Issue - items at meetings - Ad Hoc Panel on GP-Led Health Centre: 1 Year Update

Report of the Director of Strategy and Governance (copy attached)

8.1       This item was introduced by Juliet Warburton, Head of Primary and Community Care, NHS Brighton & Hove, and by Derek Witt, Care UK General Manager.

8.2       Members were told that the Centre had experienced a very successful first year, and had over-performed in terms of both patient registration and unregistered patient visits to the walk-in centre. Patient satisfaction was also very high. The Centre did have some ‘partly achieved’ scores in terms of its contract targets, but these are thought to be due to factors relating to the recent opening of the centre (e.g. some records re: patient satisfaction were incomplete, but this was because there were too few patients attending the centre in its first few months of operation to make data collection via the national Patient Survey tenable). NHS Brighton & Hove is confident that these standards will be met in the current year.

8.3       The committee was informed that work was ongoing to gauge what impact the opening of the Centre may have had on local A&E admissions.

8.4       In terms of any negative impact on neighbouring GP practices, members were told that there was no evidence thus far of any such issues.

8.5       In answer to a question relating to ‘continuity of care’ at the Centre, Mr Witt told members that Care UK employed a permanent team of salaried GPs to staff the Centre, and was therefore confident that continuity of care was good. Ms Warburton added that, if patients were unhappy with the continuity of care provided, this would be flagged up in patient satisfaction surveys – but currently survey data shows no such concern.

8.6       Ms Warburton told members that it had been necessary to sign-post some attendees away from the Centre’s walk-in service towards the end of the year, as the Centre had over-performed on this service and more costs would have been incurred by NHS Brighton & Hove had the walk-in service continued to see all patients who presented for treatment. The second year of the contract provides for an increase in walk-in patients, so this problem should not repeat itself. The diversion of patients was closely monitored, and all patients who required urgent treatment were dealt with promptly. There were no patient complaints arising from the diversion to other services.

8.7       In response to a question on the high number of unregistered patients visiting the Centre who did not reveal the identity of their own GP, Ms Warburton told members that many patients, particularly younger ones, simply did not know who their GP was, although some patients may actively have chosen to visit the Centre rather than their GP (e.g. to discuss issues they would have felt embarrassed to raise with their own doctor). Care UK and the PCT have worked hard to improve data collection in this respect, and results have improved considerably in recent months.

8.8       In reply to a question from the Chairman, Cllr Peltzer Dunn, concerning repeat prescriptions issued by the Centre, Mr Witt explained that the Centre would issue repeat prescriptions to people visiting the city, but would not do so for people already registered with a city GP. There is a degree of trust involved in issuing repeat prescriptions, as visitors who have forgotten their medicines are unlikely to have evidence of their prescriptions to hand. However, the Centre will only ever provide a repeat prescription once, so there is limited scope for the system to be abused. When a repeat prescription is issued, this is flagged on the GP practice software system and the patient’s medical records are updated to show that the prescription has been issued

8.9       In response to a question from Cllr Allen about the impact of the Centre on neighbouring GP practices, Ms Warburton told members that there had to date been no negative feedback from local practice managers. The PCT continues to monitor this closely, particularly in terms of patients registering with the Centre (which might have an impact in the medium term had many of them previously been registered with neighbouring practices).

8.10    In reply to a question from Mr Robert Brown concerning how the Centre was advertised to Travellers (many of whom seemingly eschew GP services, choosing to present for treatment at A&E), Ms Warburton told members that she would be happy to investigate what more could be done in terms of informing the Traveller community about the facilities offered by the Centre.

8.11    Ms Warburton and Mr Witt were thanked for their contributions.

8.12    RESOLVED – That the report be noted and an update report be requested in 12 months time.