Agenda and draft minutes

Apologies have been received from Councillor Rosenberg, Keith Mallinson, and Lucia Boddington, Linda Jackson and Victoria Brignell.

This meeting was inquorate. Therefore, this was held as an informal meeting

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At meetings where members of the public are allowed to be in attendance and speak, any Councillor with a disclosable pecuniary interest or other significant interest may also make representations, give evidence or answer questions about the matter. The Councillor must then withdraw immediately from the meeting before the matter is discussed and any vote taken.

Where Members of the public are not allowed to be in attendance and speak, then the Councillor with a disclosable pecuniary interest should withdraw from the meeting whilst the matter is under consideration. Councillors who have declared other significant interests should also withdraw from the meeting if they consider their continued participation in the matter would not be reasonable in the circumstances and may give rise to a perception of a conflict of interest.

Councillors are not obliged to withdraw from the meeting where a dispensation to that effect has been obtained from the Standards Committee.

There were no declarations of interest.

To approve the minutes of the meeting on 31 January 2024 as an accurate record and note any outstanding actions.

MatterS Arising

Councillor Ben Coleman (Deputy Leader and Cabinet Member for Health and Social Care) voiced his concerns regarding recent press reports highlighting the presence of elevated levels of E. coli bacteria in the river Thames attributed to sewage dumping. Cllr Coleman and DPH had today written a letter to the Chief Executive of Thames Water, urging prompt action and assurance to safeguard public health.

Jim Grealy (Co-opted Member) requested an update on the letter sent to Imperial College Healthcare NHS Trust and enquired about the response received. The Chair confirmed that a response had been received, and this would be circulated to the Committee.

Action: David Abbott/Jo Baty

RESOLVED

The minutes of the meeting held on 31^st January 2024 were agreed as an accurate record.

This report presents a briefing paper on the current state of primary care access across North West London following recent changes to GP contracts and plans to improve same day access to primary care for patients. The briefing paper was originally produced for the North West London Joint Health Overview Scrutiny Committee meeting on 14 March 2024 and is presented for information.

Representatives from NHS North West London will provide an updated presentation for discussion at the meeting.

Dr James Cavanagh (Medical Director for H&F) provided a verbal update on the same day access to primary care approach. Although the plan was devised with good intentions and aimed to enhance patients access and continuity of care, he highlighted the apprehensions felt by patients regarding its implementation. It was noted that various members of the Integrated Care Systems (ICS) had also expressed their apologies. Following the extensive and constructive feedback received from numerous individuals the position of the ICS had changed.

Many residents in Northwest London expressed dissatisfaction with their access to GP services, making it a top priority for the ICS. Addressing these issues required collaboration among residents, GP’s, and stakeholders in the area. This Committee would provide an opportunity to identify where the innovation fell short and to ascertain how the ICS could build on this for future improvements.

Dr James Cavanagh noted the lack of sufficient engagement at all stages of this initiative, highlighting the failure to take the appropriate steps to fully develop it. Going forward the ICS aimed to prioritise engagement at both practice and Primary Care Network (PCN) level, involving residents and other stakeholders interested in the discussions. Primary care teams within each borough would lead this initiative. Furthermore, funding for access remained available for those that who wished to participate.

Dr Kyla Cranmer (GP Chair of the H&F Local Medical Committee) gave an overview of her concerns regarding the access proposals. This included patient safety, the disruption to continuity of care and the possibility of widening health inequalities. She acknowledged that access was a key concern across the board. However, questioned whether further research had been conducted to determine if, in addition to access, it was equally important for patients to consult with a qualified doctor and to be seen at their own GP surgery.

Dr Kyla Cranmer highlighted that her practice had been striving to enhance access for its patients over the years, continuously evolving its model. Whilst she acknowledged the importance of triage in improving access to general practice, she disagreed with the proposed approach at scale, noting that there was a lack of evidence to support it. She also expressed disagreement with the model that separated simple straightforward care from chronic disease management / complex care, emphasising the importance of continuity of care for both types of cases. It was noted that maintaining care within GP surgeries was essential to uphold continuity of care. Concerns were raised about the impact on GP trainees, training opportunities if services were diverted to hubs and vulnerable patients having to navigate multiple steps to receive care. Finally, it was suggested that the ICS should provide resources to enhance the effectiveness of current operations within the GP surgeries.

Dr James Cavanagh pointed out that the ICS wasn’t mandating access at scale but rather encouraging practices and PCNs to engage in discussions with their patients to enhance access, considering evidence from the 10 sites across Northwest London. Practices were now given the choice  ...  view the full minutes text for item 4.

For the Committee to suggest items for the work programme.

Councillor Amanda Llyod-Harris requested that the long list of agenda items be included as part of the agenda for future meetings.

Action: David Abbott

Councillor Amanda Llyod-Harris noted that access to dentistry and suicide prevention would be future topics of interest.

The Chair requested that the minutes of the last Health & Wellbeing Board be forwarded to Councillor Amanda Llyod-Harris.

Action: Amrita White

RESOLVED

The Committee noted the work programme.

To note the following dates of future meetings:

·       17 July 2024

·       13 November 2024

·       29 January 2025

·       28 April 2025

The next meeting would take place on 17^th July 2024.