Agenda item

The Board considered an update from Jessica Arnold, Associate Director: Primary Care, Bromley Clinical Commissioning Group on primary care performance and strategy which included the relative performance and achievement of Bromley’s 45 General Practitioner practices against key locally and nationally commissioned services and measures.  The report also provided an update on progress towards developing a Bromley General Practice Strategy and Action Plan for 2019/20-2020/21.

The Bromley Care Performance Dashboard had been developed to enable robust performance monitoring of the key services and targets commissioned by Bromley Clinical Commissioning Group and NHS England, as well as help General Practitioner (GP) practices, commissioners and other stakeholders to have a better understanding of GP practice performance across the Borough.  Key highlights from the dashboard included the identification of a drop of 3-4% in childhood immunisation rates for most immunisations as well as the low rates of flu immunisation of under 65 years ‘at risk’ groups, although Bromley continued to be the highest performer for flu vaccinations within the South East London region.  The dashboard also identified variable levels of GP practice referrals into the proactive care pathway for integrated case management of the most vulnerable patients for which a review would be undertaken in early 2019.  The Bromley General Practice Strategy and Action Plan for 2019/20-2020/21 had been developed to clarify the strategic direction and local priorities for Bromley GP practices and would also outline commissioning intentions for GP practices, as well as funding allocations and bid writing with the aim of supporting the transformation of GP practices within a challenging primary care context.  Alongside the strategy, an action plan would be implemented for delivery of primary care improvement, resilience and transformation into Primary Care Networks within an Integrated Care System.  The Bromley Care Performance Dashboard and General Practice Strategy were in the final stages of development and were expected to be adopted and implemented by Bromley Clinical Commissioning Group in April 2019. 

The Chairman welcomed the update and placed it into context alongside recent announcements in the media about the new five-year contract for General Practice across England that would see significant investment made in improving access and offering expanded services, as well as increasing the role of other community services including those offered by pharmacists.  The Associate Director: Primary Care, Bromley Clinical Commissioning Group noted that work was underway to develop clinical and non-clinical roles within General Practice and that this would include the use of physicians’ associates who would support doctors in patient diagnosis and management.  There would be an increased emphasis on signposting patients to the right care to meet their needs, and a Member underlined the need to better promote self-referral services such as the physiotherapy service.  Early intervention services including social prescribing would also help to reduce pressure on GP services.  The Associate Director: Primary Care, Bromley Clinical Commissioning reported that the GP online consultations pilot had been introduced at nine GP practices and that patient feedback had been positive.  There was an increasing uptake of the online service to book appointments, request repeat prescriptions and view test results. 

A Member queried the action taken when a GP practice was rated as ‘Inadequate’ by the Care Quality Commission.  The Associate Director: Primary Care, Bromley Clinical Commissioning advised that GP practices were supported to address any issues identified during an inspection by the Care Quality Commission and that the improvement process was overseen by NHS England.  Where sufficient improvement was not made, it was possible for a GP practice to have its registration cancelled; however a range of measures were in place to maintain a consistently high standard of GP services across the Borough.

In response to a query from a Member regarding Cross Hall Surgery, St Mary Cray, the Associate Director: Primary Care, Bromley Clinical Commissioning Group confirmed that the GP practice had experienced a number of issues with its contract and premises and that work was underway to identify how GP services could be provided most effectively to patients within the St Mary Cray area.  A Board Member noted that GP practices were increasingly moving to more collaborative working, including offering shared services across groups of practices.  A Member queried why there was no screening programme for prostate cancer within the Borough, and a Board Member confirmed that there was no national screening programme for prostate cancer and that focus was on promoting awareness and supporting early diagnosis.

RESOLVED that the update be noted.