Post on 08-Oct-2020
NHS CROYDON CCG PRIMARY CARE COMMISSIONING COMMITTEE
Meeting in Public
Tuesday 3 March 2020 12 00 – 13 30
The Recreational, Fairfield Halls Park Lane, Croydon CR9 1DG
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Croydon Clinical Commissioning Group Primary Care Commissioning Committee Meeting in Public
Agenda
Meeting: 3 March 2020, 12 00 – 13 30 Location: The Recreational, Fairfield Halls Park Lane, Croydon CR9 1DG Members of the public are welcome to attend this meeting of Croydon CCG’s Primary Care Commissioning Committee meeting. There will be the opportunity to ask questions during the Open Space. Questions will be limited to one question, plus one supplementary question, per person.
Item Time Authors Enclosure
1 12 00
Apologies for absence Verbal
2 Declaration of Interests
Verbal
3 Minutes of the meeting held on 3 December 2019 For agreement
Chair Enclosure 1
4 Matters Arising
• Action Log
Chair
Enclosure 2
Governance
5 12 10 Chair’s Report
Chair Verbal
6 12 15 Croydon Primary Care Governance For approval
Mark Creelman Interim Project
Director
Enclosure 3
7 12 25 Primary Care Finance Report – Month 10 For noting
Mike Sexton Joint Chief
Finance Officer
Enclosure 4
Transformation
8 12 30 Locally Commissioned Services For approval
Mark Creelman Interim Project
Director
Enclosure 5
Assurance
9 12 40 Contractual and Commissioning Update For noting
William Cunningham
Davis, Director of Primary Care,
NHS England
Enclosure 6
10 12 50 Medicines Shortages Update For noting
Mark Creelman Interim Project
Director
Enclosure 7
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11 12 55 Primary Care Quality Update
For discussion and noting
Dr Mike Simmonds, GP Governing Body
Member
Enclosure 8
12 13 15 Croydon Primary Care Estates Strategy For approval
Mark Creelman Interim Project
Director
To follow
Open Space for Public Questions
13 13 20
Any Other Business
14 Any other business
Chair
Date of next Meetings in Public of
15 TBC
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Croydon Clinical Commissioning Group Primary Care Commissioning Committee
MINUTES
Date: 3 December 2019 Time: 12 00 – 13 30 Location: Markee Room, Croydon Conference Centre, Surrey House, 5 – 9 Surrey Street,
Croydon CR0 1RG
Present: In Attendance:
▪ Philip Hogan, (PH) Lay Member – Finance (Chair)
▪ Josh Potter (JP), Joint Director of Strategy and Transformation, CCG/ CHS
▪ Elaine Clancy (EC), Joint Chief Nurse, CCG/ CHS
▪ William Cunningham Davis (WCD), Head of Primary Care, SWL Primary Care Team
▪ Sarah Warman (SW), Director of Joint Commissioning, CCG/ Croydon Council
▪ Agnelo Fernandes (AF), Clinical Chair, Croydon CCG
▪ Mike Sexton (MS), Joint Chief Finance Officer, CCG/ CHS
▪ Vaishali Shetty (VS), GP Governing Body Member, CCG
▪ Mike Simmonds (MSi), GP Governing Body Member, CCG
▪ Roger Eastwood (RE), Lay Member Governance and Conflict of Interest Guardian, CCG
▪ Amy Page (AP), Registered Nurse, Governing Body Member, CCG
▪ Les Ross, (LR), Secondary Care Doctor, Governing Body Member
▪ Richard Brown (RB), Medical Director, Surrey and Sussex LMC
▪ Gordon Kay (GK), Health Watch ▪ Vasudha Rai (VR), Business
Manager, Croydon CCG (minutes)
Apologies ▪ Paulette Lewis (PL), Lay Member, PPI, CCG ▪ Emily Symington (ES), GP Governing Body
Member, CCG ▪ Sarah Blow (SB), Interim Accountable Officer,
Croydon CCG
Apologies ▪ Rachel Flowers (RF), Director of
Public Health, Croydon Council
Ref: 2019/12/01
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1 Welcome and Apologies for absence Action
1.1 Phil Hogan welcomed members to the meeting. Apologies were noted as above.
Ref: 2019/12/02
2 Declaration of Interests
2.1
GP colleagues declared their conflict of being commissioners as well as providers.
Ref: 2019/12/03
3 Minutes of the Meeting held on 3 September 2019
3.1 The minutes of the meeting held on 3 September 2019 were approved, pending the change in title for Phil Hogan.
Ref: 2019/12/04
4 Matters Arising
4.1
Action Log Medicines Shortages Josh Potter explained that this report had been deferred to the March Committee due to the pre-election period and partly as still work in progress to understand the final position.
JP
Ref: 2019/12/05
5 Chair’s Report
5.1 5.2 5.3 5.4
Phil Hogan reported that there had not been any meetings of the Primary Care Commissioning Committee held in private since the meeting in September and provided a verbal update on the changes. SWL CCG Merger In October 2019, NHS England approved the application from the SWL CCGs to merge and become one NHS South West London CCG on 1 April 2020. There were a number of work streams underway to mobilise the new organisation. Staff Changes Phil Hogan reported that since the last Committee there had been some staff changes namely:
• Andrew Eyres had left and Sarah Blow had been appointed as the interim Chair for Croydon CCG;
• Martin Ellis was on a secondment at Kingston and Richmond CCG as Director of Transformation;
• Les Ross, had been appointed as the Secondary Care Doctor on the Governing Body
• Josh Potter, had been appointed as the Joint CCG/ CHS Director of Strategy and Transformation
Josh Potter added that Leilla Thomas, Head of Primary Care would be leaving Croydon CCG at the end of the month and Mark Creelman had been appointed as Interim Project Director and would have the Primary Care portfolio.
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5.5
Rita Barfoot Phil Hogan presented the Committee’s condolences to the family and friends of Rita Barfoot, who had recently passed away and paid tribute to her work in Coulsdon in the development of primary care provision.
Ref: 2019/12/06
6 Primary Care Finance Report – Month 7
6.1 6.2 6.3 6.4
Mike Sexton presented the Month 7 Finance report and explained that the CCG was reporting a year to date position of £0.1m underspend and a forecast position of £1.1m overspend for Primary Care Services. Additionally, a year to date position of £0.6m underspend and a forecast position of £0.4m underspend for Primary Care Delegated Commissioning was also being reported. The Committee noted that the key risks were in respect of the system’s inability to rapidly invest in Primary Care Network (PCN) workforce and primary care at scale development. There was also some rick in respect of GP IT support services. There was a discussion in regards to extended access. There was some concern that some practices had not been paid as per budgeted. The Committee noted that some practices had not provided this service during Quarter 3, therefore had not been paid. This could explain some of the discrepancy. The Committee noted that Locally Commissioned Services (LCS) were mainly activity driven and reflected that there was a need to engage and support practices to ensure that they were signing up to the LCSs. The Committee tasked the Primary Care Commissioning Working to define this engagement model. The Primary Care Commissioning Committee noted the report.
Ref: 2019/12/07
7 Croydon Primary Care Strategy – update on monitoring
7.1 7.2 7.3
Josh Potter presented this paper and explained that the Committee had approved the strategy in September but had asked for clarifications in regards to the methodology and how progress would be tracked and monitored. Agnelo Fernandes recognised that the strategy was evolving and was pleased to note that ICN development had been included both in the Primary Care Strategy as well as the Health and Care Plan, however would be keen to understand how Primary Care colleagues would be engaged in the process. Josh Potter explained that the engagement would be done mostly through the Primary Care Working Groups. The terms of reference for the Working Group would be discussed at the December meeting and would welcome comments and feedback from Committee members.
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7.4 7.5 7.6
The Committee noted that tasks and finish groups would also be set up as required. Phil Hogan reflected that there was a need to ensure that all the various components were appropriately managed and to ensure that once the SWL CCGs had merged, the assurance element was not lost. William Cunningham Davis reassured that SWL Primary care would maintain the same level of engagement as current practice with Croydon, post the merger. Gordon Kay referred to the patient involvement and wanted to know if the patient centred measures have had any further consideration and highlighted that Health Watch would be keen to be assist in that process. Josh Potter explained that patient engagement would be clarified as further evolution of the strategy and Health Watch would be engaged as required. The Primary Care Commissioning Committee noted the proposals for monitoring process against the Primary Care Commissioning Strategy.
Ref: 2019/12/08
8 Locally Commissioned Services (LCS)
8.1 8.2 8.3 8.4
Long Term Conditions Proactive and Preventative LCS Josh Potter explained that the NHS Long Term Plan identified the prevention, identification and management of diabetes, respiratory and cardiac disease as key national priorities where the NHS can make rapid impact on people’s health, save lives, reduce life years lost to disability and reduce the need for hospital services. In 2018, a detailed analysis was carried out illustrated the challenge to health and social care partners of the existing and cumulative impact of the Long- Term Conditions in Croydon. The Long-Term Conditions Proactive and Preventative Service LCS was developed as a response to the findings with a view to increase proactive identification of the estimated 2100 undiagnosed people with Atrial Fibrillation (AF) as well as providing targeted support for patients with either Hypertension, AF and/or Type 2 Diabetes in line with best practice. It was anticipated that the service would be implemented in 2020/21. The Committee noted that the Clinical Leadership Group had been engaged in the development of this LCS and they were supportive of the specifications. The Group Consultation approach and support being made available was noted and commended by the Committee. This LCS would be funded from the 2018/19 Quality Premium funding allocation.
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8.5 8.6 8.7 8.8
Following a query from Gordon Kay in respect of the patient engagement approached referred to in Phase 1, it was noted that practices would be required to demonstrate that patient engagement had been carried out. This could be evidenced by ensuring that documents would be made available in various languages. Attention was drawn to a patient engagement event that was planned for 11 December 2019. The invite for this event would be extended to Health Watch. The Primary Care Commissioning Committee approved the Long-Term Conditions LCS subject to funding. Spirometry Locally Commissioned Schemes Josh Potter explained that the Spirometry LCS had been developed to support the high level of undiagnosed COPD patients in Croydon. This LCS would incentivise practices in targeting high risk category patients for quality assured spirometry. The Respiratory Clinical Working Group have championed changes based on the awareness that accuracy of COPD diagnosis in primary care remains variable. The LCS takes into account NHS England’s best practice guidelines to reflect that clinicians delivering the test needed to be qualified with an Association for Respiratory Technology and Physiology (ARTP) Certificate of Competence and to be on the ARTP Spirometry Register by 2021. Additionally, colleagues involved in interpreting the results would also need to have the certification and be on the register. Attention was drawn to the uplift to the price of each test to consider the extra resource involved in delivering the changes. The Primary Care Commissioning Committee approved the Spirometry LCS subject to funding. Update on Locally Commissioned Service arrangements for 2020/21 Josh Potter provided an overview of the LCS Review undertaken as well as the work in progress to further refine these and the activity and finance impacts. The Primary Care Commissioning Committee noted the update on LCS arrangements for 2020/21.
Ref: 2019/12/09
9 Primary Care at Scale (PCAS) Funding
9.1
Josh Potter explained that the CCG had been allocated Transformation Funding to support PCAS and the delivery of Extended Access in 2019/20. The funding for extended access was already committed through existing contracts with an additional £300,000 earmarked for improving utilisation of the extended
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9.2 9.3
access hubs, and to meet the specification requirements. The CCG Primary Care have engaged with Primary Care Networks to understand the development needs. Clinical Directors completed a baseline assessment against the maturity matrix and had requested investment for Organisational Support to each Primary Care Network. There had also been an ask for additional roles reimbursement for the two larger Primary Care Networks. The Committee was pleased to note that organisational development support had been sought. The proposed investment of PCAS monies to support the development of PCNs was approved.
Ref: 2019/12/10
10 Croydon Urgent Care Alliance and GP Enhanced Access Contract Extensions
10.1 10.2
The Committee noted that the contract to provide Urgent Care services in Croydon, covering the Urgent Care Treatment Centre, GP Out of Hours service and the urgent care GP Hubs was awarded to the Croydon Urgent Care Alliance (CUCA), with the contract commencing on 1 April 2017 for a period of 3 years and due to expire on 31 March 2020 with the option to extend for up to a further two. Josh Potter explained that there have been a number of changes and initiatives that have changed the landscape of health and social care in Croydon. There was a need to consider these changes and initiatives and understand the right model for Croydon. The Committee noted that to enable this the Croydon Urgent Care Alliance had been extended for a period of two years subject to an improvement plan to be implemented during this period. The Primary Care Commissioning Committee ratified the decisions in respect of the Croydon Urgent Care Alliance and GP Enhanced Access Contract Extensions
Ref: 2019/12/11
11 Contractual Update
11.1 11.2
William Cunningham Davis presented the Contractual Update. Catchment area William Cunningham Davis explained that when Coulsdon Medical Practice closed on 26 October 2018, the patient list size was dispersed. One third of these patients chose to register with Old Coulsdon Medical Practice. The Primary Care teams had recommended the Practice to formally apply for an extension to their practice boundary. This application has been submitted. The Primary Care Commissioning Committee approved the
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11.3 11.4 11.5 11.6 11.7
extension to the catchment area. Annual Practice self-declaration (eDec) 2018/19 William Cunningham provided an update from practices in relation to their mandatory 2018/19 annual practice declaration and reported that most practices had provided sufficient assurance that no contractual action was required. Two practices had not confirmed that they had established a Patient Participation Group. The Committee had a discussion on the contractual obligations in respect of Patient Participation Groups. William Cunningham Davis explained that as long as practices were able to evidence engagement with their patient groups and NHS England would be supportive of any mechanism. William Cunningham Davis explained that an additional question in respect of training was included in the annual practice declaration and some practices had not confirmed that Mental Capacity Training had been undertaken. NHE England was keen to ensure that all practices had access to the required level of safeguarding and issues relating to Mental Health. There had been some early discussion as to whether some of these training would be made mandatory. Agnelo Fernandes reflected that as a practice it was good practice to do these trainings and can be used as evidence for CQC Inspections. The Primary Care Commissioning Committee noted the annual practice self-declaration (eDec 2018/19. Contractual Changes William Cunningham Davis presented the Quarter 2 Primary Care Contracts summary report highlighting the contract variations, infection control audit, CQC inspections. Amy Page noted a decrease in the number of remedial actions and would welcome a similar trend going forward. The Primary Care Commissioning Committee noted the contractual changes update.
Ref: 2019/12/12
12 Primary Care Quality Update
12.1 12.2 12.3
Mike Simmonds explained that the Primary Care Quality update was a summary of the GP Clinical Quality Review Group GP CQRG) held on 20 November 2019. As part of the wider South West London changes, there has been a need to review current arrangements for the GP CQRG to ensure there was sufficient governance to support the quality monitoring and improvement without unnecessary duplication. The meeting held in November 2019 had discussed the Learning
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12.3 12.4 12.5
Disabilities health checks as well as the National Diabetes Prevention Programme and NRLS Incidents reporting. Mike Simmonds reported that the GP CQRG had received its first influenza immunisation uptake data and had noted that the uptake amongst over 65s was significantly higher than last year’s data. The Primary Care Commissioning Committee noted that NHS England data indicated that Croydon’s performance in respect of immunisations, in general, was poor. William Cunningham Davis reported that NHS England had been having discussions on developing the appropriate support to practices to improve their immunisation rate. The Committee would welcome an immunisation improvement plan at the March Committee. The GP Patients Survey results had not been included in the quality report due to the timing of the Committee and the publication date. An update would be brought to the March Committee.
MS
MS
Ref: 2019/12/13
13 Open Space for Public Questions
13.1 13.2 13.3 13.4 13.5 13.6 13.7 13.8
Q: Member of public referred to projected takeover of BMI by Circle and wanted to know the impact on the current contractual agreements with BMI. A: The CCG was not aware of this proposal but would expect that the contractual agreements with BMI would be binding regardless of takeovers. Q: In the event of the take-over, whether there was a potential for the CCG to pay more for services commissioned? A: Contractual agreements would not be changed and would seek legal advice if needed. Q: Representative from GSK wanted to know how decisions would be taken post SWL Merger? A: Representative was reminded that this session was an opportunity for members of the public to ask question in regards to services commissioned and was not appropriate for these types of queries. Additionally, given that the CCG was in the pre-election period would not be able to answer this. Q: Member of the public referred to GP practices in Surrey being offered GP video consultations and wanted to know when this would be available in Croydon. A: The Committee explained that Doctor Link, which was being deployed by South West London would enable video consultations. This was part of the long-term plan. Richard Brown clarified that the video consultation in Surrey was for extended access and not available during contracted time. He also explained that whilst the leaflet referred to a GP there was a need to be mindful that this
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would not necessarily mean the GP that the patients normally see.
Ref: 2019/12/14
14 Any other Business
14.1 14.2
South West London Merger Phil Hogan referred to the March 2020 Primary Care Committee as the last meeting of the Committee under the current Terms of reference and recommended that it would be helpful for the Committee to have a review of how accountability and responsibilities have been discharged to date. There was no further business to discuss.
Ref: 2019/12/15
15 Date of Next Meeting
15.1 TBC
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Enclosure 2
CCG Primary Care Commissioning Committee Meeting - ACTION LOGOn target to meet resolution date
Up to 1 week behind target resolution date
Last updated: 27 February 2020More than 1 week behind target resolution date
Ref No CCG Date Owner (responsible)Action RAG Status
Due
DateNotes (progress to date, problems encountered, etc.)
12/12/2019 03-Dec-19 Martin Ellis Josh Potter Primary Care Quality Update
- A report on the GP Patients Survey results would be included in the March
Primary Care Quality Update
- An immunisation improvement plan would also be inlcuded in the March Primary
Care Quality Update
CLOSED 03-Mar-20This in included in the pack, to be presented by GP Chair of Quality forum (previous
CQRG)
07/09/2019 03-Sep-19 Martin Ellis Josh Potter Primary Care Finance Report – Month 4
The Committee requested that the report on Medicine shortages in Croydon and
what actions were being taken to mitigate this risk be brought to the December
Committee.
CLOSED 03-Dec-19 Due to the pre-election period this item has been deferred to the March Committee
12/09/2019 03-Sep-19 Martin Ellis Josh Potter Croydon Primary Care Estates Development Overview
The Committee noted that the Estates Board was developing a Croydon wide
strategy based around the ICN+ development as well as acute needs and
recommended that the strategy included an updated premise needs assessment
for all GP Practices. The refreshed strategy would be brought to the December
Committee.
CLOSED 03-Dec-19 This item is on the agenda
Key to RAG Status:
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REPORT TO CROYDON CLINICAL COMMISSIONING GROUP PRIMARY CARE COMMISSIONING COMMITTEE MEETING IN PUBLIC
3 March 2020
Title of Paper: Croydon Primary Care Governance
Lead Director Josh Potter Director of Strategy and Transformation
Report Author Andrew McMylor SWL Director of Primary Care Programmes
Committees which have previously discussed/agreed the report.
Primary Care Working Group
Committees that will be required to receive/approve the report
Primary Care Commissioning Committee
Purpose of Report For Approval
Recommendation:
The Primary Care Commissioning Committee is asked to:
▪ note the contents of the paper and the work is progressing with Croydon primary care team to ensure a seamless transition to the new governance arrangements by April 2020.
Background:
As part of the merger of the six SWL CCGs, there is a requirement to have a single Primary Care Commissioning Committee (PCCC) which will ratify (per the NHS England delegation agreement) a number of matters concerning primary care contracts.
Key Issues:
Extensive work in developing terms of reference, including ‘testing’ a number of worked examples has been conducted over the autumn in order to ensure the SWL CCG can deliver its requirements. This has involved discussions with a number of clinicians and managers, including discussions with the two Local Medical Committees across SWL. Information was also shared with Member Practices ahead of the merger vote on how primary care governance would work with the SWL CCG. Reason for Primary Care Commissioning Committee review: To provide assurance that detailed plans are in place with regards to primary care
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contracting as part of the SWL CCG from April 2020. The PCCC will already be aware as part of Moving Forwards Together discussions that all decisions around local primary care, such as strategy and budgets, will remain with the Croydon (Place Based) Committee. In addition, to provide the PCCC with further information and detail on how the governance for primary care contracting will be taken forward in the CCG.
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Governance: Corporate Objective The merger of the SWL CCGs into a single CCG
supports our delivery of the LTP objectives and enables us to deliver our commitments to the SWL population more effectively and efficiently.
Risks
The Croydon primary care team and SWL team are working together to ensure all existing actions requiring resolution by 1 April 2020 are completed; and an implementation plan for post-April 2020 is in progress.
Financial Implications
None specifically for primary care contracting.
Conflicts of Interest
N/A
Clinical Leadership Comments
Implications for Other CCGs
N/A
Equality Analysis
N//A
Patient and Public Involvement
N/A, however Patient and Public engagement groups have been engaged in the overall merger process through SWL Forums.
Communication Plan N/A
Information Governance Issues
Nil Known
Reputational Issues
Nil Known
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Primary Care governance from April 2020
Purpose of paper This paper is split into three main sections with the overarching objective of demonstrating how from April
2020 primary care governance will function, specifically in relation to the commissioning and contracting of
‘core’ general practice contracts.
The main sections;
- Primary Care governance; description of the governance operating at local level and the
relationship with the one SWL Primary Care Commissioning Committee (PCCC).
- Decision-making; articulating how decision-making will function including the relationship between
local level and SWL PCCC across a number of primary care functions.
- Terms of reference; the terms of reference for the SWL PCCC, a model terms of reference for a
local PCMG (for local additions to be made, e.g. membership) and an FAQ page that was sent to
Member practices ahead of the merger vote in Aug/Sep 2019.
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SECTION 1: Primary Care governance
1. The function of Primary Care Commissioning Committees
Primary Care Commissioning Committees (PCCCs) deliver the statutory functions of CCGs as set out by
NHS England as part of the delegation agreement for primary care.
Functions PCCCs deliver include ratifying new incentive schemes, agreeing significant changes to
practices or overseeing primary care contracts.
We currently have six PCCCs in SWL (i.e. one for each CCG). All operate with very similar terms of
reference and membership given the statutory functions are the same for each, as they will be for the
SWL CCG from April 2020.
Each PCCC is supported locally by Primary Care teams with the support of the SWL contracting team.
Typically they meet every two to three months in public and along with ensuring the statutory functions
are delivered, also provide a steer on the local primary care strategy and budget.
2. The role of the SWL PCCC from April 1st 2020
In keeping with the commitment to maintain and enhance primary care locally as part of the Moving
Forwards Together process, as much business as possible will be transacted at Borough level. The terms
of reference for the PCCC are included as an appendix to this paper, and have been developed following
detailed discussions with the Surrey & Sussex Local Medical Committee.
This approach will ensure that primary care continues to be strengthened and empowered within Croydon
with only matters needing formal PCCC ratification being escalated.
Whilst we are required to have a single PCCC for SWL to mirror one CCG, the PCCC needs to ensure
the statutory functions are delivered. These include (terms of reference in full at the end of this document)
the following;
- GMS, PMS and APMS contracts; taking contractual action such as issuing breach/remedial notices,
and removing a contract;
- Ratification of newly designed Local Incentive Schemes (LISs) on the recommendation of the relevant
Borough Committee of the CCG.
- Ratification of newly designed local incentive schemes as an alternative to the Quality Outcomes
Framework (QOF) on the recommendation of the relevant Borough Committee of the CCG.
- Decision making on whether to establish new GP practices in an area on the recommendation of the
relevant Borough Committee of the CCG.
- Approving practice mergers on the recommendation of the relevant Borough Level Committee of the
CCG; and
- Making decisions on ‘discretionary’ payments where Standard Operating Procedures do not exist on
the recommendation of the relevant Borough Committee of the CCG.
It is important to note that the PCCC ‘in attendance’ membership will contain a representative of the
Croydon Committee.
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The terms of reference for the PCCC are very similar to the existing Croydon PCCC given the statutory
functions will be the same. We envisage the PCCC meeting every two months in public initially.
The terms of reference have been overseen by the SWL Governance Oversight Group and have been
reviewed by Governance to ensure compliance with the legal and statutory framework for CCGs.
3. The role of the Croydon Primary Care Management Group
Croydon will have its own formal Primary Care Management Group (PCMG – mirroring the existing
Operational Group) where the vast majority of business can be agreed, delivered and monitored. Typically
the PCMG will meet monthly and will be chaired by a Croydon senior manager with membership including
local GPs, the LMC and the SWL Primary care team colleagues, along with any additional members as
required or requested.
The PCMG will report into the Croydon Committee who in turn will ensure the PCCC receive the
appropriate papers.
Only decisions formally needing PCCC approval will be sent to the PCCC.
The Croydon Committee may ask for advice or guidance from SWL colleagues before making a local
decision. Such an advisory group would help us share our learning and make sure we are making the
right decisions for local people, including managing any conflicts of interest if these could not be resolved
locally.
4. Reporting arrangements of the PCMG
In order to ensure the smooth running of the PCCC, the Croydon Committee and the PCMG need to
establish clear reporting lines.
PCMG reports to; The Croydon Committee; establishing appropriate relationships with other
committees for example quality and finance where required. It should be noted the vast majority of primary
care contracting is considered ‘business as usual’ and would not need discussion at the PCMG.
Membership; Monthly meeting chaired by a Croydon senior manager with membership including local
GPs, the LMC and the SWL contracting team. Its function is to have an understanding of all matters
concerning local primary care, with a specific approvals and recommendations remit in line with Standard
Operating Protocols (see below).
Responsible for; Across London and the UK, Standard Operating Protocols have been agreed covering
a number of transactional elements. For example, a request to vary a contract (e.g. one Partner retiring)
or a small boundary change amendment request. These areas can be discussed and agreed at the PCMG
without further escalation providing any conflicts of interest are managed accordingly.
However, there will be a number of functions that cannot (as set out in the statutory framework and
reflected in terms of reference for the PCMG and PCCC) be resolved by the PCMG and require the PCCC
approval.
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For example, a contract termination. On these matters the PCMG will develop a paper for the Croydon
Committee and/or key officers to scrutinise before a paper along with recommendation is sent to the
PCCC to make a formal decision.
The Croydon Committee may not require papers for some functions however it is suggested members
receive the papers before being sent to the PCCC, and as such the Croydon Committee will act as a
gate-keeper for the PCCC. This will ensure that all local leaders are fully sighted on Croydon primary
care matters.
5. Worked example – new APMS contract
Where it has been identified a new APMS contract is required in Croydon area (for example, a closure of
a large practice requiring new capacity) the following process would be used;
The Primary Care Management Group would develop the procurement documents, and with the input
of local GPs, SWL contracting team (to use their expertise and experience) and recommend any relevant
targets for the new provider to attain.
The Croydon Committee would take a wider-system view in ensuring that the service provider will play
a strong role in the Croydon health and care system, and also that the PCMG has developed a strong
service model for the provider to deliver against. The Croydon Committee would then recommend
approval to the PCCC.
The Primary Care Commissioning Committee would formally authorise the establishment of a new
APMS provider and assure itself that the process followed in Croydon was compliant with good-practise
procurement and will deliver value for money.
Members of the Primary Care Management Group would then oversee the implementation of the contract,
working with the provider to ensure the service is delivered as procured.
6. Worked example - Practices merging
Where two or more practices wish to merge, members of the Primary Care Management Group would
meet with the practices to understand the proposal and to work with them to ensure due process is
followed, for example, to consult with patients and to ensure the proposal would maintain or enhance
existing service delivery.
The Primary Care Management Group (managing conflicts of interest accordingly) would scrutinise the
subsequent business case proposal (of which, South West London Primary Care contracting team have
produced template for completion) from the practices and assure itself that any service changes are
clearly articulated, for example, a change of location(s) or opening hours of bases. In addition the Group
would ensure that any risks are highlighted and mitigated.
The Primary Care Management Group would also monitor the process to ensure key changes, for
example, new IT configuration have a deliverable action plan.
The Croydon Committee will seek assurances from the PCMG that the proposal supports the wider
primary care strategy of the borough, for example, in the development of Primary Care Networks.
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The Croydon Committee, or key officer(s) will make a formal recommendation to the Primary Care
Commissioning Committee that due process has been followed and the proposal maintains or enhances
existing service delivery.
The Primary Care Commissioning Committee would formally authorise the merger assuring itself that
all the appropriate documentation has been completed satisfactorily via the PCMG and Croydon
Committee. Where members of the PCCC require further information, this will be provided in advance so
that a decision can be made at the next available opportunity. As applications to merge must be submitted
four months in advance, scheduling onto a PCCC agenda will be achieved without causing a delay to the
process.
Members of the Primary Care Management Group would then oversee the contract, as per all other
primary care contracts.
7. Quality matters
Matters concerning the quality of primary care are of interest across all levels of the CCG.
On a contractual level, the PCCC would need to approve any relevant contract action, for example
resulting from a CQC inspection of a general practice. As described, such breach notices would be sent
to the PCCC from the local PCMG and Borough Committee for ratification.
However, whilst helpful to explicitly state the contractual role of the PCCC, there are a number of other
areas in which the CCG would support the quality of primary care in the aim of avoiding contractual action
in the first instance.
Locally, CCGs have Primary Care Quality Groups (or equivalent) which have a key role in bringing
together a number of strands of quality in a supportive and facilitative forum. For example, to maintain a
Borough view on any rising tide events in order to enable general practices to be better prepared.
Additionally, through the relationships local teams have worked hard with practices to develop, to provide
1:1 support and guidance to practices.
From April 2020 the Croydon Committee may wish to be appraised of any general themes across general
practice in order to better understand how, for instance, a primary care strategy can be developed to
support the quality and resilience of primary care. The Committee may of course be able to direct more
resources should there be a pressing issue either the PCMG or Quality Group wish to highlight that cannot
be resolved through normal business operations of either group.
How the local PCMG and Quality Group relate to one another is down to local discretion, though typically,
the PCMG is more focused on individual contractual matters (e.g. CQC breach notices and subsequent
monitoring of the remedial action plan) with pro-activeness of general themes and deep-dive on specific
quality matters the domain of the Quality Group.
Furthermore the SWL Quality, Performance and Oversight Committee from April 2020 will be able to
advise (as requested) on any local matters along with supporting any pan-CCG workstreams.
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SECTION 2: Decision-making
The London Primary Care Operating Model (unless identified with an * in the table below) identifies a
number of decisions and decision-making requirements of the CCG in respect of executing delegated
responsibilities for primary care.
Within SWL there will be;
- One Primary Care Commissioning Committee
- Six place-based Local Committees
- Six place-based Primary Care Management Groups
In order to understand the relationship between each of the groups along with the decision-making
accountability it is necessary to consider a number of functions given the very broad area covered within
primary care.
The table below identifies, per key function, the respective role of each of the three groups/committees
along with the final decision-making point.
Function Role of PCMG Role of Local Committee
Role of SWL PCCC
Final approval by
Comments
Development of local primary care strategy*
Provide data and intelligence to the Local Committee to aid the development of the strategy To oversee specific delivery actions as requested
Oversee the development and delivery Direct PCMG or sub-groups accordingly
N/A Local Cmte
A SWL Advisory Group can be established to provide advice and guidance to Local Committees with regards to any issue raised locally
Transformation of local primary care services*
Provide data and intelligence to the Local Committee to aid the development of the strategy To oversee specific delivery actions as requested
To ensure all services affecting primary care (i.e. not just those delivered solely by primary care) fit with local primary care strategy and that local clinicians
N/A Local Cmte
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are involved in the development
Function Role of PCMG Role of Local Committee
Role of SWL PCCC
Final approval by
Comments
Control of delegated primary care budgets*
Work with local finance colleagues to ensure a full understanding of the budget including any general themes or emerging issues
To receive standard report as per other delegated budgets
N/A – to be advised of general themes or emerging issues
Local Cmte
Primary Care core contracts and value are set nationally for which the CCG receives the annual allocation
Control of non-core contract budgets, e.g. Local Incentive Scheme* NB these remain under local control
Oversee the delivery of key indicators and to ensure services benefit patients and represent value for money
To receive standard report, flagging any issues/options for local consideration
N/A unless approving a new service
PCMG
Quality within primary care*
To work with other local groups, e.g. quality sub-committees to support practices on any emerging or key issues and to address pro-actively To deliver any actions as requested by the Local Committee
Receive reports from PCMG and other sub-committees, and to direct actions accordingly The SWL Quality Performance and Oversight Group may be asked for support and guidance as requested locally
N/A – to be advised of general themes or emerging issues
Local Cmte
Duty in relation to the quality of primary care medical services is the formal responsibility of the PCCC and therefore, working with other sub-committees of the CCG Governing Body, the PCCC may wish to adopt a holistic approach
List closure (three to four across SWL per year)
Approval of closure following the London Standard Operating Procedure
Consider impact of list closure and work with PCMG to ensure due process is followed Can direct PCMG for any related actions, e.g. securing a new APMS contract
N/A – to be advised at next meeting
PCMG London Standard Operating Procedure exists documenting the process to follow and to note this may or may not be as a consequence of CQC enforcement
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(requiring PCCC ratification) Officers may be involved pending appeal
Senior Local Manager to be notified
Function Role of PCMG Role of Local Committee
Role of SWL PCCC
Final approval by
Comments
Practice merger/move (10 to 15 across SWL per year)
To work with the affected practice(s) and to consider the impact of the proposal
Unlikely to be discussed in full at the Local Committee however may wish to consider impact of practice merger/move and work with PCMG
To ratify the recommendation of the Local Committee
PCCC Senior Local Manager to be notified
Boundary changes (three to four)
Approval/rejection of boundary change following London SOP
N/A N/A – to be advised at next meeting
PCMG London SOP exists
New APMS contracts (one to two in SWL)
With other groups, such as finance, to work up local performance indicators and overarching procurement documentation
Receive from the PCMG overall summary of the requirements and approach to ensure fit with primary care strategy Make recommendation to the PCCC
Receive recommendation from Local Committee. Ensure good governance conducted (e.g. represents value for money)
PCCC APMS procurements are often delivered following a London process
PMS Reviews Develop, alongside local GPs, appropriate service specifications for discussion with the relevant LMC
Ensure proposed service areas fit with local strategy, e.g. sufficient focus on local priority areas
Receive recommendation from Local Committee. Ensure good governance conducted
PCCC PCMG will also oversee regular reviews of current indicators to ensure continued delivery and fitness for purpose
Remedial and breach notices
Follow due process in ensuring relevant paperwork is complete and undertake practice visit(s)
Unlikely to be discussed at the Local Committee however the Local Senior Manager should be made aware
Approval to issue breach notice
PCCC
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and to sign-off paper for PCCC
CQC Inadequate & Requires Improvement notices
Follow due process in ensuring relevant paperwork is complete and undertake practice visit(s)
Unlikely to be discussed at the Local Committee (unless in private session to consider a PCMG report) however the Local Senior Manager should be made aware and to sign-off paper for PCCC
Approval to issue relevant notice. Whilst a paper will be received from PCMG, the notices are from the CQC and not open for CCG interpretation
PCCC In the public domain once CQC publish their report – PCMG will oversee any remedial actions and liaise with the practice and CQC
Function Role of PCMG Role of Local Committee
Role of SWL PCCC
Final approval by
Comments
Contractual changes (contentious/major impact) (10 to 12)
Provide an options paper to the Local Committee
Unlikely to be discussed at the Local Committee (unless in private session to consider a PCMG report) however the Local Senior Manager should be made aware and to sign-off paper for PCCC
Receive recommendation from the Local Committee and/or key officer(s)
PCCC
Locum reimbursements
Approval/rejection of contractual changes following the London SOP or local precedence
N/A however Local Senior Manager may be involved pending appeal
N/A – to be advised at next meeting
PCMG London SOP exists
GP performer payments sickness
Approval/rejection of payment(s) following the London SOP or local precedence
N/A however Local Senior Manager may be involved pending appeal
N/A – to be advised at next meeting
PCMG London SOP exists
Infection prevention & control
Ensure practices follow infection prevention & control guidance including regular inspections
N/A however Local Senior Manager may be involved pending appeal
N/A – to be advised at next meeting
PCMG London process established PCMG may work with other sub-groups, e.g. quality
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SECTION 3: Terms of Reference for PCCC, PCMG (generic) and FAQ sent to
Member practices in Aug/Sep 2019. Enc
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Document management
Revision history
Version Date Summary of changes
0.1 Pre 05/09/19 Comments as per tracker
0.2 06/09/19 Amendments as per tracker
0.3 02/12/19 Amendments following legal review. Amendments as per tracker (06/09/19 –
02/12/19)
0.4 20/02/20 Comments as per tracker (02/12/19 – 20/02/20)
Reviewers
This document must be reviewed by the following people:
Reviewer name Title/responsibility Date Version
Governance Lay Members September 19 -20 0.1-0.4
SMT September 19 -20 0.1-0.4
Chairs September 19 -20 0.1-0.4
LMC September 19 -20 0.1-0.4
Approved by
This document must be approved by the following people:
Name Signature Title Date Version
SWL Governing Body
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1. Introduction
1.1. In accordance with its statutory powers under section 13Z of the National Health Service Act 2006
(as amended), NHS England has delegated the exercise of the functions specified in Schedule 2 of
the Delegation Agreement to these Terms of Reference to NHS South West London Clinical
Commissioning Group (hereby known as the CCG).
