Nine point plan to improve under pressure GP services in Milton Keynes

The committee met last week to discuss the findings of a special ‘task and finish group’, which was set up initially to investigate the disappointing results in the 2014 GP Patient Satisfaction Survey, which saw Milton Keynes come close to the bottom in the country.

The Provision of GP Services in Milton Keynes was carefully reviewed by the Task and Finish Group, who produced the report, following two years’ worth of investigations and work.

The key issues identified were a decline in the number of GPs, an increase in workload, and the knock-on effect of more people turning to Accident & Emergency services, which in turn generated its own problems. These are similar to the difficulties faced nationally.

Although the committee heard that the most recent survey showed a very slight improvement, the committee welcomed the report and agreed the following measures:

Writing a letter to NHS England asking them to respond to the report, reflecting the council’s commitment to see improvements to local GP access, and inviting the NHS to appear before full Council.

Meeting with the Clinical Commissioning Group within six months and on a regular basis so that councillors can raise any ward issues/concerns directly.

Reviewing progress on the implementation of recommendations by the CCG/NHS within six months.

A request for the latest GP satisfaction survey (broken down by GP Practice) to be provided to councillors.

Committee Chair, Cllr Alice Jenkins, said: “I believe this report has pinpointed the problems being faced by residents when trying to access health centres and surgeries in Milton Keynes.

“It is one of the most complained about issues by residents in Milton Keynes and we rightly take the problems the city is facing very seriously. We want to see considerable improvements to GP access and are going to continue pressing both the CCG and NHS England for improvements to the service, using the report as the basis on which they should be moving forward.

“Milton Keynes is an attractive, vibrant place to work and we need to be doing what we can to attract and retain GPs to the city – pointing out to them why they should locate here.

“We are incredibly grateful for the work that members of the Task and Finish Group have put into the report and it is now down to the council to ensure NHS England and the CCG respond proactively.”

The committee also agreed to look at access of healthcare by homeless people, especially those with complex needs.

The full recommendations of the Task and Finishing Group report are as follows:

1. That better communications and education from healthcare providers is needed so that clear messages about alternative sources of healthcare were given. A lot of routine treatment, such as blood pressure checks, diabetes monitoring etc, does not have to be performed by GPs – other healthcare practitioners can and do provide these services. The Group felt that there was a need for much greater patient education about when it was appropriate to see someone other than a GP for routine healthcare or advice.

2. That better training be provided for reception staff so that they can advise patients about extended hours appointments provided by the Prime Minister’s Challenge Fund, Walk-in Centres etc but without patients feeling they are being “fobbed off”. Many of the complaints about trying to make appointments centred on the poor service given by reception / administrative staff in GP surgeries and their unwillingness or inability to try and find solutions.

3. That GP practices consider the introduction of more GP triage and telephone consultations. According to Healthwatch, trials of GP triage and/or telephone consultations have proved successful in maximising GP availability and are popular with patients. They are reassured by a GP-led triage, as many are reluctant to discuss problems / symptoms with untrained reception staff and a telephone consultation, particularly for items of a routine nature, can save both the GP and patient time.

4. That the Milton Keynes Clinical Commissioning Group launches a concerted campaign to attract more GPs to work in Milton Keynes. Milton Keynes is more than just the music hall joke of the concrete cows; it is good place to live and work as can be attested by the recent, rapid population growth in the area. Thousands of people are recognising the benefits of living in Milton Keynes and are opting to move here each year. They have spotted the area’s potential and GPs looking for a change or new challenge need to be encouraged to consider coming to Milton Keynes.

5. That the Clinical Commissioning Group and the NHS England Area Team need to adapt their forward planning models to be more responsive to the data on future population growth / number of new houses to be built in any particular area provided by the Council. 14 Analysing the responses to the questionnaire sent to the NHS England Area Team in December, the Group felt that these lacked clarity and detail and did not provide the re-assurance about adequate future planning strategies the Group was seeking on behalf of the Council and residents of Milton Keynes.

6. That the Council be requested to consider inviting NHS England to attend a full Council to provide the Council with an up-date on the healthcare provision in Milton Keynes and respond to the issues identified in the report. The Council is particularly keen for the NHS England Area Team to expand on its answers to questions 1, 3, 4 and 5 in an open forum so that it, and the residents of Milton Keynes, can be reassured that all possible measures are being taken to adequately plan for future healthcare provision in Milton Keynes.

7. That the extended hours and enhanced services currently provided by the Prime Minister’s GP Access Fund pilot continue and become embedded into the local provision of primary healthcare in Milton Keynes. Following the pilot based on the above, the Clinical Commissioning Group and the NHS England Area Team, possibly with support from the local MPs and the Council, should lobby the Department of Health for sufficient funding to embed the extended hours scheme into the local provision of primary healthcare.

8. That the Clinical Commissioning Group investigates what makes the patient experience considerably better at some surgeries compared to others. Data from the NHS Choices website relating to individual surgeries across Milton Keynes showed that, of the 27 surgeries in Milton Keynes, only 4 were rated as outstanding, 12 were average, whilst the remaining 11 were deemed unsatisfactory. What are the lessons for best practice that can be learnt from the four outstanding surgeries which could be passed on in order to improve both services, and the patient experience, at other surgeries?

9. That the Clinical Commissioning Group be asked to consider ways in which healthcare services for the homeless can be better provided, possibly in conjunction with the ‘one-stop shop’ service recommended by the Homelessness Task and Finish Group in its recent report.