Agenda item

12:00

The paper (JHO10) aims to provide the Oxfordshire Joint Health and Overview Scrutiny Committee with an update on:

1.    General Practice workloads and appointment data

2.    The delivery of services through the pandemic and vaccination programme

The Committee considered a paper on General Practitioner workloads and delivery of services through the pandemic and vaccination programme.

Jo Cogswell, Director of Transformation, Oxfordshire Clinical Commissioning Group (OCCG), introduced the item.  In response to questions submitted in advance, she clarified that the appointments information in her report related to appointments offered in general practice, not just appointments offered by doctors of general practice, and that appointments for vaccinations were not included.

Dr Rahman Nijjar, Chair of the Local Medical Committee (LMC), emphasised that GP practices were open and trying to manage demand.  Their role in the biggest vaccination programme ever had taken them away from routine GP practice.  Everyone wanted to have face-to-face appointments where one could build relationships but for now access depended on clinical demand.

Dr Nijjar stated that recent government guidance had been quite hurtful and damaging.  He emphasised that GPs were putting patients’ health above their own.

The Chair asked about the situation with regard to health problems for which one would expect a physical examination and how that was being handled in the triage system.

Councillor Charlie Hicks asked if there was any data on staff and patient satisfaction with the digital platforms and if there were plans to roll them out further.

Dr Alan Cohen asked what had been put in place to support the welfare of GPs and staff coping with enormous workloads and if there were implications in relation to long-term planning.

Barbara Shaw noted that experience of the ease in getting face-to-face appointments and the ease of use of GP websites appeared to vary greatly from practice to practice.  She asked if that had been seen to be the case in their feedback.

District Councillor Andy Foulsham noted the number of programmes that required additional work by GPs and asked if the capacity was there to meet these.

Dr Rahman Nijjar responded that the triage service collected a lot of information before making a judgment on whether a face-to-face appointment was required.  Triage also gave advice on what to do should the patient’s condition deteriorate.

Feedback on services varied across the county – the majority were pleased but a minority had access problems and their feedback was regularly reviewed to improve the systems.

Jo Cogswell recalled that the Committee received a report on feedback from the public in September 2020.  She offered to provide an update when the data was refreshed.

Dr Sam Hart, North Network Clinical Director at OCCG and a practicing GP in Islip, noted that we had seen the same changes in health services as in all other walks of life during the pandemic – a shift from face-to-face to virtual.  This had shown that there were potential efficiencies in the new systems.  Generally, ninety percent plus of the information required to make a diagnosis was in the patient’s history.  There would be a low threshold for judging if there was a clinical need for a face-to-face appointment.

GPs had done their best to look after staff with additional leave and acknowledged the important support from volunteers.

Councillor Arash Fatemian asked if there was more that Public Health could do in communicating the best pathways for the public to use to ease the pressure on GPs.

Dr James McNally, GP in South East Oxford and Medical Director of the LMC, recalled that there had been public messaging even before the pandemic encouraging people to self-treat, check trusted websites and consider their local pharmacy before contacting their GP.  He was aware that messaging was being prepared to encourage more use of the 111 service.

The Chairman thanked the GPs for their participation and added that the Committee would support efforts to ensure that the right people get to the right places for treatment.

Action: Jo Cogswell to provide an update on feedback from the public when the data was refreshed.