements and that practices had expanded to cope with the additional patients. The Assistant Director of Primary Care Quality and Development advised that in addition to the purpose built practices in Noel Park, Tottenham Hale and Green Lanes, it was likely that additional premises would be required in Northumberland Park and Muswell Hill due to population growth. The Board considered that the joint working undertaken between the Council, CCG and Healthwatch; to see where the areas of need were and where the suitable sites were, was a significant positive in terms of planning for developing future sites.

The Cabinet Member for Children and Families cautioned that some consideration would need to be given to the ease with which residents could access their closet hub and the proximity of residents to their nearest primary care provider. Assistant Director of Primary Care Quality and Development acknowledged these concerns and agreed that there was consideration of how to meet the needs of a local population within a particular area. The availability of GP’s practices was noted as an ever evolving picture with a number of smaller practices closing down. The Chair of Haringey CCG commented that there was a discussion to be had around the provision of specialised services and whether residents were prepared to travel further for a better standard of care. The Board considered that with technology moving so rapidly, there would opportunities for people to have contact with primary care services without necessarily needing to access a building.

RESOLVED:

That the Health and Wellbeing Board:

I). Notes and comments on the progress of primary care capacity and developments.

II). Provide feedback in relation to the draft guiding principles document.