Agenda item

Report of the Assistant Managing Director Planned and Unscheduled Care, Harrow Clinical Commissioning Group

The Board considered an update on the development of the General Practice Access Centre (GPAS) at the Alexandra Avenue Medical Centre in South Harrow which had opened that day.  The Board agreed on the grounds of urgency  to consider an appendix to the report  which set out questions asked and answers given at the Health and Social Care Scrutiny Sub-Committee when it discussed the matter at its meeting on 16 October.

The Managing Director introduced the report stating that the GPAS arrangements were in accordance with the requirements of the agreed London Specification for Improved Access which included the availability of GP Extended Access pre bookable appointments that were available for the CCG area registered population.  A CCG officer stated that the walk-in centres were not seen as long term care for which patients would have a better outcome through their GP practice.  For general needs, if a GP practice had insufficient appointments and there was a need for an appointment within 24 hours, an appointment could be made for Alexandra Avenue at which patient’s records would be available, rather than a ‘sticking plaster’ approach.

The Board was informed that an engagement event was due to be held at Harrow Baptist Church that evening.

A Member stated that her understanding had been that the walk-in centres provided for emergencies, in order to reduce the pressure on A and E or when GP appointments were not available.  She expressed concern that the new arrangements would further increase the use of Northwick Park Hospital urgent care centre.  In response, the Managing Director stated that discussion and planning were underway regarding the impact of the new arrangements on A&E.  It was reported that the PPC provider regularly monitored the situation and that attendance at A&E that day had included three people from Brent and Hillingdon.  Patients registered with Hillingdon and Brent GPs had been consulted.  Fortnightly escalation meetings, an A&E delivery board for each hospital and monthly contract monitoring were taking place.

With regard to comments on the other 2 centres in Harrow, it was reported that no changes were currently under discussion and early engagement would be undertaken should there be any future proposals.

In response to a question, the CCG undertook to circulate information on the number of times an ambulance had been called to a walk-in centre or if someone was taken ill at a GP surgery.

Concern was expressed that:  there had been insufficient discussion prior to the implementation of the new arrangements; the number of appointments was a third less than the number of people who attended the previous year; the effect on Harrow residents who were not registered with a Harrow GP; previous publicity had stated not to attend walk in clinic unless seriously ill but the new process allocated appointments there; the effect on Northwick Park Hospital which was now accepting people from a wider area.

Information was sought by Board Members on the number of Harrow residents registered with GP practices outside Harrow, whether visitors to Harrow residents could be treated at the Medical Centre; the capacity at the Pinn Surgery, and whether, provided they arrived prior to 8pm, all would be seen.

In response to questions, the Managing Director informed the Board that

·                     recharging arrangements with other CCGs were in existence but required the agreement of the other CCG.  Such an agreement was in place with Hillingdon CCG.  Neither of the neighbouring boroughs wished to buy into the Harrow offer to commission extra capacity at the Medical Centre;

·                     there was a duty of care which included treating visiting relatives in an emergency;

·                     further analysis would take place and be disseminated by herself or senior staff.  Approximately 50% of the available appointments at the Medical Centre had been booked by midday;

·                     it was hoped to improve the engagement on mandatory assessment.

RESOLVED:  That

(1)          the report be noted;

(2)          further information and an update be submitted to the next meeting;

(3)          information be circulated on the number of times an ambulance was called to a walk in centre or GP practice.