1.2. The CCG Primary Care Commissioning Committee (hereby known as the Committee) is
established as a Committee of the CCG Governing Body (hereby known as the Governing Body) in
accordance with Schedule 1A of the “NHS Act”.
1.3. The Committee will exercise the delegated powers as outlined in these Terms of Reference.
1.4. The ongoing relationship the Committee will have with NHS England will be revised on an ongoing
basis, though is currently outlined as in Schedule 2 of the Delegation Agreement.
1.5. The Committee, in common with all CCG Governing Body Committees is formally accountable for
furnishing the Finance and Audit Committees with the formal reports it requires to assure the
Governing Body that Primary Care Co-Commissioning is being effectively governed and managed.
1.6. The members acknowledge that the Committee is subject to any directions made by NHS England
or by the Secretary of State.
2. Statutory Framework for the CCG
2.1. NHS England has delegated to the CCG authority to exercise the primary care commissioning
functions set out in Schedule 2 of the Delegation Agreement in accordance with section 13Z of the
NHS Act.
2.2. Arrangements made under section 13Z may be on such Terms and Conditions (including terms as
to payment) as may be agreed between NHS England and the CCG.
2.3. Arrangements made under section 13Z do not affect the liability of NHS England for the exercise of
any of its functions. However, the CCG acknowledges that in exercising its functions (including
those delegated to it), it must comply with the statutory duties set out in Chapter A2 of the NHS Act
and including:
2.3.1. Management of conflicts of interest (section 14O);
2.3.2. Duty to promote the NHS Constitution (section 14P);
2.3.3. Duty to exercise its functions effectively, efficiently and economically (section 14Q);
2.3.4. Duty as to improvement in quality of services (section 14R);
2.3.5. Duty in relation to quality of primary medical services (section 14S);
2.3.6. Duties as to reducing inequalities (section 14T);
2.3.7. Duty to promote the involvement of each patient (section 14U);
2.3.8. Duty as to patient choice (section 14V);
2.3.9. Duty as to promoting integration (section 14Z1);
2.3.10. Public involvement and consultation (section 14Z2).
2.4. The CCG will also need to specifically, in respect of the delegated functions from NHS England,
exercise those set out below:
2.4.1. Duty to have regard to impact on services in certain areas (section 13O);
2.4.2. Duty as respects variation in provision of health services (section 13P).
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3. Role of the Committee
3.1. The overall scope of the Committee consists of those primary care co-commissioning functions
formally delegated by NHS England to the CCG as a new CCG function from 1st April 2016.
3.2. In performing its role the Committee will exercise its management of the functions in accordance
with the agreement entered into between NHS England and the CCG, which will sit alongside the
delegation and Terms of Reference.
3.3. The functions of the Committee are undertaken in the context of a desire to promote increased co-
commissioning to increase quality, efficiency, productivity and value for money and to remove
administrative barriers.
3.4. The role of the Committee shall be to carry out the functions relating to the commissioning of
primary medical services under section 83 of the NHS Act.
3.5. This includes the following:
3.5.1. GMS, PMS and APMS contracts; taking contractual action such as issuing breach/remedial
notices, and removing a contract;
3.5.2. Ratification of newly designed Local Incentive Schemes (LISs) on the recommendation of
the relevant Borough Committee of the CCG;
3.5.3. Ratification of newly designed local incentive schemes as an alternative to the Quality
Outcomes Framework (QOF) on the recommendation of the relevant Borough Committee of
the CCG;
3.5.4. Decision making on whether to establish new GP practices in an area on the
recommendation of the relevant Borough Committee of the CCG;
3.5.5. Approving practice mergers on the recommendation of the relevant Borough Level
Committee of the CCG;
3.5.6. Making decisions on ‘discretionary’ payments where Standard Operating Procedures do not
exist on the recommendation of the relevant Borough Committee of the CCG; and
3.5.7. The Committee will receive quarterly reports form the Borough Committee on the decisions
that it has made in relation to the CCG’s delegation agreement.
4. Exclusions
4.1. Control of primary care (core contracts and discretionary such as LISs) budgets is delegated from
the CCG to individual Borough Committees and as such is not within the remit of the Committee.
As such, Borough Committees can develop local incentive schemes as per local strategy.
4.2. Design, development and delivery of Borough-level primary care strategies is not within the remit of
the Committee, with all such matters the responsibility of individual Borough Committees.
5. Geographical Coverage
5.1. The Committee will comprise of decisions relating to primary care within South West London, as
define in the Constitution.
6. Membership
6.1. The Committee shall consist of:
6.1.1. Members
6.1.1.1. Chair – Lay Member
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6.1.1.2. Lay or Independent Member (Vice Chair) 6.1.1.3. GP Lead for Primary Care 6.1.1.4. 2x CCG Executive Directors 6.1.1.5. Independent (non-SWL) GP
6.1.2. Attendees:
6.1.3. HealthWatch representative 6.1.4. Londonwide LMC representative or Merton, Sutton, Wandsworth representative 6.1.5. Surrey & Sussex LMC representative 6.1.6. Place based representative (Croydon) 6.1.7. Place based representative (Kingston) 6.1.8. Place based representative (Merton) 6.1.9. Place based representative (Richmond) 6.1.10. Place based representative (Sutton) 6.1.11. Place based representative (Wandsworth)* 6.1.12. SWL Director Primary Care 6.1.13. Primary Care representatives from Borough level as appropriate
*The Place Based representative will either be the GP Borough Lead or the Locality Director
6.2. The Chair of the Committee shall be a CCG Governing Body Lay Member, who should not be the
Chair of the Audit Committee.
6.3. The Vice Chair of the Committee shall be a CCG Governing Body Lay or Independent Member.
6.4. The Committee may appoint ad-hoc members to advise it on specific matters within its terms of
reference from time to time as appropriate.
6.5. There will be an annual review of the Committee’s membership to support its efficient functioning.
7. Conflicts of Interest
7.1. Conflicts of Interests will be managed in accordance with the Constitution that outlines the current
policy; ‘Standards of Business Conduct and Managing Conflicts of Interest Policy’.
7.2. Where a Committee member has, or may have, a conflict of interest, arrangements will be put into
place to manage that Conflict of Interest in accordance with the Constitution and the Conflicts of
Interest Policy.
8. Meetings and Voting
8.1. The Committee will operate in accordance with the CCG’s Constitution, Standing Orders and the
Delegation and Delegation Agreement, which take precedence in the event that there is any
inconsistency. The Secretary to the Committee will be responsible for giving notice of meetings.
This will be accompanied by an agenda and supporting papers and sent to each member
representative no later than five working days before the date of the meeting. When the Chair of
the Committee deems it necessary in light of the urgent circumstances to call a meeting at short
notice, the notice period shall be such as s/he shall specify.
8.2. The Committee will make decisions within the bounds of its remit.
8.3. The decisions of the Committee shall be binding on NHS England and the CCG.
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8.4. Each member of the Committee shall have one vote. The Committee shall reach decisions by a
simple majority of members present, but with the Chair having a second and deciding vote, if
necessary. However, the aim of the Committee will be to achieve consensus decision-making
wherever possible.
8.5. Members of the Committee have a collective responsibility for the operation of the Committee.
They will participate in discussion, review evidence and provide objective expert input to the best of
their knowledge and ability, and endeavour to reach a collective view.
8.6. Meetings of the Committee:
8.6.1. may resolve to exclude the public and non-voting attendees from a meeting that is open to
the public (whether during the whole or part of the proceedings) whenever publicity would be
prejudicial to the public interest by reason of the confidential nature of the business to be
transacted or for other special reasons stated in the resolution and arising from the nature of
that business or of the proceedings or for any other reason permitted by the Public Bodies
(Admission to Meetings) Act 1960 as amended or succeeded from time to time.
9. Quorum
9.1. The Committee will be Quorate with three of the five voting members in attendance, with at least
one Lay or independent Member present. A majority of Lay, Independent and Executive Members
must be maintained. Where a member(s) have a Conflict of Interest they may be excluded from the
agenda item decision. The Chair may ask them to be part of the discussion before the decision is
made.
10. Confidentiality
10.1. Members of the Committee shall respect confidentiality requirements as set out in the CCG
Constitution or Standing Orders.
11. Frequency of meetings
11.1. In the first year, the committee will meet a minimum of 6 times. After the first year, the
committee will meet a minimum of 4 times. The committee will always be in public and will rotate
across all boroughs.
11.2. The Chair can request additional meetings where required.
11.3. Where the Chair determines there is insufficient business to be conducted at the Committee,
a meeting may be cancelled providing five working days notice is given.
12. Urgent Decision Making
12.1. The Committee has a delegated responsibility from NHS England to make a range of
decisions relating to the commissioning of primary care medical services.
12.2. In the vast majority of cases these decisions can be made by the Committee as part of
business as usual. However, there may be occasion, when an urgent situation arises that requires
a decision or actions to be agreed either immediately or before the next Committee takes
place.
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12.3. Urgent Decision Making (UDM) meetings, in person or via teleconference, can be called by
the Chair (or vice-chair in their absence) or designated deputy. Wherever possible, members will
be given five working days notice.
12.4. A minimum of two voting members of the Committee must be present in person or on the
teleconference, both of whom must be either a CCG Governing Body Lay Member or an Executive
Member for it to be quorate.
12.5. A meeting will be convened by the Committee Chair (or Committee Vice-Chair in their
absence) and an Executive Director or designated deputy. Consultation will be made with the
Committee Vice-Chair and all other available members of the Committee unless in exceptional
circumstances where a time delay cannot be permitted. If other Committee members are not
consulted they will be informed at the earliest possible time.
12.6. All decisions will be reported at the next available Committee meeting.
13. Other Matters
13.1. The Committee may delegate tasks to such individuals, sub-committees or individual
members as it shall see fit, provided that any such delegations are consistent with the parties’
relevant governance arrangements, are recorded in a Scheme of Delegation, are governed by
Terms of Reference as appropriate and reflect appropriate arrangements for the management of
conflicts of interest.
13.2. The Committee may call additional experts to attend meetings on an ad hoc basis to inform
discussions.
13.3. The Committee shall:
13.3.1. Have access to sufficient resources to carry out its duties;
13.3.2. Be provided with appropriate and timely training, both in the form of an induction programme for new
members and an ongoing basis for all members;
13.3.3. Give due consideration to laws and regulations impacting on the work of the Committee;
13.3.4. At least once a year, review its own performance and terms of reference to ensure it is operating at
maximum effectiveness and recommend any changes it considers necessary to the Governing Body.
14. Reporting
14.1. The Committee will present its agreed minutes and an executive summary report to the
Governing Body, following each meeting, for information, including the minutes of any sub-
committees to which responsibilities are delegated.
14.2. There is a statutory requirement that the Committee publishes a register of its decisions,
outlining the management of any Conflicts of Interest.
14.3. The CCG will also comply with any reporting requirements set out in its Constitution.
15. Review of Terms of Reference
15.1. It is envisaged that these Terms of Reference will be reviewed annually, reflecting
experience of the Committee in fulfilling its functions. NHS England may also issue revised model
terms of reference from time to time.
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Document management
Revision history Version Date Summary of changes
0.1 Pre 05/09/19 Comments as per tracker
0.2 05/09/19 Amendments as per tracker
0.3 25/09/19 From LMC meeting on 18/09/19 - added 2.2.5 / 8.5 / 10.2
0.4 30/09/19 From LMC meeting on 26/09/19 – amended 5.2 to ‘bi-monthly’
0.5 02/12/19 Amendments made following legal review. Amendments as per tracker (36/09/19 – 02/12/19)
0.6 20/02/20 Amendments as per tracker (02/12/19 – 20/02/20)
Reviewers This document must be reviewed by the following people:
Reviewer name Title/responsibility Date Version
Governance Lay Members September 19 – February 20
0.2-0.6
SMT September 19 – February 20
0.2-0.6
Chairs September 19 – February 20
0.2-0.6
LMC September 19 – February 20
0.2-0.6
Approved by
This document must be approved by the following people:
Name Signature Title Date Version
PCCC
Borough Committee
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1. Introduction
1.1. The Primary Care Management Group (PCMG) is established as a sub-committee of the Croydon
Borough Level Committee of the South West London Clinical Commissioning Group.
1.2. PCMG’s role is to ensure the transactional aspects of primary care commissioning are undertaken
efficiently, clearly and in line with national regulation and local strategy.
1.3. The PCMG will establish a direct reporting arrangement with the Croydon Borough Level
Committee; acknowledging it has specific authority where there are London Standard Operating
Procedures ((SOPs) as outlined in sections 22 and 23 of the terms of reference),
1.4. Matters where the South West London Primary Care Commissioning Committee (PCCC) have
formal decision-making responsibilities, as outlined by the NHS England Delegation Agreement,
the PCMG will firstly make recommendations to the Croydon Borough Level Committee of the SWL
CCG who will provide the PCCC with a recommendation for ratification.
2. Authority
2.1. The PCMG is authorised by the Croydon Borough Level Committee of the SWL CCG to:
2.1.1. Apply the national Primary Care contracting regulations in the context of local strategy and
agreed London Standard Operating Procedures (SOPs);
2.1.2. Make recommendations to the Borough Level Committee and/or Local Senior Manager on
other matters;
2.1.3. Seek advice on aspects of its work requiring specialist knowledge (e.g. legal, estates) as
agreed with the Local Senior Manager.
3. Objectives
3.1. The priorities for the Primary Care Management Group will include, but are not limited to:
3.2. Assurance:
3.2.1. Implementing the strategy and work programmes of the Croydon Borough Level Committee
of the SWL CCG;
3.2.2. Lead on the management of the day to day responsibilities of delegated commissioning;
3.2.3. Providing the relevant data and information on issues to be discussed at relevant Quality
Committees, either at Croydon or SWL.
3.2.4. Support NHS England to manage the Reserved Functions as appropriate or as directed by
NHS England.
3.2.5. Support the ongoing quality improvement of primary care through pro-active support and
guidance (noting this excludes performance management), and working with other local groups
and Committees as established in relation to primary care quality.
3.3. Risk:
3.3.1. Manage risk within the framework of the authorities and duties of the PCMG as established in
sections 22 and 23 of the terms of reference;
3.3.2. Oversight of risk register with regards to sections 22 and 23 of the terms of reference.
3.4. Contracting:
3.4.1. Apply the national Primary Care contracting regulations in the context of local strategy and
agreed SOPs.
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3.4.2. Support the contract development and management processes associated with GMS, PMS
and APMS Practices.
3.4.3. Following approval via the relevant Committee; Implement and oversee any alternative
contracts for Quality Outcomes Framework (QOF), (as agreed by the SWL Primary Care Direct
Enhanced Services (DES) and Local Incentive Schemes (LIS).
3.4.4. NB control of primary care (core and discretionary such as LISs) budgets is delegated from
the SWL CCG to the CROYDON.
3.5. Engagement:
3.5.1. Liaising with GP practice and other primary care providers in conjunction with NHS England
representation on commissioning issues arising for practices.
4. Membership
4.1. The membership shall consist of:
4.1.1. Chair – Senior Local Manager;
4.1.2. Deputy Director of Primary Care (Vice Chair);
4.1.3. Head of Primary Care;
4.1.4. SWL Primary Care Contracting Team representatives
4.1.5. LMC Representative;
4.1.6. Locally elected clinical representatives FINAL NUMBER/ROLES TO BE INSERTED;
4.1.7. Senior Finance Manager.
4.2. The group may invite other individuals or organisations as required, for example the Local
Pharmaceutical Committee. Practice representatives may also be invited to attend for items that
concern them.
4.3. For some items, the input from the Performers’ List team at NHS England will be important. For this
reason, we will ensure that this team has early sight of the agenda for PCMG meetings and that
“Relevant Input from Performers’ List Team” is a standing item on all agendas.
5. Quorum
5.1. A quorum shall be the following three members; Chair or Vice Chair, at least one primary care team
member and a finance member.
6. Frequency of Meetings
6.1. Meetings shall be held monthly, however this is at the discretion of the Chair in relation to matters
requiring discussion.
6.2. As an absolute minimum, meetings will be held bi-monthly.
7. Urgent actions
7.1. In the vast majority of cases these actions can be made by the PCMG as part of business as usual.
However, there may be occasion, when an urgent situation arises that requires an action to be
agreed either immediately or before the next meeting takes place.
7.2. Urgent action meetings, in person or via teleconference, can be called by the chair (or vice-chair in
their absence). Wherever possible members will be given five working days notice.
7.3. A minimum of three members of the PCMG must be present for it to be quorate as per paragraph
4.
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7.4. An urgent action meeting will be convened by the Chair (or Vice-Chair in their absence).
Consultation will be made with the Vice-Chair and all other available members of the PCMG unless
in exceptional circumstances where a time delay cannot be permitted. If other PCMG members are
not consulted they will be informed at the earliest possible time. Where an urgent-action is taken,
this will be officially recorded as such immediately.
7.5. All actions will be reported at the next available PCMG meeting.
7.6. When national timescales demand it and in exceptional/operationally urgent situations a “virtual
meeting” may take place, using email or phone conferencing (this shall not be a reason for
inadequate planning.) Alternatively, after taking advice, Chair’s action may be taken and
immediately recorded as an urgent action being taken. Chair’s action will be ratified at the next full
meeting of the group. For example, this may occur when a statutory response time of 28 days
applies, as is the case in some procedures.
8. Duties
8.1. To apply the SOPs in regards to:
8.1.1. List closure;
8.1.2. List suspension;
8.1.3. Boundary changes;
8.1.4. Discretionary payments;
8.1.5. Contractual changes (transactional);
8.1.6. Locum reimbursements;
8.1.7. GP performer payments sickness;
8.1.8. Infection Prevention & Control.
8.2. To make recommendations in line with SOPs to PCCC via the Croydon Borough Level Committee):
8.2.1. Practice merger/move;
8.2.2. New APMS contracts;
8.2.3. PMS Reviews;
8.2.4. Remedial and breach notices;
8.2.5. CQC Inadequate & Requires Improvement ratings ;
8.2.6. Contract termination;
8.2.7. Contractual changes (contentious or major).
8.3. To correspond with practices on the above issues, to ensure actions are made with the fullest
possible information and to communicate back to practices clearly and promptly.
8.4. To improve quality, safety and patient experience of primary care services, as part of the CCGs
overall responsibilities for improving quality across all commissioned services. Relationships with
Quality Committee(s) will be established accordingly.
8.5. To give due consideration to the well-being and development needs of all staff providing and
delivering primary care services.
9. Reporting and Accountability
9.1. The PCMG will report to the Croydon Borough Level Committee of the SWL CCG. Regular reports
should be provided to the SWL Primary Care Commissioning Committee on any actions taken at the
PCMG.
10. Relationships
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10.1. The PCMG will have a working relationship with other local groups as established.
10.2. The PCMG will establish clear reporting lines with the SWL Quality, Performance and
Oversight Committee and the SWL Quality Surveillance Group.
10.3. The PCMG will establish a clear remit from the Croydon Borough Level Committee of the SWL
CCG with regards to its responsibilities around primary care strategy, including but not limited to, the
development of Primary Care Networks.
11. Reporting
11.1. A formal record of meetings will be kept and an action log maintained. Draft notes will be
made available within a week of the meeting. Notes will be subject to the Freedom of Information
Act. Certain parts of the notes may be redacted, if deemed confidential/not in the public interest.
12. Appeals
12.1. If a practice considers that the PCMG has not followed due procedure in its application of the
SOPs, it may appeal to the Local Senior Manager who in turn may refer the matter to the SWL
PCCC.
13. Conflicts of interest
13.1. Conflicts of Interests will be managed in accordance with the CCG Constitution that outlines
the current policy; ‘Standards of Business Conduct and Managing Conflicts of Interest Policy’.
13.2. Where a PCMG member has, or may have, a conflict of interest, arrangements will be put
into place to manage that conflict of interest in accordance with the Constitution and the Conflicts of
Interest Policy of the SWL CCG.
14. Review of Terms of Reference
14.1. It is envisaged that these Terms of Reference will be reviewed annually.
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FAQ sent to Member practices – August/September 2019
Who will the voting members be on the SWL PCCC, and how different is it to now?
In keeping with NHS England requirements, the PCCC will be chaired by a lay member along with key CCG officers. Local GPs will be non-voting members so they can provide advice and guidance to the voting members. The voting members are very similar to the existing PCCCs. This is because the requirements from NHS England on this are very clear.
Why can’t local GPs be a voting member of the PCCC?
Again, the requirements from NHS England are clear on this, and since PCCCs started over three years ago, none have had local GPs as voting members. The PCCC exists to ensure that any possible conflicts of interest, for example in the development of a new service with funding going to local GPs, are managed appropriately.
The PCCC has a vital governance role in ensuring that matters around individual contracts or new services have been developed fairly and there is no risk of a legal challenge. In fulfilling this role the PCCC acts as an important safety net to protect the integrity of the CCG and its Member practices.
What will be the relationship between the SWL PCCC and the Local Committee and PCMG?
The local PCMG and Local Committee will be responsible for developing any proposals that require the approval of the PCCC. Typically this is where the proposal recommends payment to GP practices or a decision has a large impact on one individual contract. The PCCC will receive all its information, along with a recommendation from the Local Committee on what to approve and why. The PCCC then acts as the final check to ensure the proposal represents good value for money and has been developed fairly.
Will the SWL PCCC reject local recommendations?
This is not the intention of the SWL PCCC. In the unlikely event the SWL PCCC had reason to question how a service or a proposal was developed, before approving it, the PCCC would wish to work with the Local Committee and PCMG to answer any questions.
Will the SWL PCCC be responsible for the primary care strategy across each Borough?
No, this sits firmly with the Local Committee and our commitment to enhance primary care support locally.
Won’t the SWL PCCC just do all the work of the six existing PCCCs?
Many changes affecting GP practices do not need the approval of the PCCC. For example, discretionary payments, GP rent review process, boundary changes, infection control and contract changes (for example, addition of a new Partner) can all be approved locally. Where items that significantly affect a contract require approval, for example a PMS Review, contract termination or merger along with the award of a new contract, only these matters need the approval of the PCCC. As stated, before they reach the SWL PCCC each will have been discussed locally with a recommendation made to the SWL PCCC.
Won’t have a meeting every two months slow our progress locally if we want to deliver a service?
Firstly, we would expect that the SWL PCCC will ‘forward plan’ so would know in advance of any new proposals requiring its approval, so that it could be timetabled accordingly. However if something required an urgent approval, then there are a number of options available. For example, the Chair could take a ‘Chair’s action’ in consultation with other voting-members to approve with the decision communicated at the next meeting in public. Of course, we could decide to meet more frequently and as such we will keep this under review.
Will the SWL PCCC manage primary care budgets?
No, this is delegated to the Local Committee to manage accordingly. This includes both core contracts as well as locally designed incentive schemes.
How will we ensure sufficient local debate and input into primary care?
By having more local GP input at the PCMG including the LMC we are confident this will ensure a healthy and robust debate. Equally, by having a clinical majority on the Local Committee, and by having the budgets delegated locally, there are a number of ways in which to input into primary care.
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REPORT TO CROYDON CLINICAL COMMISSIONING GROUP PRIMARY CARE COMMISSIONING COMMITTEE
3 MARCH 2020
Title of Paper: 2019/20 PRIMARY CARE FINANCE REPORT: PERIOD 10 (January 2020)
Lead Director Mike Sexton Chief Finance Officer
Report Author Edward Odoi Chief Management Accountant
Committees which have previously discussed/agreed earlier version of this report.
N/A
Committees that will be required to receive the report
N/A
Purpose of Report For discussion and noting
Recommendation:
The Primary Care Commissioning Committee is asked:
▪ To note that 2019-20 month 10 (January 2020) reported position of £0.4m underspend year to date and £0.5m forecast underspend. The two component elements of the budget are summarised below:
▪ Primary Care Services (£54.6m annual budget including Prescribing): £0.4m overspend year to date and £1.1m forecast overspend.
▪ Primary Care Delegated Commissioning (53.9m annual budget): £0.9m underspend year to date and £0.7m forecast underspend.
Background:
Following the publication of the Primary Care Medical allocations as part of the place-based funding for all CCGs, CCGs taking full delegation received the funding direct as a separate Medical Services recurrent allocation. The allocation is provided solely for commissioning Primary Care Medical services on behalf of NHS England under delegation therefore cannot be used for other CCG expenditure or vired to another budget area.
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Key Issues:
This finance report reflects 2019-20 Primary Care related expenditure. Cost pressures and benefits identified have been included in the reported position.
Governance:
Corporate Objective To achieve financial surplus of £3.5m in 2019/20
Risks See Risk Section. 50:50 risk share in operation between Trust and CCG on breach of control total
Financial Implications Management of risk within the agreed control and delivery of £27.5m CIP / QIPP Programme
Conflicts of Interest No specific conflicts of interest.
Clinical Leadership Comments Clinical Leadership Group and the Cost & Quality Oversight Board (CQOB) is supporting the delivery of the CIP / QIPP and transformation programme.
Implications for Other CCGs Croydon CCG works closely with the other SWL
CCGs as part of the SWL Health and Care
Partnership.
Equality Analysis All CIP / QIPP and expenditure programmes are
required to have an EIA, compliance monitored
by the PMO.
Patient and Public Involvement All service redesign, QIPP projects and
expenditure reductions must meet the requisite
PPI requirements.
Communication Plan The 2019/20 Financial Plan have been shared in the public domain and with stakeholders.
Information Governance Issues
Restrictions on access to patient level activity data limiting the ability of CCG to review provider performance and to monitor some QIPP schemes.
Reputational Issues Delivery of financial plan.
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Primary Care Services - 2019/20 M10 (January 2020) 1. Overview: Croydon CCG is reporting a year to date position of £0.4m overspend and a forecast position of £1.1m overspend for Primary Care Services, and a year to date position of £0.9m underspend and a forecast position of £0.7m underspend for Primary Care Delegated Commissioning at month 10 (January 2020). The key risks are (i) the system’s ability to rapidly invest in PCN workforce and primary care at scale development, and (ii) financial pressures on GP IT support services. 2. 2019/20 Budgets: The combined total Primary Care annual budget of £108.5m includes £53.9m for Primary Care Delegated Commissioning, £43.9m for Prescribing, £6.6m for Community Based Services, £2.7m for GPFV and £1.3m for Primary Care IT. The budgets were set based on commitments and to meet all known costs in line with current contractual obligations. The budgets include an allowance for demographic growth. 3. Capitation Report
CCG
Normalised weighted list
as at 01/04/2018
Normalised weighted list
as at 01/04/2019
Year on Year % Movement
Normalised weighted list
as at 01/01/2020
YTD Movement 01/01/2020
% YTD Movement
Full Year budgeted Growth %
Croydon 377,819 382,058 1.1% 386,447 4,388 1.1% 1.1%
Croydon’s normalised weighted population increased by 1.1% (4,239) year on year from April 2018 to April 2019 and a further increase of 1.1% (4,388) from April 2019 to January 2020.
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4. Primary Care Expenditure: The 2019/20 M10 (January 2020) financial position all NHS Croydon CCG Primary Care Services is set out in tables below.
Primary Care Services - 2019/20 M10 (January 2020)
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Primary Care Commissioning - 2019/20 M10 (January 2020)
COST CENTRE NAME Budget Total
Commitment
Var 2019/20
Annual
Budget
Forecast
Outturn
Var
£000s £000s £000s £000s £000s £000s
Medicines Management Team 1,363 1,257 (107) 1,636 1,530 (105)
Prescribing:
GP Practice & Specialist Clinics(Inc. IPP-PMd Adj.) 32,297 33,375 1,078 38,468 39,956 1,488
East Surrey Reserve - - - - 172 172
PADM (Cost of Drugs) 1,008 1,000 (8) 1,210 1,219 9
Prescribing Cost Recharge (153) (221) (68) (184) (221) (37)
Community Education Provider Network(CEPNs) (9) - 9 (10) - 10
Medicines Optimisation - Community 87 - (87) 104 - (104)
Minor Ailments 192 123 (69) 230 123 (108)
Lipid Modification Proj 27 (34) (61) 32 32 -
Drugs Met Centrally 1,078 1,086 8 1,294 1,328 34
New Oxygen Service 339 309 (30) 407 385 (22)
Atrial Fibrillation Patient Optimisation 124 124 0 297 297 -
Scripswitch/Eclipse/Presqipp 97 161 64 116 161 44
Prescribing Incentives Scheme 277 277 - 333 333 -
Sub Total 35,364 36,199 836 42,296 43,783 1,487
Sub-total: Prescribing 36,727 37,456 729 43,932 45,314 1,382
Local Incentives Schemes:
Urology 33 23 (10) 40 32 (8)
Phlebotomy 208 170 (38) 249 212 (38)
Phlebotomy - CHS 148 157 10 177 189 12
Coeliacs 6 4 (3) 8 5 (3)
Barretts 12 14 2 14 17 3
Spirometry 115 70 (45) 138 88 (50)
Care Homes 290 146 (143) 347 204 (143)
Cardiology 98 91 (7) 118 110 (7)
MGUS CLL - - - - - -
Latent TB 32 32 (0) 38 38 -
Mental Health LES - - - - - -
Pre-Op Hernia 5 (3) (8) 6 (2) (8)
Diabetes 137 172 35 164 199 35
Basket 472 444 (28) 567 539 (28)
Elective Care Del. & Trans Prog (PDDS) 387 387 (0) 465 465 -
Proactive Care Management (PDDS) 1,705 1,705 (0) 2,046 2,046 -
PDDS & GP E-Referral excluding Prescribing Incentive Scheme 40 (411) (451) 48 (411) (459)
Primary Care - £1.5 per head 520 540 21 623 644 20
Sub Total 4,207 3,541 (666) 5,049 4,374 (675)
Primary Care Other:
Variation Team: Pay 207 204 (3) 249 245 (3)
Variation Team: NonPay 4 1 (3) 5 4 (0)
Rainbow PCTMS 32 84 52 38 95 57
Collaborative/Assessment Fees Claims 202 179 (23) 242 229 (13)
Out Of Hours - CUCA 808 808 (0) 969 969 (0)
Primary Care Other 1,252 1,276 23 1,503 1,542 40
Sub-total: Community Based Services 5,460 4,817 (643) 6,552 5,916 (635)
GPFV
Primary Care Network development and support funding 140 140 - 279 279 -
International Recruitment 46 46 - 81 81 -
Improving Access to General Practice 894 894 - 1,073 1,073 -
Primary Care at Scale (PCAS) 1,078 1,078 - 1,294 1,294 -
Sub Total 2,158 2,158 - 2,727 2,727 -
GP IT 1,103 1,427 324 1,344 1,730 386
Grand Total 45,447 45,857 410 54,555 55,687 1,132
PERIODS TO DATE FULL YEAR
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Primary Care Delegated Commissioning - 2019/20 M10 (January 2020)
COST CENTRE NAME Budget Total
Commitment
Var 2019/20
Annual
Budget
Forecast
Outturn
Var
£000s £000s £000s £000s £000s £000s
Primary Care Medical Services (PMS,GMS,APMS)
Essential and Additional Services 33,131 33,109 (22) 39,757 39,764 7
Enhanced Services 650 714 64 780 772 (8)
Quality and Outcomes Framework (QOF) 3,584 3,559 (25) 4,301 4,301 -
Premises Payment 3,783 3,812 29 4,540 4,604 64
Seniority 202 195 (7) 242 241 (1)
Other Administered Funds (Maternity etc) 543 507 (36) 651 631 (20)
Personally Administered Drugs 193 213 21 231 231 -
Other Medical Services 24 23 (1) 29 29 -
Primary Care Networks 1,651 1,197 (454) 1,981 1,532 (449)
Primary Care Transformation - OOH/PDDS 667 800 133 800 800 -
Additional Investment(Including care homes) 265 (41) (307) 392 71 (321)
Ear Syringing LCS 54 27 (27) 65 65 -
Nurse Lead, Named GPs & Others 142 160 18 170 180 9
District Valuer Charges 17 10 (7) 20 20 -
GP at Hand patient transfers (28) - 28 (33) - 33
East Surrey Reserve - - - - 278 278
Prior Year Accruals - (263) (263) - (263) (263)
Total Primary Care Delegated Commissioning 44,877 44,021 (856) 53,927 53,256 (671)
PERIODS TO DATE FULL YEAR
5. Financial Performance Summary At the end of month 10, for delegated Primary Care, there is year to date £0.9m underspend and a forecast underspend of £0.7m.Unutilised accruals from previous years has created a non-recurrent £263k benefit in the current year and is carried forward as part of the forecast as at Month 10. Locum costs are currently better than budget, and a re-assessment of likely costs in the remainder of the year has been made resulting in a forecast underspend £20k The “old” Extended Hours DES has been replaced by a PCN Extended Hours scheme, but the Quarter 1 payments made were £8k less than budget due to non-delivery of the full service by some practices, this has been included as a saving in the forecast. Minor Surgery and LD Health Checks DESs are currently over-spending but are forecast to fall back in line with budget. A significant % rent increase at Parkway Health Centre charged by NHSPS has contributed to a forecast overspend of £25k to be included for this rent increase, in additions a significant rent review adjustment was required for the Selsdon Park adjustment, which created a further £39k forecast overspend in premises (£64k in total). The CCG allocation for the delegated budget was reduced by £33k in month, for the impact of the GP at Hand practice adjustment.
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REPORT TO CROYDON CLINICAL COMMISSIONING GROUP PRIMARY CARE COMMISSIONING COMMITTEE MEETING HELD IN PUBLIC
3 March 2020
Title of Paper: UPDATE ON LOCALLY COMMISSIONED SERVICE ARRANGEMENTS FOR
2020/21
Lead Director Josh Potter Joint Director of Strategy and Transformation
Report Author Mark Creelman Project Director
Committees which have previously discussed/agreed the report.
Updates have been shared with SMT and Primary Care Working Group; Primary Care Committee will have previously reviewed an update in December 2019 on the overall LCS programme as well as specific papers / proposals on key schemes. Primary Care Working Group 26 February 2020 Procurement Advisory Group 25 February
Committees that will be required to receive/approve the report
Health Management Board (27 February 2020) Primary Care Commissioning Committee
Purpose of Report For Approval
Recommendation: The Primary Care Commissioning Committee is asked to:
▪ APPROVE the continuation of LCS schemes outlined herein for 2020/21 including: o APPROVE the approach for the Care Home and Proactive Management LCS’ for
2020/21 based upon the impact of the associated DES schemes o APPROVE the budget identified for the LCS programme o NOTE the changes to the previously agreed plans for spirometry – separate paper
for approval supplied
▪ APPROVE the additions to the service specification templates
▪ NOTE and comment on the risks identified
Background:
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During 2019/20 a review of all LCS arrangements was undertaken to:
1. Ensure that all services commissioned from General Practice outside the core contract meets the requirements of the procurement advisory group and are approved by the appropriate committees.
2. Ensure that all patients registered with a Croydon GP are able to access enhanced services provided through the primary care network model.
3. Ensure that all services delivered through an enhanced service are relevant to local population needs and are equitable, with clear and measurable outcomes.
4. Develop a contracting framework for General Practice LCS that is aligned to the network delivery model and reduces the administrative burden for commissioners and General Practice.
This work has been overseen by the Primary Care Quality, Planning and Finance Group which reports
to the Primary Care Working Group. Key outputs from this review has been the confirmation of the
commissioning principles for enhanced primary care services alongside CCG statutory requirements,
alignment with guidance in the long-term plan and our commissioning strategy and assess current
schemes against these principles to determine plans for 2020/21 and beyond.
Key Issues:
This paper aims to outline and summarise:
• The output of the LCS review undertaken in 2018/19 and 2019/20. This included consideration of the implementation of network based working to support ensuring population coverage for all schemes. Discussions have taken place with PCN leads for key schemes – notably spirometry and long term conditions. However, based upon feedback from practices it has been agreed to:
o Delay implementation of the new spirometry service specification until December 2020 to support practices and networks to ensure staff are appropriately accredited to deliver the service and develop network working where possible / required. This timeline also meets the national deadline for implementation.
o For all other schemes, the option for network based or cross practice arrangements to be implemented to ensure all patients have access to services has been included within the service specification. This includes new ways of working e.g. development and delivery of group consultations as part of the long term conditions LCS.
