Report of the Deputy Medical Director, NHS Greater Manchester Integrated Care (Manchester Locality) and Associate Director Primary Care, NHS Greater Manchester Integrated Care (Manchester Locality)

This report provides an overview on the provision and access to General Practice services across Manchester.

The Committee considered the report of the Deputy Medical Director, NHS Greater Manchester Integrated Care (Manchester Locality) and the Associate Director Primary Care, NHS Greater Manchester Integrated Care (Manchester Locality)

that provided information and an overview on the provision and access to General Practice services across Manchester.

This report built upon the information presented to Health Scrutiny in September 2021 specific to access to General Practice; and provided the context, services in place that were currently providing access to General Practice, as well as describing the challenges and pressures General Practice was facing and plans to make sure patients could get access to their GP Practice and appropriate care.

Key points and themes in the report included:

·         Providing an introduction and background;

·         Information on the introduction of Integrated Care Systems;

·         Information on the implications of these arrangements both in a national and Manchester context;

·         Noting that there were 83 GP Practices in Manchester that provided access to primary medical care services and the contractual requirements;

·         Information relating to the Primary Care Network Enhanced Access;

·         Information on the Greater Manchester Clinical Assessment Service;

·         Information on the GP Out of Hours service;

·         Providing an update on current access and provision, noting that the Covid pandemic had resulted in a significant shift in the way that patients accessed services at their GP Practice;

·         Describing that as part of winter planning 2021/22, Manchester Health and Care Commissioning (MHCC) had established a pilot to provide access to additional GP appointments by an online video consultation provider (Livi), funded via the national Winter Access Fund (WAF) allocation;  

·         Winter pressures and surge planning;

·         General Practice Pressures, with information on Primary Care Situation Reporting;

·         Discussion of the additional issues that had impacted upon General Practice in Manchester over recent years adding to the increase in demand and pressure;

·         Information on recovery, highlighting some of the work underway and planned to support this; including workforce recruitment and retention and Primary Care Quality Recovery and Resilience Scheme (PQRRS) which aimed to reduce unwarranted variation, tackle inequalities in health outcomes and support general Practice in recovery; and

·         Conclusions.

Some of the key points that arose from the Committee’s discussions were: -

·         Recognising the important and hard work undertaken on behalf of residents by all Manchester GPs and Practice staff;

·         Welcoming the information provided in relation to NHS Greater Manchester Surge Hubs and if the intention was to continue with this model;

·         Welcoming the information within the report, however the anecdotal evidence from residents was that it was still very difficult to secure a GP appointment;

·         Condemning any aggression or threats to GPs and Practice staff;

·         The information for the public relating to Walk In Centres needed to be updated on the website as this still referred to modifications introduced during the pandemic;

·         The Committee had argued against the closure of Walk In Centres in Manchester, commenting that additional Walk In Centres would have taken the pressure off GP Practices;

·         The need for planning of GP Practices when developing new housing schemes across the city to ensure the demand was met;

·         Welcoming the support described that was provided for refugees in the city, adding that the Government had failed to fund resources required in Manchester to support refugees; and

·         Noting the important thread of Health Equity that ran through the suite of reports. 

The Deputy Head of Primary Care (Manchester Locality), NHS Greater Manchester Integrated Care advised that the Surge Hubs had significantly increased capacity and had been introduced rapidly to respond to unprecedented demand. He commented that this had been funded using Greater Manchester resources. He advised that analysis of this model was currently being undertaken and it was anticipated that these would remain until the end of March this year. He further referred to the MARIS (Manchester Acute Respiratory Infections Service) service that had been introduced to support patients with respiratory conditions.

The Deputy Head of Primary Care (Manchester Locality), NHS Greater Manchester Integrated Care advised that under the new ICB arrangements the NHS were working much closer with the Council when new housing schemes were being developed. He made further reference to the work that had been reported to the previous meeting of the Committee that had discussed the approach to improving and maximising the use of the existing GP estate.

The Deputy Medical Director (Manchester Locality), NHS Greater Manchester Integrated Care responded to the comments made regarding difficulty experienced by residents attempting to access appointments by advising that all feedback was welcomed and considered. He said that best Practice in regard to this was shared, recognising that a one size fits all approach was not appropriate and resources needed to be managed efficiently. He further commented that workforce recruitment would also address pressures experienced at sites. In response to a question regarding data and ‘pressure points in the city’ he stated that this would be supplied following the meeting. Similarly, he advised that data in relation to the uptake of Child Vaccinations would be provided following the meeting.

The Associate Director of Primary Care (Manchester Locality), NHS Greater Manchester Integrated Care welcomed the comments and feedback from the Committee. She stated that demand on GP Primary Care had risen across the city and she acknowledged the comments made regarding funding for refugees in Manchester. She advised that they continued to work with the Home Office to seek increased investment to support this activity.

The Executive Member for Healthy Manchester and Adult Social Care reiterated the point raised regarding the failure of the Government to adequately fund the needs of refugees in the city. He said despite this Manchester had a long and proud history of welcoming refugees into the city. He reassured the Members that the Deputy Leader, along with members of the Public Health team had undertaken a visit to all hotels used to accommodate refugees and he suggested that the Committee may wish to receive a report on this area of activity at a future meeting. The Committee endorsed this suggestion.

The Executive Member for Healthy Manchester and Adult Social Care advised that GPs were very much included in the conversations that were undertaken by the various Boards that were referred to in section 2.1 of the paper.

Decision

To note the report.