To note the award of a contract for the development of a GP-led walk-in health centre for Herefordshire and the provision of the out of hours service.

The Committee was informed of the award of a contract for the development of a GP-led walk-in health centre for Herefordshire and the provision of the out of hours service to Nestor Primecare.

The Chairman reported that, in response to comments made about the proposed development of the GP-led Health Centre at the Committee’s meeting in December  2008, she had met the Director of Integrated Commissioning and the Equitable Access to Primary Medical Care Programme Manager (EAPMCPM) to seek clarification and assurance on a number of points. 

The report summarised the history of previous reports to the Committee on the project and the clarification and assurances received in response to questions asked by the Chairman following the Committee’s meeting in December.

In the course of discussion the following principal points were made:

·         Mixed views were expressed about the advantages of the Centre, its cost and potential effect on existing services.  Further clarification was sought in particular on the implications for local GP surgeries within the County of the Centre’s ability to register patients.  The EAPMCPM emphasised in response that the Centre would only be able to register patients within the Hereford City boundary.  People living outside the City boundary would, however, be able to attend the Centre on a walk-in basis.  He added that registrations were restricted to 3,000 over the life of the five year contract representing some 5% of the City population.  The safeguards outlined in the report reflected the Primary Care Trust’s (PCT) aim to avoid destabilising the existing services but provide an additional service, a principal benefit of which would be to reduce pressure on the Accident and Emergency Unit.

·         In reply to a question about the views of Hereford City GPs it was replied that the Local Medical Committee (LMC) had invited Nestor Primecare to take part in LMC meetings.  The PCT had also been constrained to a degree in the discussions it could have with GPs during the tender process by the fact that a consortium involving some local GPs had submitted a bid for the contract.  Since the award of the contract the PCT was now able to discuss the plans more openly with the GPs and explain the safeguards in the contract, the absence of a financial incentive in the contract to increase registrations and the focus of the key performance indicators in the contract on reducing inappropriate A&E attendances through the provision of walk-in capacity.  This had addressed a lot of the GPs’ concerns.

·         Asked about recruitment of staff the EAPMCPM said that a local GP had been appointed by Nestor Primecare as the GP lead for the Centre.  Nestor Primecare’s wide contacts should assist in the recruitment drive.  Given the economic downturn Members suggested that Nestor Primecare should be encouraged to employ local people where possible.

·         The Director of Integrated Commissioning reported in response to a question that it was still hoped that it would be possible to accommodate the Centre on the Hereford Hospital site.  Discussions with the Hospitals Trust were continuing.

·         It was observed that the provision of a walk-in centre open from 8am until 8pm seven days a week contrasted favourably with provision in the Market Towns and rural areas.  It was noted that GPs had the option to provide extended opening hours and at the moment some 50% of GP practices in the County had opted to do so. The range of services offered by GP practices also varied.  It was proposed that there should be a scrutiny review of the services offered by GP practices within the County.

The Chairman concluded the discussion by observing that the Committee had been provided with firm assurances that there were safeguards within the contract to prevent the development being to the detriment of existing services.  The Committee would have the opportunity at its next meeting to ask Nestor Primecare about its business plan to improve service provision in the County.

RESOLVED:

That    (a)        the report be noted: and

            (b)       a scoping report for a scrutiny review of the services offered by GP practices within the County be prepared.