Agenda item

The CCG is under financial pressure and needs to ensure it is using money in the most efficient way.  This report considers the urgent care contracts that are up for renewal and the current demand for services.  The report also discusses whether savings can be made by reducing services when there is little or no usage from residents.

Janet Cree provided details about primary care and urgent care proposals, pre-consultation business case.  It was confirmed that the term “underutilisation” would be replaced with something more helpful. This was the pre-consultation business case to ensure that the right decisions were being made and to ensure that it was informed.  The next step was to present the business case to the NHS Clinical Senate.

Cllr Coleman asked about the options for change in UCC (urgent care centre) services. Janet Cree responded that there was a case for closing the Hammersmith UCC, between 12pm and 8am, due to low attendance.  Cllr Coleman queried the reduction in GP out of hours appointments, also being considered in the proposals at the same time.  Janet Cree explained that the proposal was to move from the local specification to the national one.  Moving to the national framework would ensure lower levels of underuse and bring the Borough into line with what other CCGs offered.  The national framework was also less costly and could potentially produce savings.  Vanessa Andreae added that that the adjustment was proportional to the list size of each practice, so the larger practices could offer more extended hours.

ACTION: CCG to consider if the potential saving does equate to the 20% reduction in cost

Keith Mallinson reported that Healthwatch had met with the CCG and communications officers to ensure that details of the proposed changes were clearly communicated in plain English.  Healthwatch was keen to work with the CCG to ensure proper public consultation.

Development of the consultation and the shape of the engagement, required some final refinement and would be ready in mid-February.  It would target patients and members of the public and it was acknowledged that not all patients would be residents of LBHF.  The consultation would contact registered patients, and, over night service users from Ealing (low in number), so Ealing councillors will also be consulted.  Patients registered with GP At Hand would also be contacted and since the consultation was available online, this would reduce the costs. 

The Board queried how questions in the consultation would be worded, and how accessible it would be.  There was an awareness that engagement in the consultation was a process of self-selection but placing the information at accessible, public points, such as libraries, would be helpful.  A member of the public commented that this was the first time that they had heard about the hubs and suggested that focused, targeted interventions were needed. Other points of access such as children’s centres and schools, messages in newsletters, council media channels, were also suggested as ways of raising awareness.  Although it was recognised that there was a potential ‘workload’ in most options.

Each of the proposals would have a different, cumulative impact and Councillor Coleman expressed concern about this. The combined effect of changes in all three could not be understated and it was difficult to present the full range of arguments for the changes at the same time.  He asked about the questions that would be put in the consultation and how they would be framed.  The patient’s voice was at risk of not being heard.  Patients using the services and it was understood that the CCG had planned to consult service users.  However, it was also clear that if, for example, the majority rejected the proposals, then this information would inform the CCGs Governing Body’s decision-making.

Councillor Coleman concluded that this was the first of many serious consultations that the CCG would be undertaking and welcomed the discussion, which he hoped would inform future planned consultations.