GP Led Health Centres in Rural Areas (Polyclinics) (Agenda item 7)

Posted on December 18, 2009. Filed under: GP-led health centres, Reports/papers |

Breckland Council | Meeting | accessed 18 December 2009

Meeting of Policy Development and Review Panel 3, Tuesday, 16th September, 2008 10.00 am (Item 34.)

Presentation by Clive Rennie (PCT).

Minutes:

Clive Rennie, the Assistant Director for Commissioning (NHS Norfolk), was in attendance for this item.  A presentation was provided and had been attached to the Minutes for information.

The historical background was explained.  Ministers had reaffirmed that there should be at least one GP Led Health Centre in each PCT area.  On 23 November 2007, Ministers had announced a list of 38 PCTs that would receive additional funding to procure 100 new GP practices.

For each locality there was no prescribed national specification for the services provided.  For any new services, the money had to be spent on new provision, not existing provision.

In Norfolk, as per other PCT areas, investment was for additional capacity i.e. extra GPs, nurses and support staff.

In March 2007, Norwich had been identified as the preferred location based on criteria set by the Department of Health i.e. deprivation, population etc for the first GP Led Health Centre.  Consideration had to be given to developing more in other areas of Norfolk. As part of the development of the GP Led Health Centre, NHS Norfolk had agreed to re-provide the Dussindale Centre in the East side of Norwich into the new centre.  The major rational for this re-provision was that a more central location was required to provide equity of access for all residents of the greater Norwich and for commuters and also to target the most deprived areas of Norwich.  Anyone could register with this Practice within the designated catchment area of Greater Norwich; however, if you lived outside the catchment area, you would not be able to register with the practice but you would be able to receive services as a “walk-in” patient.  Clive Rennie then explained how the process worked with medical records if someone registered with a GP Led Health Centre as well as their own GP.

Some Polyclinics, typically London based, could almost be described as ‘mini hospitals’ with services including MRI scanners.  Urgent care could be provided. A Member asked whether urgent care would still be located in the hospitals accident & emergency department.  He also wished to know what GP led stood for – if it wasn’t GP led, was it nurse led.

In response, Clive Rennie advised that nurses could only carry out the service up to a certain point, beyond that, the Doctor had to take responsibility.  It was much more cost effective to attend a walk-in centre rather than an A&E but the decision to attend the walk-in or A&E should be based on clinical severity of the presenting condition.

The Chairman felt that it would be a good idea to have a Polyclinic situated in every market town and he asked how it had been justified in clinical terms, to have the one and only Polyclinic in Norwich.  It was explained that it was not clinically a better service, it was more about choice and the basis of the siting of the GP Led Health Centre in Norwich had been based on a number of criteria; one of the main ones being deprivation.  The GP Led Health Centre in Norwich would be judged on how it worked, and how cost effective it was before any possible roll out to other areas.

Members were informed that to help alleviate the current problems, such as having to wait weeks for an appointment, Doctors had been given the opportunity via a cost enhanced service specification form Norfolk NHS based on a national specification from the Department of Health to extend their current service hours to include opening their surgeries on week day nights and/or Saturday mornings.

Referring to the Local Development Framework (LDF), a Member questioned the Primary Care Trust’s (PCTs) commitment concerning forward planning with other stakeholders.  He felt that it would be useful for Breckland’s planners to be informed whether potential sites in town centres could be identified during the LDF process.  In defence, Clive Rennie explained that the PCT had been heavily involved with the local authority for the Norwich development regarding transportation routes and population demographics.

Members then discussed the Thetford town centre site that originally housed a cottage hospital which, in their opinion, would be an ideal place for a GP Led Health Centre to be situated.  They were disappointed that the PCT was trying to sell the site for further housing development.

It was understood that Norwich was the biggest urban area in Norfolk but at what point did a town become big enough to sustain a Centre?  Members felt that the PCT should consider more remote areas.

RECOMMEND that

1)           the Overview and Scrutiny Commission requests that the PCT, responsible for the people of Norfolk, provide an interactive map on its website, highlighting where these services were or would be situated, including the catchment areas; and

2)           the Environmental Planning Manager, be asked to attend a future Panel meeting to discuss forward planning for Polyclinics sites.

Supporting documents:

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