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South Holderness Medical Practice
PRG Comments on Approach to Procurement
South Holderness Medical Practice Patient Reference Group
Patient Reference Group response to:
Local Enhanced Services: Future Commissioning Arrangements for Services from 2014/15. Approach to Procurement. Closing date for comments Friday 25th October.
Introduction
1.The Patient Reference Group (PRG) is asked by the Clinical Commissioning Group (CCG) to comment on a paper providing “a simple outline of the procurement project” as part of the process of commissioning future arrangements for services from 2014/15. The paper includes a brief summary about each of the services that the CCG proposes to re-commission. The paper is dated 4 October 2013 and comments are requested by 25 October. The PRG comprises a Virtual Group and a Core Group, the latter meeting quarterly and publishingminutes on the Practice website, taking into account any observations from the Virtual Group submitted by email. For the purpose of this exercise, both Core and Virtual Group members were emailed copies of the consultation document and the comments below reflect the PRG’s opinion.
2.Reference is made in the email from the CCG to “Specifications have been circulated in draft form”. These specifications have not been seen by the PRG. It is understood that providers of services other than GP Practices could tender for future services if they meet the specifications. For example it might be that any competent and qualified health professional could tender for a service, depending on whether particular locations (such as surgeries) are specified and it is noted in the consultation paper that the private sector can tender for provision of services. The PRG’s view is that, for the convenience of patients, as many services as are possible should be offered in a Primary Care GP surgery, rather than in Secondary Care hospitals, although it is noted that in South Holderness the hospital in Withernsea may be a convenient location, depending on the clinical expertise available. If private providers bid to offer services, the PRG hopes that locations for services will be specified by the CCG that will include the South Holderness Surgeries and WithernseaHospital.
Comment
3.It is especially important to note that the NHS is a Service for patients and that patients should be at the heart of decision making.
4.The document is not “reader friendly” for the PRG lay person using the NHS.
5.As far as possible, patients in South Holderness should be provided with services in the immediate locality, preferably at one of the three Practice surgeries, to prevent their having to travel to Hull, Hedon or Hornsea or Beverley or elsewhere in the locality. This is especially important considering the number of elderly patients and patients who do not have access to their own transport in the Practice area. The PRG is aware of patients who have been required to travel to inconvenient locations in Hull for appointments. At one venue the provision for disabled parking was so poor that a penalty fine was issued.
6.It is noted that the first three services outlined in the document are provided by all GP Practices in the locality and the PRG supports the expectation that these services will continue at the South Holderness Practice.
7.The PRG takes the view that whilst the Mirena Coils service is apparently now offered by the East Riding Council, it is important from a public health perspective that this service, together with other contraceptive services, can be accessed locally in Withernsea, whether or not in the GP Practice.
8.It is understood that an Oral Glucose Tolerance Testing service is provided at the WithernseaHospital and it is hoped that this arrangement will continue.
9.The Insulin service is very important in South Holderness. Noting that only 10 practices have been involved in providing this service, of which South Holderness is one, the PRG hopes that this will continue, since the Group understands that the Practice currently meets the criteria for the number of patients accessing the service.
10.The PRG has no opinion on where the Challenging Behaviour service should be provided, or on the special Immediate Care provider.
11.The PRG regards Post Op Care as very important and, whilst the Practice does not currently offer this service,the Group hopes that it will continue to be provided by local health care professionals.
12.Similarly, Secondary Care Investigations are supported, although it is not clear from the CCG document which services are provided by GPs and those provided in Secondary Care. The Group notes that blood tests are carried out at WithernseaCommunityHospital which is accessed locally and it is hoped this will continue. It is understood that 24 hour ECG monitoring is not one of the enhanced services, but the PRG is strongly against the removal of this service, however it is provided. Patients should not be expected to travel to a distant hospital when the Practice can provide the necessary service.
13.The PRG has no opinion on where the Urea Breath Testing service should be provided.
14.The PRG regards Anticoagulation Therapy as very important. The description of the service in the consultation document refers to 4 levels, but the current provider base only states “All practices are involved except the 2 practices in Goole”. The PRG understands that the South Holderness Medical Practice is formally engaged up to Level 2. As level 3 is the same as Level 2 in terms of the Practice taking responsibility for anticoagulant dosing, and since, it is understood, the Practice is already informally involved with Initiation (Level 5?) the PRG strongly supports the Practice in endeavouring to offer ALL levels, as many patients in the area will benefit from all aspects of Anticoagulation Therapy being provided within the Practice.
15.The PRG recommends that the Community Ophthalmic Referral Refinement Scheme should continue. The PRG is not aware of this service being provided in Withernsea, but would support any proposal for its being offered locally.
16.It is noted that there is no reference to Hearing Loss and testing services, but the PRG wishes to record that patients have experienced very long waiting times for appointments at WithernseaCommunityHospital.
On behalf of South Holderness Medical PracticePatient Reference Group
Richard Watson, Chair