• Outline of LCS for implementation and continuation in 2020/21 and budgets including:
o New schemes previously agreed through PCCC / SMT e.g. long term conditions preventative and proactive LCS and insulin injectables and spirometry LCS’
o The impact of the release of the confirmed DES service specifications on local plans for the proactive management LCS’.
o Proposal for the continuation of the current care home LCS for April to September 2020, and development with stakeholders of a new model of care for implementation from October 2020. This approach aims to support the continuation of meeting local need, supporting the implementation of the DES care home service requirements from October 2020.
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• Update on the progress towards implementing automation of reporting for LCS’ through EMIS Enterprise.
Governance:
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Corporate Objective Ensure all services commissioned from primary care meet the requirements of the new contract.
Ensure that we commission services in primary care in line with our responsibilities under delegated commissioning authority, and with due diligence.
Risks
Key risks are outlined in section 4
Financial Implications
Potential increase in activity have been reviewed by SMT based on the assumption of all practices signing up to key schemes – this has informed budget setting for 2020/21 (costs of schemes is outlined in appendix 1)
Conflicts of Interest
Conflicts of Interest have been managed where appropriate as per the Conflicts of Interest policy.
Implications for Other CCGs
None – however, with the creation of SWL CCG, review and harmonisation of schemes will be required.
Equality Analysis
Plan to ensure all patients can access all commissioned enhanced services.
Patient and Public Involvement
The majority of schemes are being retained with no overall change in service delivery. Where new schemes are in development, patient and public involvement would be undertaken in line with CCG policy.
Communication Plan Discussion with PCNs on the approaches to delivery of key schemes has been undertaken via the PCN Business Leads and Clinical Directors. In addition, updates will be discussed at relevant Croydon wide GP / Practice meetings over recent months. LMC representation has been included within the Primary Care Quality, Finance and Planning Group which is responsible for the development of LCS’. Where schemes have identified additional stakeholders for ongoing communication, these were identified within plans for each scheme.
Information Governance Issues
None identified
Reputational Issues
None identified
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UPDATE ON LOCALLY COMMISSIONED SERVICE (LCS) ARRANGEMENTS FOR
2020/21
The following provides an overarching summary of the LCS review and plans for 2020/21 for
approval. A separate paper on the LCS’ for Spirometry has been provided.
1. Service Review Update on Progress During 2019/20 a review of all LCS arrangements was undertaken to:
5. Ensure that all services commissioned from General Practice outside the core contract meets the requirements of the procurement advisory group and are approved by the appropriate committees.
6. Ensure that all patients registered with a Croydon GP are able to access enhanced services provided through the primary care network model.
7. Ensure that all services delivered through an enhanced service are relevant to local population needs and are equitable, with clear and measurable outcomes.
8. Develop a contracting framework for General Practice LCS that is aligned to the network delivery model and reduces the administrative burden for commissioners and General Practice.
This work has been overseen by the Primary Care Quality, Planning and Finance Group which
reports to the Primary Care Working Group. Key outputs from this review has been the confirmation
of the commissioning principles for enhanced primary care services alongside CCG statutory
requirements, alignment with guidance in the long-term plan and our commissioning strategy and
assess current schemes against these principles to determine plans for 2020/21 and beyond.
Discussions regarding delivering population coverage for new LCS’ has taken place, however,
feedback from practices has highlighted a number of challenges. This includes the difference in
maturity of PCNs across Croydon and the work still in progress to embed this way of working. It has
therefore been agreed that:
1. Options for PCN / network based working have been built into new LCS’:
• Long term conditions proactive and preventative LCS – providing an option for PCN or practice based working to deliver group consultations.
• Spirometry – in-depth discussions have taken place with the aim of supporting network based approaches to ensuring sufficient accredited staff available to deliver the service. In order to provide sufficient time for practices / PCNs to develop the approach to delivering the revised service specification, implementation has been delayed until December 2020. The 2019/20 service specification for spirometry will remain in place for April to November 2020. A separate paper on this service has been provided.
2. For all other LCS’ the option for sub-contracting / referring to other practices has been included, to support delivery of population coverage. Further work is required to support practices wishing to implement this approach.
In addition, work is in progress with Croydon GP Collaborative to develop automation of reporting
through EMIS Enterprise where possible, to reduce the burden of reporting on practices and
validation for the CCG. To date this has been completed for the transforming elective care, care
homes and ear irrigation LCS’, and is in development for new schemes to be implemented in April
2020 i.e. long term conditions and insulin injectables.
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2. Plans for 2020/21 by LCS
For clarity schemes for 2020/21 have been separated into three groups (full list in appendix 1,
including financial implications.)
2.1. Services where there is no change: For most Schemes currently in place, there will be little or no change, other than to review key performance indicators and update service specifications where there is new or updated guidance. Key developments for these schemes are:
• Review of activity undertaken and links with other service developments to provide assurance of need
• Review of cost and 2020/21 predicted activity to inform budgets
• Review of service specification to provide a consistent approach (see section 3).
• For clarity and to support ongoing development, the ‘basket’ LCS has been separated into its component parts and therefore will become two LCS’ – one scheme for shared care / Zoladex and another for leg ulcer and wound management. This allows for ongoing development linked with both the current SWL shared care review and local urgent care services.
• This group also includes continuation of new schemes implemented in 2019/ 20 – mental health, elective care transformation and ear irrigation.
2.2. New or significantly revised services Significant work has been undertaken to develop the LCS for insulin injectables, long term conditions and spirometry. This has included engagement with practices and PCN business leads and clinical directors. All of these schemes have included the development of a network (PCN) based approach to support delivery of new ways of working e.g. to support delivery of group consultations or address work force issues where new accreditation is required. Given PCN working is in its infancy and at differing levels of maturity across Croydon, the implementation of a PCN based approach to these schemes from April 2020 has been identified as a challenge. Therefore, it has been proposed that the implementation of elements of these schemes is phased to support roll out:
• Spirometry – as outlined above will continue with the current 2019/20 service, with a revised service specification from December 2020.
• Insulin injectables – to be implemented in full from April 2020. The service is to fund general practice for taking on the extra care, time and responsibility for the management of patients with more complex needs including who require insulin or injectable glucogen-like-peptide-1 (GLP1) agent
• LTC Preventative and Proactive LTC – aims to identify a proportion of patients with either Hypertension and/or Type 2 Diabetes, who are not meeting their clinical treatment targets, and provide them with enhanced support pre-dominantly through group consultations, which may be network or practice based dependent upon local arrangements.
2.3. LCS impacted by changes to the national DES service specification consultation.
Following the outcome of the national consultation on the DES service specifications (including care homes and anticipatory care). It has been confirmed that:
• Structured Medication Review and Medicines Optimisation will be implemented from April 2020
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• Supporting Early Cancer Diagnosis will commence from April 2020
• Enhanced Health in Care Homes will commence October 2020, however, preparatory work is required between PCNs and the CCG to support alignment of care homes to PCNs and identify new ways of working.
• Anticipatory Care and Personalised Care are deferred until 2021/22. Full details on the DES schemes are available at https://www.england.nhs.uk/wp-content/uploads/2020/02/update-to-the-gp-contract-agreement-2021-2324.pdf
2.3.1. Care Home LCS The guidance on the implementation of the DES service specifications outlines the following:
• ‘A new ‘Care Home Premium’ will provide an additional and specific contribution, responding to concerns about care home distribution between PCNs. PCNs will be entitled to a recurrent £120 per bed per year. Given that the core requirements of the 2020/21 Enhanced Health in Care Homes service specification do not come into effect until 30 September 2020, this funding is on a half-year (£60 per bed) basis in the first year;
• Where a LES/LIS already exists for a service that is duplicated by the DES requirements, no decommissioning of that service by the CCG should take place until the DES requirements commence. For the care homes service, for example this will be 1 October 2020. Where the requirements in an existing LES/LIS exceed those in the DES, commissioners must, engaging with PCNs and LMCs and taking account of the PCN employment liabilities directly linked to delivery of the LES/LIS, consider maintaining this higher level of service provision to their patients, alongside an appropriate portion of existing funding additional to the entitlements of the national contract. And all funding previously invested by CCGs in LES/LIS arrangements which are now delivered through the DES must be reinvested within primary medical care.’
Further discussions are taking place with LMCs in early March 2020, and full guidance on implementation has yet to be released. Given the current position it is proposed that the Care Home LCS for 2020/21 take the following form: 1. The current LCS be continued for the period April to September 2020 2. A working group will be urgently implemented to develop a new model of care. This will
identify the service requirements to support implementation and delivery of the DES specification as well as meeting local needs and supporting continuation of care. A workshop is currently being planned for late March 2020 to commence this work, with input from GPs, practice managers, PCN clinical directors and business leads, LMC, Croydon GP Collaborative, community healthcare providers and other stakeholders.
In order to support and ensure sign up for the service from April 2020, the service specification has been revised to include the commitment to this development approach.
2.3.2. Proactive management LCS
This scheme was implemented in July 2019 with the aim of being replaced by the DES service specification for anticipatory care. Given the deferment of the implementation of the anticipatory care DES, early discussions have taken place with clinical leads to determine whether the current scheme is suitable for extension into 2020/21 and what, if any, further developments are required. Given the timescale for implementation it has bee recommended that the scheme continue in its current form. However, further review is warranted particularly in relation to:
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1. Reporting requirements - feedback from practices is that this is repetitive and onerous. Work is required to streamline reporting.
2. Huddle surveys were initially to be undertaken quarterly, however, due to the work involved and the limited benefit of this frequency it is proposed that the requirement for Q1 2020/21 be updated to reflect the requirement to feedback on actions taken to address issues identified within the survey undertaken in Q4 2020/21. For 2020/21 survey will therefore be undertaken in Q2 and Q4.
2.4. Automation of Reporting The CCG is working with the Croydon GP Collaborative to develop an approach to support automation of reporting for LCS’ where this is appropriate to the information required. This process is supported by a user guide and includes the process for reconciliation of returns in the next payment run, in exceptional events where errors have been identified Automation of reporting has been implemented for elective care transformation, ear irrigation and care homes LCS’. Work is in progress for the new schemes to be implemented from April 2020 – LTC and insulin injectables. In order to support use of automated returns it is recommended that payment will only be made on receipt of automated return and service specifications have been updated to reflect this approach. Support and feedback will be provided by the GP collaborative team to ensure practices are able to implement this process from Q1 2020/21. Where automation is not developed at the start of 2020/21, consideration will made regarding the feasibility of mid-year implementation taking into account potential additional work for practices to transfer to a new reporting approach. Automation of returns will include the development of EMIS templates which will be in line with current reporting requirements and will be supported by a user guide. Updated reporting workbooks will also be provided with clear direction on which LCS’ should be reported manually and which are only available for automated reporting. Where changes to reporting are identified, the CCG will work with CGPC and practices to seek feedback on proposals and ensure sufficient notice and support is implemented, commensurate with the impact of proposed new ways of working on practices.
3. Service specification updates:
In order to provide a consistent approach to LCS’ and alignment with the latest national NHS
contract framework all local LCS will be transferred to the national service specification template,
with the following additions where appropriate to each specification:
3.1. GP Practices are expected to provide the essential and additional services for which they are contracted to provide to their registered patients through their core contract. The specification of this service is designed to cover the enhanced aspects of clinical care for patients which are beyond the scope of essential services. No part of the specification by commission, omission or implication defines or redefines essential or additional services.
3.2. Accessibility
The provider must ensure that the venues for clinics are accessible, local and suitable to undertake this clinical function. Accessibility must meet current accessibility compliance and
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the locations must be within reach by public as well as private transport. Patients will be offered choice of location and time of appointment. The premises must comply with relevant standards and meet the CCG’s estates requirements for safety and security. Other venues that offer similar standards of clinical functionality, infection control, privacy and dignity, clinical waste, can be considered as long as standards are met and in agreement with the commissioner. The service will also ensure that appropriate administrative support is present. The provider will need to ensure that reasonable adjustments are made to ensure services are accessible for all people with protected characteristics under the Equalities Act. Clinical support to people within Croydon will be provided irrespective of any other need (including, but not limited to, housebound, mental health diagnosis, learning disabilities, transgender, or disability)
3.3. Network based delivery
The ambition is for this model to facilitate closer working with a range of local providers,
including across primary care. In line with the ambition to realise integrated working the CCG
is supporting practices to work collaboratively to deliver the services outlined in this
specification. Some of the key benefits in operating in this way include;
o Primary care can operate more effectively in partnership with other providers o Better use of resources through economies of scale in pooling resources o Enable practices to benefit from partnership working and peer support o Take account workforce issues particularly around recruitment of specialist skills o Viability of providing care where patient numbers may be small on a practice level but
sufficient case load when at network level Practices may sub-contract delivery clinical services to another provider on the basis of the following conditions being met and in accordance with the relevant subcontracting clauses within the GMS, PMS or APMS contract that the provider is contracted to provide medical services under. Ensuring:
o Convenient access for patients will be maintained – patients to be referred to a neighbouring practice either within the network which the referring practice operates or with a reasonable and accessible radius of the practice premises
o The provider has assured themselves that the sub-contracted practice can deliver services to the level of skill and quality standards described in this specification
o Payment for activity delivered under the LCS will still be made directly to the provider. Arrangements for payment from sub-contracting arrangements to be managed between those parties
o The provider will ensure they inform the CCG where services are being delivered from under these arrangements
o To inform the CCG where the arrangements change within 30 day of the change becoming material
o The provider will ensure adequate data sharing arrangements are in place
3.4. Updated appendix to include reference to reporting requirements and automated reporting.
As well as the addition of relevant reporting templates and timelines service specifications will
include the following:
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3.4.1. For those schemes where automation has been developed the service specification will include the following:
‘The CCG is working with the Croydon GP Collaborative to develop an approach to support
automation of reporting for LCS’ where this is appropriate to the information required. This process is
supported by a user guide and includes the process for reconciliation of returns in the next payment
run, in exceptional events where errors have been identified.
Payment for this service will only be made upon receipt of automated returns. Where there are issues
with automation this should be highlighted to the Enhanced Services Contracts Team.’
3.4.2. For those schemes where automation has not yet been developed:
‘The CCG is working with the Croydon GP Collaborative to develop an approach to support
automation of reporting for LCS’ where this is appropriate to the information required. This process is
supported by a user guide and includes the process for reconciliation of returns in the next payment
run, in exceptional events where errors have been identified.
Where automation is not developed at the start of 2020/21, consideration will made regarding the
feasibility of mid-year implementation taking into account potential additional work for practices to
transfer to a new reporting approach. Automation of returns will include the development of EMIS
templates which will be in line with current reporting requirements and will be supported by a user
guide. Updated reporting workbooks will also be provided with clear direction on which LCS’ should
be reported manually and which are only available for automated reporting.
Where changes to reporting are identified, the CCG will work with CGPC and practices to seek
feedback on proposals and ensure sufficient notice and support is implemented, commensurate with
the impact of proposed new ways of working on practices.’
4. Risks Risk Mitigation
Risk that increased uptake of schemes by practices and / or increased activity undertaken due to changes in approach (e.g. move to PCN based models of care) or increased communication may incur additional spend over previous years outturn.
Where identified, increases in activity and associated costs for 2020/21 have been highlighted. Ongoing review will be undertaken through confirmation of uptake of schemes by practices and monitoring of activity reports.
Risk that changes to the funding streams for the care home LCS’ due to the implementation of the PCN DES from October 2020 will impact on the uptake and delivery of care home support, and on local financial arrangements. The DES service specification has been released at £120 per bed and therefore represents a significant reduction in remuneration for practices compared with the current funding (£220) for nursing home residents.
Review of current funding arrangements has been undertaken. It is proposed that the current LCS arrangements are implemented for the period April to September 2020. During this time co-design will be undertaken with practices, LMC, PCNs and other stakeholders to develop a model of care which meets local needs and supports delivery of the care home DES requirements, for implementation from October 2020.
Risk to continuity for supporting, overseeing and developing LCS’ due to changes in organisational structure within both the CCG and CSU. This will affect:
Processes are in place to record handover arrangements for CCG staff as part of the transition to SWL CCG.
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• Processes to ensure practice payment for Q4 of 2019/20 (due end of May 2020)
• Ongoing oversight and management of schemes for 2020/21
Confirmation of leads for key areas of LCS management have been sought and are to be confirmed.
5. Communication and Next Steps: Final approval for all schemes for 2020/21 will be sought from the Primary Care Working Group,
Procurement Advisory Group, SMT and Primary Care Commissioning Committee in February /
March 2020, enabling release of schemes to practices for sign up on 3rd March 2020. To support
sign up, service specifications for schemes which are continuing or have previously been approved
agreed (i.e. group 1 or 2 described above) will be shared with practices shortly.
The following provides a summary of next steps for the LCS programme for ease of reference:
Date Stakeholders Aim
By 21st February 2020 All practices Share service specifications for ongoing services with all practices ‘pending PCCC approval’ Plus update on approach for all schemes
25th February 2020 (TBC) Primary Care Working Group
Approval
25th February 2020 PAG Approval
25th February 2020 SMT Approval
3rd March 2020 PCCC Approval
3rd March 2020 Practices Release of final service specifications and contract sign up sheets
25th March 2020 Practices Return of sign up sheets
1st April 2020 Practices LCS’ go live
6. Recommendation:
The Committee are asked to:
1. APPROVE the continuation of LCS schemes outlined herein for 2020/21 including: a. APPROVE the approach for the Care Home and Proactive Management LCS’ b. APPROVE the budget identified for the LCS programme c. NOTE the changes to the previously agreed plans for spirometry – separate paper for
approval supplied 2. APPROVE the additions to the service specification templates 3. NOTE and comment on the risks identified
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Appendix 1: Summary and spend by LCS The following table outlines the plans for each LCS, including spend identified, and an update on the changes to the service specification / service delivery requirements:
Name of LCS (2019/20) Summary of plans for 2020/21 Predicted spend 2020/21
summary of changes to service specification
Group 1 - No change to existing services
Barretts Oesophagus Management
No change to service for April 2020; ongoing review regarding this pathway in progress.
£ 45,700 Aligned with NHS standard contract
framework including additional text as outlined within section 3
Leg ulcer management / wound management (formerly part of the Basket LCS)
No change in service requirements, activity or cost identified - LCS disaggregated to support ongoing development and alignment with arrangements for local urgent care services (some activity currently undertaken within GP Hubs)
£ 368,550 Aligned with NHS standard contract
framework including additional text as outlined within section 3
Shared Care Prescribing / Zoladex (formerly part of the Basket LCS)
No change in service requirements, activity or cost - LCS disaggregated to support ongoing development and alignment with the approach for shared care across SWL
£ 198,450 Aligned with NHS standard contract
framework including additional text as outlined within section 3
Coeliac No service change for April 2020, no change in activity or cost identified. £ 20,000 Aligned with NHS standard contract
framework including additional text as outlined within section 3
ECG
No change to service for April 2020; however, ongoing review in progress due to end of contract for ECG reporting. Increased activity and associated costs identified for 2020/21 .
£ 132,000 Aligned with NHS standard contract
framework including additional text as outlined within section 3
Latent TB No service change for April 2020, no change in activity or cost identified. £ 79 Aligned with NHS standard contract
framework including additional text as outlined within section 3
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Name of LCS (2019/20) Summary of plans for 2020/21 Predicted spend 2020/21
summary of changes to service specification
MGUS & CLL No service change for April 2020, no change in activity or cost identified. Development of hub based model to be undertaken.
£ 11,500 Aligned with NHS standard contract
framework including additional text as outlined within section 3
Phlebotomy & Phlebotomy Community
No service change for April 2020, no change in activity or cost identified. £ 214,440 Aligned with NHS standard contract
framework including additional text as outlined within section 3
Pre-op Hernia Service to be decommissioned from 30th March 2020 - approved by PCCC December 2019, and communicated to practices.
£ - NA
Urology (prostate) No service change for April 2020, no change in activity or cost identified. £ 32,661 Aligned with NHS standard contract
framework including additional text as outlined within section 3
Ear Syringing To move from the pilot arrangements implemented in June 2019 to a substantive LCS for 20/21 (agreed by SMT 10th December 219)
£ 77,000 Aligned with NHS standard contract
framework including additional text as outlined within section 3
Elective Care transformation (blue button)
No change in service delivery, cost and activity identified. Scheme for 2020/21 will request that practices either deliver the current 8% reduction in referrals or maintain if already achieved.
£ 622,500 Aligned with NHS standard contract
framework including additional text as outlined within section 3
Mental Health Ongoing implementation of new scheme from 2019/20 £ 500,000 Aligned with NHS standard contract
framework including additional text as outlined within section 3
Group 2 - new or significant change on current arrangements
LTC Proactive and preventative LCS (business case pending final approval)
New service specification developed and approved by PCCC in December 2019. This specification includes PCN based working to support delivery of enhanced reviews and care planning.
£ 270,164 As per service specification agreed by
PCCC in December 2019.
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Name of LCS (2019/20) Summary of plans for 2020/21 Predicted spend 2020/21
summary of changes to service specification
Diabetes injectables
New service specification developed and approved by PCCC. Includes the option for injectable therapy delivery within the primary care networks. Increased activity and associated compared with 2018/19 and 2019/20. Engagement undertaken with PCN and practice leads.
£ 198,000 As per service specification agreed by
PCCC in December 2019.
Spirometry
New service specification developed and approved by PCCC in December 2019. This specification includes PCN based working to support delivery of the requirement regarding accreditation of staff undertaking spirometry. Funding previously identified included an increase in activity but no change in remuneration per test. However, on further discussion with practices potential increased costs have been identified as well as challenges with PCN working. Further report to be presented to the Primary Care Working Group in February 2020, including the option for delaying delivery of the revised service specification until late 2020. Spend updated to reflect this proposal
£ 131,000
2019/20 service specification aligned with NHS standard contract framework
including additional text as outlined within section 3
Group 3 - Services awaiting outcome of DES PCN Service Specification.
Proactive Management Proposal for continuation of the current service into 2020/21 outlined within section 2.3.2 given the DES service specification for anticipatory care has been delayed until 2021/22
£ 2,730,700 Aligned with NHS standard contract
framework including additional text as outlined within section 3
GP Care Homes Proposal for continuation of the current service to September 2020 outlined within section 2.3.2 to support delivery of the DES service specification from October 2020.
£ 519,906 Aligned with NHS standard contract
framework including additional text as outlined within section 3
TOTAL £ 6,072,649
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Appendix 2: Care Home LCS 1 April 2020 to 30 September 2020 - service specification
SCHEDULE 2 – THE SERVICES
A. Service Specifications
This is a non-mandatory model template for local population. Commissioners may retain the structure below,
or may determine their own in accordance with the NHS Standard Contract Technical Guidance.
Service Specification No. Draft specification – Pending PCCC approval 3rd March
2020
Service Enhanced Care Home Support
Commissioner Lead Kare Barkway
Provider Lead GP Practices
Period April 2020 – September 2020
Date of Review June 2020
1. Population Needs
Summary
This service aims to ensure that the best possible enhanced primary care is provided to people
living in both nursing and residential homes in Croydon. It does not replace the requirement
within the GMS core contract for practices to register patients who are residents of care homes
within their catchment area. However, it will operate as part of a wider, Care Home
Transformation programme, spanning secondary care, enhanced virtual support (telemedicine)
and other health and social care services. The overall aim is to improve outcomes and quality
of life for residents, enhance the care delivered in care homes and reduce avoidable pressures
on the wider healthcare system.
Problem statement
Croydon has the highest number of care homes in London, 131 care homes and approximately
2,700 beds (1517 in nursing homes and 1156 in residential homes). During 2017/18 demand
from unscheduled care from care homes generated the following pressures on the health and
social care system:
• Croydon has among the highest rate of ambulance call out rates in London: 2115
incidents in care homes between March 2017 and March 2018.
• Between March 2017 and March 2018, care home residents accounted for more than
2,000 non-elective admissions and 2,300 delayed days in 2017/18 (24% of all delayed
days).
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Local context
Croydon has good provision of health and social care services which support care homes; but
there are some gaps, inconsistencies and particular issues which need to be addressed:
• Inequitable split of patient registration and activity across different practices, with
practices registering higher or lower number of care home patients than would be
expected from their local care home population.
• Lack of consistent training and capability framework for care home staff, compounded
by high levels of staff turnover.
• Support services for care homes not consistently well co-ordinated or understood
• Evidence that care home staff do not know when and how to refer to care home
support services
• Significant pressure placed on primary care, leading to over reliance on emergency
services for crisis management
• Variable approach to pro-active care in managing chronic disease and medicine among
care homes residents
• Inconsistent approach to care planning, especially around end of life (EOL)
Many of the barriers to good care reflect the national picture: a narrow focus on medical rather
than holistic needs, reactive and inconsistent care and variable access for care home residents
to NHS services. This is compounded by the scale of Croydon’s care home market and
volume of patient need – which has created a compelling case for change and strong local
commitment for the successful delivery of a significant major multi-sector care home
transformation programme.
This programme is now being mobilised and includes a number of work-streams:
1. Enhanced primary care support for care homes through the delivery of this service specification
2. Mobilisation and effective embedding of telemedicine approach to support and enhance the delivery of care across Croydon’s care homes through addressing urgent care needs.
3. The development of the specialist care home support initiative which includes the Complex Care Support Service and enhanced medicines support.
4. The development of delivery of a LA/CCG bed commissioning strategy which seeks to achieve a consistent, streamlined and sustainable commissioning framework.
5. The development and delivery of a workforce development plan for care home staff focused on training and support designed to increase the capacity and capability of staff to support their patients and reduce unnecessary use of health and social care resources.
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Primary care
As part of wider transformation plans, NHS Croydon CCG supports primary care
transformation and more resilient and sustainable services to provide a consistent quality
service to residents of Croydon.
Following the release of the 1NHS Long Term Plan in January 2019, and the associated early
guidance on the approach for the 2GP Contract Framework, the requirements within this
specification have been aligned where possible to the latest national requirements. This
service therefore represents an interim arrangement for the period to 31st March 2020; and
aims to support the transition from the current service into the implementation of the national
service specification requirements.
Key within the NHS Long Term Plan is the development of Primary Care Networks (PCNs). A
network based approach to the support and management of Care Home residents has been in
discussion across Croydon for some time. Aiming to provide equitable registration, streamline
the number of practices supporting each individual Care Home, and continuing to build upon
the relationships between care homes and primary care, and facilitate inter- and intra-network
working to mitigate against the impact of the geographical spread of care homes and therefore
workload for these residents. The approach to network working for care homes will be
facilitated through PCNs in line with planning for the implementation of the new National
specification for ‘Enhanced Health in Care Homes’.
With the release of the DES Service specification for Enhanced Care in Care Homes in
February 2020, for implementation from October 2020, this LCS specification will be
implemented for the period April 2020 to 30 September 2020. The CCG will work with
wider primary care colleagues and other stakeholders to develop a new model of care
1 https://www.longtermplan.nhs.uk/
2 https://www.england.nhs.uk/publication/gp-contract-five-year-framework/
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which meets local needs and supports implementation of the DES requirements from
October 2020, enabling local requirements to be maintained and ensuring continuity of
care.
Telemedicine
The implementation of telemedicine to support care homes commenced in winter 2018/19. The
aim of this service is to provide support for both nursing and residential homes through remote
review of patients and provision of advice during periods of crisis or exacerbation of existing
conditions. Early data suggests that over 75% of the telemedicine contacts would have
otherwise contacted a GP for support, with only 27% of these requiring onward referral to a GP
service (both in and out of hours). This therefore provides an additional resource to support
care homes and reduce the reliance on GPs to respond to urgent requests for assistance.
Combined with the ward round and proactive review approach outlined within this specification
and the Proactive Management LCS service specification, this aims to provide a robust and
effective approach to managing the health needs of care home residents.
Service description: Enhanced care home LCS:
The overall aim is to improve outcomes and quality of life for residents, support nursing and
residential homes to provide more timely and appropriate care in the home, rather than utilising
the LAS and acute trust services. Other aims are to:
• Improve the quality of care delivered to care home residents and reduce avoidable pressures on the healthcare system.
• Provide consistency, co-ordination and a multidisciplinary (MDT) approach with rapid access to specialist advice when necessary.
• Promote independence and self-care for care home residents
• Support nursing and residential homes to provide more care in the home, rather than using emergency services inappropriately
1.3 Objectives
• Enhance access to personalised, high quality primary care for residents of care homes
• Ensure that the majority of care home residents are registered with Croydon practices which are delivering the LCS and located within reasonable proximity to the care home
• Ensure patients have high quality proactive care management plans (full requirements are outlined within the service specification for the Proactive Management LCS)
• Support medical optimisation of patients within nursing and residential homes
• Work with other services as required such as telemedicine, Integrated Care networks and the Complex Care Support Service
• Act as primary care resource for care home staff
• Improve: o Medicines management o Integrated and Proactive management planning o Patient experience; o Shared-care and joint working between health and social care professionals, and
care home teams o Shared Decision Making, including with residents, families and carers; o Self-care;
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2. Outcomes
2.1 NHS Outcomes Framework Domains & Indicators
Domain 1 Preventing people from dying prematurely
Domain 2 Enhancing quality of life for people with long-term conditions ✓
Domain 3 Helping people to recover from episodes of ill-health or following injury
✓
Domain 4 Ensuring people have a positive experience of care ✓
Domain 5 Treating and caring for people in safe environment and protecting them from avoidable harm
✓
2.2 Expected (local) outcomes
The Provider is expected to provide an enhanced primary care service for care homes (nursing
home and residential homes). This service will deliver the following outcomes:
Enhanced primary care service outcomes:
• Improved clinical care • Better co-ordination of services delivered within the care home • Alignment of services • Linkages with pathway development for complex care support • Better integration of proactive management pathway
Support wider Care home Transformation outcomes
• Better experience and outcomes for care home residents • Supported and sustainable care home model • Care home staff have tools, confidence and capability deliver timely and appropriate
care in the home • Reduce levels of inappropriate LAS call outs • Reduced levels of inappropriate A&E attendances • Reduces levels of inappropriate non-elective hospital admissions • Reduced length of stay following admission • Reduced inappropriate and lower acuity demand for unscheduled care services • Increase in positive CQC inspections • Reassurance for relatives and carers
▪
3. Scope
GP Practices are expected to provide the essential and additional services for which they are
contracted to provide to their registered patients through their core contract. The specification
of this service is designed to cover the enhanced aspects of clinical care for patients which are
beyond the scope of essential services. No part of the specification by commission, omission
or implication defines or redefines essential or additional services.
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3.1 Care Pathway and Requirements
The following diagram outlines the relationships and interdependencies between relevant
services:
Figure 1: Services supporting people with complex health needs
3.1.1 Proactive care management and review
The CCG has developed a proactive care clinical model which aims to ensure that patients
with complex and escalating needs receive the best care. Co-ordinate My Care (CMC) is used
as the template for the care plan. This approach is fully defined within the Proactive
Management LCS service specification.
The proactive plan should be a collaborative process between the patients (and carer/family).
The consultation should seek to address how their care will be managed to:
• Enable effective management of their long term conditions
• Enable optimum support for self-management
• Provide clear contact points for times of crisis/exacerbation
• Understand the patient’s interactions with other agencies providing support to them
• Consider the needs of the patient’s carers (this should be done via the Care home who
will have more contact with family on a regular basis)
• Review medications being taken by the patient and support improved compliance
where appropriate
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• Reduce their risk of avoidable admission to hospital
This plan will be regularly reviewed – on an annual basis as a minimum for stable patents - and
updated at key points including
• Unplanned admission
• Following discharge from intermediate care services (such as Living Independently For
Everyone (LIFE) services) (within 3 working days)
• New significant diagnoses,
• Contact with the Telemedicine service,
• Other significant change of circumstances.
This model operates across a joined-up continuum of care spanning enhanced primary care,
MDT Huddles and the Complex Care Support Service and is outlined within the above pathway
diagram (Figure 1 above).
3.1.2 MDT Huddles
MDT huddles are in place across all practices with Croydon. This multi-agency team aims to
discuss the care planning of people with complex health and care needs. The purpose is to
proactively plan care so to reduce the need for future hospital admissions or other escalated
care needs. Huddles are the cornerstone to the development of effective multi-agency working
and the establishment of Integrated Community Networks (ICNs). They provide a platform for
all community services to strengthen their working relationships through mutual learning and
open communication. The model provides opportunities to avoid delays, complex referral
processes and duplications for timely and efficient care for people.
Where required, MDT huddles may provide further opportunities to support care planning for
care home residents.
3.2 Key intervention points
Newly admitted care home residents will be visited within one week of admission to the care
home. The review should cover:
• Information gathering;
• Initial physical and mental health assessment;
• medication reconciliation; with a full medication review supported by a pharmacist within
1 month
• Completion of co-ordinate my care record (or review and updating if already developed)
▪ 3.3 Care Home Ward Rounds
Practices will provide regular routine ward MDT rounds which should include the care home GP,
other key individuals, such as pharmacists and other ICN staff, and senior care home staff. Ward
rounds should be mutually agreed with the care home and the frequency agreed with the Care
Home Manager appropriate to the size and complexity of the residents and performance of the
Care Home. The purpose of the ward round is to:
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• Co-ordinate clinical activities to enable the provision of timely, quality care for patients and their families – shifting the balance of care from reactive to proactive.
• Update the Co-ordinate My Care (CMC) record and comprehensive geriatric assessment as it develops.
• Identifying residents requiring proactive care to remain healthy • Providing responsive care in a timely way • A whole system approach to care delivery
3.3.1 Frequency of ward rounds
GPs will decide the most appropriate frequency of ward round based on clinical need and in
discussion with the Care Home Manager. However, a review on a weekly basis would be
recommended for nursing homes. For residential homes, a reduced frequency of ward rounds
is likely to be sufficient and is recommended to take place monthly as a minimum. Noting that,
as a new service for residential homes, more frequent ward rounds may be required initially.
The time required for a ward round will vary according to the number of patients, their needs
and the professional skills required.
3.4 Medication review
GPs will be expected to work with pharmacists to ensure medications are optimised as soon as
practically possible. Pharmacists will attend ward rounds until such medications are optimised.
Pharmacists may be members of the CCG medicines optimisation team or identified by the
practice and accredited by the CCG medicines optimisation team.
Once optimised, medication focussed ward rounds should take place every six months.
3.5 Emergency admissions review
Residents who have had an emergency admission should be reviewed during the agreed ward
rounds, and if further support and review is required, referred into the Complex care support
team
The review will cover:
• what could have avoided the emergency admission
• what will be done differently next time
• to identify gaps in service
3.6 Responsibilities of the GP
In order for the service to be effective participating GPs will be expected to:
• Work with care home staff and other specialists to prepare patients and families in
advance, when appropriate, to facilitate shared decision making and review
• Ensure that all relevant actions are implemented/handover over
• Attend best interest meetings
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• Develop clear management and clinical protocols to achieve clear communications with
all staff in the care home, including managers, nursing staff and administrative staff. This
could include agreed processes for repeat and urgent prescriptions, use of the
telemedicine service and how to obtain a telephone opinion or triage in urgent
circumstances;
• Liaise with patients previous GP (or current GP if only temporarily registered in Croydon)
where necessary
3.7 Additional responsibilities
Croydon CCG is strengthening specialist palliative care input to the care planning progress. This
includes:
• Expansion of the PEACE (PErsonalised Advisory CarE) planning model to at least 140
patients including 10 care homes. The PEACE plan is a document to help health care
professionals deliver the best care to frail, people with life-limiting illnesses who are
anticipated to be in the last year of their life and reside in a care home. PEACE will be
delivered by specialist nurses with community geriatrician oversight, the PEACE planning
process can indicate how best to deliver care in the care home, and what support is
available in the community to do this. GPs will not be responsible for the development
of this plan but may be requested to provide information where appropriate.
• EOLC focussed ICN huddles with specialist input from St Christopher’s hospice. These
occur on a 6 weekly basis, depending on GP list size.
3.8 Interdependence with other services/providers
GPs will be expected to work closely with:
• Complex Care Support Team which operates to enhance best practice and improve quality aligned to CQC domains.
• Highly Specialist Speech and Language Therapist which manages and supports patients with swallowing difficulties (dysphagia) and training to Care Home staff and other Health Professionals.
