The report (Document “AA”) submitted by the Airedale, Wharfedale and Craven Clinical Commissioning Group (CCG) provides an updated position relating to access to primary medical services in Airedale, Wharfedale and Craven.  

Recommended –

That the report be received and noted.

(Lynne Scrutton – 01274 237325)

The Chief Operating Officer, Airedale, Wharfedale and Craven Clinical Commissioning Group (CCG), presented Document “AA” which provided an update on the position relating to primary medical services.  Members were informed that there was a workforce crisis in relation to GPs and the Council’s budget cuts had a massive impact on primary care.  The CCG wanted to work with the Council in order to devise new ways of working and look at current practice.  It was noted that 85% of patients had a positive experience of GP practices, however, there was a great deal of pressure on these services and other options would need to be explored as GPs would not be available.  The Chief Operating Officer stated that a number of new approaches, such as Complex Care and Enhanced Primary Care, were being progressed.  Complex Care was a proactive service and every patient would be allocated navigational support.  The next tier down was Enhanced Primary Care followed by self care and prevention, which would provide people with individual support and empower them to look after themselves.

The Chair queried why local GPs were moving to Australia and New Zealand and was informed that it was due to the better lifestyle.

A representative of the local Medical Committee stated that low morale was a major problem within the GP service along with the huge pressures put upon them.  He expressed concerns in relation to the alternative models and new ways of working that were being proposed and explained that patients wanted to be seen by a GP and unless their mind set was changed then the demand would not be met.

Members then raised the following issues:

·         What was an extensivist GP?

·         Was it an internal scheme?

·         Would the personal support navigator function take over personal prescribing?

·         What was the CCG’s opinion of GPs being trained in the UK and then leaving?  How could the situation be turned around?

·         Was there anything that could be done to retain GPs?

·         It had been stated 2 years ago that there was a massive crisis in GP practices.  Doctors could not be made to go into General Practice.  If the issue had been known, what had been done about it?

·         How were GPs being persuaded to enter into practices within the area?

·         What were the differences between GPs and physician associates?

·         Were physician associates trained in medical school?

·         There was an oversubscription of students in medical schools.

·         What was the percentage of graduates that went into General Practice?

·         The retention of Pharmacy First was welcomed.

In response Members were informed that:

·         An extensivist was a GP that had undertaken additional training and would be responsible for where a patient was directed to and the proactive treatment of a cohort of patients.  It was a pilot scheme.

·         It was a new service.

·         The role would be an enhancement of personal prescribing.

·         The CCG was trying to make General Practice more attractive, however, funding was being reduced.

·         The CCG was trying to create more capacity within the GP service, however, an understanding of the patients and population was required.

·         The CCG had physician associates.

·         Patients were triaged by GPs and seen by an appropriate person.

·         Yes, physician associates trained for 2 years and enabled patients to be seen quickly.

·         The problem was getting students to move into General Practice.

·         It used to be 50%, but was probably less now.

·         Many patients asked about medication that could be bought and they were directed to Pharmacy First.  Over 2000 appointment slots had been saved and the service would be continued, with evaluations undertaken every 6 months.

The representative of the local Medical Committee stated that he was a great believer in the local GP service, however, people could not be blamed for leaving when they saw what was on offer elsewhere.  There was more work that could be done, GPs needed to be trained and primary care funding should be increased.

Resolved –

That a further report be submitted to the Committee in 12 months, with the proviso that any major issues that arise prior to then be reported as and when necessary.

Action: Chief Operating Officer, Airedale, Wharfedale and Craven Clinical Commissioning Group (CCG)