The Committee considered a joint report of East Leicestershire and Rutland Clinical Commissioning Group and West Leicestershire and Rutland Clinical Commissioning Group which provided an update on the development of Primary Care Networks (PCNs) across Leicester, Leicestershire and Rutland. A copy of the report, marked ‘Agenda Item 12’, is filed with these minutes.
The Committee welcomed Tim Sacks, Chief Operating Officer, ELRCCG to the meeting for this item.
Arising from discussions the following points were noted:
(i) Each PCN was to be provided with funding for the 2019/20 year to recruit physiotherapists and social prescribing practitioners; job advertisements had already been circulated for the first 26 posts. By 2023 it was expected that PCNs would have approximately 13 new members of staff, excluding doctors and nurses, per 50,000 people for carrying out primary care services. The intention behind the new staffing requirements was to address the shortage of doctors and nurses by providing the services in other ways. The CCGs recognised there could be difficulties recruiting to these additional posts given existing issues with staffing and recruitment and the fact that there would be national competition for the posts. There was a need to make primary care in Leicestershire a more attractive place to work. There had been a national drive to recruit more GPs from overseas and LLR had gained 14 international GPs. However, there were still gaps and more medical school places had also been created in Lincoln.
(ii) A requirement of the Long Term Plan was a large increase in the number of pharmacists for each PCN area and the CCGs were working on a programme for pharmacists, including support and career development advice, to ensure that there was adequate provision across all areas in LLR.
(iii) In response to a concern raised by a member that the phrase ‘neighbourhood’, which was used in relation to the geographical area covered by PCNs, did not accurately describe an area of between 30,000 and 50,000 patients, it was explained that this was national terminology which the LLR CCGs had no control over.
(iv) One of the aims of PCNs was to help reduce avoidable A&E attendances and members raised concerns that there was confusion amongst the public regarding whether they could attend Urgent Care Centres without an appointment. Some patients were being turned away because they had not booked an appointment through NHS 111. In response it was acknowledged that there were problems with the system of patients booking into Urgent Care Centres and work needed to take place with the provider of the service to improve clarity and communication to the public. In LLR appointments at Urgent Care Centres were 15 minutes in length. NHS England required commissioners of Urgent Care Services to provide 30 minutes per 1000 patients; the current provision in LLR was more than double with 67 minutes per 1000 patients.
(v) In response to concerns regarding whether the primary care infrastructure would be able to meet the housing growth in Leicestershire reassurance was given that this was being considered as part of development of the Primary Care Estates Strategy and mapping was taking place to analyse the condition of buildings and what they could be used for. Local Plans were being taken into account when carrying out estates planning. It was confirmed that funding received under Section 106 of the Town and Country Planning Act 1990 could not be used for GP salaries as it was capital funding. However, revenue funding would increase with growth as it was based on the number of patients.
(a) That the update on Primary Care Network development across Leicester, Leicestershire and Rutland be noted;
(b) That officers be requested to produce a report on the Primary Care Estates Strategy for a future meeting of the Committee.
(c) That details of the Primary Care Networks for Leicester, Leicestershire and Rutland, including geographical areas and names of Accountable Clinical Directors, be circulated to all members of the Committee once available.