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Response to Healthwatch Report – Invisible at the desk

NHS Airedale, Wharfedale and Craven Clinical Commissioning Group (AWC CCG) is the NHS organisation comprised of local GPs who plan and buy (commission) health services for the population of Airedale, Wharfedale and Craven.

The services that the CCG is responsible for buying are those typically provided by hospital trusts, including community and mental health services, emergency and urgent care, and some voluntary and third sector services.

NHS England is the NHS organisation that is responsible for commissioning primary care services (GP services, dentists, pharmacists, eye care), as well as specialist health services and health services for offenders and members of the armed forces.

This paper is a response from AWC CCG to the recommendations in the Healthwatch report Invisible at the desk: Experiences and views of people using Primary Care services in Bradford and District. In writing this response, the CCG has considered the national GP Patient Survey (2013) responses and their comparison to the national responses for the local area of the CCG.

AWC CCG wants to hear what the public thinks about their local NHS and welcomes this report from Healthwatch. We are pleased to note the positive experiences of primary care services and look forward to working with Healthwatch in making improvements to the quality of primary care.

General Comments

AWC CCG is responsible for commissioning health services for Airedale, Wharfedale and Craven, which covers Keighley, Ilkley, Burley-in-Wharfedale and their surrounding areas. Craven area was also covered by this report, but not all the practices in the Craven area were included. Bradford Districts CCG serves a population that includes areas such as Bingley, Shipley, Saltaire, Heaton and Tong. Bradford City CCG serves the population of the city area of Bradford.

As this report looks at the Bradford local authority area, it covers primary care services that come under all three CCGs. AWC CCG would like to explore further with Healthwatch the feedback that relates specifically to the Airedale, Wharfedale and Craven services. We would also be keen to gain more insight from certain groups where we feel there is a gap in our understanding, such as children and young people.

Some of the recommendations in this report will also be of interest to the City of Bradford Metropolitan District Council, who has responsibility for providing social care services that help people to live independently. For example, day to day tasks, such as helping people in their own home with bathing and dressing would generally be undertaken by a social care worker rather than a district nurse.

Recommendations – specific feedback

Broad Recommendations:

1/ We are currently looking at ways of sharing good practice across our CCG area and have established a quality forum to support this work. It is particularly focused on the sharing of clinical incidents and feedback around patient safety. However, this forum could be used for the sharing of good practice. The CCG also supports practices to meet together in their local areas every two months for joint learning sessions and sharing good practice.

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2/ We hope to work with Healthwatch to gather more insight from these particular groups of patients to inform our work in supporting primary care quality improvement.

3/ NHS England, as the commissioner of primary care, would be the best placed organisation to respond to this recommendation.

Access and Appointments

4/ The GP Patient Survey suggests that access and experience of making appointments is generally good in Airedale, Wharfedale and Craven with 76% of people reporting a positive experience. However we will ask the GP patient participation groups to undertake further work in this area.

5/ Urgent care is a priority for the CCG and there is an established urgent care working group across the three CCGs looking at the issues raised.

6/ Each GP practice in Airedale, Wharfedale and Craven has a Patient Participation Group (PPG). PPGS are made up of a group of volunteer patients and staff from the GP practice and meet to discuss the services on offer, and how improvements can be made for the benefit of patients and the practice. The chair of the Patient Participation Group (PPG) Network for Airedale, Wharfedale and Craven attends the CCG’s Patient and Public Engagement Reference Group (PPERG), which reviews and provides advice on engagement. The CCG has asked the PPG Network to discuss the Healthwatch Report at each PPG meeting and feedback to their practice manager any issues with appointment booking arrangements at their practice. In the national GP Patient Survey, the response rate for ease of contacting the surgery was on par with the national average, and above the national average for how helpful receptionists at the surgery are.

7/ Decisions on the best allocation or triage system are made at a practice level and assessing the effectiveness of these arrangements would be most effective at individual practice level to ensure that local needs and preferences are taken into account.

8/ The CCG has asked the PPG Network to discuss the Healthwatch Report at each PPG meeting and

feedback to their practice manager any issues with privacy at their practice.

9/ NHS England commission dental services and would be best placed to respond to this recommendation.

Person Centred Primary care

10, 11 and 12/ GP practices decide what training their staff should undertake. The CCG has established local commissioning forums where GPs meet within their local area to receive updates on pathways and service changes, share best practice and provide the CCG with clinical feedback on current services. In addition, the practice has their own protected learning time which will encompass an update to clinical skills. Many GP practices already provide training for their administrative and reception staff on customer service, confidentiality and other areas. All GP practices and NHS England have a complaints procedure if a member of the public is unhappy with their care and wishes to complain. AWC CCG has a process for people to provide feedback, a Patient Advice and Liaison Service and a complaints procedure, these are all available on the website.

13/ The three CCGs, the local authorities and providers of health care are working together to develop person centred coordinated care which will involve patients as partners in their care. We

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are currently inviting patient representatives to participate in local groups so we can understand better how to progress this work, and self-care is a priority area for the CCG.

Continuity of Care

14/ The CCG has asked the PPG Network to discuss the Healthwatch Report at each PPG meeting

and feedback to their practice manager any comments on people with long term conditions seeing

the same GP each time at their practice. There will be an enhanced service (enhanced services are in

addition to the core GP services) for practices from 1 April 2014, where patients over the age of 75

with complex care needs will be required to have a named GP, which should help with this.

15/ There is a national requirement in place for all people with a registered learning disability to receive a health check. NHS England would be best placed to advise on whether there are plans to resource GPs to undertake an annual health check for carers.