Agenda item

To receive a presentation from Betsi Cadwaladr University Health Board.

 

                                                                                                            9.35 a.m.

 

Betsi Cadwaladr University Health Board (BCUHB) representative gave a presentation outlining the background to the proposed changes in the provision of primary healthcare in Prestatyn.  The main areas detailed in the PowerPoint presentation included:-

 

Ø    Background, including an overview of traditional primary care

Ø    detail of current GP providers

Ø    An overview of the Contemporary Primary Care model:

·           Unscheduled Primary Care Centre

·           Planned Care

·           Home Care Home Support

·           The academy

Ø    Progress to date

      

The BCUHB representatives advised that:-

 

·                     The fact that two General Practitioner (GP) surgeries in the Prestatyn area had given notice of their intention to terminate their contract with the Health Board from the 31^st March, 2016 had necessitated the Board to consider the most appropriate solution for the delivery of primary health services to a population of circa 21,000 patients;

·                     Whilst the GPs at both surgeries were resigning their General Medical Services (GMS) contract, which was the traditional type of contract by which most GP services were delivered across North Wales, the majority of GPs at the surgeries concerned were still interested in delivering GP services if their roles were more manageable;

·                     Recent national research and studies had stated that the delivery of primary care needed to change to include a range of healthcare professional i.e. nurses, physiotherapists, pharmacists, audiologists, voluntary sector etc.

·                     Due to the number of patients in the Prestatyn area the Health Board was of the view that the optimum solution for the delivery of services to the area’s population would be the development of a Contemporary Primary Care Facility, which would include:-

 

Ø    An unscheduled primary care centre (where patients could have same day appointment with the relevant health practitioner)

Ø    A Planned Care Centre (where patients could have regular care for chronic conditions provided by the same practitioner)

Ø    A Home and Care Home Support (dedicated specialist healthcare provision for vulnerable/frail patients either in their own homes or in residential/nursing homes); and

Ø    An Academy (where existing professionals could continue to develop and share skills, where patients could be taught to manage their own health and well-being or their own conditions, and where regular patient feedback could be sought and analysed in order to improve services)

 

·                     With a view to moving the project forward and have the basic requirements in place for the proposed new service to become operational on the 1^st April, 2016 a project board and team had been established.  The team was based at the Royal Alexandra Hospital site at Rhyl and was currently dealing with the TUPE of existing staff to the new service, recruitment of new staff and communicating about the changes to residents and stakeholders; and

·                     They had also within the past few days registered an interest in securing the former council office building and site at Tŷ Nant, Prestatyn as a base for the new Contemporary Primary Care facility.

 

Some Members commented that, whilst they had been somewhat skeptical about the contemporary health care model initially, now that they had more detail about how it would work it was finding more favour with them.  They enquired whether there was a concise summary available to residents on what was proposed, as this would reassure them on the developments.

 

Responding to Members’ questions BCUHB officials advised that:-

 

·                     With a view to having effective communication channels with all stakeholders the Health Board had engaged external communication support, in addition they were also looking at establishing an interactive website for this purpose;

·                     The Council’s own communications team was also assisting BCUHB with the information sharing  on this project;

·                     The volume of calls to the dedicated public helpline on changes to primary healthcare in Prestatyn had decreased lately, but was expected to rise again nearer to the change date in April, 2016;

·                     Despite initial concerns, having received assurances from the Health Board that there would be primary care available to residents, present patients at both GP practices had not transferred their registration to other GP surgeries;

·                     They agreed with Elected Members that GPs’ workload needed to be reviewed, however the lead on this would need to come from the Welsh Government (WG);

·                     There were 4 GP clusters which operated within Conwy and Denbighshire.  These ‘clusters’ could raise any concerns they had with the Health Board, and if the Board did not have the powers to resolve those issues it could raise them with the WG.  As BCUHB was in ‘special measures’ it did have the ‘ear’ of the WG on matters of significant concern;

·                     The proposed contemporary health care model proposed for Prestatyn would not be suitable or viable for all areas across the region, the population size in the Prestatyn area meant that the proposed model should work well.  This type of model was likely to appeal to newly qualified GPs who, having trained for a number of years, would have educational fees to pay therefore they were unlikely to want to buy into a private practice.  However, this model was unlikely to be viable for smaller, or single GP practices, therefore in future there was likely to be a mix of GMS and contemporary health care model practices across North Wales;

·                     If the Tŷ Nant site could be acquired it would give BCUHB the opportunity to bring the entire contemporary health care model into being in its entirety, albeit on a phased basis, with the unscheduled primary care phase being given priority.  It would replace the current Pendyffryn Medical Group and Seabank Surgeries and the Clinic, however the two branch surgeries at Meliden and Ffynnongroyw would remain open;

·                     If the Health Board could not secure the Tŷ Nant site the proposed model would proceed but would not be fully operational for some length of time as the Board would need to secure an alternative site, or apply for planning permission to extend the current Pendyffryn Medical Group site and clinic;

·                     Health Board officials were due to meet officers from the Council the following week to discuss their interest in the Tŷ Nant site, and they confirmed that they were looking at securing the building and the car park for the project;

·                     Apart from being unable to secure a suitable location for the contemporary health care centre other risks to the project coming into fruition included the recruitment of a full team (recruitment of the core team was not a problem).  There was also a need to work with patients to reassure them that the new model of primary care would actually meet their specific needs better that the current model;

·                     staffing calculations and the proposed centre’s capacity to deal with the influx of the tourist population during the summer months had already been factored into the model being put forward.  Similarly local development plan (LDP) proposals would also be included as part of the forward planning for the centre;

·                     they had recently received notice that a GP practice in Rhuddlan would be terminating its contract with the Health Board from 31 March 2016.  This affected circa 2,000 patients and negotiations were currently underway to seek the most appropriate solution for the provision of primary healthcare to those patients.  More information would be available at the beginning of 2016 on how the Board proposed to secure services for these patients;

·                     as the contemporary primary care model became embedded other services, such as counsellors and debt management services, or any other service or organisation that support the health and well-being agenda, could be located at the same site; and

·                     undertook to continue the dialogue with the Prestatyn Member Area Groups (MAG) on this issue and to liaise with all MAGs on a regular basis with respect to developments in their area, as they found MAGs to be valuable forums to discuss and disseminate information.

 

At the conclusion of the discussion Members welcomed the proposals being put forward for Primary Healthcare in Prestatyn, with a view to breaking down barriers between different healthcare practitioners for the benefit of the individual patient.  They were also pleased that the communication with all stakeholders was improving, but had concerns that specific WG rules seemed to place constraints on certain healthcare practitioners who were willing to work on either side of the English/Welsh border and they felt that this should be raised with the WG.  They also fully supported the Health Board’s bid to secure the former Tŷ Nant building and car park for the purpose of developing and operating a contemporary primary health care facility for the Prestatyn area, and they asked that their views were drawn to the attention of relevant officers associated with those discussions.  It was:-

 

RESOLVED – that the Communities Scrutiny Committee agrees that:-

 

(a) subject to the above observations, to receive and support the Health Board’s proposals for the future provision of primary healthcare services in the Prestatyn area from April 2016; and

(b) the relevant Lead Members and Officers of Denbighshire County Council be made aware of the Committee’s views ahead of their meeting with Betsi Cadwaladr University Health Board officials to discuss their expression of interest in the former Tŷ Nant office and car park site.