• Croydon Mental Health of Older Adults and Psychological Medicine (CHIT) • St Christopher’s Hospice provides training and education – joint End of Life care reviews • Integrated Community Networks.
The service will also be expected to give particular focus to support the effective delivery
of the following services:
Complex care support Team which is an extension of the existing Integrated Community
Networks. It comprises specialist staff (e.g. Community Geriatrician, mental health workers) and
will provide specialist advice/consultation; assessment and care planning support; and training
and development to support front line workers to proactively manage people with complex health
and care needs.
Telemedicine service Supporting 80 care homes across Croydon, this new service provides an
accessible single point of access 24/7 365 days per year, and access to a highly experienced
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telemedicine clinical team providing timely and responsive comprehensive “visual” assessments
of the resident via HD video links.
▪ 3.9 Care home workforce
Responsibilities of Care Home Managers to support the service are set out under appendix 1.
3.10 Network based delivery
The ambition is for this model to facilitate closer working with a range of local providers, including across
primary care. In line with the ambition to realise integrated working the CCG is supporting practices to
work collaboratively to deliver the services outlined in this specification. Some of the key benefits in
operating in this way include;
• Primary care can operate more effectively in partnership with other providers
• Better use of resources through economies of scale in pooling resources
• Enable practices to benefit from partnership working and peer support
• Take account workforce issues particularly around recruitment of specialist skills
• Viability of providing care where patient numbers may be small on a practice level but sufficient case load when at network level
Practices may sub-contract delivery clinical services to another provider on the basis of the following
conditions being met and in accordance with the relevant subcontracting clauses within the GMS, PMS or
APMS contract that the provider is contracted to provide medical services under. Ensuring:
• Convenient access for patients will be maintained – patients to be referred to a neighbouring practice either within the network which the referring practice operates or with a reasonable and accessible radius of the practice premises
• The provider has assured themselves that the sub-contracted practice can deliver services to the level of skill and quality standards described in this specification
• Payment for activity delivered under the LCS will still be made directly to the provider. Arrangements for payment from sub-contracting arrangements to be managed between those parties
• The provider will ensure they inform the CCG where services are being delivered from under these arrangements
• To inform the CCG where the arrangements change within 30 day of the change becoming material
• The provider will ensure adequate data sharing arrangements are in place
▪ 4. Applicable Service Standards
1. Practices participating in the LIS will be required to provide the following monitoring
information on an annual basis (as per workbook in Appendix 2)
I. Patient ID, and date arrived in care home
II. Dates of urgent / emergency visits or interventions undertaken by the GP to
support residents
III. Frequency of ward rounds undertaken by the GP Practice within the home and
the activity undertaken
IV. Confirmation whether telephone consultations are used to support patients
V. Number of advanced care plans completed (recorded in CMC in line with the
Proactive Management LCS requirements) including resuscitation decisions and
DNaCPR forms as required
VI. Number of medication reviews undertaken including anticipatory prescribing
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2. The above monitoring will be performance managed and validated through the Contracting
Team’s returns process from practices to claim their annual payments.
3. Practices are asked to ensure that patient contacts are appropriately recorded and coded
on EMIS / Vision to support the development of automated reporting.
5. Applicable quality requirements and CQUIN goals
Practices signing up to this scheme will be expected to participate fully in the initiatives and
services describes above to support Care Home Residents, as well as complying with and
supporting the delivery of, national guidance e.g. Managing Medicines in Care Homes NICE
Guidance3
6. Location of Provider Premises
Not applicable. The service will be delivered from Croydon care homes.
7. Individual Service User Placement
Not used
8. Payment
Practices signing up to this scheme will receive:
• £220 payment per patient per year for nursing homes
• £120 payment per patient per year for residential homes
NB:
• Workbooks should clearly articulate any changes to individual residents circumstances
(leaving care home or RIP – to be included within the field ‘ date patient no longer
permanent resident at care home’) to support payment on a per patient basis within the
total number of beds for that care home.
See appendix 1 for reporting requirements
Appendix 1: Reporting
The CCG is working with the Croydon GP Collaborative to develop an approach to support automation of
reporting for LCS’ where this is appropriate to the information required. This process is supported by a user
guide and includes the process for reconciliation of returns in the next payment run, in exceptional events
where errors have been identified.
3 https://www.nice.org.uk/Guidance/SC1
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Reporting for this LCS is through completion and submission of the automated return for care homes via EMIS
Enterprise and will be collected at the end of Q2 for the period April 2020 to September 2020.
Further queries on this process can be raised via:
▪ CROCCG.EnhancedServicesClaims@nhs.net
1. Submission of returns
▪ Submissions can only be made by e-mail and no paperwork copies will be accepted. Where automated
reporting is available through EMIS Enterprise, emails will not be accepted.
2. Submission Dates
▪ Data must be submitted to the CCG at the end of quarter 2. Please note the following submission dates for the
year:
• TBC
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Appendix 2: Responsibilities of Care Home Manager
The care home manager will be expected to
• Support proactive GP involvement for their homes and provide feedback to relevant
bodies of any concerns
• Arrange for a patient to be registered with the nominated GP practice under this
scheme as soon as possible upon arrival in the home unless the patient is choosing
to stay with another GP practice.
• Ensure that summary patient information from the patient’s previous practice, including
list of medications, is available to the GP within 3 days of the patient’s arrival
• Make sure that the patient’s medication record and any new any hospital-provided or
community service information is made available to the GP when visiting the patient.
• Provide the GP with a list of patients with queries/issues prior to every ward round visit
using a secure method of communication
• Arrange for the nurse in charge/on duty to be available to discuss patients on the list
with the visiting GP and accompany the GP to see any patients. Drug charts should
be to hand.
• Ensure that key points arising from these visits are communicated to colleagues or
written in nursing notes.
• Work with the GP to address medication issues in order to reduce prescribing errors
and promote high quality and cost effective prescribing.
• Ensure full engagement with the telemedicine service from all staff through training
and identification of a telemedicine champion.
• Make all reasonable efforts to contact the responsible GP practice; or telemedicine
service where an urgent review is required
▪
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Appendix 3: Assurance process for GP practice pharmacists undertaking medication reviews.
The Quality assurance process for GP practice pharmacists undertaking reviews in care homes as
part of the LCS 2019/20 has been approved and is attached below.
Assurance process
for GP practice pharmacists undertaking medication reviews in Care homes as part of the GP care home locally commissioned scheme 2019-20.pdf
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REPORT TO CROYDON CLINICAL COMMISSIONING GROUP PRIMARY CARE COMMISSIONING COMMITTEE (PART 1)
3 March 2020
Title of Paper: Commissioning Update
Lead Director William Cunningham-Davis Head of Primary Care Commissioning SW London Primary Care
Report Author SWL Primary Care Team
Committees which have previously discussed/agreed the report.
Primary Care Commissioning Working Group, 26th February 2020
Committees that will be required to receive/approve the report
Primary Care Commissioning Committee
Purpose of Report For Approval and for Noting
Recommendation:
The Primary Care Commissioning Committee is asked to:
• Approve the recommendation to issue a Remedial Notice relating to contractual breaches identified following the CQC’s inspection visit findings for East Croydon Medical Centre / Edridge Road.
• Approve the recommendation to issue a Remedial Notice relating to contractual breaches identified following the CQC’s inspection visit findings for Hartland Way Surgery.
• Note the merger update for Addington Medical Practice and Dr Baskaran, Parkway Health Centre.
Background & Key Issues:
• East Croydon Medical Centre / Edridge Road Community Health Centre This summary provides the Primary Care Commissioning Committee with an overview of the contractual requirements breached by East Croydon Medical Centre and Edridge Road Community Health Centre which have been identified following a joint inspection of the practices by the CQC as outlined below.
6 November 2019 visit (publication 8 January 2020) Overall ‘requires improvement’. ‘Requires improvement’ in ‘safe’, ‘effective’, ‘responsive’ and ‘well-led’ domains and ‘good’ in ‘caring’ domain.
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If a practice has been rated overall as ‘requires improvement’, the Standard Operating Procedure for Commissioners in responding to CQC reports, states that if three or more domains are rated as such, it is suggested that formal contractual action would be reasonable and proportionate. The concerns identified cover a high number of areas e.g. recruitment checks, staff records, appraisals, training, premises and security; governance systems; significant events systems and learning; medicines and safety alerts implementation system; infection control audit actions; monitoring of vaccine fridge temperature; blood tests reviews. PMS/APMS contractual clauses breached are respectively Clauses 76/69 ‘Compliance with Legislation and Guidance’; Clauses 9/4 ‘Quality Standards’; Clauses 11/50 ‘Clinical Governance’; Clauses 14/12 ‘Infection Control’; Clauses 21/14 ‘Training’. It is recommended that a Remedial Notice is issued to both practices, requesting that they complete and submit an action plan with supporting evidence to the Commissioners for review, within 28 days of the issue date, and that a visit to the practices will be arranged by Commissioners to progress this. This recommendation was agreed by the Primary Care Commissioning Working Group on 26 February 2020.
• Hartland Way Surgery This summary provides the Primary Care Commissioning Committee with an overview of the contractual requirements that have been breached by Hartland Way Surgery. The breaches in contractual compliance have been identified following an inspection of the practice by the CQC as outlined below.
3 November 2019 visit (report published on 7 January 2020) Overall ‘requires improvement’. ‘Requires improvement’ in ‘safe’, ‘effective’ and ‘well-led’ domains and ‘good’ in ‘caring’ and ‘responsive’ domains. The concerns identified by the CQC include – systems and processes requiring improvement to keep patients safe e.g. no robust system for recruitment management, safety system, infection prevention and control; medicines management; safety alerts; appropriate staff training incomplete; not demonstrating improved outcomes for patients from their quality improvement activities; governance arrangements need improving as no staff meetings to effectively share learning. PMS clauses breached are Clause 76 ‘Compliance with Legislation and Guidance’; Clause 9 ‘Quality Standards’; Clause 11 ‘Clinical Governance’; Clause 14 ‘Infection Control’; Clause 19 ‘Staff’; Clause 21 ‘Training’.
It is recommended that a Remedial Notice is issued to the practice, requesting that they complete and submit an action plan with supporting evidence to the Commissioners for review, within 28 days of the issue date, and that a visit to the practice will be arranged by Commissioners to progress this. This recommendation was agreed by the Primary Care Commissioning Working Group on 26 February 2020.
• Addington Medical Practice (AMP) and Dr Baskaran, Parkway Health Centre (PHC)
This summary provides the Primary Care Commissioning Committee with an overview of progress regarding the merger of AMP and PHC, for noting. The merger was approved in 2018 as a two-stage merger. The first stage involved
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varying both contracts to include the same partners on each contract from 1st April 2019, with the practices working as one practice, sharing services and staff. A full business case has been provided and the second stage for the full merger is currently underway, involving the IT systems merger and the termination of the PHC contract. The date of the full merger will be in the new financial year (2020/21), actual date to be confirmed. No change is required to the practice boundary as it covers both practice catchment areas.
Governance:
Corporate Objective To commission integrated, safe, high quality service in the right place at the right time.
Risks
Need to ensure the best possible GP services to patients registered with this practice – adverse CQC reports highlight risks that need resolving
Financial Implications
n/a
Conflicts of Interest
Any GP who may have an interest in providing services to practice’s patients
Clinical Leadership Comments n/a
Implications for Other CCGs
n/a
Equality Analysis
n/a
Patient and Public Involvement
n/a
Communication Plan n/a
Information Governance Issues
n/a
Reputational Issues
Need to ensure the best possible GP services to patients registered with this practice – adverse CQC reports could potentially erode confidence in services in this practice.
SW London Primary Care Team swlhcp.swlprimarycare@nhs.net 26th February 2020
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South West London Primary Care Contracts
Summary Report 2019/20 Q3 – Croydon CCG
Date: 01/01/2020
Prepared by the SWL Primary Care Contracting Team on behalf of
Croydon CCG
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Contract Variations
2
Practice Code
Practice NameContract
TypeList Size
Type of Action Contract Variation Details
Number of Partners following variation
Date of Change
Status Status Action
H83013 Old Coulsdon Medical Practice PMS 14980 Partnership Change Dr has joined the partnership 5 01/04/19 Agreed Complete
H83015 Parkside Group Practice PMS 13222 Partner Retirement Dr has taken 24hr Retirement 4 01/04/19 Agreed Complete
H83027 Parkway Health Centre PMS 6264 Partnership Change Dr has joined the Partnership 5 01/04/19 Agreed Complete
H83028 Addington Medical Practice PMS 3308 Partnership Change 3 Drs has joined the partnership 5 01/04/19 Agreed Complete
H83011 North Croydon Medical Centre PMS 5362 Partnership Change Dr has resigned from the partnership 2 16/04/19 Agreed Complete
H83020 Eversley Medical Practice PMS 10629 Partner Retirement Dr has taken 24hr Retirement 3 01/05/19 Agreed complete
H83625Broughton Corner Medical Centre
PMS 3704 Partnership Change Dr has resigned from the partnership 1 01/07/19 Agreed Complete
H83050 The Moorings Medical Practice PMS 6146 Partner Retirement Dr has taken full retirement 2 30/09/19 Agreed Complete
H83016 Keston Medical Practice PMS 16108 Partnership Change 5 Drs has joined the partnership 7 01/10/19 Agreed Complete
H83050 The Moorings Medical Practice PMS 6146 Partnership Change 2 Drs has joined the partnership 7 01/10/19 Agreed Complete
H83010South Norwood Hill Medical Centre
PMS 6986 Partnership Change Dr (Managing Partner) will join the partnership 2 31/01/20 Withdrawn Practice has withdrawn the CV
H83010South Norwood Hill Medical Centre
PMS 6986 Partnership Change Dr will leave the partnership 2 01/02/20 PendingRequest on hold until additional GP partner joins
H83004 The Farley Road Surgery PMS 11669 Partner Retirement Dr will take 24hr Retirement 1 22/02/20 Agreed Complete
H83001 Portland Medical Centre PMS 12154 Partnership ChangeDr and Managing Partner will resign from their partnership
3 31/03/20 Pending Draft CV sent to Practice
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Contract Variations
Variations typeCroydon
Pending Withdrawn Agreed
Partnership Change 2 1 7
Partnership Retirement 4
Change in Practice Details
Contractual change
Merger
Terminations
PMS to GMS
Contractual Breach Notice
List Closure
Branch Open / Closure
Total2 1 11
Grand Total14
3
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Infection Control audits
4
Summary of Infection Control Visits - Croydon CCG 16/17 17/18 18/19 19/20
Contra
ct Type
Practic
e CodePractice Name
Main Practice
/Branch
Date of
Audit
Overall
Complia
nce
Score
RAG PriorityDate of
Audit
Overall
Complia
nce
Score
RAGMinor
Surgery
2018/19
Priority
Date of
Audit
Overall
Complia
nce
Score
Minor
SurgeryPriority
Date of
Audit
Overall
Complia
nce
Score
PMS H83001Portland Medical Centre Main Practice No No
PMS H83004The Farley Road Surgery Main Practice 01/07/16 99% Green Yes Yes
PMS H83004The Farley Road Surgery
(Holmbury Grove)Branch 01/07/16 98% Green Yes Yes
PMS H83005Upper Norwood Group Practice Main Practice 20/07/16 95% Green Yes Yes
APMS H83006AT Medics Parkway Health
CentreMain Practice 12/07/16 97% Green No Yes
APMS H83006AT Medics Fieldway Medical
PracticeBranch No Yes ==>
PMS H83007Violet Lane Medical Practice Main Practice Yes Yes
GMS H83008The Addiscombe Road Surgery Main Practice Yes ==> 11/09/18 14/14 Yes
GMS H83008The Addiscombe Road Surgery Branch Yes Yes
PMS H83009Norbury Health Centre Main Practice Yes Yes
PMS H83010South Norwood Hill Medical
CentreMain Practice 22/09/16 97% Green 25/07/17 88% AMBER Yes Yes
PMS H83011North Croydon Medical Centre Main Practice No ==> 18/09/18 10/14 No
PMS H83012St James' Medical Practice Main Practice Yes Yes
PMS H83012St James' Medical Practice Branch Yes Yes ==> 02/07/19 13/14
PMS H83013Old Coulsdon Medical Practice Main Practice 18/07/16 98% Green Yes Yes
PMS H83014Queenhill Medical Practice Main Practice Yes Yes
PMS H83015Parkside Group Practice Main Practice 21/07/16 95% Green Yes Yes
PMS H83016Keston Medical Practice Main Practice ==> 15/11/17 98% GREEN Yes Yes
PMS H83017Brigstock and South Norwood
Medical PartnershipMain Practice Yes Yes
PMS H83018The Selsdon Park Medical
PracticeMain Practice Yes Yes
PMS H83019Friends' Road Medical Practice Main Practice Yes Yes ==>
PMS H83020Eversley Medical Practice Main Practice 11/07/16 93% Amber Yes ==> 19/09/18 11/15 Yes
PMS H83021London Road Medical Practice Main Practice Yes Yes
PMS H83022Thornton Heath Medical Centre Main Practice ==> 21/11/17 79% RED Yes 15/05/18 12/14 Yes
PMS H83023Morland Road Surgery Main Practice Yes ==> Yes ==>
PMS H83024Woodcote Medical Main Practice 13/09/16 95% Green Yes 02/10/18 14/15 Yes
PMS H83024Woodcote Medical Branch 13/09/16 94% Amber Yes ==> 15/10/18 14/14 Yes
PMS H83027Parkway Health Centre Main Practice Yes ==> 11/09/18 11/14 No
PMS H83028Addington Medical Practice Main Practice No Yes
PMS H83028Gravel Hill Surgery Branch 01/09/16 97% Green No Yes
PMS H83029Hartland Way Surgery Main Practice Yes Yes ==>
GMS H83030Broom Road Medical Practice Main Practice 15/09/16 96% Green No N/A
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Infection Control audits
5
Summary of Infection Control Visits - Croydon CCG 16/17 17/18 18/19 19/20
Practic
e CodePractice Name
Contra
ct Type
Main Practice
/Branch
Date of
Audit
Overall
Complia
nce
Score
RAG PriorityDate of
Audit
Overall
Complia
nce
Score
RAGMinor
Surgery Priority
Date of
Audit
Overall
Complia
nce
Score
Minor
SurgeryPriority
Date of
Audit
Overall
Complia
nce
Score
H83031The Haling Park
PartnershipPMS Main Practice 22/08/16 96% Green No Yes
H83033Ashburton Park Medical
Centre GMS Main Practice 30/08/16 98% Green No No
H83034The Whitehorse Practice PMS Main Practice Yes Yes
H83037Auckland Surgery PMS Main Practice Yes Yes
H83039Stovell House Surgery PMS Main Practice Yes Yes
H83040Mitchley Avenue Surgery PMS Main Practice ==> 15/11/17 95% GREEN Yes Yes
H83042Leander Road Primary
Care CentreGMS Main Practice Yes Yes ==>
H83043Shirley Medical Centre GMS Main Practice Yes Yes
H83043Shirley Medical Centre GMS Branch ==> Yes Yes ==>
H83044East Croydon Medical
PracticePMS Main Practice Yes Yes
H83049AT Medics Headley Drive
SurgeryAPMS Main Practice 12/07/16 98% Green No Yes
H83050The Moorings Medical
PracticePMS Main Practice 31/08/16 93% Amber Yes Yes
H83051AT Medics Thornton Road
SurgeryAPMS Main Practice 23/08/16 99% Green No No
H83051AT Medics Valley Park
SurgeryAPMS Branch No No
H83052Bramley Avenue Surgery GMS Main Practice 19/09/16 99% Green No No
H83053Parchmore Medical Centre PMS Main Practice 05/09/16 99% Green Yes Yes
H83608Brigstock Family Practice PMS Main Practice No No
H83609Mersham Medical Centre PMS Main Practice 26/09/16 97% Green Yes Yes
H83611Selhurst Medical Centre GMS Main Practice 06/09/16 99% Green No N/A
H83624Fairview Medical Centre PMS Main Practice 28/09/16 94% Amber Yes Yes
H83625Broughton Corner Medical
CentrePMS Main Practice 03/10/16 95% Green No No
H83627The Birdhurst Medical
PracticePMS Main Practice No No
H83631Greenside Group Practice PMS Main Practice 19/07/16 99% Green Yes Yes
H83631Greenside Group Practice
(Lennard Road branch)PMS Branch 19/07/16 98% Green Yes Yes
Y02962Edridge Road Community
Health Centre APMS Main Practice 25/08/16 95% Green Yes ==>
Y05317Country Park Practice PMS Main Practice 27/04/16 96% Green Yes Yes
Y05318Denmark Road Surgery PMS Main Practice 26/04/16 99% Green Yes 09/11/18 6/15 Yes ==>
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6
Practice DetailsDates of CQC Inspection
or Annual Regulatory Review (ARR)CQC Ratings
Practice Code
Practice NameYear of
Inspection or ARR
Date of Inspection or
ARR
Date of Publication
CQC OVERALL Rating
SAFE Rating
EFFECTIVE Rating
CARING Rating
RESPONSIVE Rating
WELL-LED Rating
H83001 Portland Medical Centre 2017-18 14/07/17 17/08/17 Good Good Good Good Good Good
H83004 The Farley Road Surgery 2016-17 18/01/17 16/03/17 Good Good Good Good Good Good
H83005 Upper Norwood Group Practice 2016-17 08/03/17 30/03/17 Good Good Good Good Good Good
H83006 New Addington Group Practice 2018-19 19/12/18 11/02/19 Good Good Good Good Good Good
H83007 Violet Lane Medical Practice 2019-20 29/05/19 03/07/19 Good Good Good Good Good Good
H83008 The Addiscombe Road Surgery 2018-19 24/01/19 11/03/19 Good Good Good Good Good Good
H83009 Norbury Health Centre 2017-18 11/04/17 10/05/17 Good Good Good Good Good Good
H83010 South Norwood Hill Medical Centre 2017-18 15/02/18 29/03/18 Good Good Good Good Good Good
H83011 North Croydon Medical Centre 2016-17 21/06/16 06/11/17 Good Good Good Good Good Good
H83012 St James' Medical Practice 2016-17 18/08/16 08/02/17 Good Good Good Good Good Good
H83013 Old Coulsdon Medical Practice 2016-17 26/05/16 04/07/16 Good Good Good Good Good Good
H83014 Queenhill Medical Practice 2017-18 09/01/18 15/03/18 Good Good Good Good Good Good
H83015 Parkside Group Practice 2016-17 16/11/16 17/02/17 Good Good Good Good Good Good
H83016 Keston Medical Practice 2017-18 25/04/17 02/06/17 Good Good Good Good Good Good
H83017 Brigstock Medical Centre 2019-20 28/05/19 15/07/19 GoodRequires
ImprovementGood Good Good Good
H83018 The Selsdon Park Medical Practice 2016-17 05/07/16 23/09/16 Good Good Good Good Good Good
H83019 Friends' Road Medical Practice 2015-16 20/11/15 12/05/16 Good Good Good Good Good Outstanding
H83020 Eversley Medical Practice 2017-18 12/09/17 31/10/17 Good Good Good Good Good Good
H83021London Road Medical Practice/ Cavendish house
2016-17 05/09/16 26/10/16 Good Good Good Good Good Good
H83022 Thornton Heath Health Centre 2017-18 08/09/17 09/10/17 Good Good Good Good Good Good
H83023 Morland Road Surgery 2016-17 14/10/16 15/11/16 Good Good Good Good Good Good
H83024 Woodcote Medical 2016-17 28/06/16 01/08/16 Good Good Good Good Good Good
H83027 Parkway Health Centre (Dr B Baskaran) 2016-17 05/04/16 12/05/16 Good Good Good Good Good Good
H83028 Addington Medical Practice 2018-19 12/02/19 24/04/19 GoodRequires
ImprovementGood Good Good Good
H83029 Hartland Way Surgery 2016-17 17/05/16 22/06/16 Good Good Good Good Good Good
CQC inspections
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CQC inspections
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Practice DetailsDates of CQC Inspection
or Annual Regulatory Review (ARR)CQC Ratings
Practice Code
Practice NameYear of
Inspection or ARR
Date of Inspection or
ARR
Date of Publication
CQC OVERALL Rating
SAFE Rating
EFFECTIVE Rating
CARING Rating
RESPONSIVE Rating
WELL-LED Rating
H83030 Broom Road Medical Practice 2017-18 25/07/17 12/09/17 Good Good Good Good Good Good
H83031 The Haling Park Partnership 2016-17 25/08/16 04/11/16 Good Good Good Good Good Good
H83033 Ashburton Park Medical Centre 2016-17 15/12/16 31/01/17 Good Good Good Good Good Good
H83034 The Whitehorse Practice 2015-16 31/03/16 24/08/16 Good Good Good Good Good Good
H83037 Auckland Surgery 2017-18 18/05/17 13/06/17 Good Good Good Good Good Good
H83039 Stovell House Surgery 2018-19 13/12/18 04/02/19 Good Good Good Good Good Good
H83040 Mitchley Avenue Surgery 2015-16 17/12/15 14/07/16Requires
mprovementRequires
ImprovementGood Good Good
Requires Improvement
H83042 Leander Road Primary Care Centre 2017-18 08/11/017 05/12/17 Good Good Good Good Good Good
H83043 Shirley Medical Centre 2018-19 23/01/19 22/03/19 Good Good Good Good Good Good
H83044 East Croydon Medical Practice 2018-19 05/09/18 14/11/18Requires
improvementGood
Requires Improvement
Good GoodRequires
Improvement
H83049 AT Medics Headley Drive Surgery 2016-17 11/08/16 24/02/17 Good Good Good Good Good Good
H83050 The Moorings Medical Practice 2017-18 11/05/17 13/06/17 Good Good Good Good Good Good
H83051 Thornton Road and Valley Park Surgery 2016-17 27/07/16 18/11/16 Good Good Good Good Good Good
H83052 Bramley Avenue Surgery 2017-18 25/04/17 25/05/17 Good Good Good Good Good Good
H83053 Parchmore Medical Centre 2016-17 10/05/17 07/06/17 Good Good Good Good Good Good
H83608 Brigstock Family Practice 2019-20 26/01/19 31/05/19 Good Good Good Good Good Good
H83609 Mersham Medical Centre 2019-20 03/07/19 16/08/19 Good Good Good Good Good Good
H83611 Selhurst Medical Centre 2016-17 05/05/16 24/06/16 Good Good Good Good Outstanding Good
H83624 Fairview Medical Centre 2017-18 24/05/17 27/06/17 Good Good Good Good Good Good
H83625 Broughton Corner Medical Centre 2016-17 17/06/16 05/12/16 Good Good Good Good Good Good
H83627 The Birdhurst Medical Practice 2018-19 12/12/18 08/02/19 Good Good Good Good Good Good
H83631 Greenside Group Practice 2019-20 08/05/19 12/07/19Requires
improvementRequires
ImprovementRequires
ImprovementGood Good Good
Y02962 Edridge Road Community Health Centre 2018-19 02/08/18 23/10/18 Inadequate Good InadequateRequires
ImprovementInadequate Inadequate
Y05317 Country Park Practice 2019-20 08/05/19 12/07/19Requires
improvementRequires
ImprovementRequires
ImprovementGood Good Good
Y05318 Denmark Road Surgery 2019-20 23/10/19 10/12/19Requires
improvementRequires
ImprovementRequires
ImprovementGood Good
Requires Improvement
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SWL Primary Care Contracting Team
Email : swlhcp.swlprimarycare@nhs.net
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Page 1 of 3
REPORT TO CROYDON CLINICAL COMMISSIONING GROUP PRIMARY CARE COMMISSIONING COMMITTEE (PART 1)
Tuesday 3rd March 2020
Title of Paper: 2019 GP Patient Survey
Lead Director William Cunningham-Davis Head of Primary Care Commissioning SW London Primary Care
Report Author SWL Primary Care Team
Committees which have previously discussed/agreed the report.
Primary Care Working Group
Committees that will be required to receive/approve the report
Primary Care Commissioning Committee
Purpose of Report For Noting
Recommendation:
The Primary Care Commissioning Committee is asked to note the following: 1. 2019 Croydon CCG GP Patient Survey – SWL Primary Care Team 2. 2019 SWL GP Patient Survey – NHSE/I Patient and Public Voice Team
Background:
The 2019 GP Patient Survey results were published by Ipsos Mori in July 2019. 1. The SWL Primary Care Team undertook a review of the 2019/20 GP Patient Survey for
Croydon CCG (Appendix 1a). The slides provide a comparison against 2018 achievement and the SWL & NHS England averages, for a sample of the questions. Appendix 1b provides breakdown of the 2019 survey results for Croydon CCG published by Ipsos Mori.
2. The Patient and Public Voice Team at NHS England & Improvement have recently undertaken a review of the 2019 GP Patient Survey Results. Appendix 2 provides a copy of their review for South West London. This is the first time the team have undertaken this work, and currently the slides remain unpublished.
Key Issues:
n/a
Governance:
Corporate Objective To commission integrated, safe, high quality service in the right place at the right time.
Risks
n/a
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Financial Implications
n/a
Conflicts of Interest
n/a
Clinical Leadership Comments n/a
Implications for Other CCGs
n/a
Equality Analysis
n/a
Patient and Public Involvement
n/a
Communication Plan n/a
Information Governance Issues
n/a
Reputational Issues
Need to ensure the best possible GP services to patients registered with this practice – adverse CQC reports could potentially erode confidence in services in this practice.
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Recommendation The Primary Care Commissioning Committee is asked to note the attached reviews of the 2019 GP Patient Survey. SW London Primary Care Team swlhcp.swlprimarycare@nhs.net 26th February 2020
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GP Patient Survey 2019
Croydon CCG
Summary Report
SWL Primary Care Team
October 2019
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Contents
2
No. Section Slide no.
1 Introduction 3
2 Background to GP patient Survey 4
3 Section1: CCG results 5
4 Section 2: Practice achievement against SWL and England averages 6 – 16
5 Section 3: Practice rankings 17 – 18
6 Summary 19
7 Further information 20
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Introduction
The 2019 GP Patient Safety results were published in July 2019. This summary report provides some further detail and comparable results to help inform the CCG for planning work with practices to address any concerns and to develop action plans in order to improve patient satisfaction.
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Background to the GP Patient Survey
The GP Patient Survey (GPPS) is an England-wide survey, providing practice-level data about patients’ experiences of their GP practices.
Ipsos MORI administers the survey on behalf of NHS England.
This slide pack presents some of the key results for NHS Croydon CCG.
The data in this slide pack are based on the July 2019 GPPS publication. In contrast to previous years when the survey was carried out across two
waves, the GPPS now consists of a single wave of fieldwork carried out annually, from January 2019 to March 2019. However, the sample size
has remained similar, continuing to provide practice-level data.
In NHS Croydon CCG, 19,992 questionnaires were sent out, and 5,481 were returned completed. This represents a response rate of 27% (-0.6%
from the previous year).
Prior to 2015 these slide packs presented Area Team averages for each CCG. These are no longer included following the integration of Area Teams
into the four existing Regional Teams. However, CCGs can still see how their results compare to those of other local CCGs.
The GP Patient Survey measures patients’ experiences across a range of topics.
The GP Patient Survey provides data at practice level using a consistent methodology, which means it is comparable across organisations and over
time.
The survey has limitations:
Some of the questions were changed following the 2017 survey. This 2019 summary report provides a sample of the questions, with
comparisons to the 2018 survey results.
Sample sizes at practice level are relatively small.
The survey does not include qualitative data which limits the detail provided by the results.
The data are provided once a year rather than in real time.
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Section 1: CCG results
5
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Overall experience of GPSurgery
Ease of getting through toGP surgery
How satisfied are you withthe general practice
appointment times thatare available to you?
Overall experience ofmaking an appointment
How long after yourappointment did you wait
to see or speak to thehealthcare professional (15
mins or less)
Did you have confidenceand trust in the healthcare
professional you saw orspoke to?
In the past 12 months haveyou contacted an NHS
service when you wantedto see a GP but your GP
practice was closed?
How helpful do you findthe receptionists at your
GP practice
Croydon CCG 2019 achievement comparison against SWL and England averages
Croydon 2019 SWL 2019 England 2019
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Section 2: Practice achievement against SWL and England averages
• The following slides provide a comparison against the 2018 and 2019 practice achievement, against 2019 SWL and England averages, for the following eight questions of the GP Patient Survey:
• Overall experience of GP surgery
• Ease of getting through to GP surgery
• How satisfied are you with the general practice appointment times that are available to you?
• Overall experience of making an appointment
• How long after your appointment did you wait to see or speak to the healthcare professional (15 minutes or less)
• Did you have confidence and trust in the healthcare professional you saw or spoke to?
• In the past 12 months have you contacted an NHS service when you wanted to see a GP but your GP practice was closed?
• How helpful do you find the receptionists at your GP practice?
