The Committee gave consideration to a progress report of the Head of Primary Care Trafford on the accessibility of Primary Care Services in the Borough, following the Covid-19 pandemic and the ongoing work on quality improvement. This report was an update on the information that had been provided to the Committee in March.

The Clinical Director and the Joint Interim Accountable Officer from Trafford Clinical Commissioning Group (CCG) attended the meeting to present the information and answered the questions of the Committee.

CCG representatives outlined the changes to primary care services and the introduction of the Digital Front Door which gave practices the ability to offer on line patient consultation. Although digital improvement had been planned before the pandemic hit, the need for these on line platforms increased dramatically during lockdown.

Primary care continued to face an increase in service demand across the country due to several factors; in Trafford, currently, approximately 8-10% of patients on the registered list were contacting the practice every week; this was previously averaged at 6% of the list.

CCG representatives informed the Committee that there were a number of issues to address such as ensuring equitable access for patients while continuing increasing the use of on line consultation features, reducing health inequalities and the transition from the CCG to the Integrated Care System.  In addition to these changes, the implementation of the Collaborative Providers through which the primary care network would be part of a broader community within the neighbourhood offer.

Members sought and received clarification on a number of matters such as the ability for patients to contact their practice when the on line portal was not active and the mention on the NHS letter dated 23^rd Aug 2021 of financial incentives for practitioners. CCG representatives informed that, contractually, practices had to be open at certain times and the web-site would always inform patients to contact their G.P. via telephone when the on line portal was not available. With regards to financial incentives, CCG representatives were of the opinion that it was important to have a conversation about how the service was funded in order to better support practitioners and patients. 

Members asked about on line access for patients who suffered from a mental health issue. The CCG representatives reassured Members that safety was paramount and risk management was always the G.P. focus. When asked about accessibility for hearing impaired patients, CCG representatives informed of alternative consultation offer such as text messaging and live chat tools.

Members also sought and received clarification on the electronic record system to ensure that patients discharged from hospital had their up to date list of prescribed medications and information communicated to their G.P. 

Members enquired about the pressure in general practice linked to the shortage of G.P in the country. CCG representatives explained that the Government was trying to recruit new practitioners to fill the gap. However, different roles could be called into the system. In Trafford there was no shortage of G.P.s as recruitment had been successful.

The Committee asked about what was being done to increase the number of face to face consultations. CCG representatives informed that the national guidelines had not changed yet and although work was ongoing to increase access, G.P.s had to follow the guidance.

Members enquired on decision making about children and the difficulty of phone triage. CCG representatives considered that G.P.s had to manage risk and children were likely to be seen face to face.

The Committee asked about what was being done to avoid unnecessary prescribing of antibiotics. CCG representatives explained that this matter was part of Trafford quality improvement programme.

Members asked whether patients were requested to take a lateral flow test before seeing a G.P. CCG representatives informed that patients were asked to take a PCR test when they had symptoms.

Members asked how data was gathered about serious cases that might have been missed by the system. CCG representatives informed that Manchester University Foundation Trust was working on a study which would include the attempt to quantify late presentations of medical emergencies such as strokes.

The Committee enquired about communication and accessibility of information for residents in relation to the new system in order to reduce the level of anxiety that some residents might experience. CCG representatives explained that information campaign had been delivered but most people would look for information when a need arose.

The CCG representatives concluded their presentation informing the Committee that, in the near future, all primary care services would be provided by Manchester University Foundation Trust and clinicians would provide a standardise offer. 

The Chair of the Committee thanked the CCG representatives for their attendance and asked to pass the Committee’s gratitude towards all those members of staff in primary care who had worked through the pandemic and continued to work to support residents’ health.

RESOLVED that the content of the report be noted.