Agenda item

Report of the Harrow Borough Director, North West London - Integrated Care Board

The Harrow Director of the North West London Integrated Care Board (ICB) presented the GP Patient Survey Results and ongoing initiatives to improve access to primary care.

Primary Care and Access:  The Director emphasised that primary care included not only GP appointments but also preventive care, such as immunisation and cancer screening, and proactive management of long-term conditions.  Challenges in primary care continue to grow, particularly around access.

GP Access in North West London:  Access to GP services remained a priority, and several methods to improve accessibility had been implemented, this included online platforms video and phone consultations, self-care pathways, and pharmacy-first schemes.  New roles within practices resulted in increased appointment availability significantly, with more than 15.5 million GP appointments annually and an additional 1.1 million online consultations.

Enhanced Access Hubs:  Hubs provided appointments outside of core hours, including weekends.  These hubs were intended to alleviate pressure on primary care by offering more flexible access.

Harrow had a registered population of around 300,000, served by 31 GP contracts across five Primary Care Networks (PCNs).  Despite a total of 1.6 million appointments provided in the past year, demand continued to grow, partly driven by increased health needs and population growth.

NHS National Patient Survey:  The survey, with over 3,300 responses, measured patient satisfaction across GP practices.  Results varied, with one Harrow PCN scoring highest in ease of contact in Northwest London, though most PCNs were around the national average.  Plans were in place to address variations in performance and improve areas of need.

HealthWatch Findings:  Additional insights were provided by HealthWatch surveys, highlighting high ratings for quality of care and compassion but also challenges with telephone access and hospital wait times.

Challenges and Areas for Improvement:  Significant challenges were noted, including an aging GP workforce, the need for improved estates, digital exclusion, health inequalities, and a rising demand due to population growth.

Actions to Improve Access:  The ICB (Integrated Care Board), aims to increase same-day access, reduce defaulting to urgent care due to the lack of same-day appointments, and address winter pressures.  Workforce development was also underway, with the introduction of diverse roles such as pharmacists, mental health practitioners, and social prescribers in primary care settings to ensure patients see the appropriate clinician.

The Board asked the following questions:

The Board raised concerns about over 50% of GPs in Harrow being over 65 and the potential for practice closures.  The Board enquired about plans to attract new practices.  The Vice Chair responded that a new GP recruitment scheme aimed to place newly qualified GPs in Harrow.  The Vice Chair anticipated 6-10 new GPs under the scheme, would GP shortages.

The Board noted a lack of continuity of care with an increase in locum doctors, which made it challenging for patients to see familiar GPs.  The Vice Chair clarified that Harrow currently had a stable salaried GP workforce and fewer locum issues compared to other boroughs.

The Board highlighted difficulties that elderly residents face when accessing GPs through digital systems like Patches, resulting in delayed care and A&E pressures.  The Board emphasised the need for improvements, especially for those who cannot access digital platforms.  The Director of the North West London Integrated Care Board (ICB) confirmed ongoing efforts to improve same-day access and alternative communication methods, alongside implementation of new same-day access hubs to ease system pressures

The Board also questioned NHS dental access in Harrow.  The Director of the North West London (ICB) stated that NHS dental services, recently taken over by the ICB, are making progress, this included budget reallocations to clear waiting lists for children's procedures.

The Chair echoed concerns about NHS dental availability, citing frequent public complaints.  The Director of Public Health outlined plans for preventative oral health programs targeting children, which could include initial dental exams to increase registration rates.

The Board requested clarification on funding prioritisation for primary care, specifically related to population needs and practice mergers.  The Director of the North West London (ICB) explained that primary care funding was based on GP registrations and noted ongoing efforts to expand primary care estate in Harrow to meet the growing demand.

The Board also raised concerns about digital poverty affecting patient access, suggesting collaboration with voluntary sectors to address this.

RESOLVED:  The Board

(1)            noted the report which highlighted the increasing demand for primary care services as a result of an aging population and population growth as part of the Borough’s regeneration programme; and

(2)            supported the initiatives and actions to improve access to services, specifically in relation to the estate’s challenges highlighted in the report.