Agenda item

This report is for the attention of Board members, sharing a Healthwatch report which looks at the results of a survey exploring people’s experiences of accessing GP services within the city of York.

The Manager of Healthwatch York presented the report, which summarised the results of a survey exploring people’s experiences of accessing GP services within the city of York.

She stated that the intention had been to encourage open, honest conversations about access to primary care and thanked respondents to the survey which formed the basis of the report.

She emphasised that when visiting their GP, respondents overwhelmingly indicated they wanted a consistent point of contact who knew them and who they trusted. Patients with chronic conditions wished to have their doctor understand their condition, but not to attribute or link all health concerns to this condition.

She noted that this report and the other items on the agenda illustrated that capacity and demand were not currently in step with one another, but opportunities had been presented in this report, the urgent care report and the pharmacy report, which could be explored collectively by partners to develop a strategy for how the ideas might take shape.

She cited examples such as integrated Care Community hubs, changing roles for pharmacies and independent prescribing, better access to voluntary and community services to alleviate Health and Care Services and early intervention and prevention.

She noted that formal recommendations for the board had not been made in this report, but next steps had been proposed and the board’s views and suggestions on these would be welcomed.

The board commended the report.

Since this report was titled an “interim report” the board asked when the final report was due.

The Healthwatch Manager responded that what had been published reflected the full results of the surveys undertaken by Healthwatch, but it was titled an “interim” report at publication because further work on these results had not then been completed by Healthwatch, who sought to explore solutions. She added that they had since undertaken follow up meetings with those in primary care to explore how they might bring people and clinicians together and work on systemic improvements.

The board stressed the importance of people still coming forward for care, and not presenting late or avoiding doing so for fear of overburdening their GP as was suggested by quotes from respondents in the report. Despite the disproportionate pressure on GPs, who see 90% of all contacts, triage in this area has been a key innovation to ensure that those most in need are seen first and patients should contact their GP to allow for this rather than stay silent.

The board expressed concern about situations arising where a specialist/consultant advises that they will send something through to a patient’s GP, followed by a break in the flow of the service and a potential breakdown in communication at the patients end, resulting in confusion as to whether or not the GP has actually received this information. Residents have reported believing they had a prescription ready, only to find out this was not the case weeks later.

The Joint Chair of York Health and Care Collaborative responded to this, quoting the NHS Constitution on responsibility for prescribing between primary and secondary care, stating that secondary care practitioners, if they feel a drug needs to be issued with urgency, can  issue it immediately.  A GP constitutionally has 28 days to receive a letter from secondary care, read it, action it and put it on a patient’s notes. It is therefore reasonable to expect a GP to take up to 28 days to have your prescription prepared and ready. It was conceded that current pressures on the NHS have meant that these targets are not always met, and expectation management for patients was vital.

The Chief Superintendent, North Yorkshire Police agreed that expectation needed to be realistic, and from a police perspective additional services had been launched with no additional staffing resource.

The Manager of Healthwatch York agreed that there was frustration on both sides (patients and GPs) emphasising the pressing need to refocus resources on where they can make the most impact. She stated that more patients were being seen by primary care than before the pandemic; while some of these were seen online, face to face appointments had nearly returned to pre-covid levels and there were more online and more telephone than before.

She stated that it was vital to have a really good conversation about how to make GP services as good as they can be for our population, acknowledging that current demand cannot be met and prioritising a way forward that people respect and understand.

She concluded with three key questions to take away from the report:

1.    How can capacity be increased?

2.    How can other areas of the system be utilised more effectively to make sure that that GP support is there for the people who need it?

3.    How can communication be improved between primary and secondary care so we don't have GPs, members of the public and people working in hospitals chasing each other for things as raised by board members?

Resolved:   That the Board noted Healthwatch York’s Report – Exploring Access to GP Services in York – Interim Report September 2024, and commented on the updates provided within the report and its associated annexes.

Reason:      To keep up to date with the work of Healthwatch York and monitor progress regarding recommendations.