For the Scrutiny Board to receive:
· Update on access to GP Services for Solihull Residents
· Update on the reprovision of services at Solihull Hospital
· Communications and engagement plan
Update on access to primary care
The Chief Officer for Partnerships and Integration, BSOL ICS, took Members through the initial report, updating them on access to Primary Care services.
Members raised a number of queries and observations, which in summary included the following:
· Members expressed their thanks for the report and to all staff in Primary Care, recognising the significant challenges.
· A Member raised the following points:
- They noted the update on demand and activity – they questioned how many people may have stopped attempting to arrange an appointment, due to difficulties in accessing services.
- The latest average call waiting time in Solihull was 24 minutes – they queried what further measures could be undertaken to help reduce this down further.
- They questioned whether a call-back service could be used to help reduce call waiting times.
· The Chief Officer for Partnerships and Integration explained how, across Birmingham and Solihull, 95 per cent of practices had Cloud-based telephony. This enabled greater functionality to provide additional services, such as a call-back option. Work was being undertaken at a BSOL-level, to support practices to make further use of this technology. The Cloud-based telephony also provided opportunities for further data collection, to help assess services and monitor trends. The Chief Officer for Partnerships and Integration detailed the work being undertaken on this with the GP teams.
· The Chief Officer for Partnerships detailed how phone calls could take 4-5 minutes, due to the triage process. This was to determine the order of treatment of patients, to ensure those in most need were seen first and refer people to the appropriate support.
· In response to a Member query, the Chief Officer for Partnerships and Integration confirmed the GP sites advised the triage system added value. The Member queried whether any local Universities had undertaken research on the efficacy of the triage system - the Chief Officer for Partnerships and Integration explained national research had been undertaken and it was confirmed this request could be looked into.
· A Member detailed the challenges they faced recently when attempting to get a family member a triage appointment.
· The Chief Officer for Partnerships and Integration confirmed they would be happy to have a further conservation with the Councillor, to gain further understanding of their experience and learning. It was explained how GP sites were a multi-disciplinary environment and all staff were trained and supervised to support the triage system.
· A Member expressed concern at non-GP staff determining whether people should receive an appointment, as part of the triage system. They also raised their concerns that, during the pandemic, systems had been rapidly put in place. The Member queried what assessments were being undertaken to ensure these systems were robust.
· The Chief Officer for Partnerships and Integration agreed it was correct that, in a number of instances, systems had been rapidly put in place to initially offset the impact of the pandemic. However, he explained that, prior to Covid, there had been national initiatives to expand digital services in Primary Care. It was noted that a significant proportion of Primary Care appointments were now face-to-face. He also highlighted the explanation previously provided, on working with the GP teams to maximise data collection, to help assess the effectiveness of services.
· A Member requested further details on the winter plans in place for GP teams across the Borough.
· The Chief Officer for Partnerships and Integration detailed how there were 2 elements to the winter plans. The first part was a national NHS initiative to help boost GP services for the winter. As part of this, all local GP teams had submitted their plans, which would generate approximately 6000 additional appointments over this period. For the second part, BSOL ICS had asked all GP teams to work in collaboration, alongside other partners, to provide additional capacity – to help relieve pressures on Primary Care, as well as other providers, such as Emergency Services.
UPDATE ON THE RE-PROVISION OF A MINOR INJURIES UNIT (MIU) AT SOLIHULL HOSPITAL
The Chief Operating Officer, University Hospitals Birmingham (UHB) presented the report, which updated Members on the measures that were proposed to support the recovery of hospital services across Birmingham and Solihull, specifically the re-provision of a Minor Injuries Unit (MIU) at Solihull Hospital.
Members raised the following queries and observations:
· Members welcomed the re-provision of a MIU at Solihull Hospital and expressed their thanks to all staff at UHB in supporting this. Members also welcomed the re-provision of the MIU as soon as possible, in accordance with statutory requirements and good practice.
· The Chief Communications Officer for UHB confirmed there wasn’t a statutory requirement to undertake a consultation, as it was the re-provision of a service. The focus was upon communicating to patients and the public on the recovery and improvement of services and this wouldn’t impact on timescales.
· Members noted UHB was collaborating with the ICB regarding the reinstatement of an urgent treatment centre (UTC) for patients with urgent primary care concerns. Members requested further information on this.
· The Chief Operating Officer for UHB outlined how he was now the lead officer on the Urgent Care Strategy for the BSOL system, where there was focus upon future provision arrangements.
· A Member noted MIUs were nationally classified as type three departments, led by emergency nurse practitioners, supported by other clinical and non-clinical staff. They queried how this would work for complex cases, including where patients may have a background of ill health.
· The Chief Operating Officer for UHB confirmed the emergency nurse practitioners would be trained and working according to the scope of a type three MIU. As part of the governance arrangements, they would be working under the broader Emergency Medicine Team, which included a range of senior staff and healthcare professionals.
· A Member highlighted how it was proposed the MIU would operate between 08:00 and 22:00 hours, seven days per week. They queried whether 24 hour provision had been considered over the weekend period, including to help reduce pressures on other services.
· The Chief Operating Officer for UHB detailed how they had reviewed overnight attendance levels at the MIU pre-pandemic, which showed a very low number of patients had been presenting. This would be kept under review, taking into account demand levels going forward.
· A Member queried whether a pharmacy would be on site at Solihull Hospital. It was confirmed a written update would be provided on this. It was also emphasised Solihull had a high level of pharmaceutical provision across the Borough.
· It was confirmed future updates on the re-provision of the MIU could be provided to Members, as required.
The Health and Adult Social Care Scrutiny Board:
(i) Noted the update on access to GP Services for Solihull residents and agreed that a response to the report be recorded as part of agenda item 9 – Motion from Council.
(ii) Noted the update on the re-provision of services at Solihull Hospital and endorsed the option, as set out in the report, to re-provide a Minor Injuries Unit on the Solihull Hospital site, in line with the national service specification.
(iii) Agreed to receive a future report on the re-provision of an Urgent Treatment Centre at the Solihull Hospital site.
(iv) Endorsed the Communications and engagement plan for the Recovery and Proposed Configuration of services across University Hospitals Birmingham NHS Foundation Trust.