The Scrutiny Support Officer submitted an introductory report in relation to the South Tees Urgent Care Review.
On 18 November 2014, the Health Scrutiny Panel received information in relation to the Alternative Provider Medical Service (APMS) contract review at the Resolution Health Centre. The Panel was informed of the co-terminus nature of the contract which also involved the walk-in centre based in North Ormesby. Whilst the Resolution Centre contract was extended until March 2016, the Panel was advised that the walk-in element (the part of the contract held by the CCG) was also subject to a decision by the CCG at its Board meeting in November.
The Panel subsequently wrote to the CCG outlining its support for the walk-in centre and its wish to see the provision remain in its current form, due to the recognition that it was a valuable resource for the town.
Members were also informed about an Urgent Care Review that was being undertaken by the South Tees CCG and it was agreed that the Panel wished to receive further information. Accordingly, appropriate representatives had been invited to the meeting.
Doctor M Milner, Urgent Care Lead, South Tees CCG had been invited to attend the meeting to provide information in relation to the Urgent Care Review, however, he submitted his apologies as he had been unavoidably detained. The Panel agreed that he should be invited to a future meeting. C Blair, Associate Director of Commissioning Delivery and Operations, South Tees CCG and R McKenna, Commissioning Manager, North of England Commissioning Support Unit, were in attendance at the meeting to provide information. A report prepared by the South Tees CCG in relation to the review at the Resolution Practice, had been circulated to Members prior to the meeting.
The report provided detailed information in relation to the Resolution Practice, including background information, current service provision, contracted activity, unregistered attendances, patient demographics and analysis of attendances.
It was highlighted that the APMS Review demonstrated that attendances at the practice were well above those that had been contracted, clearly demonstrating existing patient demand. The success of the walk-in centre appeared to have created new patient demand and there was no evidence that there had been a decrease in the demand for accident and emergency.
In relation to the future of the walk-in service at Resolution, three options were identified and outlined at 6.1 of the circulated report. As a result, the South Tees CCG Governing Body approved the extension to the unregistered element of the APMS contract until March 2016.
A discussion ensued and the following issues were raised:-
Reference was made to the fact that the number of patients attending A&E had not decreased, despite an increase in the use of the walk-in element of the Resolution Practice and it was queried whether staff at the Resolution would ever refer patients to A&E if the practice was busy. The Panel was advised that patients would only be referred to A&E if their condition was life-threatening. At busy times, additional capacity should be called on in order to meet current KPIs of patients being seen within 30 minutes.
In response to a query, it was confirmed that those patients referred to James Cook A&E from the Resolution walk-in were not monitored so it would be difficult to know whether patients presenting at A&E had initially attended Resolution.
Reference was made to ensuring that patients attended the appropriate place and it was highlighted that around 35,000 patients per annum, attending A&E could have been self-managed. It was felt that consideration was required in relation to promoting clearer signposting to appropriate services.
The issue of GP services was touched upon, including the variation in patient appointment booking systems between practices and whether this impacted upon the numbers of patients using the Resolution walk-in service and A&E. The Panel considered it would be worthwhile looking at direct access to each of the 26 GPs surgeries across Middlesbrough and how appointments were offered.
It was highlighted that the Resolution walk-in was in addition to the three GP practices within North Ormesby Health Village. Despite being located in separate buildings, it had been noted that some patients, if dissatisfied with GP appointment times offered to them, attended the walk-in as an alternative.
Councillor N Walker, Ward Councillor for Hemlington, was in attendance at the meeting and referred to the issue of Hemlington Medical Centre which had also been subject to the APMS contract review. Councillor Walker updated the Panel in respect of the latest position and advised that the current providers contract had been extended for a three-month period whilst a branch surgery provider was sought.
The Chair thanked the representatives for their attendance and the information provided.
AGREED as follows:-
That the contents of the circulated report be noted.
That the Panels position in relation to the Resolution Walk-in Centre remained unchanged, in so far as the Panel wished to see the Walk-in Centre maintained in its current form as it was a valuable resource for the town.
That the Scrutiny Support Officer liaise with NHS England to obtain information in relation to the appointment booking systems for the 26 GP practices in Middlesbrough and to report back to the Panel.
That Doctor Milner be invited to attend a future Panel meeting in relation to the Urgent Care Review.
That the Panels previous views in relation to maintaining a GP practice at Hemlington be reiterated.