Report of Deputy Director, Primary Care Integration, Manchester Health and Care Commissioning

This report updates the Committee on access to Primary Medical Care in Manchester; both in core and also extended hours.

The Committee considered the report of the Deputy Director, Primary Care Integration, Manchester Health and Care Commissioning (MHCC) that provided Members with an update on access to Primary Medical Care in Manchester; both in core and also extended hours.

The Deputy Director, Primary Care Integration, MHCC referred to the main points of the report which were: -

·                Access to General Practice during core hours;

·                Information on the 9 Primary Care Standards;

·                Extended hours population coverage and Primary Care Networks;

·                Patient and public perspectives of Primary Care access;

·                An update on the enhanced 7 day access service;

·                National review of Access;

·                Developing a model for integrated urgent and enhanced access;

·                Digital access and Manchester’s Strategy for Primary Care Information Management and Technology; and

·                Inclusion Health – Safe Surgeries designed to ensure that Manchester’s Primary Care system is properly inclusive to all groups and communities.

Members discussed the difficulties they had experienced in securing GP appointments, commenting that the requirement to call at a specified time, often to find that there were no appointments left and was asked to call back the next day was not acceptable. Members commented that there was no triage of patients applied and there was a first come / first served system and further questioned the findings of the patient survey that reported that 69% of patients found it fairly to very easy to get through to someone at their GP surgery on the phone, slightly above the national average of 68%.

Dr Kumar described that Primary Care was experiencing significant pressures due to an ageing population with complex health needs. She said that whilst it was recognised that some patients still required face to face consultations, the options of providing online consultations and telephone consultations, where appropriate were being considered. She described that consideration would be given to understand what patients required from this offer, adding that it needed to be appropriate for patients. She stated that this would also reduce the demand at GP surgeries for appointments and help alleviate the experiences described by Members when telephoning surgeries.

Dr Kumar responded to a question from a Member by explaining that GPs were required to review patients’ medications, even if they had been prescribed by a Consultant as responsibility was with the GP. She stated that it was correct and appropriate to undertake periodic health checks, such as blood pressure monitoring to ensure patients remained safe and healthy.

A Member commented that the closure of Walk In Centres had a detrimental impact on residents ability to access GP appointments, with the result that patients presented at Emergency Departments that resulted in additional pressures on these services. The Member further commented that more needed to be done to publicise the availability of the extended hours and enhanced offer provided through the Primary Care Networks. He said that leaflets and posters needed to be prominently displayed in GP surgery waiting areas, in addition to reception staff informing their patients.

The Deputy Director, Primary Care Integration, MHCC stated that there were three Walk In Centres in Manchester and the intention was to incorporate this model to complement and support other offers. 

In response to a question regarding the number of Did Not Attends at extended hour appointments Dr Kumar reported that they were currently at 10%, and this reflected the number of Did Not Attends at GP practices. She said that the system had been improved so that patients could now cancel appointments using a text message service. Members recommended that consideration should be given to sending appointment reminder messages also.

Members welcomed the Inclusion Health programme, a range of initiatives and programmes to ensure that Manchester’s Primary Care system is properly inclusive to all groups and communities.

The Deputy Director, Primary Care Integration, MHCC informed the Committee that the introduction of Primary Care Standards provided a better offer to patients and addressed the issue of variation that had previously been evident in GP Primary Care. He stated that mystery shopping exercises would be undertaken to assess

how these standards were implemented. In response to a specific question regarding the number of single or two doctor Practices in Manchester, he said these were extremely low and he would circulate this information following the meeting. He further informed the Committee that Surgeries could close for training and development purposes only when reasonable alternatives and satisfactory arrangements had been agreed for their patients.  

Decision

To note the report.