Agenda item

Provision of Health Care Services within the District

To receive an update from the Clinical Commissioning Group (CCG).


The Chairman welcomed Mr Robert Evans, Head of Operational Care from Mid-Essex Clinical Commissioning Group (CCG), and Dr Julie McGeachy, General Practitioner (GP) at Dengie Medical Partnership and Clinical Director of the Dengie Primary Care Network, to the Committee. 


Mr Evans passed on apologies from Ms Kerry Harding, Director of Estates for CCGs in Mid & South Essex. 


Both Mr Evans and Dr McGeachy delivered the following information to the Committee:

·       NHS Long Term Plan is a ten-year investment plan which aims on expanding and developing primary and community services.

·       Primary Care Network (PCN):

o   Groups of GPs with a population of 40-50,000 as an ideal, in order to retain a personal touch.

o   There are five PCNs within Mid-Essex, one of which is in the Dengie.  These were formed 1 July 2019.  Surgeries were formed to work together on an integrated basis in order to develop services and provide additional resource and linked into voluntary organisations, in addition to developing the role of clinical pharmacists.

·       Priorities for 2019/20:

o   PCN Cycle – aims to identify and inform the public of alternative primary care workers, such as physiotherapists, nurses, pharmacists etc.  This would be expected to release extra capacity to GPs for patients with more complex needs. 

o   Additional capacity would be enabled through two services:

§  Extended Access Service (from October 2018):-  This service is year-round including bank-holidays and weekends, and designed to provide additional capacity, creating around 738 additional appointments per week across the area.  These are provided by four permanent hubs across Maldon, once of which is located at the Blackwater Medical Centre.

§  Enhanced hours:-  Practices were looking to extend their opening hours, i.e. opening an hour earlier or closing an hour later.  Every practice within the area has identified a way to accommodate this.

o   It is expected the integration of services would provide a more holistic approach.

o   CCG have been consulting with NHS England and is one of five to have formed a Sustainability and Transformation Partnership (STP). 

·       Maldon District and Dengie:

o   There is a population of approximately 55-56000 people.

o   There are seven practices within the area which offer primary care, these are regulated by the Care Quality Commission.

o   The CCG identified five outstanding practices, of which three are located within Mid-Essex.  Two of these are situated within the Dengie.

o   Quality of service within the district is considered to be very good; a patient survey showed they were broadly satisfied, however there were concerns regarding access to GPs.

·       Staffing of General Practices:

o   Last year the Mid Essex CCG reinvested over £2.5million invested into primary care, for surgeries to use as they see fit.

o   The CCG are currently working towards a broader skill mix to navigate problems and identify the right care for patients.

·       Estates:

o   The Trinity Medical Practice, Dengie: additional capital had been confirmed with a view to develop the site

o   William Fisher Medical Centre: the site is likely to stay, and expansion was being considered.

o   The Blackwater Medical Centre: it was noted that the site would eventually be relocated.

o   Redevelopment of St Peters Hospital: it was noted that a project team had been set up and MDC were involved.  The project lead had advised that a business plan would be compiled within the next few months.

o   Heybridge: there was an intention to create a merged site to increase capacity.  It was acknowledged that this was currently at the informative and planning stage.

·       Promotion of Primary Care Services:

o   Promotional material was being developed by the CCGs communication team.

o   Members requested that a flyer be included with the annual billing.  It was agreed that MDC would liaise with the CCG to develop this.

·       Patient Care:

o   Current guidelines recommend 10-minute appointments with patients.  A scheme under consideration within the Dengie would look to offer 15-minute appointments to patients requiring one.

o   Quality Care Commission examine practices every 5 years to ensure that the service delivered is appropriate and acceptable.

o   CCG Risk Review showed that future staffing levels could become a problem.

o   There is a National Resilience Scheme in place to help get over short term difficulties.

·       Overstretched Practices:

o   Two previously oversubscribed GP Surgeries within the Maldon Town are once again accepting patients for registration.

o   It was noted that Receptionists frequently receive bad press as they should be seen to signpost patients towards the appropriate type of care and not demanding personal information.

o   There is a significant number of missed appointments.  The CCG are currently considering ways to reduce this number.

·       Retention of General Practitioners:

o   What encourages people to become GPs:

§  Work/life balance etc.

§  Current workforce is mature, this is being looked at.

§  Survey of GP burnouts run by Anglia Ruskin University

§  New medical school at Anglia Ruskin University

§  Working towards a GP led service, rather than a GP provided service, responsible for the level of care not necessarily the delivery of the care.

o   It was acknowledged that GPs were keen to spend more time with patients.  Every surgery had replaced some ten-minute slots with fifteen-minute slots. The patients were identified by GPs who booked these appointments directly.

·       Primary Care Network within the Dengie:

o   It was anticipated that PCN within the Dengie would adopt a Buurtzorg style of neighbourhood care.  This would be expected to increase the level of service.  It was noted that several locations within the UK had successfully adopted this style of practice.  It was also acknowledged that this would take time to implement as the scheme would need to be adapted to suit the needs of the area.

o   The Committee was informed that the surgery within Southminster was at full capacity and had insufficient space to offer the required services.  This was being mitigated by having a GP working out of the Mayland practice until a new building had been acquired.



                        (i)          The Director of Service Delivery to meet with the CCG to develop promotional material for inclusion with the annual council tax bills.

                      (ii)          Further information be requested from the Director of Estates for CCGs in Mid & South Essex on various sites within the district.