Agenda item

Innes Richens, Chief Operating Officer, and Dr Tim Wilkinson Clinical Chairman will present and answer questions on the attached report.

Alan Banting, Chair of Pompey Pensioners gave a deputation in support of keeping the Guildhall Walk Healthcare Centre which included the following points:

·         He has been a registered patient at Guildhall Walk Healthcare Centre (GHW) for five years.

·         He is very happy with the flexibility of access and that the doctor comes to the waiting area to call the patients.

·         He recommended that the panel read Monitor's recent review of centres.

Innes Richens and Dr Tim Wilkinson, CCG introduced the report and the summary of engagement activity which had been circulated with the agenda and added the following points:

·         The CCG is mid-way through the engagement process and no decision would be made until this was completed. 

·         GPs support the minor injuries unit at St Mary's Hospital but have mixed views regarding the minor illness unit. 

·         There is some evidence that a number of patients are being referred to their own GP. 

·         GPs prefer to see their own patients. 

·         Co-locating the two walk-in services would strengthen the service.

·         The CCG will continue working with all GP practices to extend access to primary care.

·         It is committed to providing primary care service for homeless if the GHW were to be closed.

·         A survey has been sent to all patients registered at GHW. 

In response to questions from the panel, the following points were clarified:

·         The CCG is meeting with the university to discuss the needs of their students.

·         The GHW is used by many people who live outside the city but work in the city centre.

·         The majority of people use it as a walk-in service but are registered elsewhere.  This means that the commissioners pay twice. 

·         Both walk-in centres are seeing the number of patients that they are contracted to.

·         If the GHW walk in service were to be moved to St May's the CCG would commission the same level of activity. 

·         All GP practices offer same day appointments by employing different methods. 

·         There are good transport routes to St Mary's Hospital.

·         Some GP practices have indicated that they would be able to accept more patients if the GHW were to be closed.

·         An Equalities Impact Assessment was completed in 2010 and another one is currently being discussed and will be carried out.

·         Patients generally report good access to their GPs and 80 are happy with the access.   A small number prefer to attend A&E rather than wait to be seen at their GP practice. 

·         Work is being carried out to encourage GPs to work together to increase accessibility. 

·         Patients are happy to see any GP as long as they have access to their records.

·         A GP practice can close its list to new patients only with permission from the CQC.

·         In Portsmouth a significant number of GPs and Practice Nurses are approaching retirement within 3 or 4 years' time.  There are not enough in the pipeline to replace them.  This reflects the national picture.    Federation working is one of the possible solutions being discussed. 

·         All practices offer same day access in different ways. 

·         Front line staff are under pressure dealing with the demand for same day appointments.  If a patient needs to be seen, they should be.

·         Feedback from GP Practice Participation Groups is very important. 

·         The nonattendance rate in the city is 8%.

·         According to the last survey, there are between 1,000-1,100 homeless people in the city.  There used to be one GP practice in the city that specialised in offering services to homeless patients.  The CCG is currently discussing their needs with the Salvation Army and other agencies.

·         The GHW is the only practice that offers a seven day service.

·         Last Christmas, a weekend service at some GPs was commissioned with national funding.  The take up was very low.  This may be because people are not used to it. 

·         There are clear patterns of usage for the GHW.

·         If the contract were to be extended it would possibly be for another five years.

40% of GP training positions are not taken up.

Members made the following comments:

·         Travelling by bus from East to West in the city is not as easy as from North to South. 

·         More and more university accommodation is being built in the city centre. 

·         It is important to hear what patients say about the proposals. 

·         Having one pattern for urgent care would benefit the whole area.

·         A large number of patients are turned away from the Minor Injuries Unit at the War Memorial Hospital.

·         The limited resources must be spent wisely.

·         Having a GP presence at St Mary's walk-in centre would make the service more efficient.

·         It is not clear that there would be sufficient capacity at other GP practices to take on the patients from GHW were it to close.  This could lead to people not registering with a GP.

Actions

·         Visits would be arranged to the GHW and St Mary's Minor Injuries Unit before the next HOSP meeting.

·         An information paper on GP commissioning be provided to the HOSP.