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7
Practice code Practice name Overall experience of GP Surgery Ease of getting through to GP surgery
How satisfied are you with the general practice appointment
times that are available to you? Overall experience of making an appointment
2018 CCG England 2019 CCG England 2018 CCG England 2019CCG England 2018 CCG England 2019 CCG England 2018CCG England 2019CCG England
H83001 PORTLAND MEDICAL CENTRE 72% 83% 84% 64% 82% 83% 46% 71% 70% 36% 72% 68% 51% 67% 66% 55% 67% 65% 41% 71% 69% 44% 70% 67%
H83004 THE FARLEY ROAD MEDICAL PRACTICE 92% 83% 84% 92% 82% 83% 91% 71% 70% 94% 72% 68% 82% 67% 66% 85% 67% 65% 90% 71% 69% 93% 70% 67%
H83005 UPPER NORWOOD GROUP PRACTICE 93% 83% 84% 92% 82% 83% 93% 71% 70% 92% 72% 68% 88% 67% 66% 85% 67% 65% 96% 71% 69% 92% 70% 67%
H83006 PARKWAY HEALTH CENTRE (02) 77% 83% 84% 83% 82% 83% 76% 71% 70% 78% 72% 68% 78% 67% 66% 80% 67% 65% 74% 71% 69% 80% 70% 67%
H83007 VIOLET LANE MEDICAL PRACTICE 83% 83% 84% 80% 82% 83% 66% 71% 70% 76% 72% 68% 62% 67% 66% 72% 67% 65% 69% 71% 69% 73% 70% 67%
H83008 THE ADDISCOMBE SURGERY 84% 83% 84% 83% 82% 83% 84% 71% 70% 82% 72% 68% 61% 67% 66% 75% 67% 65% 68% 71% 69% 72% 70% 67%
H83009 NORBURY HEALTH CENTRE (02) 82% 83% 84% 78% 82% 83% 72% 71% 70% 69% 72% 68% 68% 67% 66% 70% 67% 65% 69% 71% 69% 72% 70% 67%
H83010 SOUTH NORWOOD HILL MEDICAL CENTRE 95% 83% 84% 84% 82% 83% 89% 71% 70% 66% 72% 68% 50% 67% 66% 59% 67% 65% 72% 71% 69% 49% 70% 67%
H83011 NORTH CROYDON MEDICAL CENTRE 65% 83% 84% 73% 82% 83% 43% 71% 70% 61% 72% 68% 37% 67% 66% 66% 67% 65% 36% 71% 69% 61% 70% 67%
H83012 ST.JAMES'S MEDICAL CENTRE 82% 83% 84% 74% 82% 83% 74% 71% 70% 70% 72% 68% 67% 67% 66% 53% 67% 65% 74% 71% 69% 56% 70% 67%
H83013 OLD COULSDON MEDICAL PRACTICE 95% 83% 84% 95% 82% 83% 90% 71% 70% 78% 72% 68% 80% 67% 66% 82% 67% 65% 93% 71% 69% 80% 70% 67%
H83014 QUEENHILL MEDICAL PRACTICE 95% 83% 84% 97% 82% 83% 95% 71% 70% 96% 72% 68% 80% 67% 66% 94% 67% 65% 90% 71% 69% 96% 70% 67%
H83015 PARKSIDE GROUP PRACTICE 93% 83% 84% 97% 82% 83% 74% 71% 70% 89% 72% 68% 69% 67% 66% 85% 67% 65% 75% 71% 69% 82% 70% 67%
H83016 KESTON MEDICAL PRACTICE 80% 83% 84% 81% 82% 83% 55% 71% 70% 52% 72% 68% 62% 67% 66% 68% 67% 65% 60% 71% 69% 55% 70% 67%
H83017 BRIGSTOCK & SOUTH NORWOOD PARTNERSHIP 82% 83% 84% 74% 82% 83% 65% 71% 70% 64% 72% 68% 74% 67% 66% 64% 67% 65% 71% 71% 69% 68% 70% 67%
H83018 SELSDON PARK MEDICAL PRACTICE 94% 83% 84% 95% 82% 83% 90% 71% 70% 91% 72% 68% 87% 67% 66% 94% 67% 65% 90% 71% 69% 90% 70% 67%
H83019 FRIENDS ROAD MEDICAL PRACTICE 77% 83% 84% 78% 82% 83% 80% 71% 70% 79% 72% 68% 63% 67% 66% 61% 67% 65% 60% 71% 69% 62% 70% 67%
H83020 EVERSLEY MEDICAL CENTRE 74% 83% 84% 76% 82% 83% 53% 71% 70% 54% 72% 68% 51% 67% 66% 68% 67% 65% 60% 71% 69% 62% 70% 67%
H83021 LONDON ROAD MEDICAL PRACTICE 75% 83% 84% 80% 82% 83% 73% 71% 70% 82% 72% 68% 50% 67% 66% 62% 67% 65% 57% 71% 69% 67% 70% 67%
H83022 THORNTON HEATH HEALTH CENTRE 82% 83% 84% 82% 82% 83% 68% 71% 70% 64% 72% 68% 61% 67% 66% 73% 67% 65% 64% 71% 69% 71% 70% 67%
H83023 MORLAND ROAD SURGERY 86% 83% 84% 80% 82% 83% 65% 71% 70% 64% 72% 68% 57% 67% 66% 70% 67% 65% 59% 71% 69% 62% 70% 67%
H83024 WOODCOTE MEDICAL 82% 83% 84% 78% 82% 83% 75% 71% 70% 72% 72% 68% 62% 67% 66% 68% 67% 65% 71% 71% 69% 61% 70% 67%
H83027 PARKWAY HEALTH CENTRE (01) 79% 83% 84% 77% 82% 83% 90% 71% 70% 95% 72% 68% 75% 67% 66% 79% 67% 65% 82% 71% 69% 79% 70% 67%
H83028 ADDINGTON MEDICAL PRACTICE 92% 83% 84% 98% 82% 83% 99% 71% 70% 97% 72% 68% 79% 67% 66% 85% 67% 65% 88% 71% 69% 94% 70% 67%
H83029 HARTLAND WAY SURGERY 85% 83% 84% 87% 82% 83% 85% 71% 70% 81% 72% 68% 67% 67% 66% 81% 67% 65% 73% 71% 69% 75% 70% 67%
H83030 BROOM ROAD MEDICAL PRACTICE 76% 83% 84% 85% 82% 83% 80% 71% 70% 84% 72% 68% 57% 67% 66% 75% 67% 65% 80% 71% 69% 74% 70% 67%
H83031 THE HALING PARK PARTNERSHIP 76% 83% 84% 85% 82% 83% 82% 71% 70% 77% 72% 68% 60% 67% 66% 69% 67% 65% 58% 71% 69% 69% 70% 67%
H83033 ASHBURTON PARK MEDICAL CENTRE 84% 83% 84% 89% 82% 83% 77% 71% 70% 74% 72% 68% 71% 67% 66% 80% 67% 65% 75% 71% 69% 80% 70% 67%
H83034 THE WHITEHORSE PRACTICE 74% 83% 84% 62% 82% 83% 66% 71% 70% 53% 72% 68% 57% 67% 66% 51% 67% 65% 57% 71% 69% 57% 70% 67%
H83037 AUCKLAND SURGERY 97% 83% 84% 93% 82% 83% 93% 71% 70% 94% 72% 68% 74% 67% 66% 84% 67% 65% 81% 71% 69% 81% 70% 67%
H83039 STOVELL HOUSE SURGERY 93% 83% 84% 94% 82% 83% 95% 71% 70% 90% 72% 68% 89% 67% 66% 83% 67% 65% 84% 71% 69% 83% 70% 67%
H83040 MITCHLEY AVENUE SURGERY 99% 83% 84% 99% 82% 83% 95% 71% 70% 92% 72% 68% 95% 67% 66% 99% 67% 65% 92% 71% 69% 96% 70% 67%
H83042 LEANDER ROAD SURGERY 83% 83% 84% 85% 82% 83% 54% 71% 70% 51% 72% 68% 58% 67% 66% 71% 67% 65% 55% 71% 69% 60% 70% 67%
H83043 SHIRLEY MEDICAL CENTRE 84% 83% 84% 81% 82% 83% 95% 71% 70% 84% 72% 68% 76% 67% 66% 74% 67% 65% 68% 71% 69% 69% 70% 67%
H83044 EAST CROYDON MEDICAL CENTRE 81% 83% 84% 77% 82% 83% 80% 71% 70% 57% 72% 68% 52% 67% 66% 66% 67% 65% 67% 71% 69% 59% 70% 67%
H83049 HEADLEY DRIVE SURGERY 91% 83% 84% 88% 82% 83% 83% 71% 70% 90% 72% 68% 86% 67% 66% 93% 67% 65% 87% 71% 69% 91% 70% 67%
H83050 THE MOORINGS MEDICAL PRACTICE 94% 83% 84% 94% 82% 83% 93% 71% 70% 87% 72% 68% 71% 67% 66% 86% 67% 65% 88% 71% 69% 81% 70% 67%
H83051 THORNTON & VALLEY PARK SURGERY 93% 83% 84% 83% 82% 83% 82% 71% 70% 84% 72% 68% 82% 67% 66% 71% 67% 65% 80% 71% 69% 71% 70% 67%
H83052 BRAMLEY AVENUE SURGERY 98% 83% 84% 94% 82% 83% 98% 71% 70% 92% 72% 68% 85% 67% 66% 77% 67% 65% 95% 71% 69% 80% 70% 67%
H83053 PARCHMORE MEDICAL CENTRE 70% 83% 84% 81% 82% 83% 38% 71% 70% 48% 72% 68% 61% 67% 66% 73% 67% 65% 57% 71% 69% 55% 70% 67%
H83608 BRIGSTOCK FAMILY PRACTICE 84% 83% 84% 61% 82% 83% 68% 71% 70% 45% 72% 68% 55% 67% 66% 63% 67% 65% 64% 71% 69% 48% 70% 67%
H83609 MERSHAM MEDICAL CENTRE 98% 83% 84% 96% 82% 83% 90% 71% 70% 89% 72% 68% 75% 67% 66% 83% 67% 65% 88% 71% 69% 82% 70% 67%
H83611 SELHURST MEDICAL PRACTICE 89% 83% 84% 88% 82% 83% 89% 71% 70% 94% 72% 68% 76% 67% 66% 84% 67% 65% 75% 71% 69% 84% 70% 67%
H83624 FAIRVIEW MEDICAL CENTRE 87% 83% 84% 88% 82% 83% 91% 71% 70% 94% 72% 68% 77% 67% 66% 88% 67% 65% 82% 71% 69% 82% 70% 67%
H83625 BROUGHTON CORNER MEDICAL CENTRE 59% 83% 84% 67% 82% 83% 36% 71% 70% 46% 72% 68% 48% 67% 66% 56% 67% 65% 34% 71% 69% 49% 70% 67%
H83627 BIRDHURST MEDICAL PRACTICE 94% 83% 84% 87% 82% 83% 93% 71% 70% 91% 72% 68% 70% 67% 66% 75% 67% 65% 77% 71% 69% 79% 70% 67%
H83631 GREENSIDE MEDICAL PRACTICE 76% 83% 84% 74% 82% 83% 64% 71% 70% 62% 72% 68% 55% 67% 66% 68% 67% 65% 57% 71% 69% 53% 70% 67%
Y02962 THE PRACTICE SURGERIES LTD 60% 83% 84% 43% 82% 83% 34% 71% 70% 18% 72% 68% 65% 67% 66% 43% 67% 65% 43% 71% 69% 29% 70% 67%
Y05317 COUNTRY PARK PRACTICE 73% 83% 84% 77% 82% 83% 54% 71% 70% 55% 72% 68% 59% 67% 66% 61% 67% 65% 60% 71% 69% 57% 70% 67%
Y05318 DENMARK ROAD SURGERY 77% 83% 84% 85% 82% 83% 53% 71% 70% 62% 72% 68% 58% 67% 66% 81% 67% 65% 58% 71% 69% 70% 70% 67%
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8
Practice code Practice name
How long after your appointment did you wait to see or speak
to the healthcare professional (15 mins or less)
Did you have confidence and trust in the healthcare professional
you saw or spoke to?
In the past 12 months have you contacted an NHS service
when you wanted to see a GP but your GP practice was
closed? How helpful do you find the receptionists at your GP practice
2018CCG England 2019CCG England 2018CCG England 2019CCG England 2018CCG England 2019CCG England 2018CCG England 2019CCG England
H83001 PORTLAND MEDICAL CENTRE 43% 57% 69% 40% 68% 69% 90% 92% 96% 87% 94% 95% 26% 22% 23% 22% 23% 23% 82% 86% 90% 75% 89% 89%
H83004 THE FARLEY ROAD MEDICAL PRACTICE 81% 57% 69% 89% 68% 69% 96% 92% 96% 95% 94% 95% 14% 22% 23% 18% 23% 23% 98% 86% 90% 98% 89% 89%
H83005 UPPER NORWOOD GROUP PRACTICE 77% 57% 69% 80% 68% 69% 96% 92% 96% 96% 94% 95% 7% 22% 23% 16% 23% 23% 97% 86% 90% 95% 89% 89%
H83006 PARKWAY HEALTH CENTRE (02) 75% 57% 69% 71% 68% 69% 94% 92% 96% 92% 94% 95% 10% 22% 23% 16% 23% 23% 90% 86% 90% 90% 89% 89%
H83007 VIOLET LANE MEDICAL PRACTICE 84% 57% 69% 80% 68% 69% 96% 92% 96% 94% 94% 95% 23% 22% 23% 25% 23% 23% 80% 86% 90% 92% 89% 89%
H83008 THE ADDISCOMBE SURGERY 68% 57% 69% 67% 68% 69% 94% 92% 96% 96% 94% 95% 22% 22% 23% 25% 23% 23% 86% 86% 90% 91% 89% 89%
H83009 NORBURY HEALTH CENTRE (02) 68% 57% 69% 65% 68% 69% 95% 92% 96% 88% 94% 95% 20% 22% 23% 28% 23% 23% 94% 86% 90% 94% 89% 89%
H83010 SOUTH NORWOOD HILL MEDICAL CENTRE 58% 57% 69% 54% 68% 69% 100% 92% 96% 100% 94% 95% 18% 22% 23% 22% 23% 23% 94% 86% 90% 90% 89% 89%
H83011 NORTH CROYDON MEDICAL CENTRE 33% 57% 69% 35% 68% 69% 87% 92% 96% 96% 94% 95% 21% 22% 23% 19% 23% 23% 62% 86% 90% 88% 89% 89%
H83012 ST.JAMES'S MEDICAL CENTRE 69% 57% 69% 57% 68% 69% 98% 92% 96% 89% 94% 95% 26% 22% 23% 21% 23% 23% 95% 86% 90% 91% 89% 89%
H83013 OLD COULSDON MEDICAL PRACTICE 78% 57% 69% 68% 68% 69% 97% 92% 96% 98% 94% 95% 16% 22% 23% 21% 23% 23% 98% 86% 90% 99% 89% 89%
H83014 QUEENHILL MEDICAL PRACTICE 86% 57% 69% 89% 68% 69% 99% 92% 96% 98% 94% 95% 12% 22% 23% 19% 23% 23% 97% 86% 90% 99% 89% 89%
H83015 PARKSIDE GROUP PRACTICE 77% 57% 69% 78% 68% 69% 99% 92% 96% 99% 94% 95% 23% 22% 23% 29% 23% 23% 95% 86% 90% 95% 89% 89%
H83016 KESTON MEDICAL PRACTICE 69% 57% 69% 82% 68% 69% 93% 92% 96% 96% 94% 95% 19% 22% 23% 25% 23% 23% 87% 86% 90% 87% 89% 89%
H83017 BRIGSTOCK & SOUTH NORWOOD PARTNERSHIP 66% 57% 69% 75% 68% 69% 93% 92% 96% 88% 94% 95% 23% 22% 23% 12% 23% 23% 81% 86% 90% 85% 89% 89%
H83018 SELSDON PARK MEDICAL PRACTICE 71% 57% 69% 79% 68% 69% 97% 92% 96% 98% 94% 95% 13% 22% 23% 16% 23% 23% 98% 86% 90% 98% 89% 89%
H83019 FRIENDS ROAD MEDICAL PRACTICE 72% 57% 69% 72% 68% 69% 95% 92% 96% 93% 94% 95% 27% 22% 23% 28% 23% 23% 89% 86% 90% 83% 89% 89%
H83020 EVERSLEY MEDICAL CENTRE 55% 57% 69% 65% 68% 69% 91% 92% 96% 94% 94% 95% 28% 22% 23% 33% 23% 23% 85% 86% 90% 85% 89% 89%
H83021 LONDON ROAD MEDICAL PRACTICE 52% 57% 69% 57% 68% 69% 92% 92% 96% 94% 94% 95% 29% 22% 23% 25% 23% 23% 71% 86% 90% 78% 89% 89%
H83022 THORNTON HEATH HEALTH CENTRE 69% 57% 69% 79% 68% 69% 97% 92% 96% 97% 94% 95% 20% 22% 23% 22% 23% 23% 83% 86% 90% 86% 89% 89%
H83023 MORLAND ROAD SURGERY 53% 57% 69% 58% 68% 69% 98% 92% 96% 100% 94% 95% 25% 22% 23% 32% 23% 23% 87% 86% 90% 80% 89% 89%
H83024 WOODCOTE MEDICAL 47% 57% 69% 64% 68% 69% 97% 92% 96% 90% 94% 95% 19% 22% 23% 20% 23% 23% 87% 86% 90% 89% 89% 89%
H83027 PARKWAY HEALTH CENTRE (01) 75% 57% 69% 67% 68% 69% 88% 92% 96% 93% 94% 95% 6% 22% 23% 26% 23% 23% 93% 86% 90% 95% 89% 89%
H83028 ADDINGTON MEDICAL PRACTICE 80% 57% 69% 83% 68% 69% 98% 92% 96% 99% 94% 95% 18% 22% 23% 22% 23% 23% 97% 86% 90% 93% 89% 89%
H83029 HARTLAND WAY SURGERY 79% 57% 69% 78% 68% 69% 93% 92% 96% 98% 94% 95% 19% 22% 23% 19% 23% 23% 91% 86% 90% 95% 89% 89%
H83030 BROOM ROAD MEDICAL PRACTICE 54% 57% 69% 56% 68% 69% 92% 92% 96% 95% 94% 95% 23% 22% 23% 21% 23% 23% 87% 86% 90% 89% 89% 89%
H83031 THE HALING PARK PARTNERSHIP 66% 57% 69% 75% 68% 69% 92% 92% 96% 98% 94% 95% 24% 22% 23% 21% 23% 23% 84% 86% 90% 85% 89% 89%
H83033 ASHBURTON PARK MEDICAL CENTRE 57% 57% 69% 77% 68% 69% 98% 92% 96% 97% 94% 95% 24% 22% 23% 19% 23% 23% 86% 86% 90% 95% 89% 89%
H83034 THE WHITEHORSE PRACTICE 56% 57% 69% 63% 68% 69% 92% 92% 96% 91% 94% 95% 27% 22% 23% 34% 23% 23% 86% 86% 90% 81% 89% 89%
H83037 AUCKLAND SURGERY 83% 57% 69% 90% 68% 69% 93% 92% 96% 96% 94% 95% 16% 22% 23% 19% 23% 23% 96% 86% 90% 95% 89% 89%
H83039 STOVELL HOUSE SURGERY 71% 57% 69% 73% 68% 69% 93% 92% 96% 94% 94% 95% 17% 22% 23% 16% 23% 23% 95% 86% 90% 96% 89% 89%
H83040 MITCHLEY AVENUE SURGERY 84% 57% 69% 86% 68% 69% 98% 92% 96% 99% 94% 95% 10% 22% 23% 21% 23% 23% 99% 86% 90% 100% 89% 89%
H83042 LEANDER ROAD SURGERY 43% 57% 69% 43% 68% 69% 90% 92% 96% 98% 94% 95% 33% 22% 23% 26% 23% 23% 89% 86% 90% 89% 89% 89%
H83043 SHIRLEY MEDICAL CENTRE 56% 57% 69% 48% 68% 69% 90% 92% 96% 93% 94% 95% 19% 22% 23% 28% 23% 23% 96% 86% 90% 89% 89% 89%
H83044 EAST CROYDON MEDICAL CENTRE 71% 57% 69% 75% 68% 69% 97% 92% 96% 96% 94% 95% 29% 22% 23% 30% 23% 23% 89% 86% 90% 78% 89% 89%
H83049 HEADLEY DRIVE SURGERY 87% 57% 69% 83% 68% 69% 95% 92% 96% 90% 94% 95% 21% 22% 23% 20% 23% 23% 92% 86% 90% 95% 89% 89%
H83050 THE MOORINGS MEDICAL PRACTICE 79% 57% 69% 78% 68% 69% 93% 92% 96% 98% 94% 95% 13% 22% 23% 33% 23% 23% 92% 86% 90% 94% 89% 89%
H83051 THORNTON & VALLEY PARK SURGERY 60% 57% 69% 65% 68% 69% 95% 92% 96% 93% 94% 95% 19% 22% 23% 30% 23% 23% 93% 86% 90% 91% 89% 89%
H83052 BRAMLEY AVENUE SURGERY 81% 57% 69% 84% 68% 69% 99% 92% 96% 99% 94% 95% 28% 22% 23% 36% 23% 23% 97% 86% 90% 93% 89% 89%
H83053 PARCHMORE MEDICAL CENTRE 51% 57% 69% 49% 68% 69% 94% 92% 96% 96% 94% 95% 21% 22% 23% 19% 23% 23% 78% 86% 90% 76% 89% 89%
H83608 BRIGSTOCK FAMILY PRACTICE 62% 57% 69% 61% 68% 69% 95% 92% 96% 90% 94% 95% 19% 22% 23% 24% 23% 23% 91% 86% 90% 77% 89% 89%
H83609 MERSHAM MEDICAL CENTRE 76% 57% 69% 81% 68% 69% 100% 92% 96% 99% 94% 95% 22% 22% 23% 28% 23% 23% 98% 86% 90% 91% 89% 89%
H83611 SELHURST MEDICAL PRACTICE 60% 57% 69% 68% 68% 69% 99% 92% 96% 98% 94% 95% 13% 22% 23% 15% 23% 23% 94% 86% 90% 94% 89% 89%
H83624 FAIRVIEW MEDICAL CENTRE 68% 57% 69% 72% 68% 69% 91% 92% 96% 91% 94% 95% 22% 22% 23% 26% 23% 23% 87% 86% 90% 90% 89% 89%
H83625 BROUGHTON CORNER MEDICAL CENTRE 48% 57% 69% 76% 68% 69% 95% 92% 96% 93% 94% 95% 25% 22% 23% 27% 23% 23% 60% 86% 90% 87% 89% 89%
H83627 BIRDHURST MEDICAL PRACTICE 89% 57% 69% 83% 68% 69% 100% 92% 96% 99% 94% 95% 21% 22% 23% 15% 23% 23% 87% 86% 90% 94% 89% 89%
H83631 GREENSIDE MEDICAL PRACTICE 63% 57% 69% 56% 68% 69% 93% 92% 96% 91% 94% 95% 28% 22% 23% 17% 23% 23% 83% 86% 90% 76% 89% 89%
Y02962 THE PRACTICE SURGERIES LTD 54% 57% 69% 44% 68% 69% 83% 92% 96% 86% 94% 95% 31% 22% 23% 40% 23% 23% 76% 86% 90% 58% 89% 89%
Y05317 COUNTRY PARK PRACTICE 48% 57% 69% 51% 68% 69% 99% 92% 96% 91% 94% 95% 24% 22% 23% 30% 23% 23% 73% 86% 90% 95% 89% 89%
Y05318 DENMARK ROAD SURGERY 45% 57% 69% 53% 68% 69% 95% 92% 96% 96% 94% 95% 27% 22% 23% 29% 23% 23% 82% 86% 90% 95% 89% 89%
Enc
6 A
p1a
2019
Cro
ydon
Pt s
umm
ary
Page 95 of 233
40%
50%
60%
70%
80%
90%
100%
PO
RTL
AN
D M
EDIC
AL
CEN
TRE
THE
FAR
LEY
RO
AD
MED
ICA
L P
RA
CTI
CE
UP
PER
NO
RW
OO
D G
RO
UP
PR
AC
TIC
E
PA
RK
WA
Y H
EALT
H C
ENTR
E (0
2)
VIO
LET
LAN
E M
EDIC
AL
PR
AC
TIC
E
THE
AD
DIS
CO
MB
E SU
RG
ERY
NO
RB
UR
Y H
EALT
H C
ENTR
E (0
2)
SOU
TH N
OR
WO
OD
HIL
L M
EDIC
AL
CEN
TRE
NO
RTH
CR
OYD
ON
MED
ICA
L C
ENTR
E
ST.J
AM
ES'S
MED
ICA
L C
ENTR
E
OLD
CO
ULS
DO
N M
EDIC
AL
PR
AC
TIC
E
QU
EEN
HIL
L M
EDIC
AL
PR
AC
TIC
E
PA
RK
SID
E G
RO
UP
PR
AC
TIC
E
KES
TON
MED
ICA
L P
RA
CTI
CE
BR
IGST
OC
K &
SO
UTH
NO
RW
OO
D P
AR
TNER
SHIP
SELS
DO
N P
AR
K M
EDIC
AL
PR
AC
TIC
E
FRIE
ND
S R
OA
D M
EDIC
AL
PR
AC
TIC
E
EVER
SLEY
MED
ICA
L C
ENTR
E
LON
DO
N R
OA
D M
EDIC
AL
PR
AC
TIC
E
THO
RN
TON
HEA
TH H
EALT
H C
ENTR
E
MO
RLA
ND
RO
AD
SU
RG
ERY
WO
OD
CO
TE M
EDIC
AL
PA
RK
WA
Y H
EALT
H C
ENTR
E (0
1)
AD
DIN
GTO
N M
EDIC
AL
PR
AC
TIC
E
HA
RTL
AN
D W
AY
SUR
GER
Y
BR
OO
M R
OA
D M
EDIC
AL
PR
AC
TIC
E
THE
HA
LIN
G P
AR
K P
AR
TNER
SHIP
ASH
BU
RTO
N P
AR
K M
EDIC
AL
CEN
TRE
THE
WH
ITEH
OR
SE P
RA
CTI
CE
AU
CK
LAN
D S
UR
GER
Y
STO
VEL
L H
OU
SE S
UR
GER
Y
MIT
CH
LEY
AV
ENU
E SU
RG
ERY
LEA
ND
ER R
OA
D S
UR
GER
Y
SHIR
LEY
MED
ICA
L C
ENTR
E
EAST
CR
OYD
ON
MED
ICA
L C
ENTR
E
HEA
DLE
Y D
RIV
E SU
RG
ERY
THE
MO
OR
ING
S M
EDIC
AL
PR
AC
TIC
E
THO
RN
TON
& V
ALL
EY P
AR
K S
UR
GER
Y
BR
AM
LEY
AV
ENU
E SU
RG
ERY
PA
RC
HM
OR
E M
EDIC
AL
CEN
TRE
BR
IGST
OC
K F
AM
ILY
PR
AC
TIC
E
MER
SHA
M M
EDIC
AL
CEN
TRE
SELH
UR
ST M
EDIC
AL
PR
AC
TIC
E
FAIR
VIE
W M
EDIC
AL
CEN
TRE
BR
OU
GH
TON
CO
RN
ER M
EDIC
AL
CEN
TRE
BIR
DH
UR
ST M
EDIC
AL
PR
AC
TIC
E
GR
EEN
SID
E M
EDIC
AL
PR
AC
TIC
E
THE
PR
AC
TIC
E SU
RG
ERIE
S LT
D
CO
UN
TRY
PA
RK
PR
AC
TIC
E
DEN
MA
RK
RO
AD
SU
RG
ERY
Overall experience of GP Surgery
2018 2019 CCG England
9
Enc
6 A
p1a
2019
Cro
ydon
Pt s
umm
ary
Page 96 of 233
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Ease of getting through to GP surgery
2018 2019 CCG England
10
Enc
6 A
p1a
2019
Cro
ydon
Pt s
umm
ary
Page 97 of 233
30%
40%
50%
60%
70%
80%
90%
100%
How satisfied are you with the general practice appointment times that are available to you?
2018 2019 CCG England
11
Enc
6 A
p1a
2019
Cro
ydon
Pt s
umm
ary
Page 98 of 233
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Overall experience of making an appointment
2018 2019 CCG England
12
Enc
6 A
p1a
2019
Cro
ydon
Pt s
umm
ary
Page 99 of 233
30%
40%
50%
60%
70%
80%
90%
100%
PO
RTL
AN
D M
EDIC
AL
CEN
TRE
THE
FAR
LEY
RO
AD
MED
ICA
L P
RA
CTI
CE
UP
PER
NO
RW
OO
D G
RO
UP
PR
AC
TIC
E
PA
RK
WA
Y H
EALT
H C
ENTR
E (0
2)
VIO
LET
LAN
E M
EDIC
AL
PR
AC
TIC
E
THE
AD
DIS
CO
MB
E SU
RG
ERY
NO
RB
UR
Y H
EALT
H C
ENTR
E (0
2)
SOU
TH N
OR
WO
OD
HIL
L M
EDIC
AL
CEN
TRE
NO
RTH
CR
OYD
ON
MED
ICA
L C
ENTR
E
ST.J
AM
ES'S
MED
ICA
L C
ENTR
E
OLD
CO
ULS
DO
N M
EDIC
AL
PR
AC
TIC
E
QU
EEN
HIL
L M
EDIC
AL
PR
AC
TIC
E
PA
RK
SID
E G
RO
UP
PR
AC
TIC
E
KES
TON
MED
ICA
L P
RA
CTI
CE
BR
IGST
OC
K &
SO
UTH
NO
RW
OO
D P
AR
TNER
SHIP
SELS
DO
N P
AR
K M
EDIC
AL
PR
AC
TIC
E
FRIE
ND
S R
OA
D M
EDIC
AL
PR
AC
TIC
E
EVER
SLEY
MED
ICA
L C
ENTR
E
LON
DO
N R
OA
D M
EDIC
AL
PR
AC
TIC
E
THO
RN
TON
HEA
TH H
EALT
H C
ENTR
E
MO
RLA
ND
RO
AD
SU
RG
ERY
WO
OD
CO
TE M
EDIC
AL
PA
RK
WA
Y H
EALT
H C
ENTR
E (0
1)
AD
DIN
GTO
N M
EDIC
AL
PR
AC
TIC
E
HA
RTL
AN
D W
AY
SUR
GER
Y
BR
OO
M R
OA
D M
EDIC
AL
PR
AC
TIC
E
THE
HA
LIN
G P
AR
K P
AR
TNER
SHIP
ASH
BU
RTO
N P
AR
K M
EDIC
AL
CEN
TRE
THE
WH
ITEH
OR
SE P
RA
CTI
CE
AU
CK
LAN
D S
UR
GER
Y
STO
VEL
L H
OU
SE S
UR
GER
Y
MIT
CH
LEY
AV
ENU
E SU
RG
ERY
LEA
ND
ER R
OA
D S
UR
GER
Y
SHIR
LEY
MED
ICA
L C
ENTR
E
EAST
CR
OYD
ON
MED
ICA
L C
ENTR
E
HEA
DLE
Y D
RIV
E SU
RG
ERY
THE
MO
OR
ING
S M
EDIC
AL
PR
AC
TIC
E
THO
RN
TON
& V
ALL
EY P
AR
K S
UR
GER
Y
BR
AM
LEY
AV
ENU
E SU
RG
ERY
PA
RC
HM
OR
E M
EDIC
AL
CEN
TRE
BR
IGST
OC
K F
AM
ILY
PR
AC
TIC
E
MER
SHA
M M
EDIC
AL
CEN
TRE
SELH
UR
ST M
EDIC
AL
PR
AC
TIC
E
FAIR
VIE
W M
EDIC
AL
CEN
TRE
BR
OU
GH
TON
CO
RN
ER M
EDIC
AL
CEN
TRE
BIR
DH
UR
ST M
EDIC
AL
PR
AC
TIC
E
GR
EEN
SID
E M
EDIC
AL
PR
AC
TIC
E
THE
PR
AC
TIC
E SU
RG
ERIE
S LT
D
CO
UN
TRY
PA
RK
PR
AC
TIC
E
DEN
MA
RK
RO
AD
SU
RG
ERY
How long after your appointment did you wait to see or speak to the healthcare professional (15 minutes or less)
2018 2019 CCG England
13
Enc
6 A
p1a
2019
Cro
ydon
Pt s
umm
ary
Page 100 of 233
75%
80%
85%
90%
95%
100%
Did you have confidence and trust in the healthcare professional you saw or spoke to?
2018 2019 CCG England
14
Enc
6 A
p1a
2019
Cro
ydon
Pt s
umm
ary
Page 101 of 233
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
PO
RTL
AN
D M
EDIC
AL
CEN
TRE
THE
FAR
LEY
RO
AD
MED
ICA
L P
RA
CTI
CE
UP
PER
NO
RW
OO
D G
RO
UP
PR
AC
TIC
E
PA
RK
WA
Y H
EALT
H C
ENTR
E (0
2)
VIO
LET
LAN
E M
EDIC
AL
PR
AC
TIC
E
THE
AD
DIS
CO
MB
E SU
RG
ERY
NO
RB
UR
Y H
EALT
H C
ENTR
E (0
2)
SOU
TH N
OR
WO
OD
HIL
L M
EDIC
AL
CEN
TRE
NO
RTH
CR
OYD
ON
MED
ICA
L C
ENTR
E
ST.J
AM
ES'S
MED
ICA
L C
ENTR
E
OLD
CO
ULS
DO
N M
EDIC
AL
PR
AC
TIC
E
QU
EEN
HIL
L M
EDIC
AL
PR
AC
TIC
E
PA
RK
SID
E G
RO
UP
PR
AC
TIC
E
KES
TON
MED
ICA
L P
RA
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CE
BR
IGST
OC
K &
SO
UTH
NO
RW
OO
D P
AR
TNER
SHIP
SELS
DO
N P
AR
K M
EDIC
AL
PR
AC
TIC
E
FRIE
ND
S R
OA
D M
EDIC
AL
PR
AC
TIC
E
EVER
SLEY
MED
ICA
L C
ENTR
E
LON
DO
N R
OA
D M
EDIC
AL
PR
AC
TIC
E
THO
RN
TON
HEA
TH H
EALT
H C
ENTR
E
MO
RLA
ND
RO
AD
SU
RG
ERY
WO
OD
CO
TE M
EDIC
AL
PA
RK
WA
Y H
EALT
H C
ENTR
E (0
1)
AD
DIN
GTO
N M
EDIC
AL
PR
AC
TIC
E
HA
RTL
AN
D W
AY
SUR
GER
Y
BR
OO
M R
OA
D M
EDIC
AL
PR
AC
TIC
E
THE
HA
LIN
G P
AR
K P
AR
TNER
SHIP
ASH
BU
RTO
N P
AR
K M
EDIC
AL
CEN
TRE
THE
WH
ITEH
OR
SE P
RA
CTI
CE
AU
CK
LAN
D S
UR
GER
Y
STO
VEL
L H
OU
SE S
UR
GER
Y
MIT
CH
LEY
AV
ENU
E SU
RG
ERY
LEA
ND
ER R
OA
D S
UR
GER
Y
SHIR
LEY
MED
ICA
L C
ENTR
E
EAST
CR
OYD
ON
MED
ICA
L C
ENTR
E
HEA
DLE
Y D
RIV
E SU
RG
ERY
THE
MO
OR
ING
S M
EDIC
AL
PR
AC
TIC
E
THO
RN
TON
& V
ALL
EY P
AR
K S
UR
GER
Y
BR
AM
LEY
AV
ENU
E SU
RG
ERY
PA
RC
HM
OR
E M
EDIC
AL
CEN
TRE
BR
IGST
OC
K F
AM
ILY
PR
AC
TIC
E
MER
SHA
M M
EDIC
AL
CEN
TRE
SELH
UR
ST M
EDIC
AL
PR
AC
TIC
E
FAIR
VIE
W M
EDIC
AL
CEN
TRE
BR
OU
GH
TON
CO
RN
ER M
EDIC
AL
CEN
TRE
BIR
DH
UR
ST M
EDIC
AL
PR
AC
TIC
E
GR
EEN
SID
E M
EDIC
AL
PR
AC
TIC
E
THE
PR
AC
TIC
E SU
RG
ERIE
S LT
D
CO
UN
TRY
PA
RK
PR
AC
TIC
E
DEN
MA
RK
RO
AD
SU
RG
ERY
In the past 12 months have you contacted an NHS service when you wanted to see a GP but your GP practice was closed?
2018 2019 CCG England
15
Enc
6 A
p1a
2019
Cro
ydon
Pt s
umm
ary
Page 102 of 233
50%
55%
60%
65%
70%
75%
80%
85%
90%
95%
100%
PO
RTL
AN
D M
EDIC
AL
CEN
TRE
THE
FAR
LEY
RO
AD
MED
ICA
L P
RA
CTI
CE
UP
PER
NO
RW
OO
D G
RO
UP
PR
AC
TIC
E
PA
RK
WA
Y H
EALT
H C
ENTR
E (0
2)
VIO
LET
LAN
E M
EDIC
AL
PR
AC
TIC
E
THE
AD
DIS
CO
MB
E SU
RG
ERY
NO
RB
UR
Y H
EALT
H C
ENTR
E (0
2)
SOU
TH N
OR
WO
OD
HIL
L M
EDIC
AL
CEN
TRE
NO
RTH
CR
OYD
ON
MED
ICA
L C
ENTR
E
ST.J
AM
ES'S
MED
ICA
L C
ENTR
E
OLD
CO
ULS
DO
N M
EDIC
AL
PR
AC
TIC
E
QU
EEN
HIL
L M
EDIC
AL
PR
AC
TIC
E
PA
RK
SID
E G
RO
UP
PR
AC
TIC
E
KES
TON
MED
ICA
L P
RA
CTI
CE
BR
IGST
OC
K &
SO
UTH
NO
RW
OO
D P
AR
TNER
SHIP
SELS
DO
N P
AR
K M
EDIC
AL
PR
AC
TIC
E
FRIE
ND
S R
OA
D M
EDIC
AL
PR
AC
TIC
E
EVER
SLEY
MED
ICA
L C
ENTR
E
LON
DO
N R
OA
D M
EDIC
AL
PR
AC
TIC
E
THO
RN
TON
HEA
TH H
EALT
H C
ENTR
E
MO
RLA
ND
RO
AD
SU
RG
ERY
WO
OD
CO
TE M
EDIC
AL
PA
RK
WA
Y H
EALT
H C
ENTR
E (0
1)
AD
DIN
GTO
N M
EDIC
AL
PR
AC
TIC
E
HA
RTL
AN
D W
AY
SUR
GER
Y
BR
OO
M R
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How helpful do you find the receptionists at your GP practice
2018 2019 CCG England
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Section 3: Practice rankings
17
Five lowest ranking practices Top five ranking practices
Data collection - 2019 survey Lowest 2nd 3rd 4th 5th 5th highest 4th 3rd 2nd Highest
Overall experience of GP Surgery
Y02962
Edridge Road
H83608 Brigstock
Family
H83034
Whitehorse
H83001
Portland
H83625
Broughton
Corner
H83609
Mersham
H83015
Parkside
H83014
Queenhill
H83028
Addington
H83040
Mitchley
Avenue
Ease of getting through to GP surgery
Y02962
Edridge Road H83001 Portland
H83608
Brigstock
Family
H83625
Broughton
Corner
H83053
Parchmore
H83611
Selhurst
H83624
Fairview
H83027
Parkway
H83014
Queenhill
H83028
Addington
How satisfied are you with the general practice
appointment times that are available to you?
Y02962
Edridge Road
H83034
Whitehorse
H83012 St
James
H83001
Portland
H83625
Broughton
Corner
H83624
Fairview
H83049
Headley
H83018
Selsdon
H83014
Queenhill
H83040
Mitchley
Avenue
Overall experience of making an appointment
Y02962
Edridge Road H83001 Portland
H83608
Brigstock
Family
H83625
Broughton
Corner
H83010 South
Norwood
H83005 Upper
Norwood
H83004
Farley Road
H83028
Addington
H83014
Queenhill
H83040
Mitchley
Avenue
How long after your appointment did you wait to see
or speak to the healthcare professional (15 mins or
less)
H83011 North
Croydon H83001 Portland
H83042
Leander
Y02962
Edridge Road
H83043
Shirley
H83052
Bramley
H83040
Mitchley
Avenue
H83004 Farley
Road
H83014
Queenhill
H83037
Auckland
Did you have confidence and trust in the healthcare
professional you saw or spoke to?
