Agenda item - GP Services in Brighton & Hove

49.1    This item was presented by Hugo Luck (NHS Sussex Associate Director for Primary Care: Brighton & Hove), by Liz Davis (NHS Sussex Director of Primary Care: Brighton & Hove); by Lola Banjoko (NHS Sussex Managing Director: Brighton & Hove); and by Rob Persey (BHCC Executive Director, Health & Adult Social Care).

49.2    Mr Luck outlined some of the challenges facing general practice in the city, including the GP/patient ratio, variance in performance across practices, recruitment and resilience, and access. Recent measures taken to improve performance have included additional winter funding for all practices, the development of a locum workforce bank, and the introduction of Respiratory Hubs. There are currently more GP appointments taking place than pre-pandemic. The city GP workforce is fairly static, but there has been an increase in non-GP clinical staff at practices. All city practices are part of a Primary Care Network (PCN), with all PCNS offering enhanced services, later appointments etc. The Sussex Integrated Care Strategy has priorities for improving GP access and availability.

49.3    In response to a question from Cllr West on demand pressures, Mr Luck responded that demand has increased. However, commissioners have a much better understanding of capacity data than they do demand data, and work is under way to improve the data extraction of demand information from practices. Ms Davis added that work is planned to better communicate to residents the range of services available from GP surgeries in addition to GPs.

49.4    Cllr West noted that he would value input at future meetings from practitioners: e.g. current or former GPs, community pharmacists etc. The Chair agreed, noting that she had originally asked for the GP update to reference other aspects of primary care, but had been advised that the breadth of the topics meant it was more sensible to have a further update on other aspects of primary care at a later HOSC.

49.5    Cllr O’Quinn raised concerns about digitally excluded people. Mr Luck and Mr Persey both agreed that this is a significant issue, particularly amongst older people. The council has a digital workstream which seeks to address exclusion, and there is also Public Health funding support for older people.

49.6    Michael Whitty (Older People’s Council) expressed concerns about the GP/patient ratio and about the loss of a number of practices in recent years, asking whether the system was in crisis. Mr Luck responded that the reduction in practices needs to be seen in context: the main reason for the reduction is because practices have merged, but this does not necessarily mean that there are fewer GPs or premises. Ms Davis added that recruitment is challenging, but that there is an active push to recruit and retain GPs. Ms Banjoko told members that the GP/patient ratio has improved in recent years. Long term workforce planning is key here – e.g. knowing when GPs may retire and planning accordingly. A focus on neighbourhood working is also critical, and there will be a stakeholder workshop on this on 15 May.

49.7    Nora Mzaoui (CVS representative) asked a question about the role of PCNs. Ms Davis replied that PCN development is a priority. She would be happy to come back to a future HOSC to talk in more depth about PCNs. Mr Luck added that there are different challenges for different PCNs, so while there are commonalities, all PCNs need to be supported to develop systems that suit their particular circumstances.

49.8    Geoffrey Bowden (Healthwatch) noted that digital exclusion can be just as much about people not being able to afford technology as having problems operating it; and also noted that financial pressures exacerbate access problems. Ms Banjoko agreed with this, and told members that there is lots of work with the VCS to target specific communities which are experiencing inequalities.

49.9    Cllr Rainey asked a question about recruitment of GPs. Mr Luck responded that this was a national issue, although there may be specific issues with Brighton & Hove given the relatively high cost of living. There are steps to be taken to make the city more attractive: e.g. by investing in estates; and by encouraging trainee GP posts.

49.10  In response to a query from the Chair about the process for complaining about GP services, Mr Luck told members that there is a formal process, but that Councillors also have the option to reach out directly to him or to Lola. Cllr Grimshaw noted that she had had occasion to escalate issues to Lola and Hugo and had always been impressed at how quick and thorough their responses were.

49.11  RESOLVED – that the report be noted.