Agenda item

10.20am

To receive a report from Julie Dandridge and Dan Leveson, on behalf of the Integrated Care Board, on Primary Care and Population Growth within Oxfordshire.

This report should also be read in conjunction with the report by the Health Scrutiny Officer on the findings from the recent HOSC Primary Care  Workshop. 

To Committee is expected to consider various recommendations in respect of this item.

The Chair welcomed Julie Dandridge and Dan Leveson to the meeting who presented a report which summarised the key challenges and opportunities in respect of the provision of Primary Care in Oxfordshire. An additional report from the Health Scrutiny Officer summarised some of the key findings from the HOSC Primary Care Workshop session which highlighted the strains on demand and capacity in Primary Care as well as the opportunities for the ICB and local Councils to work closer together in regard to Primary Care Estate.

Members raised a number of issues in respect of the following:

·         Capacity of the estates and funding being in place. In response it was acknowledged that this could always be improved but the necessary expertise and skills were in place.

·         Data for wait times to see a GP. It was clarified that the wait time and number of patients at practices varied widely. In particular, it was noted that practices that dealt with students had seen a significant drop in numbers. Overall Oxfordshire practices saw 85.2% of patients within two weeks compared to a national average of 82%. It was further advised that many practices did have allocated ‘on the day’ appointments. GP patient lists were regularly reviewed to help identify issues.

·         Levels of workforce in primary care settings and the recruitment and retention of staff. In response, it was explained that £10m had been allocated to Oxfordshire in this regard but training of staff took a long time so the benefits could be some time away. It was emphasised that increased use of technology and self-management could also help.

·         In respect of GP retention it was noted that a number of schemes were in place and were proving effective in the county.

·         The importance of the One Public Estate initiative was highlighted as an example of public organisations working together to deliver health services. Local hubs where a variety of services were available was given as an example. It was anticipated that such schemes would take time to establish but could help reduce demand on primary care services. The monitoring would be undertaken through the Joint Strategic Needs Assessment and Health and Wellbeing Strategy.

The challenges relating to an ever-growing population in Oxfordshire and its effect on Primary Care Provision was detailed in the ICB’s report and drawn out during the committee meeting. It was acknowledged that, whilst the Oxfordshire Primary Care Estates Strategy highlighted the areas where additional general practice capacity would be needed because of housing growth, there were specific areas of exceptional population growth outside of Oxford City, such as in Didcot, where it was advised that the expected population growth was approximately 30% over the next 10 years. As a result, it was felt by members of the Committee that whilst the existing Estates Strategy provided good, strategic direction as to the provision of primary care estate in Oxfordshire, the strategy needed adjusting to reflect some of the stark population growth in some areas of the county.

From the Workshop session, the particular case study of Woodlands Medical Practice, where there were unsustainable levels of growth in patient numbers, had been drawn out. The Committee were subsequently advised that a portacabin would be placed on the site of the Woodlands Medical Practice to allow for more clinical space. It was also advised that the ICB were working with the District Council to secure a longer-term solution to the issues in Didcot using section 106 monies and developer contributions. Furthermore, the Committee felt that the example of Didcot and population growth figures indicated the urgency of need to provide primary care estate in the county and were concerned as to large volumes of unspent developer contributions; and a proposed recommendation was tabled to create a priority list where housing developments were already planned.

The Committee noted two projects at Long Hanborough and Didcot, which had been delivered via utilisation of Section 106 and Community Infrastructure Levy (CIL) monies, and a number of other schemes were being developed. However, the complex, intricate and technical nature of providing NHS Primary Care Estate via developer contributions was recognised by the Committee and it was acknowledged that significant, further staffing resource was required within the ICB to facilitate and project manage this. It was envisaged by the Committee that any additional role in the ICB would also aim to establish an ongoing dialogue with District Council Development Management teams and Planning Committee Chairs regarding future planned development, alterations to the development plan and available Section 106 and CIL monies for health.

Emanating from the discussions and consideration of the ICB’s report, it was also clear to Committee members that in order for the building of new Primary Care Estate to succeed there needed to be a shift in policy to make healthcare infrastructure a pre-requisite for development, as well as a greater and more flexible devolved capital funding to ICBs across the country. It was agreed by the Committee that these concerns would be captured in a letter, which would be formulated in consultation with the ICB, to the Secretary of State for Health and Social Care. It was agreed that the stark workforce issues exemplified at the Primary Care Workshop and included in the subsequent report would also be included in the letter.

The Chair summarised the discussion and made a number of recommendations which, on being put to the vote, were approved.

RESOLVED

1.            Specified roles are filled within the ICB with the primary responsibility to work with District Councils at Place Level to coordinate use of CIL funds held by the ICB and from executed Section 106 funds for Primary Care.

2.            The Oxfordshire Primary Care Estates Strategy be endorsed by the Committee following amendments, to reflect the significant population growth and change in the more rural areas of the County.

3.            A priority list for funding of new primary care facilities in Oxfordshire is created with a view to seeking contributions for health where housing developments are already planned and delivered.

4.            A letter is formulated, in consultation with the Integrated Care Board; and sent on behalf of the Committee to the Secretary of State for Health and Social Care to detail the Committee’s concerns in respect of General Practice capacity, workforce and retention issues, need for healthcare infrastructure as a prerequisite to major developments, and to highlight the need for devolved capital funding and flexibility in the interests of meeting the needs of primary care in Oxfordshire.

5.            The Cabinet is recommended to explore ways for which the Council can support the ICB, from a communications angle, to better inform the public narrative in primary care.

6.            The use of additional roles within Oxfordshire is explored by the Committee moving forward.