Agenda item

The Chairman welcomed Cheryl Rehal, Associate Director of Primary and Community Care, Bromley – SEL ICS (“Associate Director”) and Dr Andrew Parson, Co-Chair and GP Clinical Lead – One Bromley Local Care Partnership (“GP Clinical Lead”) to the meeting to provide an update on GP access.

The GP Clinical Lead noted that the presentation provided had focussed on changes relating to digital access. Nationally, the NHS app was a key enabler for patients to access primary care and other services. There was a national target for getting patients registered on the NHS app – this could help free up space and time for those still using the traditional transaction routes. In Bromley a lot of work had been undertaken to support practices and develop communications, and a steady rise in the uptake was being seen.

The Associate Director advised that, in terms of utilisation, the uptake in Bromley was higher than the averages for London and England – however there was some variability by geography. This had allowed them to identify the best way to support practices improve uptake, helping them to recognise the different set of needs/preferred access routes into general practice. They had looked into what people were using the app for, and were working with practices to encourage them to use the app for transactional elements. It was estimated that each repeat prescription requested via the app created a saving of three minutes to a practice – over 100,000 repeat prescription requests had been made in Bromley during the financial year, which equated to around 5,000 hours of time that could be diverted into other areas, such as maintaining capacity for those patients that did not use digital access. The Associate Director said they also had data regarding increases in the number of logins, views of medical records and messages to the practice – these were examples of how the app could be made part of how general practice provided services to patients. It was noted that the Chairman had asked that data relating to the use of NHS app be broken down by age – this data was currently limited, and had been requested from NHS Digital. With regards to online consultations, 150,000 requests had been submitted during the financial year – around 16% were received from patients aged 65+. The Chairman said that having the data broken down by age would allow them to benchmark where people needed more support, and noted that it would be beneficial to have this data in the future.

The Associate Director informed Members that they were trying to promote the app via different routes, and practices were playing a big part. They were also pleased to see the great efforts being made by PPGs – some had held events to help patients download the app and show them how it worked. It had been announced earlier that day that new prescriptions could be sent straight to app – it was hoped that these national messages would help encourage people to download and use the app. Members views would be welcomed in terms of how the use of the app could be further promoted. It was agreed that social media links would be provided to Members following the meeting for onward circulation.

In response to a question regarding digital inclusion, the Associate Director said that an example of the work undertaken in Penge had been provided. Organisations had been running digital workshops, which included a session on how to use the NHS app. They were working with practices where lower uptake was being seen, and considering these types of models. They were also working on the broader strategy to address digital inclusion and ensure that health outcomes were not disadvantaged.

The GP Clinical Lead highlighted that the app sat alongside a number of broader changes, which included the expansion of community pharmacy services. In response to questions, the GP Clinical Lead confirmed that the new commissioned service for pharmacies would be launched, and would include them seeing patients with minor ailments. They had been working with pharmacy colleagues across Bromley and a high expression of uptake had been indicated by most pharmacies. However this would depend on real capacity, and the services would need time to bed in. The Associate Director said that the expressions of interest were high, and indicated nearly full coverage. It was noted that not all seven clinical conditions would be covered at the launch – however there was a joint group of GP Clinical Leads and Community Pharmacy Leads who were planning the roll out. It was agreed that confirmation of the number of pharmacies in the borough, and information regarding any changes in recent years, could be provided following the meeting. The Portfolio Holder for Adult Care and Health noted that a statutory responsibility of the Health and Wellbeing Board was the publication of a Pharmaceutical Needs Assessment. The current PNA would expire in September 2025, and work would be undertaken to look at the pharmaceutical needs across the borough going forwards.

In response to questions, the GP Clinical Lead said that the app was part of the expansion and sat alongside other changes. Experience varied between practices but the approach to all problems would be treated in a similar way – the demand would be looked at against capacity and there would be a degree of prioritisation. It was noted that during the winter, extra GP capacity had been provided through winter illness hubs, which had been well utilised. It was important that modernisation work continued in practices, and took into account the local position. Areas of higher deprivation had a lower uptake of the NHS app – it was important that local practices understood this and provided fair access. The GP Clinical Lead said that some patients did use multiple routes at the same time to contact their practice. The process was that practices filtered all requests so there was no duplication – this would be a large part of the modernisation work that practices would undertake in the coming year.

With regards to retention of experience GPs, the Associate Director said they were working closely with the training hub. There was a dedicated work stream on retaining experienced GPs, led by experienced GPs themselves, and a portfolio of options were available. When GPs wanted to reduce their hours they were asked to take on other roles in borough in order to retain their expertise. The ICB had invested in more GPs being trained as ‘GP trainers’ in the borough, and experienced GPs were also acting as supervisors for the new roles coming in to general practice.

In response to a question from the Chairman, the GP Clinical Lead said that the implementation of the Epic system had had a big impact on general practice, particularly in the provision of pathology reporting services. There had been issues in recent months in terms of the timely provision of reports, and mechanisms were being put in place to address this. There was high awareness amongst GPs, who were collating and sharing information and work with the teams responsible, and there was further work to be done. It was noted that patients were attending consultations having accessed the MyChart system which allowed them to have discussions regarding the correspondence received.

The Chairman thanked the Associate Director and GP Clinical Lead for their update to the Sub-Committee.

RESOLVED that the update be noted.