Agenda item

This paper provides an update to the Health and Wellbeing Board on the key aspects of the Primary Care Strategy, ahead of its publication in mid-September 2017.

Janet Cree explained that the report provided an update on the current position of the Like Minded Strategy, covering specifically, locally deliverable actions within Hammersmith & Fulham.  The final strategy, which had been agreed at the CCG’s AGM the previous evening, had not been included in the papers but was made available following agreement at the AGM meeting.

Janet Cree commented that while access to primary care had improved, for example out of hospital services such as diabetes or the Community Independence Service, there was more that could be done to integrate care across the system, while ensuring a more sustainable primary care structure. She added that primary care networks (PCNs) in the strategy would enable GP practices and wider services to collaborate.  PCNs would be unified and collectively deliver community services through a platform of a Multispeciality Community Provider (MCP).  Referencing Appendix 1 to the report, Janet Cree explained that local engagement events had been held throughout July and the response from participants had been incorporated into the final strategy, which included adapting technical language and patient case studies. 

Section 4.6 of the report identified a number of workstreams to support the implementation of the strategy.  The transformation journey would involve the development of links with providers as this moves towards a more accountable care partnership (ACP).  It was notable that this already existed in Hammersmith & Fulham but that the links would need further development. 

Lisa Redfern welcomed the report and suggested that a transformation board or group would be helpful to facilitate the ACP, or similar mechanism to capture multi-faceted, on-going work.  Dr Tim Spicer commented that while he welcomed the suggestion to form a transformation sub-group, he observed that this a hugely complex and non-static of work, which required an overarching level of expertise that could not be provided by a single individual.  Councillor Vaughan added that it was important for the Board to have oversight in order to evaluate the impact.  Vanessa Andreae confirmed that the timetable for implementation would commence in October.  She added that there were two fundamental issues, the first, that patients needed access to services.  A second issue was the need to secure GP practices, without causing disruption to existing networks. 

Moving the discussion forward, Councillor Coleman asked about the underlying reasons for the work and what would be the outcome for residents (patients).  Dr Spicer explained that it was important for patients / residents with complex needs, being cared for by a multi-disciplinary team, to feel that care was being provided seamlessly.  Currently, 13% of patients held this view, which could be improved.  Janet Cree concurred, adding that the aim would be to remove from ASC those with long term complex needs, to care delivered through MCPs.  Councillor Coleman emphasised the importance understanding the resident experience and identify their expectations.  Vanessa Andreae confirmed that the patient experience had been included, so the patient’s voice was embedded within the development of the strategy.

Keith Mallinson queried the level of consultation undertaken.  Patients with complex needs could not be expected to traverse the borough to receive treatment.  Mike Robinson commented that the resident experience could be provided by the PCN but this might not necessarily reflect PCN aspirations.  Vanessa Andreae cited the example of the anti-coagulation service, which had recently been transferred to CLCH. A positive response to the transfer had been received from both patients and GPs. 

Harley Collins observed that a proper evaluation of patient experience was required and suggested that this could be facilitated either through a HWB transformation sub-group or through HASCSIPAC, a view which was endorsed by the CCG, to ensure that the patient voice was reflected.  Councillor Coleman reiterated that residents were at the very heart of the Council’s approach.  Improved communication with residents was required, with resident’s needs being contextualised through the receipt of improved care. 

Steve Miley explained that Children’s Services were developing a family support service and asked if the CCG required input from Children’s Services.  One of the aims was for example, to have a representative from family services in every school in the Borough and invited input from Board members to better understand how to shape family services in the context health partnership working.  The CCG indicated that this input would be welcomed and a good opportunity to work collectively.  Janet Cree responded that they were sighted on Children’s Services developments and would like to include this work, going forward. 

Graham Terry explained that it was a challenge to capture data and to understand infrastructure, to properly inform decision making.  The PCS was essentially the first building block, and that not undertaking this work would make it harder to deliver integrated care.  In discussing the issue of utilising the benefits of data analysis and sharing data between organisations, it was agreed to explore this further at a meeting to be arranged between ASC, Public Health and the CCG. 

ACTION: ASC, Public Health and CCG

With reference to Appendix 2, Ian Lawry highlighted the use of terminology such as “primary care collaboration”, which was a collective of GP practices or a primary care hub, working both autonomously and collaboratively.  It was explained that the PCS would not result in an increase of resources but was about how to reconfigure existing provision, refocused on supporting residents. 

Responding to Councillor Holder’s concerns about insufficient consultation undertaken by the CCG, Janet Cree explained that there was an engagement strategy in place, to engage with stakeholders across the Borough, including LHBF Councillors.  There was a general agreement that clear communication of details about services was fundamental for ensuring full engagement. 

RESOLVED

That the Board note the progress to date on developing the vision set out in the report and endorsed the CCG working closely with Public Health, Children’s Services and Adult Social Care teams to progress the implementation of the Primary Care Strategy.