Agenda item

Mr Robert McCulloch-Graham gave an overview of the content of the report and advised that both Ms Zena Trendell and Dr Angus McVean had been heavily involved in the production of the final improvement plan. He spoke of the background to the plan and the anticipated outcomes of its introduction in line with the new contract for GPs. He explained that it was a 3 year plan and there was an expectation that it would continue to develop and evolve over that period. The plan had been approved by the GP Sub Committee and was presented to the IJB for approval prior to a Direction being issued to the Health Board to implement the plan.

Ms Trendell gave further background information and advised that the plan was linked to the new General Medical Services (GMS) contract. It was a requirement of the GMS contract that the plan focus on 6 key areas. Ms Trendell further advised that the plan would be revised on a 6 monthly basis.

Mr John Raine arrived.

Dr Angus McVean advised that there had been funds delegated for the formulation of the plan and about £600k had been allocated to provide best value for money and best service. The main driver of the contract was to move work from GPs in day time hours to other staff such as to pharmacists to help manage and run medication reviews. He assured the Board that GPs were keen to invest in the areas of greatest value for money in the first instance and that by the end of year 3 all of the identified areas would have been addressed.

A discussion ensued that highlighted: what will good look like in 3-5 years time; GP clusters designed to maintain quality across the region; creation of multi-disciplinary teams in clusters with GPs providing local clinical leadership; inclusion of support groups and community link workers; link efforts of Local Authority, GPs and Primary Care; dependence on ability to recruit pharmacists, physiotherapists, advance nurse practitioners and support staff to ensure GPs do the job the contract envisages them doing; whilst premises and IT sat outwith the plan, there was an initiative for Health Boards to undertake the purchase of all GP practices over a 20 year period; IT was centrally purchased and it was acknowledged that it was a critical function to assist in the integration of services; need to strengthen the role of carers; potential to review Primary Care Strategy Board membership to ensure representative of community services; and it was understood that it was a live document and would evolve as it developed.

Mrs Jane Davidson reminded the Board that the GP sub-committee was a sub-committee of the Health Board and the plan was about the GP element of primary care services. She wished to make the point on governance that it was a draft diagram and there was work to be done with the Health Board through that governance structure. In regard to the inclusion of social care, nursing, voluntary sector that would be important as things developed further.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD agreed the Primary Care Improvement Plan.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD agreed to issue a direction to NHS Borders to implement the Primary Care Improvement Plan.