Y02962
Edridge Road H83001 Portland
H83009
Norbury
H83017
Brigstock
South
Norwood
H83012 St
James
H83052
Bramley
H83609
Mersham
H83627
Birdhurst
H83010 South
Norwood
H83023
Morland
In the past 12 months have you contacted an NHS
service when you wanted to see a GP but your GP
practice was closed?
Y02962
Edridge Road H83052 Bramley
H83034
Whitehorse
H83020
Eversley
H83050
Moorings
H83005 Upper
Norwood
H83006
Parkway
H83627
Birdhurst
H83611
Selhurst
H83017
Brigstock
South
Norwood
How helpful do you find the receptionists at your GP
practice
Y02962
Edridge Road H83001 Portland
H83053
Parchmore
H83631
Greenside
H83608
Brigstock
Family
H83018
Selsdon
H83004
Farley Road
H83014
Queenhill
H83013 Old
Coulsdon
H83040
Mitchley
Avenue
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Practices in bottom five (no. of times) No. Practices in top five (no. of times) No.
Edridge Road Community Health Centre 8 Queenhill Medical Practice 6
Portland Medical Centre 7 Mitchley Avenue Surgery 5
Brigstock Family Practice 4 The Farley Road Surgery 3
Broughton Corner Medical Centre 4 Addington Medical Practice 3
The Whitehorse Practice 3 Upper Norwood Group Practice 2
St James' Medical Practice 2 The Selsdon Park Medical Practice 2
Parchmore Medical Centre 2 Bramley Avenue Surgery 2
Norbury Health Centre 1 Mersham Medical Centre 2
South Norwood Hill Medical Centre 1 Selhurst Medical Centre 2
North Croydon Medical Centre 1 Fairview Medical Centre 2
Brigstock and South Norwood Medical Partnership 1 The Birdhurst Medical Practice 2
Eversley Medical Practice 1 New Addington Group Practice 1
Leander Road Primary Care Centre 1 South Norwood Hill Medical Centre 1
Shirley Medical Centre 1 Old Coulsdon Medical Practice 1
The Moorings Medical Practice 1 Parkside Group Practice 1
Bramley Avenue Surgery 1 Brigstock and South Norwood Medical Partnership 1
Greenside Group Practice 1 Morland Road Surgery 1
Parkway Health Centre 1
Auckland Surgery 1
Headley Drive Surgery 1
Practices rated in the top/ bottom 5 rated practices (2019 Patient survey)
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Summary• Croydon CCG averages are below 2019 SWL average for seven out of the eight questions, and the same as the SWL average for patients who have contacted an
NHS Service in the last 12 months to see a GP but their practice was closed. However, they are above the 2019 England average for three out of the eight questions.
• Croydon CCG 2019 averages improved against the previous year for the following:
• Ease of getting through to GP surgery
• Length of time (15 minutes or less) at waiting to see or speak to the healthcare professional
• Confidence and trust in the healthcare professional they saw or spoke to
• Helpfulness of receptionists
• In the last 12 months had contacted an NHS Service when they wanted to see a GP but their GP practice was closed
• Two practices appear the most in the bottom five ranked practices - Edridge Road Community Health Centre (8 times) and Portland Medical Centre (7 times).
• Two practices appear most in the five top ranked practices – Queenhill Medical Practice (6 times) and Mitchley Avenue Surgery (5 times).
• Overall experience of GP Surgery: 22 practices achieved below CCG and England averages for 2019. 18 of these also achieved below average in 2018.
• Ease of getting through to the surgery: 18 practices achieved below CCG and England averages for 2019. 15 of these also achieved below average in 2018.
• Satisfaction with the general practice appointment times: 11 practices achieved below CCG and England averages for 2019. Eight of these also achieved below average in 2018.
• Overall experience of making an appointment: 18 practices achieved below CCG and England averages for 2019. 15 of these also achieved below average in 2018.
• Appointment wait time (15 minutes or less): 22 practices achieved below CCG and England averages for 2019. 14 of these also achieved below average in 2018.
• Confidence and trust: Two practices achieved 100% (three had achieved this in 2018). 18 practices achieved below CCG and England averages for 2019. Five of these also achieved below average for 2018.
• Practice was closed: 24 practices achieved above CCG and England averages for 2019. 12 of these also achieved above average in 2018.
• Helpfulness of receptionist: One practice achieved 100%. 17 practices achieved below CCG and England averages for 2019. 11 of these also achieved below average in 2018.
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Further information
The published data is available here on the NHS GP Patient Survey website:
https://www.gp-patient.co.uk/analysistool?trend=0
A copy of the Croydon CCG results slide pack has also been included with this summary report.
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Version 1| Public
© Ipsos MORI 18-042653-01 | Version 1 | Public
NHS CROYDON CCG
Latest survey resultsJuly 2019 publication
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Contents
Background, introduction and guidance
Overall experience of GP practice
Local GP services
Access to online services
Making an appointment
Perceptions of care at patients’ last appointment
Managing health conditions
Satisfaction with general practice appointment times
Services when GP practice is closed
Statistical reliability
Want to know more?
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Background, introduction
and guidance
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Background information about the survey
• The GP Patient Survey (GPPS) is an England-wide survey, providing practice-level
data about patients’ experiences of their GP practices.
• Ipsos MORI administers the survey on behalf of NHS England.
• For more information about the survey please refer to the end of this slide pack or visit
https://gp-patient.co.uk/.
• This slide pack presents some of the key results for NHS CROYDON CCG.
• The data in this slide pack are based on the July 2019 GPPS publication.
• In NHS CROYDON CCG, 19,992 questionnaires were sent out, and 5,481 were
returned completed. This represents a response rate of 27%.
• In 2018 the questionnaire was redeveloped in response to significant changes to
primary care services as set out in the GP Forward View, and to provide a better
understanding of how local care services are supporting patients to live well, particularly
those with long-term care needs. The questionnaire (and past versions) can be found
here: https://gp-patient.co.uk/surveysandreports.
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Introduction
• The GP Patient Survey measures patients’ experiences across a range of topics, including:
- Your local GP services
- Making an appointment
- Your last appointment
- Overall experience
- Your health
- When your GP practice is closed
- NHS Dentistry
- Some questions about you
• The GP Patient Survey provides data at practice level using a consistent methodology, which means it is comparable across organisations.
• The survey has limitations:
- Sample sizes at practice level are relatively small.
- The survey does not include qualitative data which limits the detail provided by the results.
• The data provide a snapshot of patient experience at a given time, and are updated annually.
• Given the consistency of the survey across organisations, GPPS can be used as one element of evidence.
• It can be triangulated with other sources of feedback, such as feedback from Patient Participation Groups, local surveys and the Friends and Family Test, to develop a fuller picture of patient journeys.
• This slide pack is intended to assist this triangulation of data. It aims to highlight where there may be a need for further exploration.
• Practices and CCGs can then discuss the findings further and triangulate them with other data – in order to identify potential improvements and highlight best practice.
• The following slide suggests ideas for how the data can be used to improve services.
• This pack includes trend data, beginning in 2018. Following the extensive changes to the questionnaire in 2018, all questions at CCG and practice level are not comparable prior to this year.
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Guidance on how to use the data
• Comparison of a CCG’s results against
the national average: this allows
benchmarking of the results to identify
whether the CCG is performing well,
poorly, or in line with others. The CCG may
wish to focus on areas where it compares
less favourably.
• Considering questions where there is a
larger range in responses among
practices or CCGs: this highlights areas
in which greater improvements may be
possible, as some CCGs or practices are
performing significantly better than others
nearby. The CCG may wish to focus on
areas with a larger range in the results.
• Comparison of practices’ results within
a CCG: this can identify practices within a
CCG that seem to be over-performing or
under-performing compared with others.
The CCG may wish to work with individual
practices: those that are performing
particularly well may be able to highlight
best practice, while those performing less
well may be able to improve their
performance.
The following suggest ideas for how the data in this slide pack can be used and interpreted to
improve GP services:
*Images used in this slide are for example purposes only
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Interpreting the results
• The number of participants answering (the base size) is stated for each question. The total
number of responses is shown at the bottom of each chart.
• All comparisons are indicative only. Differences may not be statistically significant
– particularly when comparing practices due to low numbers of responses.
• For guidance on statistical reliability, or for details of where you can get more information
about the survey, please refer to the end of this slide pack.
• Maps: CCG and practice-level results are also displayed on maps, with results split across
5 bands (or ‘quintiles’) in order to have a fairly even distribution at the national level of
CCGs/practices across each band.
• Trends:
- Latest / 2019: refers to the July 2019 publication (fieldwork January to March 2019)
- 2018: refers to the August 2018 publication (fieldwork January to March 2018)
• For further information on using the data please refer to the end of this slide pack.
*More than 0% but less than 0.5%
100%Where results do not sum to
100%, or where individual
responses (e.g. fairly good;
very good) do not sum to
combined responses
(e.g. very/fairly good) this is
due to rounding, or cases
where multiple responses
are allowed.
When fewer than 10 patients respond
In cases where fewer than 10
patients have answered a
question, the data have been
suppressed and results will
not appear within the charts.
This is to prevent individuals
and their responses being
identifiable in the data.
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Overall experience of GP practice
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83%
7%
Overall experience of GP practice
44%
38%
11%
4% Very good
Fairly good
Neither good nor poor
Fairly poor
Very poor
Q31. Overall, how would you describe your experience of your GP practice?
National
6%
Good
Poor
%Good = %Very good + %Fairly good
%Poor = %Very poor + %Fairly poor
Base: All those completing a questionnaire: National (760,037); CCG 2019 (5,393); CCG 2018 (5,628); Practice bases range from 68 to 136; CCG bases
range from 2,377 to 8,129
CCG’s results Comparison of results
82%Good
Poor
CCG
83 82
7 70
10
20
30
40
50
60
70
80
90
100
2018 2019
% Good % Poor
CCG’s results over time
Practice range in CCG – % Good Local CCG range – % Good
Lowest
Performing
Highest
Performing
43% 99%
Lowest
Performing
Highest
Performing
74% 88%
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Overall experience:
how the CCG’s results compare to other local CCGs
Comparisons are indicative only: differences may not be statistically significant
74%
88%
Percentage of patients saying ‘good’
Base: All those completing a questionnaire: CCG bases range from 2,377 to 8,129 %Good = %Very good + %Fairly good
Q31. Overall, how would you describe your experience of your GP practice?
The CCG represented by this pack is highlighted in red
Results range from
to
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Overall experience:
how the CCG’s practices compare
Percentage of patients saying ‘good’
Base: All those completing a questionnaire: Practice bases range from 68 to 136
Q31. Overall, how would you describe your experience of your GP practice?
Comparisons are indicative only: differences may not be statistically significant
Results range from
to
43%
99%
%Good = %Very good + %Fairly good
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Overall experience:
how the CCG’s practices compare
Percentage of patients saying ‘good’ CCGPractices National
Base: All those completing a questionnaire: National (760,037); CCG 2019 (5,393); Practice bases range from 68 to 136
Q31. Overall, how would you describe your experience of your GP practice?
0%
10%
20%
30%
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Comparisons are indicative only: differences may not be statistically significant
%Good = %Very good + %Fairly good
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Overall experience:
how the CCG’s practices compare
Percentage of patients saying ‘good’ CCGPractices National
Base: All those completing a questionnaire: National (760,037); CCG 2019 (5,393); Practice bases range from 68 to 136
Q31. Overall, how would you describe your experience of your GP practice?
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
OL
D C
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LS
DO
N M
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NH
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Comparisons are indicative only: differences may not be statistically significant
%Good = %Very good + %Fairly good
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25%
48%
18%
10%
Very easy
Fairly easy
Not very easy
Not at all easy
68%
28%
Ease of getting through to GP practice on the phone
Q1. Generally, how easy is it to get through to someone at your GP practice on the phone?
32%
Easy
Not easy
Base: All those completing a questionnaire excluding 'Haven't tried': National (742,537); CCG 2019 (5,288); CCG 2018 (5,453); Practice bases range
from 64 to 137; CCG bases range from 2,324 to 7,930
72%Easy
Not easy
75 72
25 28
0
10
20
30
40
50
60
70
80
90
100
2018 2019
% Easy % Not easy
%Easy = %Very easy + %Fairly easy
%Not easy = %Not very easy + %Not at all easy
Practice range in CCG – % Easy Local CCG range – % Easy
Lowest
Performing
Highest
Performing
18% 97%
Lowest
Performing
Highest
Performing
52% 83%
CCG’s results Comparison of resultsCCG’s results over time
NationalCCG
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0%
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UR
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RY
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LS
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AC
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PE
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MIT
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LE
Y A
VE
NU
E S
UR
GE
RY
BR
AM
LE
Y A
VE
NU
E S
UR
GE
RY
Ease of getting through to GP practice on the phone:
how the CCG’s practices compare
Percentage of patients saying it is ‘easy’ to get through to someone on the phone
Base: All those completing a questionnaire excluding ‘Haven’t tried’: National (742,537); CCG 2019 (5,288); Practice bases range from 64 to 137 %Easy = %Very easy + %Fairly easy
Q1. Generally, how easy is it to get through to someone at your GP practice on the phone?
Comparisons are indicative only: differences may not be statistically significant
CCGPractices National
Enc
6 A
p1b
2019
Cro
ydon
Pt s
urve
y
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0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
TH
E F
AR
LE
Y R
OA
D M
ED
ICA
LP
RA
CT
ICE
AU
CK
LA
ND
SU
RG
ER
Y
SE
LH
UR
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IEW
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NT
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EA
LT
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E (
01
)
QU
EE
NH
ILL
ME
DIC
AL P
RA
CT
ICE
AD
DIN
GT
ON
ME
DIC
AL
PR
AC
TIC
E
Ease of getting through to GP practice on the phone:
how the CCG’s practices compare
Percentage of patients saying it is ‘easy’ to get through to someone on the phone
Base: All those completing a questionnaire excluding ‘Haven’t tried’: National (742,537); CCG 2019 (5,288); Practice bases range from 64 to 137 %Easy = %Very easy + %Fairly easy
Q1. Generally, how easy is it to get through to someone at your GP practice on the phone?
Comparisons are indicative only: differences may not be statistically significant
CCGPractices National
Enc
6 A
p1b
2019
Cro
ydon
Pt s
urve
y
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42%
46%
8%3%
Very helpful
Fairly helpful
Not very helpful
Not at all helpful
89%
11%
Helpfulness of receptionists at GP practice
Q2. How helpful do you find the receptionists at your GP practice?
11%
Helpful
Not helpful
Base: All those completing a questionnaire excluding ‘Don’t know’: National (751,111); CCG 2019 (5,349); CCG 2018 (5,543); Practice bases range
from 66 to 136; CCG bases range from 2,359 to 8,065
89%Helpful
Not helpful
89 89
11 110
10
20
30
40
50
60
70
80
90
100
2018 2019
% Helpful % Not helpful
%Helpful = %Very helpful + %Fairly helpful
%Not helpful = %Not very helpful + %Not at all helpful
Practice range in CCG – % Helpful Local CCG range – % Helpful
Lowest
Performing
Highest
Performing
58% 100%
Lowest
Performing
Highest
Performing
81% 92%
CCG’s results Comparison of resultsCCG’s results over time
NationalCCG
Enc
6 A
p1b
2019
Cro
ydon
Pt s
urve
y
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0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
TH
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RA
CT
ICE
SU
RG
ER
IES
LT
D
PO
RT
LA
ND
ME
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TR
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RC
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L C
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UN
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RA
CT
ICE
Helpfulness of receptionists at GP practice:
how the CCG’s practices compare
Percentage of patients saying receptionists at the GP practice are ‘helpful’
Base: All those completing a questionnaire excluding ‘Don’t know’: National (751,111); CCG 2019 (5,349); Practice bases range from 66 to 136 %Helpful = %Very helpful + %Fairly helpful
Q2. How helpful do you find the receptionists at your GP practice?
Comparisons are indicative only: differences may not be statistically significant
CCGPractices National
Enc
6 A
p1b
2019
Cro
ydon
Pt s
urve
y
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0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
DE
NM
AR
K R
OA
D S
UR
GE
RY
ST
OV
ELL
HO
US
E S
UR
GE
RY
TH
E F
AR
LE
Y R
OA
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ICE
SE
LS
DO
N P
AR
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ED
ICA
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RA
CT
ICE
OL
D C
OU
LS
DO
N M
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ICA
L P
RA
CT
ICE
QU
EE
NH
ILL
ME
DIC
AL P
RA
CT
ICE
MIT
CH
LE
Y A
VE
NU
E S
UR
GE
RY
Helpfulness of receptionists at GP practice:
how the CCG’s practices compare
Percentage of patients saying receptionists at the GP practice are ‘helpful’
Base: All those completing a questionnaire excluding ‘Don’t know’: National (751,111); CCG 2019 (5,349); Practice bases range from 66 to 136 %Helpful = %Very helpful + %Fairly helpful
Q2. How helpful do you find the receptionists at your GP practice?
Comparisons are indicative only: differences may not be statistically significant
CCGPractices National
Enc
6 A
p1b
2019
Cro
ydon
Pt s
urve
y
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Access to online services
Enc
6 A
p1b
2019
Cro
ydon
Pt s
urve
y
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49%
39%
16%
9%
34%
44%41%
15%
7%
40%
0
10
20
30
40
50
60
70
80
90
100
Bookingappointmentsonline
Ordering repeatprescriptionsonline
Accessing mymedical recordsonline
None of these Don't know
CCG
National
Awareness of online services
Comparisons are indicative only: differences may not be statistically significant
Pe
rce
nta
ge a
wa
re o
f o
nlin
e s
erv
ice
s o
ffe
red b
y
GP
pra
ctice
Base: All those completing a questionnaire: National (746,334); CCG 2019 (5,262); Practice bases range from 64 to 132
Q4. As far as you know, which of the following online services does your GP practice offer?
Practice range
within CCG
Enc
6 A
p1b
2019
Cro
ydon
Pt s
urve
y
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Online service use
19%
13%
4%
74%
15% 16%
4%
76%
0
10
20
30
40
50
60
70
80
90
100
Booking appointmentsonline
Ordering repeatprescriptions online
Accessing my medicalrecords online
None of these
CCG
National
Pe
rce
nta
ge u
se
d o
nlin
e s
erv
ice
s in
pa
st 1
2 m
on
ths
Practice range
within CCG
Base: All those completing a questionnaire: National (754,767); CCG 2019 (5,365); Practice bases range from 67 to 135
Q5. Which of the following general practice online services have you used in the past 12 months?
Comparisons are indicative only: differences may not be statistically significant
Enc
6 A
p1b
2019
Cro
ydon
Pt s
urve
y
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77%
23%
Ease of use of online services
Q6. How easy is it to use your GP practice’s website to look for information or access services?*
23%
Easy
Not easy
Base: All those completing a questionnaire excluding 'Haven't tried': National (259,817); CCG 2019 (1,909); CCG 2018 (1,799); Practice bases range
from 17 to 72; CCG bases range from 929 to 3,006
77%Easy
Not easy
%Easy = %Very easy + %Fairly easy
%Not easy = %Not very easy + %Not at all easy
Practice range in CCG – % Easy Local CCG range – % Easy
Lowest
Performing
Highest
Performing
44% 97%
Lowest
Performing
Highest
Performing
66% 79%
26%
51%
15%
8%
Very easy
Fairly easy
Not very easy
Not at all easy
74 77
26 23
0
10
20
30
40
50
60
70
80
90
100
2018 2019
% Easy % Not easy
*Those who say ‘Haven’t tried’ (60%) have been excluded from these results.
CCG’s results Comparison of resultsCCG’s results over time
NationalCCG
Enc
6 A
p1b
2019
Cro
ydon
Pt s
urve
y
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0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
TH
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ER
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D
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E
TH
E A
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Y
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DIN
GT
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AC
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E
MIT
CH
LE
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VE
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RY
HE
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LE
Y D
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NO
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Y H
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H C
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02
)
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L P
RA
CT
ICE
Ease of use of online services:
how the CCG’s practices compare
Percentage of patients saying it is ‘easy’ to use their GP practice’s website
%Easy = %Very easy + %Fairly easy Base: All those completing a questionnaire excluding 'Haven't tried': National (259,817); CCG 2019 (1,909); Practice bases range from 17 to 72
Q6. How easy is it to use your GP practice’s website to look for information or access services?
Comparisons are indicative only: differences may not be statistically significant
CCGPractices National
Enc
6 A
p1b
2019
Cro
ydon
Pt s
urve
y
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0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
UP
PE
R N
OR
WO
OD
GR
OU
P P
RA
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ICE
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RT
LA
ND
WA
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UR
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RY
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EE
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ME
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CT
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BR
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VE
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RY
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LE
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LP
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CT
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OL
D C
OU
LS
DO
N M
ED
ICA
L P
RA
CT
ICE
SE
LS
DO
N P
AR
K M
ED
ICA
L P
RA
CT
ICE
Ease of use of online services:
how the CCG’s practices compare
Percentage of patients saying it is ‘easy’ to use their GP practice’s website
%Easy = %Very easy + %Fairly easy Base: All those completing a questionnaire excluding 'Haven't tried': National (259,817); CCG 2019 (1,909); Practice bases range from 17 to 72
Q6. How easy is it to use your GP practice’s website to look for information or access services?
Comparisons are indicative only: differences may not be statistically significant
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Making an appointment
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14%
58%
10%
34%
Yes, a choice of place
Yes, a choice of time orday
Yes, a choice ofhealthcare professional
No, I was not offered achoice of appointment
62%
34%
Choice of appointment
38%
Yes
No
Base: All who tried to make an appointment since being registered excluding ‘Can’t remember’ and ‘Doesn't apply’: National (593,075); CCG 2019
(4,182); CCG 2018 (4,331); Practice bases range from 57 to 109; CCG bases range from 1,902 to 6,085
66%Yes
No
66 66
34 34
0
10
20
30
40
50
60
70
80
90
100
2018 2019
% Yes % No
Q16. On this occasion (when you last tried to make a general practice appointment), were you
offered a choice of appointment?
Practice range in CCG – % Yes Local CCG range – % Yes
Lowest
Performing
Highest
Performing
38% 94%
Lowest
Performing
Highest
Performing
57% 74%
%Yes = ‘a choice of place’ and/or ‘a choice of time or
day’ and/or ‘a choice of healthcare professional’
CCG’s results Comparison of resultsCCG’s results over time
NationalCCG
Enc
6 A
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Choice of appointment:
how the CCG’s practices compare
Percentage of patients saying ‘yes’ they were offered a choice of appointment
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
PO
RT
LA
ND
ME
DIC
AL C
EN
TR
E
TH
E P
RA
CT
ICE
SU
RG
ER
IES
LT
D
ST
. JA
ME
S'S
ME
DIC
AL C
EN
TR
E
GR
EE
NS
IDE
ME
DIC
AL P
RA
CT
ICE
BR
OU
GH
TO
N C
OR
NE
R M
ED
ICA
LC
EN
TR
E
TH
E W
HIT
EH
OR
SE
PR
AC
TIC
E
EA
ST
CR
OY
DO
N M
ED
ICA
L C
EN
TR
E
BR
IGS
TO
CK
FA
MIL
Y P
RA
CT
ICE
BR
IGS
TO
CK
& S
OU
TH
NO
RW
OO
DP
AR
TN
ER
SH
IP
CO
UN
TR
Y P
AR
K P
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CT
ICE
FR
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DS
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ME
DIC
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CT
ICE
SO
UT
H N
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HIL
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ED
ICA
LC
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TR
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MO
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OA
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UR
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ST
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ME
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ICE
HA
RT
LA
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WA
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UR
GE
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LE
AN
DE
R R
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UR
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RY
PA
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SID
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PR
AC
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LO
ND
ON
RO
AD
ME
DIC
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PR
AC
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E
PA
RC
HM
OR
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ED
ICA
L C
EN
TR
E
WO
OD
CO
TE
ME
DIC
AL
SH
IRL
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ME
DIC
AL C
EN
TR
E
CC
G
NO
RB
UR
Y H
EA
LT
H C
EN
TR
E (
02
)
BR
AM
LE
Y A
VE
NU
E S
UR
GE
RY
TH
E A
DD
ISC
OM
BE
SU
RG
ER
Y
NO
RT
H C
RO
YD
ON
ME
DIC
AL C
EN
TR
E
AS
HB
UR
TO
N P
AR
K M
ED
ICA
L C
EN
TR
E
TH
OR
NT
ON
& V
ALL
EY
PA
RK
SU
RG
ER
Y
PA
RK
WA
Y H
EA
LT
H C
EN
TR
E (
01
)
BR
OO
M R
OA
D M
ED
ICA
L P
RA
CT
ICE
TH
E H
ALIN
G P
AR
K P
AR
TN
ER
SH
IP
VIO
LE
T L
AN
E M
ED
ICA
L P
RA
CT
ICE
EV
ER
SLE
Y M
ED
ICA
L C
EN
TR
E
SE
LH
UR
ST
ME
DIC
AL
PR
AC
TIC
E
ST
OV
ELL
HO
US
E S
UR
GE
RY
AU
CK
LA
ND
SU
RG
ER
Y
OL
D C
OU
LS
DO
N M
ED
ICA
L P
RA
CT
ICE
TH
OR
NT
ON
HE
AT
H H
EA
LT
H C
EN
TR
E
TH
E M
OO
RIN
GS
ME
DIC
AL
PR
AC
TIC
E
FA
IRV
IEW
ME
DIC
AL
CE
NT
RE
DE
NM
AR
K R
OA
D S
UR
GE
RY
QU
EE
NH
ILL
ME
DIC
AL P
RA
CT
ICE
SE
LS
DO
N P
AR
K M
ED
ICA
L P
RA
CT
ICE
AD
DIN
GT
ON
ME
DIC
AL
PR
AC
TIC
E
Base: All who tried to make an appointment since being registered excluding ‘Can't remember’ and ‘Doesn’t apply’: National (593,075); CCG 2019
(4,182); Practice bases range from 57 to 109
Q16. On this occasion (when you last tried to make a general practice appointment), were you
offered a choice of appointment?
CCGPractices National
%Yes = ‘a choice of place’ and/or ‘a choice of time or
day’ and/or ‘a choice of healthcare professional’
Comparisons are indicative only: differences may not be statistically significant
Enc
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2019
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Choice of appointment:
how the CCG’s practices compare
Percentage of patients saying ‘yes’ they were offered a choice of appointment
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
ME
RS
HA
M M
ED
ICA
L C
EN
TR
E
NE
W A
DD
ING
TO
N G
RO
UP
PR
AC
TIC
E
BIR
DH
UR
ST
ME
DIC
AL
PR
AC
TIC
E
UP
PE
R N
OR
WO
OD
GR
OU
P P
RA
CT
ICE
HE
AD
LE
Y D
RIV
E S
UR
GE
RY
TH
E F
AR
LE
Y R
OA
D M
ED
ICA
LP
RA
CT
ICE
MIT
CH
LE
Y A
VE
NU
E S
UR
GE
RY
Base: All who tried to make an appointment since being registered excluding ‘Can't remember’ and ‘Doesn’t apply’: National (593,075); CCG 2019
(4,182); Practice bases range from 57 to 109
Q16. On this occasion (when you last tried to make a general practice appointment), were you
offered a choice of appointment?
CCGPractices National
%Yes = ‘a choice of place’ and/or ‘a choice of time or
day’ and/or ‘a choice of healthcare professional’
Comparisons are indicative only: differences may not be statistically significant
Enc
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73% 74%
73%
20%
7%
Yes, and I accepted anappointment
No, but I still took anappointment
No, and I did not takean appointment
Satisfaction with appointment offered
Practice range in CCG – % Yes Local CCG range – % Yes
Lowest
Performing
Highest
Performing
43% 99%
Lowest
Performing
Highest
Performing
62% 77%
Base: All who tried to make an appointment since being registered: National (711,867); CCG 2019 (5,039); CCG 2018 (5,227); Practice bases range
from 63 to 133; CCG bases range from 2,251 to 7,502
73 73
27 27
0
10
20
30
40
50
60
70
80
90
100
2018 2019
% Yes % No
Q17. Were you satisfied with the type of appointment (or appointments) you were offered?
6%
20%
7%
No, took appt
20%
Yes, took appt
No, took appt
Yes, took appt
No, didn’t take apptNo, didn’t take appt
%No = %No, but I still took an appointment +
%No, and I did not take an appointment
CCG’s results Comparison of resultsCCG’s results over time
NationalCCG
Enc
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Satisfaction with appointment offered:
how the CCG’s practices compare
Percentage of patients saying ‘yes’ they were satisfied with the appointment offered
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
TH
E P
RA
CT
ICE
SU
RG
ER
IES
LT
D
TH
E W
HIT
EH
OR
SE
PR
AC
TIC
E
ST
. JA
ME
S'S
ME
DIC
AL C
EN
TR
E
PO
RT
LA
ND
ME
DIC
AL C
EN
TR
E
BR
OU
GH
TO
N C
OR
NE
R M
ED
ICA
LC
EN
TR
ES
OU
TH
NO
RW
OO
D H
ILL M
ED
ICA
LC
EN
TR
E
FR
IEN
DS
RO
AD
ME
DIC
AL P
RA
CT
ICE
CO
UN
TR
Y P
AR
K P
RA
CT
ICE
LO
ND
ON
RO
AD
ME
DIC
AL
PR
AC
TIC
E
BR
IGS
TO
CK
FA
MIL
Y P
RA
CT
ICE
BR
IGS
TO
CK
& S
OU
TH
NO
RW
OO
DP
AR
TN
ER
SH
IP
NO
RT
H C
RO
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ON
ME
DIC
AL C
EN
TR
E
EA
ST
CR
OY
DO
N M
ED
ICA
L C
EN
TR
E
KE
ST
ON
ME
DIC
AL P
RA
CT
ICE
EV
ER
SLE
Y M
ED
ICA
L C
EN
TR
E
WO
OD
CO
TE
ME
DIC
AL
GR
EE
NS
IDE
ME
DIC
AL P
RA
CT
ICE
TH
E H
ALIN
G P
AR
K P
AR
TN
ER
SH
IP
NO
RB
UR
Y H
EA
LT
H C
EN
TR
E (
02
)
MO
RL
AN
D R
OA
D S
UR
GE
RY
LE
AN
DE
R R
OA
D S
UR
GE
RY
TH
OR
NT
ON
& V
ALL
EY
PA
RK
SU
RG
ER
Y
VIO
LE
T L
AN
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ED
ICA
L P
RA
CT
ICE
CC
G
TH
OR
NT
ON
HE
AT
H H
EA
LT
H C
EN
TR
E
PA
RC
HM
OR
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ED
ICA
L C
EN
TR
E
SH
IRL
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ME
DIC
AL C
EN
TR
E
TH
E A
DD
ISC
OM
BE
SU
RG
ER
Y
BR
OO
M R
OA
D M
ED
ICA
L P
RA
CT
ICE
BIR
DH
UR
ST
ME
DIC
AL
PR
AC
TIC
E
BR
AM
LE
Y A
VE
NU
E S
UR
GE
RY
PA
RK
WA
Y H
EA
LT
H C
EN
TR
E (
01
)
NE
W A
DD
ING
TO
N G
RO
UP
PR
AC
TIC
E
AS
HB
UR
TO
N P
AR
K M
ED
ICA
L C
EN
TR
E
HA
RT
LA
ND
WA
Y S
UR
GE
RY
DE
NM
AR
K R
OA
D S
UR
GE
RY
OL
D C
OU
LS
DO
N M
ED
ICA
L P
RA
CT
ICE
ST
OV
ELL
HO
US
E S
UR
GE
RY
ME
RS
HA
M M
ED
ICA
L C
EN
TR
E
AU
CK
LA
ND
SU
RG
ER
Y
SE
LH
UR
ST
ME
DIC
AL
PR
AC
TIC
E
TH
E F
AR
LE
Y R
OA
D M
ED
ICA
LP
RA
CT
ICE
UP
PE
R N
OR
WO
OD
GR
OU
P P
RA
CT
ICE
PA
RK
SID
E G
RO
UP
PR
AC
TIC
E
Base: All who tried to make an appointment since being registered: National (711,867); CCG 2019 (5,039); Practice bases range from 63 to 133
Q17. Were you satisfied with the type of appointment (or appointments) you were offered?
Comparisons are indicative only: differences may not be statistically significant
CCGPractices National
Enc
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Satisfaction with appointment offered:
how the CCG’s practices compare
Percentage of patients saying ‘yes’ they were satisfied with the appointment offered
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
AD
DIN
GT
ON
ME
DIC
AL
PR
AC
TIC
E
TH
E M
OO
RIN
GS
ME
DIC
AL
PR
AC
TIC
E
FA
IRV
IEW
ME
DIC
AL
CE
NT
RE
HE
AD
LE
Y D
RIV
E S
UR
GE
RY
QU
EE
NH
ILL
ME
DIC
AL P
RA
CT
ICE
SE
LS
DO
N P
AR
K M
ED
ICA
L P
RA
CT
ICE
MIT
CH
LE
Y A
VE
NU
E S
UR
GE
RY
Base: All who tried to make an appointment since being registered: National (711,867); CCG 2019 (5,039); Practice bases range from 63 to 133
Q17. Were you satisfied with the type of appointment (or appointments) you were offered?
Comparisons are indicative only: differences may not be statistically significant
CCGPractices National
Enc
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12%9%
12% 12% 13%16%
11%7%
30%
14%
8%12% 10% 10%
21%
12% 11%
29%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Got anappointment fora different day
Called an NHShelpline, suchas NHS 111
Went to A&E Spoke to apharmacist
Went to orcontacted
another NHSservice
Decided tocontact my
practice anothertime
Looked forinformation
online
Spoke to afriend or family
member
Didn’t see or speak to anyone
CCG
National
What patients do when they are not satisfied with the
appointment offered and do not take itO
f th
ose
wh
o d
eclin
ed
an
app
oin
tme
nt,
perc
enta
ge
wh
o w
ent
on to
do s
om
eth
ing
els
e
Base: All who did not take the appointment offered (excluding those who haven't tried to make one): National (34,350); CCG 2019 (270)
Q19. What did you do when you did not take the appointment you were offered?
Comparisons are indicative only: differences may not be statistically significant
Enc
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67%
14%
Overall experience of making an appointment
30%
39%
16%
9%6% Very good
Fairly good
Neither good nor poor
Fairly poor
Very poor
Q22. Overall, how would you describe your experience of making an appointment?
