The Panel will hear evidence from:
· Dr Mayur Gor, Chair of Haringey PCT Professional Executive Committee
· Dr Peter Christian, Clinical Director West Haringey (GP Dukes Avenue)
Minutes:
Dr Mayur Gor (Chair, Haringey PCT PEC)
Dr Gor made a number of points to the Panel and took a number of questions from those present. A summary of these discussions is given below.
· The Primary Care Strategy is a positive attempt to tackle some of the health problems that are faced in Haringey, in particular the significant health inequalities that exist between the east and west side of the borough.
· Whilst the Primary Care Strategy can make a significant contribution to addressing Haringey’s health problems, further input from wider services beyond the health sector will be required to make an impact on the more intransigent health problems (i.e. health inequalities).
· Consultation documents had been sent to all 59 General Practices in Haringey so that these can be distributed to patients across the borough.
· All practices in Haringey have a Patient Participation Group, where patients can directly discuss issues of concern with staff and other patients at their own surgery. People were encouraged to sign up to and attend these groups to maximise their opportunities to contribute to the development process.
· Consultations have taken place with GPs through the Local Medical Committee. In addition, consultations have also taken place with the 4 local practice based commissioning groups in Haringey. From these consultations, it was apparent that GPs and General Practices are beginning to work together and hopefully tackle the Haringey’s health problems more effectively.
· The Primary Care Strategy undoubtedly represented a major re-design of services for Haringey. The PCT would encourage people to become involved in the consultation process to help shape future services.
Dr Christian, Clinical Director West Haringey
Dr Christian made a number of points to the Panel and took a number of questions from those present. A summary of these points are given below.
· Major changes are occurring in the way that General Practices operate. Before the introduction of Practice Based Commissioning (PBC), General Practices worked independently of each other. Now, practices are required to work more collaboratively to assess patient needs and commission services for them in each Haringey locality (west, central, north east & South East). As commissioning of services is at a more localised level (GPs instead rather than then PCT) this may mean that resulting services were more sensitive to the needs of local populations.
· PBC is still in its infancy and GPs and General Practices are still learning how best this can work. GPs will have to grapple with competing expectations of patients i.e. delivering a wider range of services and speedier access to services.
· At present, any cost savings derived from PBC are reinvested within the PCT. In future, commissioning groups will be able to retain 70% of cost savings (for re-investment) and 30% will be returned to the PCT.
· Positive developments have already occurred in West Haringey as a result of PBC as practices have met to discuss the educational needs of practitioners and how these can be developed further.
· The West Haringey PBC group has not had a chance to discuss the Primary Care Strategy as yet, so views about strategy proposals presented here reflect personal perceptions of the witness.
· First perceptions of the super health centre/ polyclinic model proposed within the strategy was that these facilities would provide suitable infrastructure to support PBC. Such local centres may provide a natural base for PBC groups.
· A significant number of local practices are restricted in what services they can offer because of the physical limitations of their buildings. Such restrictions are compounded as there is little prospect of development in many cases (planning blight). In this context, the strategy proposals for super health centres had considerable merit in that they would contribute to the improvement of local primary care facilities.
· The GP profession is changing from being predominantly male oriented profession to where women now make up a majority of practitioners. In addition, more GPs are entering the profession in salaried GPs. Thus the expectations and aspirations of GPs in terms of their role and working practices may be evolving, particularly in terms of the nature of the General Practice that they may wish to work in. This may have a significant bearing on planned future developments.
· New super health centres may seem more attractive to newly qualified GPs than traditional General Practices, as they may offer greater potential for professional and personal development. Given the wider range of services that may be potentially be offered through super health centres (which is above that provided from traditional surgeries), this may be an important factor in the drive to recruit and retain GPs in Haringey.
· In assessing the proposals presented within the Primary Care Strategy there is a need for further debate about what constitutes a good general practice. There are many positive developments happening in General Practice at the current time, such as the innovative use of computing and other new technologies. Careful consideration should be given as to how these are resourced and retained within any new structure.
· There is a need for further information about the nature of services planned super health centres.