NHS Bradford City and NHS Bradford Districts Clinical Commissioning Groups (CCGs) continue to work with patients and stakeholders to improve the quality of all services they commission and to fulfil their statutory duty to improve the quality of primary medical care.  Document “AB” describes initiatives that primary care providers are undertaking to improve access, including how they are engaging patients in the process and the challenges in maintaining sustainability of the service in the face of the nationally mandated funding review, increasing demand and workforce challenges. 

Recommended –

That the Committee:

(1)       Receive and note the Clinical Commissioning Groups’ commitment and actions taken to improve access to appropriate primary medical services.

(2)       Receive and note initiatives within Bradford that are being developed that will impact the primary medical service offer to Bradford residents.

(Karen Stothers – 01274 237430)

The Head of Primary Care, Bradford Districts Clinical Commissioning Group (CCG), presented a report (Document “AB”) that described the initiatives being undertaken to improve access to primary care.  It was reported that both CCGs had the same workforce pressures as Airedale, Wharfedale and Craven and a five year strategy had been developed.  There were 67 GP practices in Bradford, 19 of which were within 1 square mile of another.  In relation to Primary Medical Services (PMS) funding, a Plan had to be in place to ensure that within 5 years everyone would be on the same contract value.  It was noted that new roles were being piloted and the role of the pharmacist was key.  GP practices were being encouraged to work together or merge contracts and it needed to be ensured that the vision was sustained for patients.  The Head of Primary Care explained that Bradford’s National survey results were lower and different to those for Airedale, Wharfedale and Craven.  Members were informed that positive development had been achieved with Practice Participation Groups (PPGs) and an event would take place in May.  The CCGs were trying to support GP Practices in any way and were submitting bids for National funds wherever possible.  The cost of locums was huge and the CCGs were trying through resilience money to assist.  GP Practices were being pushed to integrate, as back office work could be done together and Practices were going to be asked to undertake more work.

Members then posed the following questions:

·         Was social prescribing limited to City practices or spread across the District ?

·         Why was social prescribing required?

·         The navigation of the systems was an issue.  What could be done to ‘signpost’ people?

·         It was common sense for people to work together to ensure that the correct pathways were identified.

·         A telephone line could be established to help people in association with ‘111’.

·         What evidence was there to substantiate that the new procedures would work in Bradford?

·         It was disappointing that Pharmacy First was not being retained.  What would the impact be?

·         Pharmacy First had not allowed repeat prescriptions.

·         Many disabled people were concerned that they would have to go back to see their doctor.

·         Would the Pharmacy First service be retained for children?

In response it was explained that:

·         Social prescribing was spread across the District.

·         It had been a competitive process and the need for social prescribing had been identified in the bids submitted and 26 practices had been funded.

·         Work could be undertaken with PPGs and experiential learning could be used in order for services to be right the first time, which would enable people to change their practice. 

·         A number of Practices were trialling models from Vanguard areas.

·         The numbers using the service had reduced and the decision had been made to not support Practices by allowing patients to obtain over the counter medications, as it was against protocol and policy.  It was also costly to the Practice as NHS prescription charges had to be paid on top.

·         The issue was in relation to repeat ordering.  Some pharmacies over ordered and needed to be stopped.

·         There were exceptions to the rule and vulnerable patients were one of them.  This information could be made available.

·         No, the service would not be retained as it was contrary to the stopping of over counter prescribing, however, GPs would have some discretion.  

Resolved –

That a further report be submitted to the Committee in 12 months.

Action: Head of Primary Care, Bradford City and Bradford Districts Clinical Commissioning Group (CCG)