Agenda item

The Board considered a report of the Strategic Director, Adults and Community which informed the Members of the proposed reorganisation of the Widnes GP Health Centre located at the Health Care Resource Centre (HCRC) in Widnes, and an associate internal restructuring of the GP out of hours service.

 

The Board was advised that Halton Health Limited (HH) provided a number of services locally including the Widnes GP Health Centre based at the Health Care Resource Centre and the GP Out of Hours Service (OOH) for Halton Borough. HH also had the contract for the Windmill Hill GP surgery, the intermediate care beds at Halton Hospital, Halton Single Point of Access service plus some services in Warrington.

 

The Board was further advised that the contract with Halton Health in April 2011 would become funded on a capitation basis. The contractor had expressed concern to the PCT that it would not be financially viable to continue to delivery the service under this arrangement and may need to terminate the contract.

 

It was reported that the Primary Care team had been discussing with the provider how a service could be maintained and as part of the cost improvement programme deliver efficiencies. As a result two proposals have been put to the NHS Halton & St Helens Board:

 

·        reorganise the GP Led; and

·        extend the OOH contract for 2 years but at a reduced contract price.

 

The Health Centre provided GP appointments to non registered patients who require a planned appointment plus a ‘traditional’ GP surgery for people who wished to register. 

 

Over the last 11 months the practice has seen 4207 non registered patients, an average of 382 per month. It has a registered list of 417 patients.(Jan 1^st 2011). Many of the non registered patients were presenting themselves as they could not get an immediate appointment with their own GP. This was not the intention of the scheme.

 

It was reported that the Out of Hours service providers were expected to meet nationally agreed quality standards and HH was an experienced provider of OOH services and met the contract quality standards.

 

         A combined proposal had been developed as follows:-

 

·        No longer see non registered patients;

 

·        The existing registered patients to be given the choice of transferring to another practice which could include Runcorn and therefore Windmill Hill. If the later, HH would continue to operate a daily surgery for booked appointments, 7 days a week at the HCRC (this would be at no extra cost and was additional to the current 5 day service and subject to demand). Home visits would continue as present i.e. according to clinical need;

 

·        Walk-in / unregistered would still be able to be seen by the nurse led walk in centre at the HCRC;

 

·        Reorganise the OOH and extend the contract to 2013;

 

·        Face to face patients at Widnes would be by appointment only. This would be achieved by bringing the visiting GP over to Widnes 7 days per week. In addition 8 hours of further GP time would be provided at Widnes for OOH’s appointments for Saturday, Sunday and Bank Holidays; and

 

·        The treatment centre GP’s at Runcorn and the nurse triage would remain unchanged.

 

In conclusion, it was reported that the proposals provided an opportunity to improve the efficiency, organisationally and economically, of the service.  The impact for patients was minimal as the nurse led walk in centre was still available and the provider would still provide a service to registered patients at the HCRC.

 

The following points arose from the discussion:-

 

·        Page 19 – Paragraph 4.1 – clarity was sought on the profile of the 417 registered patients.  In response it was reported that it was predominantly people between the age of 17 – 54 years.  However, there were six people over 65 years.  

 

·        Page 21 – Paragraph 13.1 – Clarity was sought on ‘protected characteristics’ and how were they not going to be disadvantaged.  In response it was reported that this quote was taken from the Equality Act 2010 which covered a multitude of groups such as, age, carers and disabilities etc.  In addition, it was reported that the Out of Hours Service would be clinically assessed i.e. 1) telephone advice, 2) a visit to a centre either in Widnes or Runcorn and 3) a Home Visit would be undertaken;

 

·        It was noted that all registered patients had received notification of the changes and two further meetings were taking place with residents this week;

 

·        It was noted that the Nurse Led Walk In System would continue and that a significant number of patients used this facility.  It was also noted that patients could still register with a GP at the centre;

 

·        It was reported that the service was not intended to be used as a substitute for patients who had been unable to get an appointment with their own GP.  In addition, it was noted that GP practices were monitored with a particular focus on patient access as they were awarded for good access;

 

·        It was reported that disabled people in wheelchairs had difficulties using the lift as it was not big enough and it resulted in them having to go in forwards and exit the lift backwards.  In response, it was reported that this matter would be looked into;

 

·        It was reported that it was extremely cold when the two doors were open and it was suggested that some form of heater be installed.  In response, it was reported that this matter would be looked into;

 

·        It was noted that not many homeless people had registered or had used the centre and in particular young people.  It was also noted that the centre had been well publicised in homeless centres such as the YMCA, the Women’s Refuge etc, but the  majority of homeless people were treated in casualty. However, it was reported that there would continue to be a focus on encouraging homeless people of all ages to register with a GP;

 

·        The difficulty with parking at the centre was noted; and

 

·        It was noted that the facility would be open 7 days a week until 6.30 pm  and patients who were not happy with their GP had the choice of registering with an alternative GP.

 

RESOLVED: That

 

(1)                     Mr Simon Griffiths be thanked for his informative verbal presentation;

 

(2)                     the proposed reconfiguration to the practice be supported;

 

(3)                     the report and comments made be noted; and

 

(4)                     a report on oral health in young people be presented to a future meeting of the Board.