Practice range in CCG – % Good Local CCG range – % Good
16%
Good
Poor
Lowest
Performing
Highest
Performing
29% 96%
Lowest
Performing
Highest
Performing
57% 75%
%Good = %Very good + %Fairly good
%Poor = %Very poor + %Fairly poor
Base: All who tried to make an appointment since being registered: National (705,310); CCG 2019 (5,018); CCG 2018 (5,183); Practice bases range
from 65 to 133; CCG bases range from 2,244 to 7,482
70%Good
Poor
71 70
14 140
10
20
30
40
50
60
70
80
90
100
2018 2019
% Good % Poor
CCG’s results Comparison of resultsCCG’s results over time
NationalCCG
Enc
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Overall experience of making an appointment:
how the CCG’s practices compare
Percentage of patients saying they had a ‘good’ experience of making an appointment
Base: All who tried to make an appointment since being registered: National (705,310); CCG 2019 (5,018); Practice bases range from 65 to 133
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
TH
E P
RA
CT
ICE
SU
RG
ER
IES
LT
D
PO
RT
LA
ND
ME
DIC
AL C
EN
TR
E
BR
IGS
TO
CK
FA
MIL
Y P
RA
CT
ICE
SO
UT
H N
OR
WO
OD
HIL
L M
ED
ICA
LC
EN
TR
EB
RO
UG
HT
ON
CO
RN
ER
ME
DIC
AL
CE
NT
RE
GR
EE
NS
IDE
ME
DIC
AL P
RA
CT
ICE
KE
ST
ON
ME
DIC
AL P
RA
CT
ICE
PA
RC
HM
OR
E M
ED
ICA
L C
EN
TR
E
ST
. JA
ME
S'S
ME
DIC
AL C
EN
TR
E
TH
E W
HIT
EH
OR
SE
PR
AC
TIC
E
CO
UN
TR
Y P
AR
K P
RA
CT
ICE
EA
ST
CR
OY
DO
N M
ED
ICA
L C
EN
TR
E
LE
AN
DE
R R
OA
D S
UR
GE
RY
NO
RT
H C
RO
YD
ON
ME
DIC
AL C
EN
TR
E
WO
OD
CO
TE
ME
DIC
AL
FR
IEN
DS
RO
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ME
DIC
AL P
RA
CT
ICE
EV
ER
SLE
Y M
ED
ICA
L C
EN
TR
E
MO
RL
AN
D R
OA
D S
UR
GE
RY
LO
ND
ON
RO
AD
ME
DIC
AL
PR
AC
TIC
E
BR
IGS
TO
CK
& S
OU
TH
NO
RW
OO
DP
AR
TN
ER
SH
IP
TH
E H
ALIN
G P
AR
K P
AR
TN
ER
SH
IP
SH
IRL
EY
ME
DIC
AL C
EN
TR
E
CC
G
DE
NM
AR
K R
OA
D S
UR
GE
RY
TH
OR
NT
ON
HE
AT
H H
EA
LT
H C
EN
TR
E
TH
OR
NT
ON
& V
ALL
EY
PA
RK
SU
RG
ER
Y
TH
E A
DD
ISC
OM
BE
SU
RG
ER
Y
NO
RB
UR
Y H
EA
LT
H C
EN
TR
E (
02
)
VIO
LE
T L
AN
E M
ED
ICA
L P
RA
CT
ICE
BR
OO
M R
OA
D M
ED
ICA
L P
RA
CT
ICE
HA
RT
LA
ND
WA
Y S
UR
GE
RY
PA
RK
WA
Y H
EA
LT
H C
EN
TR
E (
01
)
BIR
DH
UR
ST
ME
DIC
AL
PR
AC
TIC
E
NE
W A
DD
ING
TO
N G
RO
UP
PR
AC
TIC
E
OL
D C
OU
LS
DO
N M
ED
ICA
L P
RA
CT
ICE
AS
HB
UR
TO
N P
AR
K M
ED
ICA
L C
EN
TR
E
BR
AM
LE
Y A
VE
NU
E S
UR
GE
RY
AU
CK
LA
ND
SU
RG
ER
Y
TH
E M
OO
RIN
GS
ME
DIC
AL
PR
AC
TIC
E
PA
RK
SID
E G
RO
UP
PR
AC
TIC
E
ME
RS
HA
M M
ED
ICA
L C
EN
TR
E
FA
IRV
IEW
ME
DIC
AL
CE
NT
RE
ST
OV
ELL
HO
US
E S
UR
GE
RY
SE
LH
UR
ST
ME
DIC
AL
PR
AC
TIC
E
%Good = %Very good + %Fairly good
Q22. Overall, how would you describe your experience of making an appointment?
Comparisons are indicative only: differences may not be statistically significant
CCGPractices National
Enc
6 A
p1b
2019
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ydon
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urve
y
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Overall experience of making an appointment:
how the CCG’s practices compare
Percentage of patients saying they had a ‘good’ experience of making an appointment
Base: All who tried to make an appointment since being registered: National (705,310); CCG 2019 (5,018); Practice bases range from 65 to 133
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
SE
LS
DO
N P
AR
K M
ED
ICA
L P
RA
CT
ICE
HE
AD
LE
Y D
RIV
E S
UR
GE
RY
UP
PE
R N
OR
WO
OD
GR
OU
P P
RA
CT
ICE
TH
E F
AR
LE
Y R
OA
D M
ED
ICA
LP
RA
CT
ICE
AD
DIN
GT
ON
ME
DIC
AL
PR
AC
TIC
E
QU
EE
NH
ILL
ME
DIC
AL P
RA
CT
ICE
MIT
CH
LE
Y A
VE
NU
E S
UR
GE
RY
%Good = %Very good + %Fairly good
Q22. Overall, how would you describe your experience of making an appointment?
Comparisons are indicative only: differences may not be statistically significant
CCGPractices National
Enc
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last appointment
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Perceptions of care at patients’ last appointment with a
healthcare professional
Base: All who had an appointment since being registered with current GP practice excluding 'Doesn't apply': National (717,030; 715,282; 717,062); CCG
2019 (5,062; 5,063; 5,073)
CCG’s results
Nationl results %
Poor (total)
CCG results
% Poor (total)
%Poor (total) = %Very poor + %Poor
Q26. Last time you had a general practice appointment, how good was the healthcare professional
at each of the following
44% 49% 49%
41%39% 37%
11% 8% 10%3% 3% 3%
Giving you enough time Listening to you Treating you with care and concern
Very good Good Neither good nor poor Poor Very poor
National results
% ‘Poor’ (total)
CCG results
% ‘Poor’ (total)
Very poor
Very good
4% 4% 4%
4% 4% 4%
Giving you enough time Listening to you Treating you with care and concern
Enc
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Perceptions of care at patients’ last appointment with a
healthcare professional
Base: All who had an appointment since being registered with current GP practice excluding ‘Don’t know / doesn’t apply’ or ‘Don’t know / can’t say’:
National (637,385; 705,397; 706,338); CCG 2019 (4,467; 4,958; 4,957)
CCG’s results
Nationl results %
Poor (total)
CCG results
% Poor (total)
Q28-30. During your last general practice appointment…
58%66% 60%
35%29% 34%
8% 6% 6%
Felt involved in decisions about care andtreatment
Had confidence and trust in thehealthcare professional
Felt their needs were met
Yes, definitely Yes, to some extent No, not at all
National results
% ‘No, not at all’
CCG results
% ‘No, not at all’
No, not at all
Yes, definitely
7% 5% 6%
8% 6% 6%
Felt involved in decisions about care
and treatment Had confidence and trust in the
healthcare professional
Felt their needs were met
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49%
34%
17%
Yes, definitely
Yes, to some extent
No, not at all
86%
17%
Mental health needs recognised and understood
14%
Yes
No
Base: All who had an appointment since being registered with current GP practice excluding ‘I did not have any mental health needs’ and ‘Did not apply to my
last appointment’: National (284,999); CCG 2019 (2,039); CCG 2018 (2,146); Practice bases range from 22 to 61; CCG bases range from 852 to 3,542
83%Yes
No
83 83
17 17
0
10
20
30
40
50
60
70
80
90
100
2018 2019
% Yes % No
Q27. During your last general practice appointment, did you feel that the healthcare professional
recognised and/or understood any mental health needs that you might have had?
%Yes = %Yes, definitely + %Yes, to some extent
Practice range in CCG – % Yes Local CCG range – % Yes
Lowest
Performing
Highest
Performing
52% 100%
Lowest
Performing
Highest
Performing
76% 89%
CCG’s results Comparison of resultsCCG’s results over time
NationalCCG
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Managing health conditions
Enc
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38%
36%
27%
Yes, definitely
Yes, to some extent
No, not at all
78%
27%
Support with managing health conditions
22%
Yes
No
Base: All with a long-term condition excluding ‘I haven’t needed support’ and ‘Don’t know / can’t say’: National (292,168); CCG 2019 (1,939); CCG 2018
(2,028); Practice bases range from 22 to 54; CCG bases range from 773 to 2,655
73%Yes
No
Q38. In the last 12 months, have you had enough support from local services or organisations to
help you to manage your condition (or conditions)?
Practice range in CCG – % Yes Local CCG range – % Yes
Lowest
Performing
Highest
Performing
36% 95%
Lowest
Performing
Highest
Performing
67% 82%
73 73
27 27
0
10
20
30
40
50
60
70
80
90
100
2018 2019
% Yes % No
CCG’s results Comparison of resultsCCG’s results over time
%Yes = %Yes, definitely + %Yes, to some extent
NationalCCG
Enc
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Percentage of patients saying ‘yes’ they have had enough support to manage their condition(s)
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
TH
OR
NT
ON
& V
ALL
EY
PA
RK
SU
RG
ER
YB
RO
UG
HT
ON
CO
RN
ER
ME
DIC
AL
CE
NT
RE
TH
E P
RA
CT
ICE
SU
RG
ER
IES
LT
D
LO
ND
ON
RO
AD
ME
DIC
AL
PR
AC
TIC
E
PA
RK
WA
Y H
EA
LT
H C
EN
TR
E (
01
)
GR
EE
NS
IDE
ME
DIC
AL P
RA
CT
ICE
BR
IGS
TO
CK
FA
MIL
Y P
RA
CT
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ST
OV
ELL
HO
US
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UR
GE
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LE
AN
DE
R R
OA
D S
UR
GE
RY
ST
. JA
ME
S'S
ME
DIC
AL C
EN
TR
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TH
OR
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ON
HE
AT
H H
EA
LT
H C
EN
TR
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TH
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HIT
EH
OR
SE
PR
AC
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EV
ER
SLE
Y M
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ICA
L C
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PA
RC
HM
OR
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L C
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RS
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M M
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L C
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MO
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D R
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D S
UR
GE
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WO
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CO
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ME
DIC
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VIO
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L P
RA
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FR
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DS
RO
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ME
DIC
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HA
RT
LA
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WA
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GE
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NO
RT
H C
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ON
ME
DIC
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EN
TR
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BR
OO
M R
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D M
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ICA
L P
RA
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AU
CK
LA
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SU
RG
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Y
SO
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H N
OR
WO
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HIL
L M
ED
ICA
LC
EN
TR
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CC
G
PO
RT
LA
ND
ME
DIC
AL C
EN
TR
E
AD
DIN
GT
ON
ME
DIC
AL
PR
AC
TIC
E
NO
RB
UR
Y H
EA
LT
H C
EN
TR
E (
02
)
SE
LS
DO
N P
AR
K M
ED
ICA
L P
RA
CT
ICE
OL
D C
OU
LS
DO
N M
ED
ICA
L P
RA
CT
ICE
HE
AD
LE
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RIV
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UR
GE
RY
QU
EE
NH
ILL
ME
DIC
AL P
RA
CT
ICE
BR
IGS
TO
CK
& S
OU
TH
NO
RW
OO
DP
AR
TN
ER
SH
IP
BR
AM
LE
Y A
VE
NU
E S
UR
GE
RY
CO
UN
TR
Y P
AR
K P
RA
CT
ICE
EA
ST
CR
OY
DO
N M
ED
ICA
L C
EN
TR
E
DE
NM
AR
K R
OA
D S
UR
GE
RY
TH
E A
DD
ISC
OM
BE
SU
RG
ER
Y
UP
PE
R N
OR
WO
OD
GR
OU
P P
RA
CT
ICE
AS
HB
UR
TO
N P
AR
K M
ED
ICA
L C
EN
TR
E
SH
IRL
EY
ME
DIC
AL C
EN
TR
E
TH
E M
OO
RIN
GS
ME
DIC
AL
PR
AC
TIC
E
TH
E H
ALIN
G P
AR
K P
AR
TN
ER
SH
IP
KE
ST
ON
ME
DIC
AL P
RA
CT
ICE
Base: All with a long-term condition excluding ‘I haven’t needed support’ and ‘Don’t know / can’t say’: National (292,168); CCG 2019 (1,939); Practice
bases range from 22 to 54
Q38. In the last 12 months, have you had enough support from local services or organisations to
help you to manage your condition (or conditions)?
Support with managing long-term health conditions:
how the CCG’s practices compare
Comparisons are indicative only: differences may not be statistically significant
CCGPractices National
%Yes = %Yes, definitely + %Yes, to some extent
Enc
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Percentage of patients saying ‘yes’ they have had enough support to manage their condition(s)
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
SE
LH
UR
ST
ME
DIC
AL
PR
AC
TIC
E
FA
IRV
IEW
ME
DIC
AL
CE
NT
RE
PA
RK
SID
E G
RO
UP
PR
AC
TIC
E
TH
E F
AR
LE
Y R
OA
D M
ED
ICA
LP
RA
CT
ICE
MIT
CH
LE
Y A
VE
NU
E S
UR
GE
RY
NE
W A
DD
ING
TO
N G
RO
UP
PR
AC
TIC
E
BIR
DH
UR
ST
ME
DIC
AL
PR
AC
TIC
E
Base: All with a long-term condition excluding ‘I haven’t needed support’ and ‘Don’t know / can’t say’: National (292,168); CCG 2019 (1,939); Practice
bases range from 22 to 54
Q38. In the last 12 months, have you had enough support from local services or organisations to
help you to manage your condition (or conditions)?
Support with managing long-term health conditions:
how the CCG’s practices compare
Comparisons are indicative only: differences may not be statistically significant
CCGPractices National
%Yes = %Yes, definitely + %Yes, to some extent
Enc
6 A
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Satisfaction with general
practice appointment times
Enc
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25%
42%
16%
10%
7%Very satisfied
Fairly satisfied
Neither satisfied nordissatisfied
Fairly dissatisfied
Very dissatisfied
65%
17%
Satisfaction with appointment times
18%
Satisfied
Dissatisfied
Base: All those completing a questionnaire excluding ‘I’m not sure when I can get an appointment’: National (696,898); CCG 2019 (5,021); CCG 2018
(5,247); Practice bases range from 62 to 127; CCG bases range from 2,254 to 7,543
67%Satisfied
Dissatisfied
68 67
16 17
0
10
20
30
40
50
60
70
80
90
100
2018 2019
% Satisfied % Dissatisfied
Q8. How satisfied are you with the general practice appointment times that are available to you?*
%Satisfied = %Very satisfied + %Fairly satisfied
%Dissatisfied = %Very dissatisfied + %Fairly dissatisfied
Practice range in CCG – % Satisfied Local CCG range – % Satisfied
Lowest
Performing
Highest
Performing
41% 97%
Lowest
Performing
Highest
Performing
58% 72%
*Those who say ‘I’m not sure when I can get an appointment’ (1%) have been excluded from these results.
CCG’s results Comparison of resultsCCG’s results over time
NationalCCG
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Satisfaction with appointment times:
how the CCG’s practices compare
Percentage of patients saying they are ‘satisfied’ with the appointment times available
Base: All those completing a questionnaire excluding ‘I’m not sure when I can get an appointment’: National (696,898); CCG 2019 (5,021);
Practice bases range from 62 to 127
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
TH
E P
RA
CT
ICE
SU
RG
ER
IES
LT
D
TH
E W
HIT
EH
OR
SE
PR
AC
TIC
E
PO
RT
LA
ND
ME
DIC
AL C
EN
TR
E
ST
. JA
ME
S'S
ME
DIC
AL C
EN
TR
E
KE
ST
ON
ME
DIC
AL P
RA
CT
ICE
NO
RT
H C
RO
YD
ON
ME
DIC
AL C
EN
TR
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GR
EE
NS
IDE
ME
DIC
AL P
RA
CT
ICE
SO
UT
H N
OR
WO
OD
HIL
L M
ED
ICA
LC
EN
TR
E
PA
RC
HM
OR
E M
ED
ICA
L C
EN
TR
E
BR
IGS
TO
CK
FA
MIL
Y P
RA
CT
ICE
WO
OD
CO
TE
ME
DIC
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EV
ER
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Y M
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ICA
L C
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ST
CR
OY
DO
N M
ED
ICA
L C
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CO
UN
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Y P
AR
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RA
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NO
RB
UR
Y H
EA
LT
H C
EN
TR
E (
02
)
BR
OU
GH
TO
N C
OR
NE
R M
ED
ICA
LC
EN
TR
E
DE
NM
AR
K R
OA
D S
UR
GE
RY
FR
IEN
DS
RO
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ME
DIC
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RA
CT
ICE
MO
RL
AN
D R
OA
D S
UR
GE
RY
VIO
LE
T L
AN
E M
ED
ICA
L P
RA
CT
ICE
TH
E A
DD
ISC
OM
BE
SU
RG
ER
Y
TH
OR
NT
ON
HE
AT
H H
EA
LT
H C
EN
TR
E
CC
G
LO
ND
ON
RO
AD
ME
DIC
AL
PR
AC
TIC
E
BR
OO
M R
OA
D M
ED
ICA
L P
RA
CT
ICE
SH
IRL
EY
ME
DIC
AL C
EN
TR
E
TH
E M
OO
RIN
GS
ME
DIC
AL
PR
AC
TIC
E
BR
IGS
TO
CK
& S
OU
TH
NO
RW
OO
DP
AR
TN
ER
SH
IP
LE
AN
DE
R R
OA
D S
UR
GE
RY
PA
RK
WA
Y H
EA
LT
H C
EN
TR
E (
01
)
HA
RT
LA
ND
WA
Y S
UR
GE
RY
SE
LH
UR
ST
ME
DIC
AL
PR
AC
TIC
E
TH
E H
ALIN
G P
AR
K P
AR
TN
ER
SH
IP
PA
RK
SID
E G
RO
UP
PR
AC
TIC
E
BR
AM
LE
Y A
VE
NU
E S
UR
GE
RY
ME
RS
HA
M M
ED
ICA
L C
EN
TR
E
OL
D C
OU
LS
DO
N M
ED
ICA
L P
RA
CT
ICE
BIR
DH
UR
ST
ME
DIC
AL
PR
AC
TIC
E
AU
CK
LA
ND
SU
RG
ER
Y
ST
OV
ELL
HO
US
E S
UR
GE
RY
TH
E F
AR
LE
Y R
OA
D M
ED
ICA
LP
RA
CT
ICE
NE
W A
DD
ING
TO
N G
RO
UP
PR
AC
TIC
E
FA
IRV
IEW
ME
DIC
AL
CE
NT
RE
AS
HB
UR
TO
N P
AR
K M
ED
ICA
L C
EN
TR
E
%Satisfied = %Very satisfied + %Fairly satisfied
Q8. How satisfied are you with the general practice appointment times that are available to you?
CCGPractices National
Comparisons are indicative only: differences may not be statistically significant
Enc
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Satisfaction with appointment times:
how the CCG’s practices compare
Percentage of patients saying they are ‘satisfied’ with the appointment times available
Base: All those completing a questionnaire excluding ‘I’m not sure when I can get an appointment’: National (696,898); CCG 2019 (5,021);
Practice bases range from 62 to 127
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
UP
PE
R N
OR
WO
OD
GR
OU
P P
RA
CT
ICE
SE
LS
DO
N P
AR
K M
ED
ICA
L P
RA
CT
ICE
AD
DIN
GT
ON
ME
DIC
AL
PR
AC
TIC
E
TH
OR
NT
ON
& V
ALL
EY
PA
RK
SU
RG
ER
Y
QU
EE
NH
ILL
ME
DIC
AL P
RA
CT
ICE
HE
AD
LE
Y D
RIV
E S
UR
GE
RY
MIT
CH
LE
Y A
VE
NU
E S
UR
GE
RY
%Satisfied = %Very satisfied + %Fairly satisfied
Q8. How satisfied are you with the general practice appointment times that are available to you?
CCGPractices National
Comparisons are indicative only: differences may not be statistically significant
Enc
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Services when GP practice is closed
• The services when GP practice is closed questions are only asked of those who have recently used an NHS service when they wanted to see
a GP but their GP practice was closed. As such, the base size is often too small to make meaningful comparisons at practice level; practice
range within CCG has therefore not been included for these questions.
• Please note that patients cannot always distinguish between out-of-hours services and extended access appointments. Please view the results
in this section with the configuration of your local services in mind.
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58%
20%
3%
43%
15%
12%
19%
4%
63%
25%
5%
37%
12%
8%
17%
5%
I contacted an NHS service by telephone
A healthcare professional called me back
A healthcare professional visited me at home
I went to A&E
I saw a pharmacist
I went to another general practice service
I went to another NHS service
Can't remember
CCG National
Use of services when GP practice is closed
Base: All those who have contacted an NHS service when GP practice closed in past 12 months: National (139,476); CCG 2019 (1,035)
Q45. Considering all of the services you contacted, which of the following happened on that
occasion?
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62%
38%It was about right
It took too long
38%
Time taken to receive care or advice when GP practice is closed
66%
34%
About right
Took too long
Local CCG range – % About right
Base: All those who tried to contact an NHS service when GP surgery closed in past 6 months excluding ‘Don’t know / doesn’t apply’: National
(130,757); CCG 2019 (981); CCG 2018 (929); CCG bases range from 382 to 1,433
Lowest
Performing
Highest
Performing
52% 74%
62%About right
Took too long
Q46. How do you feel about how quickly you received care or advice on that occasion?
57 62
43 38
0
10
20
30
40
50
60
70
80
90
100
2018 2019
% About right % Took too long
CCG’s results Comparison of resultsCCG’s results over time
NationalCCG
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40%
50%
10%
Yes, definitely
Yes, to some extent
No, not at all 10%
Confidence and trust in staff providing services when GP
practice is closed
91%
9%
Yes
No
Local CCG range – % Yes
Base: All those who tried to contact an NHS service when GP surgery closed in past 6 months excluding ‘Don’t know / can't say’: National (134,437);
CCG 2019 (1,015); CCG 2018 (959); CCG bases range from 398 to 1,487
Lowest
Performing
Highest
Performing
86% 95%
90%Yes
No
90 90
10 100
10
20
30
40
50
60
70
80
90
100
2018 2019
% Yes % No
%Yes = %Yes, definitely + % Yes, to some extent
Q47. Considering all of the people that you saw or spoke to on that occasion, did you have
confidence and trust in them?
CCG’s results Comparison of resultsCCG’s results over time
NationalCCG
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29%
36%
19%
9%
7%Very good
Fairly good
Neither good nor poor
Fairly poor
Very poor
16%
Overall experience of services when GP practice is closed
69%
15%
Good
Poor
Local CCG range – % Good
Base: All those who tried to contact an NHS service when GP surgery closed in past 6 months excluding ‘Don’t know / can't say’: National (134,770);
CCG 2019 (1,011); CCG 2018 (968); CCG bases range from 395 to 1,501
Lowest
Performing
Highest
Performing
56% 77%
65%Good
Poor
62 65
19 16
0
10
20
30
40
50
60
70
80
90
100
2018 2019
% Good % Poor
%Good = %Very good + %Fairly good
%Poor = %Fairly poor + %Very poor
Q48. Overall, how would you describe your last experience of NHS services when you wanted to
see a GP but your GP practice was closed?
CCG’s results Comparison of resultsCCG’s results over time
NationalCCG
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Statistical reliability
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Statistical reliability
Participants in a survey such as GPPS represent only a sample of the total population of interest – this means we cannot be certain that the results of
a question are exactly the same as if everybody within that population had taken part (“true values”). However, we can predict the variation between
the results of a question and the true value by using the size of the sample on which results are based and the number of times a particular answer is
given. The confidence with which we make this prediction is usually chosen to be 95% – that is, the chances are 95 in 100 that the true value will fall
within a specified range (the “95% confidence interval”).
The table below gives examples of what the confidence intervals look like for an ‘average’ practice and CCG, as well as the confidence intervals at
the national level.
Average sample size on
which results are based
Approximate confidence intervals for percentages at or near
these levels (expressed in percentage points)
Level 1:
10% or 90%
Level 2:
30% or 70%
Level 3:
50%
+/- +/- +/-
National 770,512 0.10 0.15 0.16
CCG 4,034 1.29 1.96 2.14
Practice 110 6.83 10.06 10.92
An example of confidence intervals (at national, CCG and practice level) based on the average number of responses to the question
“Overall, how would you describe your experience of your GP practice?”
For example, taking a CCG where 4,034 people responded and where 30% answered ‘Very good’ in response to ‘Overall, how would you describe
your experience of making an appointment’, there is a 95% likelihood that the true value (which would have been obtained if the whole population had
been interviewed) will fall within the range of +/-1.96 percentage points from that question’s result (i.e. between 28.04% and 31.96%).
When results are compared between separate groups within a sample, the difference may be “real” or it may occur by chance (because not everyone
in the population has been interviewed). Confidence intervals will be wider when comparing groups, especially where there are small numbers e.g.
practices where 100 patients or fewer responded to a question. These findings should be regarded as indicative rather than robust.
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Want to know more?
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Further background information about the survey
• The survey was sent to c.2.3 million adult patients registered with a GP practice.
• Participants are sent a postal questionnaire, also with the option of completing the
survey online or via telephone.
• Past results dating back to 2007 are available for every practice in the UK. From 2017
the survey has been annual; previously it ran twice a year (June 2011 – July 2016), on a
quarterly basis (April 2009 – March 2011) and annually (January 2007 – March 2009).
• For more information about the survey please visit https://gp-patient.co.uk/.
• The overall response rate to the survey is 33.1%, based on 770,512 completed surveys.
• Weights have been applied to adjust the data to account for potential age and gender
differences between the profile of all eligible patients in a practice and the patients who
actually complete a questionnaire. Since the first wave of the 2011-2012 survey the
weighting also takes into account neighbourhood statistics, such as levels of deprivation,
in order to further improve the reliability of the findings.
• Further information on the survey including questionnaire design, sampling,
communication with patients and practices, data collection, data analysis, response
rates and reporting can be found in the technical annex for each survey year, available
here: https://gp-patient.co.uk/surveysandreports.
770,512Completed surveys in the July 2019 publication
c.2.3mSurveys to adults registered with an English GP practice
33.1% National response rate
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Where to go to do further analysis …
• For reports which show the National results broken down by CCG and Practice, go to
https://gp-patient.co.uk/surveysandreports - you can also see previous years’ results here.
• To look at this year’s survey data at a national, CCG or practice level, and filter on a specific participant group
(e.g. by age), break down the survey results by survey question, or to create and compare different participant
‘subgroups’, go to https://gp-patient.co.uk/analysistool/2019.
• To look at results over time, and filter on a specific participant group, go to https://gp-
patient.co.uk/analysistool/trends.
• For general FAQs about the GP Patient Survey, go to https://gp-patient.co.uk/faq.
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For further information about the GP Patient Survey, please
get in touch with the GPPS team at Ipsos MORI at
GPPatientSurvey@ipsos.com
We would be interested to hear any feedback you have on
this slide pack, so we can make improvements for the next
publication.
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South West London Health & Care
Partnership STP
Latest survey results2019 publication
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Contents
Background, introduction and guidance
Overall experience of GP practice
Local GP services
Access to online services
Making an appointment
Perceptions of care at patients’ last appointment
Managing health conditions
Satisfaction with general practice appointment times
Services when GP practice is closed
Statistical reliability
Want to know more?
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Background, introduction
and guidance
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Background information about the survey
• The GP Patient Survey (GPPS) is an England-wide survey, providing practice-level
data about patients’ experiences of their GP practices.
• Ipsos MORI administers the survey on behalf of NHS England.
• For more information about the survey please refer to the end of this slide pack or visit
https://gp-patient.co.uk/.
• This slide pack presents some of the key results for South West London Health &
Care Partnership STP (Sustainability and Transformation Partnership).
• The data in this slide pack are based on the July 2019 GPPS publication.
• In South West London Health & Care Partnership STP, 70,694 questionnaires were
sent out, and 20,474 were returned completed. This represents a response rate of 29%.
• In 2018 the questionnaire was redeveloped in response to significant changes to
primary care services as set out in the GP Forward View, and to provide a better
understanding of how local care services are supporting patients to live well, particularly
those with long-term care needs. The questionnaire (and past versions) can be found
here: https://gp-patient.co.uk/surveysandreports.
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Additional publication – CCG slide packs
• Individual slide packs for each CCG, providing more detail about local services,
including performance of individual practices can be found here:
https://www.gp-patient.co.uk/Slidepacks2019
• Slide packs for each CCG in South West London Health & Care
Partnership STP can be found here:
NHS CROYDON CCG
NHS RICHMOND CCG
NHS KINGSTON CCG
NHS WANDSWORTH CCG
NHS SUTTON CCG
NHS MERTON CCG
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Introduction
• The GP Patient Survey measures patients’ experiences across a range of topics, including:
- Your local GP services
- Making an appointment
- Your last appointment
- Overall experience
- Your health
- When your GP practice is closed
- NHS Dentistry
- Some questions about you
• The GP Patient Survey provides data at practice level using a consistent methodology, which means it is comparable across organisations.
• The survey has limitations:
- Sample sizes at practice level are relatively small.
- The survey does not include qualitative data which limits the detail provided by the results.
• The data provide a snapshot of patient experience at a given time, and are updated annually.
• Given the consistency of the survey across organisations, GPPS can be used as one element of evidence.
• It can be triangulated with other sources of feedback, such as feedback from Patient Participation Groups, local surveys and the Friends and Family Test, to develop a fuller picture of patient journeys.
• This slide pack is intended to assist this triangulation of data. It aims to highlight where there may be a need for further exploration.
• STP teams, CCGs and practices can then discuss the findings further and triangulate them with other data –in order to identify potential improvements and highlight best practice.
• The following slide suggests ideas for how the data can be used to improve services.
• This pack includes trend data, beginning in 2018. Following the extensive changes to the questionnaire in 2018, all questions at STP, CCG and practice level are not comparable prior to this year.
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Guidance on how to use the data
• Comparison of an STP’s results against
the national average: this allows
benchmarking of the results to identify
whether STPs are performing well, poorly,
or in line with the national picture.
• Analysing trends in an STP’s results
over time: this provides a sense of the
direction of the STP’s performance over
time. NHS England teams may wish to
focus on areas where an STP has seen
decline over time.
• Comparison of CCGs’ results within an
STP’s area and over time: this can
identify CCGs in an area that seem to be
over-performing or under-performing
compared with others, and provide a sense
of the direction of the CCGs’ performance
over time. NHS England teams may wish
to work with individual CCGs: those that
are performing particularly well may be
able to highlight best practice, while those
performing less well may be able to
improve their performance.
The following suggest ideas for how the data in this slide pack can be used and interpreted to
improve GP services:
*Images used in this slide are for example purposes only
*
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Interpreting the results
• The number of participants answering (the base size) is stated for each question. The total
number of responses is shown at the bottom of each chart.
• All comparisons are indicative only – differences may not be statistically
significant.
• For guidance on statistical reliability, or for details of where you can get more information
about the survey, please refer to the end of this slide pack.
• Maps: STP and CCG level results are also displayed on maps, with results split across 5
bands (or ‘quintiles’) in order to have a fairly even distribution at the national level of
STPs/CCGs across each band.
• Trends:
- Latest / 2019: refers to the July 2019 publication (fieldwork January to March 2019)
- 2018: refers to the August 2018 publication (fieldwork January to March 2018)
• For further information on using the data please refer to the end of this slide pack.
*More than 0% but less than 0.5%
100%Where results do not sum to
100%, or where individual
responses (e.g. fairly good;
very good) do not sum to
combined responses
(e.g. very/fairly good) this is
due to rounding, or cases
where multiple responses
are allowed.
When fewer than 10 patients respond
In cases where fewer than 10
patients have answered a
question, the data have been
suppressed and results will
not appear within the charts.
This is to prevent individuals
and their responses being
identifiable in the data.
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Overall experience of GP practice
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83%
5%
Overall experience of GP practice
46%
39%
10%
4% Very good
Fairly good
Neither good norpoor
Fairly poor
Very poor
Q31. Overall, how would you describe your experience of your GP practice?
National
6%
Good
Poor
%Good = %Very good + %Fairly good
%Poor = %Very poor + %Fairly poor
Base: All those completing a questionnaire: National (760,037); STP 2019 (20,166); STP 2018 (19,583)
STP’s results Comparison of results
85%Good
Poor
STP
85 85
5 50
10
20
30
40
50
60
70
80
90
100
2018 2019
% Good % Poor
STP’s results over time
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Overall experience:
how the STP’s results compare to other STPs
STP results range from
to
Comparisons are indicative only: differences may not be statistically significant
77%
88%
Percentage of patients saying ‘good’
%Good = %Very good + %Fairly good
Q31. Overall, how would you describe your experience of your GP practice?
The STP represented by this pack is highlighted in red
Base: All those completing a questionnaire: STP bases range from 6,760 to 48,016
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Overall experience:
how the STP’s CCGs compare
Percentage of patients saying ‘good’
Base: All those completing a questionnaire: CCG bases range from 2,377 to 5,393
Q31. Overall, how would you describe your experience of your GP practice?
Comparisons are indicative only: differences may not be statistically significant
CCG results range from
to
81%
88%
%Good = %Very good + %Fairly good
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Overall experience: current performance and change
over time
Base: All those completing a questionnaire: National 2019 (760,037); 2018 (746,847); STP 2019 (20,166); 2018 (19,583); CCG bases range from: 2,377 to 5,393
(2019); 2,174 to 5,628 (2018)
Q31. Overall, how would you describe your experience of your GP practice?
Comparisons are indicative only: differences may not be statistically significant
%Good = %Very good + %Fairly good
83%
85%
88%
87%
87%
84%
82%
81%
National-level
South West London Health & Care Partnership STP
NHS RICHMOND CCG
NHS WANDSWORTH CCG
NHS SUTTON CCG
NHS KINGSTON CCG
NHS CROYDON CCG
NHS MERTON CCG
2019 2018
83% q 1 84%
85% ---- 85%
88% p 1 87%
87% ---- 87%
87% ---- 87%
84% q 1 85%
82% q 1 83%
81% q 1 82%
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Local GP services
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25%
50%
18%
8%
Very easy
Fairly easy
Not very easy
Not at all easy
68%
26%
Ease of getting through to GP practice on the phone
Q1. Generally, how easy is it to get through to someone at your GP practice on the phone?
32%
Easy
Not easy
Base: All those completing a questionnaire excluding 'Haven't tried': National (742,537); STP 2019 (19,686); STP 2018 (18,992)
74%Easy
Not easy
75 74
25 26
0
10
20
30
40
50
60
70
80
90
100
2018 2019
% Easy % Not easy
%Easy = %Very easy + %Fairly easy
%Not easy = %Not very easy + %Not at all easy
STP’s results Comparison of resultsSTP’s results over time
NationalSTP
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Ease of getting through to GP practice on the phone:
how the CCGs within the STP compare
Base: All those completing a questionnaire: National 2019 (742,537); 2018 (729,884); STP 2019 (19,686); 2018 (18,992); CCG bases range from: 2,324
to 5,288 (2019); 2,127 to 5,453 (2018) %Easy = %Very easy + %Fairly easy
Q1. Generally, how easy is it to get through to someone at your GP practice on the phone?
Comparisons are indicative only: differences may not be statistically significant
68%
74%
82%
78%
77%
72%
70%
64%
National-level
South West London Health & Care Partnership STP
NHS RICHMOND CCG
NHS WANDSWORTH CCG
NHS SUTTON CCG
NHS CROYDON CCG
NHS KINGSTON CCG
NHS MERTON CCG
2019 2018
68% q 2 70%
74% q 1 75%
82% p 1 81%
78% q 2 80%
77% q 1 78%
72% q 3 75%
70% p 1 69%
64% q 1 65%
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44%
46%
8%
Very helpful
Fairly helpful
Not very helpful
Not at all helpful
89%
10%
Helpfulness of receptionists at GP practice
Q2. How helpful do you find the receptionists at your GP practice?
11%Helpful
Not helpful
Base: All those completing a questionnaire excluding ‘Don’t know’: National (751,111); STP 2019 (20,007); STP 2018 (19,339)
90%Helpful
Not helpful
90 90
10 100
10
20
30
40
50
60
70
80
90
100
2018 2019
% Helpful % Not helpful
%Helpful = %Very helpful + %Fairly helpful
%Not helpful = %Not very helpful + %Not at all helpful
STP’s results Comparison of resultsSTP’s results over time
NationalSTP
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Helpfulness of receptionists at GP practice:
how the CCGs within the STP compare
Base: All those completing a questionnaire: National 2019 (751,111); 2018 (738,543); STP 2019 (20,007); 2018 (19,339); CCG bases range from: 2,359
to 5,349 (2019); 2,155 to 5,543 (2018) %Helpful = %Very helpful + %Fairly helpful
Q2. How helpful do you find the receptionists at your GP practice?
Comparisons are indicative only: differences may not be statistically significant
89%
90%
92%
91%
91%
90%
89%
89%
National-level
South West London Health & Care Partnership STP
NHS SUTTON CCG
NHS KINGSTON CCG
NHS RICHMOND CCG
NHS WANDSWORTH CCG
NHS CROYDON CCG
NHS MERTON CCG
2019 2018
89% q 1 90%
90% ---- 90%
92% ---- 92%
91% ---- 91%
91% p 1 90%
90% q 1 91%
89% ---- 89%
89% p 2 87%
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Access to online services
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53%
42%
19%
7%
33%
44%41%
15%
7%
40%
0
10
20
30
40
50
60
70
80
90
100
Bookingappointmentsonline
Ordering repeatprescriptionsonline
Accessing mymedical recordsonline
None of these Don't know
STP
National
Awareness of online services
Comparisons are indicative only: differences may not be statistically significant
Percentage aware of online services offered by GP practice
Base: All those completing a questionnaire: National (746,334); STP (19,779)
Q4. As far as you know, which of the following online services does your GP practice offer? Enc
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Online service use
Percentage used online services in past 12 months
Base: All those completing a questionnaire: National (754,767); STP (20,076)
Q5. Which of the following general practice online services have you used in the past 12 months?
