To receive apologies for absence, including notifications of any changes to the membership of the Board.

Apologies for absence were received from Councillors Atiya-Alla and Kennedy.

To confirm as a correct record the minutes of the meeting of the Board held on 14 July 2021.

The minutes of the meeting of the Board held on 14 July 2021 were confirmed as a correct record and signed by the Chairwoman.

To receive an update to ensure that residents are receiving good services from their GPs to include:

1.          reviewing the Open Door Service and how this is accessed and the numbers of people being seen;

2.          accessibility of GP appointments and services, how residents can access services and how this compares to the numbers accessing the service pre-Covid-19; and

3.          what plans there are for GPs in the future e.g. mergers to become part of larger group surgeries.

Other useful background patient level information can be found at:

·                  https://www.healthwatch.co.uk/report/2021-03-22/gp-access-during-covid-19

·                  https://devonccg.nhs.uk/news/major-independent-survey-of-devon-patients-provides-massive-vote-of-confidence-for-gp-services

(Note:  Jo Turl, Director of Out of Hospital Commissioning, Dr Alex Degan, Primary Care Medical Director, Paul Green, Deputy Director of Primary Care and Pat Harris, Healthwatch have been invited to the meeting for this item.)

Dr Alex Degan, Primary Care Medical Director from the Clinical Commissioning Group (CCG) who was also a GP, outlined the submitted paper, provided examples of his experience of being a GP during the last 18 months and responded to Members’ questions.  Pat Harris provided examples of her experience working with Healthwatch and how they were trying to help improve services to patients and responded to questions.  Kevin Dixon from Healthwatch was also present for this item.

The Board noted that over the last 12 months in Devon, Plymouth and Torbay there had been:

·                     more than 4 million face to face appointments in general practice;

·                     more than 2 million telephone consultations (although it was not clear how many of these had resulted in face to face appointments as that data was not currently available); and

·                     more than 500,000 online consultations.

The Board discussed the benefits and disadvantages of different methods of patients contacting their GP and highlighted the inconsistencies between surgeries with some patients, particularly older patients often giving up when they have been unable to get a response within a reasonable time when telephoning their surgery.  It was suggested that good practice should be shared across surgeries to enable lessons to be learned from those with good patient access. 

Pat Harris highlighted the importance of communication and engagement with the community to enable them to better access the correct services at the appropriate time and highlighted proposed work in this respect, which would help free up capacity for GPs and the hospital as patients could go to local pharmacists or community services etc. where appropriate.

Members acknowledged the impact that Covid-19 had on people accessing their GPs with a huge drop off in the early days because of lock down and other reasons and the backlog that this had created as a result of patients not accessing services in a timely manner resulting in multiple issues needing to be addressed, some of which could have been dealt with sooner.  GPs and hospitals were working through the backlog, but it was accepted that some non-urgent routine procedures would still be delayed for a significant time e.g. gall bladder surgery.

Members were particularly concerned over delay in cancer diagnosis during the last 18 months and sought assurance that investigations were being carried out on patients journey up to diagnosis and appropriate lessons learned going forward to ensure earlier diagnosis and access to treatment.  Dr Degan gave assurance that GP practices were required to review cancer diagnosis and Pat Harris confirmed that where people have raised concern over delay in diagnosis their complaint would be escalated to the Care Quality Commission (CQC) for investigation and recommended action.

It was noted that there were currently no planned mergers of GP surgeries in Torbay, however, the future direction of travel was for larger surgeries with more support within the community working with other local health and care providers and the Local Authority.  The CCG would need to work with primary care providers to see what  ...  view the full minutes text for item 17.

To consider the submitted budget monitoring report for Quarter 1 2021/2022 and make any recommendations to the Cabinet.

The Board considered and noted the budget monitoring report which provided a high level summary of the Council’s forecasted revenue and capital income and expenditure for the financial year 2021/2022.  It was based on the figures as at the end of Quarter 1. 

The Deputy Leader of the Council and Cabinet Member for finance highlighted the key pressures identified in the report.  These related to adult social care (which had been restructured to include community services), pressure on temporary accommodation, pressures impacting the collection fund and further predicted impact as a result of changes to Universal Credit, Furlough coming to an end and the increase in the use of food banks, additional costs and investment required for SWISCo (particularly due to pressures on HGV and waste collection staff), and deficit within the Higher Needs Block of the Dedicated Schools Grant (which was a national issue impacted by insufficient funding to cover the additional costs associated with the increasing number of children with Education and Health Care Plans (EHCPs).

Resolved (unanimously):

1.         that the Assistant Director of Education, Learning and Skills be invited to the Board on 13 October 2021 to raise awareness of the impact on the Council of the increase in the Higher Needs Block of the Dedicated Schools Grant, as a result of the increase in the number of children with an Education and Health Care Plan (EHCP); and

2.         that the Cabinet be recommended to provide parking incentives on the run up to Christmas to help support the town centres.

To monitor the progress of the Cabinet’s response to the Overview and Scrutiny Review of the Planning Service Action Plan approved on 20 April 2021.

This item was deferred to the meeting of the Board to be held on 13 October 2021.