Agenda item

Betsi Cadwaladr University Health Board Update

To receive a verbal update on outstanding issues following the meeting on 12 June 2014.

Decision:

That the information be noted.

Minutes:

Mrs Lynne Joannou, Assistant Director Primary Care Support at Betsi Cadwaladr University Health Board (BCUHB) was in attendance to provide an update, following discussion at the meeting on 12 June 2014.  She advised that there were currently 114 GP surgeries across North Wales, including 23 between the three localities in Flintshire, and that despite media reports of difficulties with GP recruitment in some areas of the country, this was not the case in Flintshire.  She went on to advise that around 60% of residents in Flintshire and Wrexham were accessing NHS Dentists including some patients engaged with services across the border in England.

 

Mrs Joannou referred to the allocation of funding for GP and Dentist services across North Wales and the potential for this to be allocated on an area basis as a result of negotiations around a change in BCUHB management structure.  She spoke about the need for a different approach to the delivery of Primary Care services due to a national shortage of GPs and changes in the way that many GPs wished to work.  A move to a different model of working in terms of exploring the expertise/up-skilling of other clinical staff, Nurse Practitioners and use of pharmacists would help to maximise GPs’ time.  The introduction of the new GMS contract meant that GP practices determined their own arrangements and resources and there was no central list of GP vacancies.

 

In response to queries from Councillor Hilary McGuill, Mrs Joannou provided explanation on the annual monitoring of the Quality and Outcomes Assurance Framework (QOF) process and the provision of Orthodontist Chairs located in Shotton and Mold, with the contract for the latter coming to an end.  As part of the tender process, increased activity was identified in east Flintshire and Wrexham with new contracts starting from 1 October 2014.  She agreed to provide the Committee with figures on waiting times of the four Orthodontist practices across North Wales and would confirm the average age of GPs in Flintshire, which Councillor McGuill thought to be around 65.  The recruitment of new GPs would be addressed through joint working with nursing colleagues and other professionals.  She went on to provide explanation on contractual requirements for accessing GP practices, adding that most opening hours were between 8am and 6.30pm.  Those operating with two or more full-time GPs were not permitted to close early during the week and should be reported to the Health Board as this could potentially constitute a breach of contract.

 

Mrs Joannou agreed to follow up concerns raised about the opening hours of two local GP practices.

 

Councillor Marion Bateman commented on the possibility of GP surgeries located at some supermarkets.  Mrs Joannou said that this was not presently under consideration in Wales to her knowledge and that a lack of additional funding meant that new surgeries would need to be financed from transferred funding or the closure of another surgery.  Councillor Bateman asked if some GPs were directly employed and whether they could be invited to a future meeting.  Mrs Joannou said that the Health Board was aiming to set up its own GP service but currently had GPs engaged as professionals and locality leads as opposed to being employed as GPs.

 

In response to a question from Councillor Ian Smith on Orthodontist provision in Connah’s Quay, Mrs Joannou referred to the previous tendering process and the potential to review areas of need in 2-3 years’ time.

 

Councillor Mike Lowe referred to timing of appointments at GP surgeries and increased need arising from housing developments.  Mrs Joannou advised that GPs operated their own surgery appointment systems and were expected to adapt to best respond to their patients’ needs.  She referred to her previous comments on the lack of additional funding for new surgeries and the need for joint working.

 

During discussion on GP services, Councillors Lowe and Arnold Woolley felt that a lack of continuity of GPs was a disadvantage to the patient and could lead to a serious error.  Mrs Joannou said that practices were doing what they could to meet the demands of patients in a pressurised environment.  She added that the use of locums was often necessary due to many GPs opting to work part-time, however availability was a challenge.  With an increase in demand and reduced resources, joint working was needed to improve health education and promotion to the general public.

 

Ms Sally Baxter spoke of the co-location of teams and a single point of access achieving better outcomes for patients.  She highlighted the importance of proper consultation, assessment, diagnosis and judgement - whether by GPs or locums - and commented that patients attended by different GPs could be beneficial to some patients.

 

The Chair said it appeared that the needs of patients were secondary to that of GPs in some practices.

 

Resolved:

 

That the information be noted.