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 estate they need moving forward as many of the current GP practices were based in old buildings which were no longer fit for purpose with others being more modern.

Resolved (unanimously):

1.         that the Board express their thanks and appreciation to Clinical Commissioning Group (CCG) and Healthwatch for their work and support to the local people of Torbay, especially during the Covid-19 pandemic; and 

2.         that the CCG be recommended to continue to work closely with Healthwatch and other local partners to explore further:

§     options to enable patients to access their GP in an accessible manner;

§     what action has been taken to improve communication with patients to enable them to access the correct services at the appropriate time; and

§     how learning is shared across practices;

and provide an update to the Board on this in 12 months time.