A verbal update will be provided at the meeting
Minutes:
D Evans provided an update to the committee. An integrated care system application was submitted at the beginning of the year and approved by NHS England on 1st May 2020. A single executive lead and joint accountable for the three CCGs (West Herts Valley, East and North Herts and West Essex CCG) has been appointed as Dr Jane Halpin. The senior team is currently being established and the idea is that all three CCGs will merge into one in the future.
Covid-19 has provided an opportunity to learn from and we have looked at areas and decided whether to adopt, adapt or abandon. What has worked well, take away individual pressures, the discharge and assess model has been successful and been able to move people out of our hospitals quickly. There have been challenges in care homes but they have been supported by the team.
T Fernandes ran through the changes that had been made within GP practices such as telephone triage appointments, sending in pictures of concerning moles or marks and physiotherapists providing exercises.
Councillor Symington asked there are reports in Berkhamsted area of underused capacity at GP surgeries. Can you quantify the extent of the under used capacity?
T Fernandes said earlier on in the pandemic there was definitely under used capacity because people didn’t want to go to the surgery. In Hemel Hempstead, now seeing a huge surge in activity. There may have been times when under used but things are now returning to normal. Some people may be putting off going to the doctors as they may think it will be a long time before they can get an operation. We are getting less minor ailments, personally have seen very few children with temperatures. There have been shifts in the way people seek help and different prioritisation, may feel they don’t need to see a doctor.
Councillor Symington said from her own perception there seems to be a difficulty for people to get face to face appointments and being seen by a doctor. She asked what role the CCG have in helping issuing clear instructions to clinical providers about how to move out of this situation.
T Fernandes said there is some professional responsibly involved that GPs should be ensuring they are adequately trained and webinars from training consultants have been provided on telephone appointments.
K Minier asked how doctors where managing referral lists.
T Fernandes said if someone was due a follow up appointment, this is being dealt with by the Trust to make sure these appointments are made. People who have developed problems during covid-19 and couldn’t be referred, some practices have kept their own lists and they are being contacted to see if they still need to be assessed. People waiting for surgery and may be in pain, this is difficult one as surgery capacity has been hugely decreased. At the moment, urgent and cancer surgery has been taking place at private hospitals and consultants have been working hard to make systems that are safe.
Councillor Maddern said she would be curious to know if there has been any research done on the level of prescribing and the type of drugs prescribed whilst in a virtual setting.
T Fernandes said it will be an area that is looked into. In a virtual setting, doctors are reliant on symptoms and antibiotic prescribing has probably increased. In order to mitigate against it, need to be asking the right questions and look at their medical history and if they suffer from recurrent conditions.
D Evans said this is monitored by the medicine management team.
Councillor Maddern said the virtual setting might become the ‘new normal’ and wondered if the committee could have some feedback on prescribing over the next few months.