Comparisons are indicative only: differences may not be statistically significant
22%
13%
5%
71%
15% 16%
4%
76%
0
10
20
30
40
50
60
70
80
90
100
Booking appointmentsonline
Ordering repeatprescriptionsonline
Accessing my medicalrecordsonline
None of these
STP
National
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77%
23%
Ease of use of online services
Q6. How easy is it to use your GP practice’s website to look for information or access services?*
23%
Easy
Not easy
Base: All those completing a questionnaire excluding 'Haven't tried': National (259,817); STP 2019 (7,907); STP 2018 (7,103)
77%Easy
Not easy
%Easy = %Very easy + %Fairly easy
%Not easy = %Not very easy + %Not at all easy
25%
52%
17%
6%
Very easy
Fairly easy
Not very easy
Not at all easy
79 77
21 23
0
10
20
30
40
50
60
70
80
90
100
2018 2019
% Easy % Not easy
*Those who say ‘Haven’t tried’ (55%) have been excluded from these results.
STP’s results Comparison of resultsSTP’s results over time
NationalSTP
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Ease of use of online services:
how the CCGs within the STP compare
%Easy = %Very easy + %Fairly easy Base: All those completing a questionnaire: National 2019 (259,817); 2018 (234,144); STP 2019 (7,907); 2018 (7,103); CCG bases range from: 975 to
1,909 (2019); 871 to 1,799 (2018)
Q6. How easy is it to use your GP practice’s website to look for information or access services?
Comparisons are indicative only: differences may not be statistically significant
77%
77%
79%
78%
77%
77%
77%
74%
National-level
South West London Health & Care Partnership STP
NHS SUTTON CCG
NHS RICHMOND CCG
NHS WANDSWORTH CCG
NHS KINGSTON CCG
NHS CROYDON CCG
NHS MERTON CCG
2019 2018
77% q 1 78%
77% q 2 79%
79% q 1 80%
78% p 1 77%
77% q 5 82%
77% q 1 78%
77% p 3 74%
74% q 5 79%
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12%
61%
12%
31%
Yes, a choice of place
Yes, a choice of time orday
Yes, a choice ofhealthcare professional
No, I was not offered achoice of appointment
62%
31%
Choice of appointment
38%
Yes
No
Base: All who tried to make an appointment since being registered excluding ‘Can’t remember’ and ‘Doesn't apply’: National (593,075); STP 2019
(15,885); STP 2018 (15,391)
69%Yes
No
68 69
32 31
0
10
20
30
40
50
60
70
80
90
100
2018 2019
% Yes % No
Q16. On this occasion (when you last tried to make a general practice appointment), were you
offered a choice of appointment?
%Yes = ‘a choice of place’ and/or ‘a choice of time or
day’ and/or ‘a choice of healthcare professional’
STP’s results Comparison of resultsSTP’s results over time
NationalSTP
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Choice of appointment:
how the CCGs within the STP compare
Base: All those completing a questionnaire: National 2019 (593,075); 2018 (586,602); STP 2019 (15,885); 2018 (15,391); CCG bases range from: 1,902
to 4,182 (2019); 1,750 to 4,331 (2018)
Q16. On this occasion (when you last tried to make a general practice appointment), were you
offered a choice of appointment?
%Yes = ‘a choice of place’ and/or ‘a choice of time or
day’ and/or ‘a choice of healthcare professional’
Comparisons are indicative only: differences may not be statistically significant
62%
69%
73%
71%
68%
68%
67%
66%
National-level
South West London Health & Care Partnership STP
NHS WANDSWORTH CCG
NHS RICHMOND CCG
NHS SUTTON CCG
NHS KINGSTON CCG
NHS MERTON CCG
NHS CROYDON CCG
2019 2018
62% ---- 62%
69% p 1 68%
73% ---- 73%
71% p 2 69%
68% q 2 70%
68% p 4 64%
67% p 1 66%
66% ---- 66%
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76% 74%
76%
19%
6%Yes, and Iaccepted anappointment
No, but I still tookan appointment
No, and I did nottake anappointment
Satisfaction with appointment offered
Base: All who tried to make an appointment since being registered: National (711,867); STP 2019 (19,005); STP 2018 (18,351)
75 76
25 24
0
10
20
30
40
50
60
70
80
90
100
2018 2019
% Yes % No
Q17. Were you satisfied with the type of appointment (or appointments) you were offered?
6%
19%
6%
No, took appt
20%
Yes, took appt
No, took appt
Yes, took appt
No, didn’t take apptNo, didn’t take appt
%No = %No, but I still took an appointment +
%No, and I did not take an appointment
STP’s results Comparison of resultsSTP’s results over time
NationalSTP
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Satisfaction with appointment offered:
how the CCGs within the STP compare
Base: All those completing a questionnaire: National 2019 (711,867); 2018 (701,961); STP 2019 (19,005); 2018 (18,351); CCG bases range from: 2,251
to 5,039 (2019); 2,074 to 5,227 (2018)
Q17. Were you satisfied with the type of appointment (or appointments) you were offered?
Comparisons are indicative only: differences may not be statistically significant
74%
76%
77%
77%
77%
76%
74%
73%
National-level
South West London Health & Care Partnership STP
NHS SUTTON CCG
NHS RICHMOND CCG
NHS KINGSTON CCG
NHS WANDSWORTH CCG
NHS MERTON CCG
NHS CROYDON CCG
2019 2018
74% ---- 74%
76% p 1 75%
77% q 1 78%
77% ---- 77%
77% p 2 75%
76% p 1 75%
74% p 1 73%
73% ---- 73%
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13%9%
14%9% 11%
19%14%
11%
26%
14%
8%12% 10% 10%
21%
12% 11%
29%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Got anappointment fora different day
Called an NHShelpline, suchas NHS 111
Went to A&E Spoke to apharmacist
Went to orcontacted
another NHSservice
Decided tocontact my
practice anothertime
Looked forinformation
online
Spoke to afriend or family
member
Didn’t see or speak to anyone
STP
National
What patients do when they are not satisfied with the
appointment offered and do not take it
Of those who declined an appointment, percentage who went on to do something else
Base: All who did not take the appointment offered (excluding those who haven't tried to make one): National (34,350); STP (861)
Q19. What did you do when you did not take the appointment you were offered?
Comparisons are indicative only: differences may not be statistically significant
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67%
12%
Overall experience of making an appointment
31%
41%
16%
8%4%
Very good
Fairly good
Neither good norpoor
Fairly poor
Very poor
Q22. Overall, how would you describe your experience of making an appointment?
16%
Good
Poor
%Good = %Very good + %Fairly good
%Poor = %Very poor + %Fairly poor
Base: All who tried to make an appointment since being registered: National (705,310); STP 2019 (18,877); STP 2018 (18,203)
72%Good
Poor
72 72
12 120
10
20
30
40
50
60
70
80
90
100
2018 2019
% Good % Poor
STP’s results Comparison of resultsSTP’s results over time
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Overall experience of making an appointment:
how the CCGs within the STP compare
Base: All those completing a questionnaire: National 2019 (705,310); 2018 (693,912); STP 2019 (18,877); 2018 (18,203); CCG bases range from: 2,244
to 5,018 (2019); 2,062 to 5,183 (2018) %Good = %Very good + %Fairly good
Q22. Overall, how would you describe your experience of making an appointment?
Comparisons are indicative only: differences may not be statistically significant
67%
72%
75%
74%
74%
73%
70%
69%
National-level
South West London Health & Care Partnership STP
NHS SUTTON CCG
NHS WANDSWORTH CCG
NHS RICHMOND CCG
NHS KINGSTON CCG
NHS CROYDON CCG
NHS MERTON CCG
2019 2018
67% q 2 69%
72% ---- 72%
75% q 1 76%
74% q 1 75%
74% ---- 74%
73% p 2 71%
70% q 1 71%
69% p 2 67%
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Perceptions of care at patients’
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Perceptions of care at patients’ last appointment with a
healthcare professional
Base: All who had an appointment since being registered with current GP practice excluding 'Doesn't apply': National (717,030; 715,282; 717,062); STP
(19,050; 19,027; 19,065)
STP’s results
National results
% Poor (total)
CCG results
% Poor (total)
%Poor (total) = %Very poor + %Poor
Q26. Last time you had a general practice appointment, how good was the healthcare professional
at each of the following
47% 52% 52%
39%37% 35%
10% 7% 9%3%
Giving you enough time Listening to you Treating you with care and concern
Very good Good Neither good nor poor Poor Very poor
National results
% ‘Poor’ (total)
STP results
% ‘Poor’ (total)
Very poor
Very good
4% 4% 4%
4% 4% 4%
Giving you enough time Listening to you Treating you with care and concern
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Perceptions of care at patients’ last appointment with a
healthcare professional
Base: All who had an appointment since being registered with current GP practice excluding ‘Don’t know / doesn’t apply’ or ‘Don’t know / can’t say’:
National (637,385; 705,397; 706,338); STP (16,916; 18,710; 18,724)
STP’s results
National results
% Poor (total)
CCG results
% Poor (total)
Q28-30. During your last general practice appointment…
60%68% 62%
34%28% 33%
7% 5% 6%
Felt involved in decisions about care andtreatment
Had confidence and trust in thehealthcare professional
Felt their needs were met
Yes, definitely Yes, to some extent No, not at all
National results
% ‘No, not at all’
STP results
% ‘No, not at all’
No, not at all
Yes, definitely
7% 5% 6%
7% 5% 6%
Felt involved in decisions about care
and treatment Had confidence and trust in the
healthcare professional
Felt their needs were met
Enc
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52%
33%
15% Yes,definitely
Yes, to someextent
No, not at all
86%
15%
Mental health needs recognised and understood
14%
Yes
No
Base: All who had an appointment since being registered with current GP practice excluding ‘I did not have any mental health needs’ and ‘Did not apply to my
last appointment’: National (284,999); STP 2019 (7,527); STP 2018 (7,382)
85%Yes
No
85 85
15 15
0
10
20
30
40
50
60
70
80
90
100
2018 2019
% Yes % No
Q27. During your last general practice appointment, did you feel that the healthcare professional
recognised and/or understood any mental health needs that you might have had?
%Yes = %Yes, definitely + %Yes, to some extent
STP’s results Comparison of resultsSTP’s results over time
NationalSTP
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Managing health conditions
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40%
37%
23%Yes,definitely
Yes, tosome extent
No, not at all
78%
23%
Support with managing health conditions
22%
Yes
No
Base: All with a long-term condition excluding ‘I haven’t needed support’ and ‘Don’t know / can’t say’: National (292,168); STP 2019 (6,767); STP 2018
(6,585)
77%Yes
No
Q38. In the last 12 months, have you had enough support from local services or organisations to
help you to manage your condition (or conditions)?
78 77
22 23
0
10
20
30
40
50
60
70
80
90
100
2018 2019
% Yes % No
CCG’s results Comparison of resultsCCG’s results over time
%Yes = %Yes, definitely + %Yes, to some extent
NationalSTP
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Base: All those completing a questionnaire: National 2019 (292,168); 2018 (284,887); STP 2019 (6,767); 2018 (6,585); CCG bases range from: 773 to
1,939 (2019); 704 to 2,028 (2018)
Q38. In the last 12 months, have you had enough support from local services or organisations to
help you to manage your condition (or conditions)?
Support with managing health conditions:
how the CCGs within the STP compare
Comparisons are indicative only: differences may not be statistically significant
%Yes = %Yes, definitely + %Yes, to some extent
78%
77%
82%
81%
79%
78%
73%
73%
National-level
South West London Health & Care Partnership STP
NHS SUTTON CCG
NHS RICHMOND CCG
NHS KINGSTON CCG
NHS WANDSWORTH CCG
NHS MERTON CCG
NHS CROYDON CCG
2019 2018
78% q 1 79%
77% q 1 78%
82% p 3 79%
81% q 3 84%
79% q 1 80%
78% q 1 79%
73% q 1 74%
73% ---- 73%
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Satisfaction with general
practice appointment times
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26%
43%
16%
10%5%
Very satisfied
Fairly satisfied
Neither satisfiednor dissatisfied
Fairly dissatisfied
Very dissatisfied
65%
15%
Satisfaction with appointment times
18%
Satisfied
Dissatisfied
Base: All those completing a questionnaire excluding ‘I’m not sure when I can get an appointment’: National (696,898); STP 2019 (18,927); STP 2018
(18,310)
69%Satisfied
Dissatisfied
69 69
15 15
0
10
20
30
40
50
60
70
80
90
100
2018 2019
% Satisfied % Dissatisfied
Q8. How satisfied are you with the general practice appointment times that are available to you?*
%Satisfied = %Very satisfied + %Fairly satisfied
%Dissatisfied = %Very dissatisfied + %Fairly dissatisfied
*Those who say ‘I’m not sure when I can get an appointment’ (1%) have been excluded from these results.
STP’s results Comparison of resultsSTP’s results over time
NationalSTP
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Satisfaction with appointment times:
how the CCGs within the STP compare
Base: All those completing a questionnaire: National 2019 (696,898); 2018 (689,659); STP 2019 (18,927); 2018 (18,310); CCG bases range from: 2,254
to 5,021 (2019); 2,055 to 5,247 (2018) %Satisfied = %Very satisfied + %Fairly satisfied
Q8. How satisfied are you with the general practice appointment times that are available to you?
Comparisons are indicative only: differences may not be statistically significant
65%
69%
72%
71%
68%
68%
67%
67%
National-level
South West London Health & Care Partnership STP
NHS WANDSWORTH CCG
NHS SUTTON CCG
NHS KINGSTON CCG
NHS RICHMOND CCG
NHS CROYDON CCG
NHS MERTON CCG
2019 2018
65% q 1 66%
69% ---- 69%
72% p 1 71%
71% ---- 71%
68% q 1 69%
68% p 3 65%
67% q 1 68%
67% ---- 67%
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Services when GP practice is closed
• The services when GP practice is closed questions are only asked of those who have recently used an NHS service when they wanted to see
a GP but their GP practice was closed.
• Please note that patients cannot always distinguish between out-of-hours services and extended access appointments. Please view the results
in this section with the configuration of your local services in mind.
Enc
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59%
19%
3%
41%
13%
12%
15%
6%
63%
25%
5%
37%
12%
8%
17%
5%
I contacted an NHS service by telephone
A healthcare professional called me back
A healthcare professional visited me at home
I went to A&E
I saw a pharmacist
I went to another general practice service
I went to another NHS service
Can't remember
STP National
Use of services when GP practice is closed
Base: All those who have contacted an NHS service when GP practice closed in past 12 months: National (139,476); STP (3,784)
Q45. Considering all of the services you contacted, which of the following happened on that
occasion? Enc
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66%
34%It was aboutright
It took too long
34%
Time taken to receive care or advice when GP practice is closed
66%
34%
About right
Took too long
Base: All those who tried to contact an NHS service when GP surgery closed in past 6 months excluding ‘Don’t know / doesn’t apply’: National
(130,757); STP 2019 (3,550); STP 2018 (3,405)
66%About right
Took too long
Q46. How do you feel about how quickly you received care or advice on that occasion?
62 66
38 34
0
10
20
30
40
50
60
70
80
90
100
2018 2019
% About right % Took too long
STP’s results Comparison of resultsSTP’s results over time
NationalSTP
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46%
46%
8%Yes, definitely
Yes, to someextent
No, not at all 8%
Confidence and trust in staff providing services when GP
practice is closed
91%
9%
Yes
No
Base: All those who tried to contact an NHS service when GP surgery closed in past 6 months excluding ‘Don’t know / can't say’: National (134,437);
STP 2019 (3,645); STP 2018 (3,488)
92%Yes
No
92 92
8 80
10
20
30
40
50
60
70
80
90
100
2018 2019
% Yes % No
%Yes = %Yes, definitely + % Yes, to some extent
Q47. Considering all of the people that you saw or spoke to on that occasion, did you have
confidence and trust in them?
STP’s results Comparison of resultsSTP’s results over time
NationalSTP
Enc
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30%
39%
17%
9%5%
Very good
Fairly good
Neither good norpoor
Fairly poor
Very poor
15%
Overall experience of services when GP practice is closed
69%
15%
Good
Poor
Base: All those who tried to contact an NHS service when GP surgery closed in past 6 months excluding ‘Don’t know / can't say’: National (134,770);
STP 2019 (3,638); STP 2018 (3,521)
69%Good
Poor
67 69
16 15
0
10
20
30
40
50
60
70
80
90
100
2018 2019
% Good % Poor
%Good = %Very good + %Fairly good
%Poor = %Fairly poor + %Very poor
Q48. Overall, how would you describe your last experience of NHS services when you wanted to
see a GP but your GP practice was closed?
STP’s results Comparison of resultsSTP’s results over time
NationalSTP
Enc
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Statistical reliability
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Statistical reliability
Participants in a survey such as GPPS represent only a sample of the total population of interest – this means we cannot be certain that the results of
a question are exactly the same as if everybody within that population had taken part (“true values”). However, we can predict the variation between
the results of a question and the true value by using the size of the sample on which results are based and the number of times a particular answer is
given. The confidence with which we make this prediction is usually chosen to be 95% – that is, the chances are 95 in 100 that the true value will fall
within a specified range (the “95% confidence interval”).
The table below gives examples of what the confidence intervals look like for an ‘average’ practice and CCG, as well as the confidence intervals at
the national level.
Average sample size on
which results are based
Approximate confidence intervals for percentages at or near
these levels (expressed in percentage points)
Level 1:
10% or 90%
Level 2:
30% or 70%
Level 3:
50%
+/- +/- +/-
National 770,512 0.10 0.15 0.16
STP 18,000 0.61 0.93 1.02
CCG 4,034 1.29 1.96 2.14
An example of confidence intervals (at national, CCG and practice level) based on the average number of responses to the question
“Overall, how would you describe your experience of your GP practice?”
For example, taking a CCG where 4,034 people responded and where 30% answered ‘Very good’ in response to ‘Overall, how would you describe
your experience of making an appointment’, there is a 95% likelihood that the true value (which would have been obtained if the whole population had
been interviewed) will fall within the range of +/-1.96 percentage points from that question’s result (i.e. between 28.04% and 31.96%).
When results are compared between separate groups within a sample, the difference may be “real” or it may occur by chance (because not everyone
in the population has been interviewed). Confidence intervals will be wider when comparing groups, especially where there are small numbers e.g.
practices where 100 patients or fewer responded to a question. These findings should be regarded as indicative rather than robust.
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Want to know more?
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Further background information about the survey
• The survey was sent to c.2.3 million adult patients registered with a GP practice.
• Participants are sent a postal questionnaire, also with the option of completing the
survey online or via telephone.
• Past results dating back to 2007 are available for every practice in the UK. From 2017
the survey has been annual; previously it ran twice a year (June 2011 – July 2016), on a
quarterly basis (April 2009 – March 2011) and annually (January 2007 – March 2009).
• For more information about the survey please visit https://gp-patient.co.uk/.
• The overall response rate to the survey is 33.1%, based on 770,512 completed surveys.
• Weights have been applied to adjust the data to account for potential age and gender
differences between the profile of all eligible patients in a practice and the patients who
actually complete a questionnaire. Since the first wave of the 2011-2012 survey the
weighting also takes into account neighbourhood statistics, such as levels of deprivation,
in order to further improve the reliability of the findings.
• Further information on the survey including questionnaire design, sampling,
communication with patients and practices, data collection, data analysis, response
rates and reporting can be found in the technical annex for each survey year, available
here: https://gp-patient.co.uk/surveysandreports.
770,512Completed surveys in the July 2019 publication
c.2.3mSurveys to adults registered with an English GP practice
33.1%National response rate
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© Ipsos MORI
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19-043068-01 GPPS STP Slidepacks | Version 1 | Public
Where to go to do further analysis …
• For reports which show the National results broken down by CCG and Practice, go to
https://gp-patient.co.uk/surveysandreports - you can also see previous years’ results here.
• To look at this year’s survey data at a national, CCG or practice level, and filter on a specific participant group
(e.g. by age), break down the survey results by survey question, or to create and compare different participant
‘subgroups’, go to https://gp-patient.co.uk/analysistool/2019.
• To look at results over time, and filter on a specific participant group, go to https://gp-
patient.co.uk/analysistool/trends.
• For general FAQs about the GP Patient Survey, go to https://gp-patient.co.uk/faq.
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© Ipsos MORI
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19-043068-01 GPPS STP Slidepacks | Version 1 | Public© Ipsos MORI 19-043068-01 GPPS STP Slidepacks | Version 1 | Public
For further information about the GP Patient Survey, please
get in touch with the GPPS team at Ipsos MORI at
GPPatientSurvey@ipsos.com
We would be interested to hear any feedback you have on
this slide pack, so we can make improvements for the next
publication.
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REPORT TO CROYDON CLINICAL COMMISSIONING GROUP PRIMARY CARE COMMISSIONING COMMITTEE
3 March 2020
Title of Paper: Medicines Shortages Update
Lead Director Josh Potter Joint Director of Strategy and Transformation
Report Author Louise Coughlan Joint Chief Pharmacist
Committees which have previously discussed/agreed the report
Primary Care Commissioning Working Group
Committees that will be required to receive/approve the report
Primary Care Commissioning Committee
Purpose of Report For Information
Recommendation:
The Primary Care Commissioning Committee is asked to: ▪ Note the current medication shortage issues that are affecting both clinical care and
finance and the actions put in place to minimise risk
Background:
Shortages of medicines are becoming increasingly frequent, and have an impact on pharmacy teams in both primary and secondary care to issue/dispense medicines in a timely manner. So far, no shortages have been attributed directly to EU exit. There is also an impact on patient experience, as in some cases, medication is switched to an unfamiliar alternative product (eg HRT) or in extreme cases cannot be supplied at all. The CCG Medicines Optimisation team works closely with GPs and community pharmacists to ensure disruption is kept to a minimum, making use of local intelligence, and national resources such as the Specialist Pharmacy Service website. The Department for Health and Social Security publishes a monthly newsletter, providing information and advice on new and ongoing shortages. There are currently 75 items on this list. Most notable are: Ranitidine - withdrawn due to unacceptable levels of a potentially toxic substance, alternative agents need to be used that has required significant pharmacy resource. Fluoxetine - serious shortage protocol enacted that allowed community pharmacists to swap between strengths. Digoxin injection - manufacturing issue, prioritisation of stock required should stocks and alternatives run out. Alternative product is unlicensed and significantly more expensive.
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Phenytoin 100mg capsules – Expected to be out of stock until May 2020, alternative product may require extra monitoring. Hormone replacement therapy – significant ongoing shortages across multiple products that has caused distress for many women. We are informed of which products are in stock and recommendations for alternatives for those currently out of stock. Information for GPs are published either via a monthly newsletter, or if urgent, a memo will be distributed.
Key Issues:
• Impact on quality of care our residents receive if their regular medication cannot be supplied
• Resource issues as prescribers and pharmacists need to prescribe/source/advise alternatives
• Impact on finance as alternative products are often more costly. In Croydon, this is estimated to produce a cost pressure of approximately £1.7m for 19/20 just in primary care
• The Medicines Optimisation Team work closely with other healthcare colleagues across the system and utilises all available resources to ensure clinicians are made aware of shortages and how to manage them in order to minimise disruption to the Croydon residents.
Governance:
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Corporate Objective To commission high quality health care services that are accessible, provide good treatment and achieve good patient outcomes. To reduce the amount of time people spend avoidably in hospital through better and more integrated care in the community, outside of hospital for physical and mental health. To support local people and stakeholders to have a greater influence on services we commission and support individuals to manage their care
Risks Poor patient experience and care if shortages are unable to be managed.
Clinical Leaders comments where appropriate
Financial Implications Negative
Conflicts of Interest Nil
Implications for other CCGs Implication same for whole of UK
Equality Analysis N/A
Patient and Public Involvement N/A
Communication Plan Via relevant newsletters/memos
Information Governance Issues Nil
Reputational Issues Lack of access to medication
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REPORT TO CROYDON CLINICAL COMMISSIONING GROUP PRIMARY CARE COMMISSIONING COMMITTEE
3 March 2020
Title of Paper: Primary Care Quality and CQC visits/ratings report
Lead Director Josh Potter Director of Strategy and Transformation
Report Author Helen Goodrum Primary Care Commissioning and Quality Lead
Committees which have previously discussed/agreed the report.
Primary Care Commissioning Working Group
Committees that will be required to receive/approve the report
Primary Care Commissioning Committee Quality Committee
Purpose of Report For noting Recommendations:
The Primary Care Commissioning Committee is asked to:
▪ Note the on-going and developmental work to deliver the CCG’s statutory duties in regards to ensuring quality in General Practice
▪ Discuss, comment and support the continued proactive approach to understanding and improving quality in General Practice
▪ Note the CQC status of practices in Croydon and the CCG input and actions to support practices
Background:
A high quality and safe healthcare system is at the heart of the CCG’s ambition as delegated commissioners of General Practice and as a clinically led organisation actively supports providers to go beyond national standards towards safe care on the ground. The CCG’s role is to be assured of the care quality of its providers but more importantly lead their improvement. Croydon CCG has established a number of measures and support mechanisms which are outlined in this report, together with details of future work planned to monitor quality, safety and performance and ensure that commissioned services deliver the best health outcomes for Croydon residents. The GP Clinical Quality Review Group (CQRG) discusses and monitors clinical issues, quality of care and performance.
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General Practice Clinical Quality Review Group (GP CQRG) report This report is a summary of the contents of the CQRG meeting on 29 January 2020. Learning Disability Health Checks
An improved number of LD Health Check has been noted in Q3 2019-20 (558) compared
to Q3 2018-19 (410). Total number of Health Checks completed year to date, with a count
of 1049, compared to 901 previously. The rolling 12 month total is 1642, which currently
forecasts a >75% of the number of patients on QOF LD register 2018-19 (all ages), if Q4
2019-20 is equal to or greater than 2018-19. However caution should be exercised when
considering this forecast, since some practices have made changes to when they recall
people, attempting to administer the influenza immunisation to this group of eligible
patients in the autumn, rather than waiting to the early months of the year.
The GP dashboard is being used to help identify and address individual practices where
variation is seen. A 2.5 hour training session on Learning Disability review for Practice
Nurses is planned on 12th February 2020.
Cervical Screening
Improvement initiative making appointments available to patients in the Extended Access
Services, as well as a CGPC run initiative is planned to follow up and recall patients
offering appointments in the EAS. NHSE/I are relaunching the cervical screening text
reminder project across London region. The six-month pilot was highly effective and
resulted in a 5% increase in the uptake of cervical cancer screening. More detail on the
results is available here.
In early January 2020 we were informed only half of the Croydon practices had signed up,
at the end of January, following support from the variation team, there are two practices
who are outstanding and being chased up.
Childhood immunisations
The GP dashboard is being updated with data quarterly, the latest available is Q2 2019-20.
A Quality improvement project has commenced with Primary Care North Croydon PCN to
understand barriers and improve processes focusing on childhood immunisations.
Learning will be shared.
The CCG attend and contribute to the Croydon Council Immunisation Steering group and
the associated improvement plans for immunisations.
Changes to the GP contract agreement 2020/21 - 2023/2 recently announced include
implementing over the next two years the findings of the vaccinations and immunisations
review. The payment model will be overhauled to support improved vaccination coverage.
Vaccinations and immunisations will become an essential service in 2020. New contractual
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core standards will be introduced. Item of service payments will be introduced and
standardised across all routine programmes over the next two years. This will begin with
Measles Mumps and Rubella (MMR) in 2020/21 and extend to other vaccines from April
2021.
Elective transformation
Now at 95% Blue button usage, compared to ~35% in April 2020.
SMI Health Checks
As a CCG Croydon has 5.1% achievement in 12 months to end of September 2019. (total
percentage to get full check). London mean is 33.5%. A new LCS was launched in the
autumn 2019 supporting this, which will be promoted at the January GP open meeting. We
are awaiting details of broken down by practices to further address variation.
GP online access
Nearly 25% of the Croydon population is registered for GP Online services (appointment
bookings or prescription services). There is variation between practices, which is
highlighted on the GP dashboard. One practice is being looked into as published data is
showing zero for both services. Another practice is showing zero for number of patients
registered to book appointments online, however this is an artefact due to how they are
using Doctorlink, which is a digital software application which allows online appointments,
for example video appointments.
Diabetes – National Diabetes Audit
NDA for Jan18-Mar19 was published in December 2019. Type 1: all eight went up from
35% to 45% - taking Croydon from ‘as expected’ to ‘higher than expected’ (England is at
41%).
Type 2: all eight went up from 52% to 60% - also taking Croydon from ‘as expected’ to
‘higher than expected’ (England is at 54%). Variation between practices from 3% to 96%,
but the majority of practices are now over 50% for the completion of checks for people with
type 2 diabetes. See separate report for full details.
Diabetes - National Diabetes Prevention Programme
The CCG continues to exceed targets for the National Diabetes Prevention Programme
(NDPP); 111 were referred in December 2019, the total number of Croydon residents now
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referred to the programme exceeds 2000. Improvements have been made by the provider
aimed at increasing access to the services, a digital offering is now available and also
population specific cohorts, such as a men only group.
NRLS Incidents reporting
There have been 68 medicine related incidents reported on The National Reporting and
Learning System (NRLS). Data is also shared with CHS and the Primary Care Prescribing
Committee to allow for improved shared learning. The reports this year have been rated
as low or no harm, a theme regarding errors as a result of a lack of or incorrect coding of
allergies has been seen, learning has been shared regarding this via the Medicines
Optimisation Newsletter.
Ursula Madine (interim head of Quality Assurance) is developing a comprehensive NRLS
incident reporting plan to engage, train and support GP practices.
Influenza immunisation 2019-20 update
The GP CQRG received the influenza immunisation uptake data for the period 1st
September to w/c 5th January 2019. Uptake amongst over 65s and pregnant women is
the same /higher than this time last year, however the uptake amongst at risk groups and
is marginally lower than last year.
There continues to be some data extraction issues in December which impacted two
Croydon practices. This had been reported to the national team but in the interim they were
being supported with their manual submissions.
Practices have been reminded that the final flu activity submission for 2019/20 on
ImmForm will be 12th February 2020.
Planning for 2020-21 season is underway, practices have been advised regarding placing
orders for supplies, and an immunisation update training event for practice nursing staff
has been arranged for 5th August 2020.
Comparison of percentage uptake of flu immunisation 1st Sept-w/c 5th
Jan
2019-20 2018-19
Over 65s 62.8% 61.0%
At risk groups 36.8% 40.4%
Pregnant woman 38.0% 38.6%
Safeguarding update
The CCG Safeguarding Team continue to work to implement changes as part of the
Croydon CCG and Local Authority CQC action plan.
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Elective Transformation: Blue Button
The Variation team continues to support the Elective Transformation work.
The latest data now shows that around 90% of referrals are being managed via the Blue
Button Booking service which offers choice of provider to patients, compared to less than
35% going by this route in April 2019.
Care Quality Commission (CQC) Visits/Ratings report The CQC are the independent regulator of health and social care in England and inspect
General Practices on a three yearly cycle or whenever ‘alert’ is received.
There are currently no practices within the Croydon Borough who the CQC have rated as
‘Inadequate’ overall. There are five practices/providers who the CQC have rated as
‘Requires Improvement’ overall which impacts seven of the fifty GP contracts:
1. Denmark Road 2. East Croydon Medical Centre / Edridge Road 3. The Greenwood Group - Greenside Road / Country Park Practice. 4. Mitchley Avenue Surgery 5. Hartland Way Surgery
Whilst the remaining GP Practices within Croydon Borough are rated as “Good” overall,
some practices are rated as “Requires Improvement” in one of the CQC’s Quality Domains:
1. Addington Medical Centre - “Safe” domain; 2. Brigstock and South Norwood Partnership - “Safe” domain;
Two practices have been rated as “Outstanding” in one of the CQCs Quality Domains:
1. Friends Road Medical Centre – “Well Led” 2. Selhurst Medical Centre – “Responsive”
The table below shows details of inspections undertaken by the CQC as part of their scheduled programme, return visits, other changes or where we are awaiting publications of reports since the previous at the December PCCC meeting. Appendix 1 reflects the position of all the practices at the end of Q3, presented to the Primary Care Working group meeting on 16th January 2020.
Location Type Date of
CQC visit
Date
report
published
Current
Overall
Rating
Change to last
visit
Denmark Road
Surgery
Comprehensive 23/10/2019 10/12/2019 Requires Improvement.
Remains RI. RI in
safe, effective and
well-led domains
East Croydon Medical Centre /
Comprehensive 6/11/2019 08/01/2020 Requires Improvement.
Remains RI. RI in
safe, effective,
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▪ A number of themes emerge from the CQC report findings regarding practices’ shortcomings, these include;
• Medicines Optimisation processes
• QOF / Clinical Care
• HR / Employment processes
• Estates / risk assessments
• Complaints / Incidents / sharing learning CQC Reports Published since December 2019 Denmark Road Surgery – Overall Rating: Requires Improvement The CQC inspected the practice on 23rd October 2019, and published the report on 10th December 2019. It is rated as “Requires Improvement” overall, having previously been placed in special measures in October 2018. It has been rated as a “Requires Improvement” in the CQC’s Quality Domains of “safe”, “effective” and “wed-led” The CQC determined that the provider “Must” make improvements in the following areas:
• Ensure that care and treatment is provided in a safe way
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care
The CQC determined that the practice “Should” make improvements in the following areas:
• Review antibiotic prescribing
• Review procedures in place to demonstrate improved outcomes for patients
• Consider ways to improve uptake for childhood immunisations, bowel cancer screening and cervical screening.
East Croydon Medical Centre – Overall Rating: Requires Improvement The CQC inspected the practice on 6th November 2019, and published the report on 8th January 2020. It is rated as “Requires Improvement” overall, having previously been rated as “Requires Improvement” following an inspection in September 2018. It has been rated as a “Requires Improvement” in the CQC’s Quality Domains of “safe”, “effective”, “responsive” and “wed-led” The CQC determined that the provider “Must” make improvements in the following areas:
Edridge Road
responsive and
well-led domains
Hartland Way
Surgery
ARR triggered 13/11/2019 07/01/2020 Requires Improvement
Previously Good. RI in safe, effective
and well-led domain
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• Ensure that care and treatment is provided in a safe way
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care
The CQC determined that the practice “Should” make improvements in the following areas:
• Review procedures in place for appropriate coding of medicine reviews
• Consider ways to improve uptake for childhood immunisations and cervical screening
• Review procedures to improve organisation of recruitment and training records to enable monitoring
• Review service procedures to improve low scoring areas in the national GP patient survey to improve patient satisfaction
Hartland Way Surgery – Overall Rating: Requires Improvement The CQC inspected the practice on 13th November 2019, and published the report on 7th January 2020. It is rated as “Requires Improvement” overall, having previously been rated as “Good”. It has been rated as a “Requires Improvement” in the CQC’s Quality Domains of “safe”, “effective” and “wed-led”. The CQC determined that the provider “Must” make improvements in the following areas:
• Ensure that care and treatment is provided in a safe way
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care
The CQC determined that the practice “Should” make improvements in the following areas:
• Review procedures in place to demonstrate improved outcomes for patients
• Consider providing equality and diversity training for staff
• Review procedures in place for appropriately code medicine reviews in the patient management system.
• Consider ways to improve uptake for cervical screening and childhood immunisations
• Review reception and clinical staffing levels in response to staff feedback Future CQC Visits and Quality Assurance The CQC have introduced annual regulatory reviews (ARR) to monitor practices rated as
good and outstanding. This includes all GP practices rated good or outstanding being sent
an email explaining that annual regulatory reviews were being rolled out and that the next
step will be a phone call from an inspector, to set a date four weeks later. Further details
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on the process can be found here: https://www.cqc.org.uk/guidance-providers/gps/how-we-
monitor-gp-practices
It is anticipated that the CQC will continue to undertake return visits for practices rated as “Requires Improvement” within the next 3-6 months. The CQC are in regular contact with Croydon CCG Primary Care Team and have been invited to attend a future General Practice CQRG meetings. Croydon CCG Primary Care, Variation and Medicines Optimisation teams are working actively to support Practices who are not rated as “Good” by the CQC. Regular supportive visits are undertaken by CCG representatives, including Clinical Leads, to understand the progress against their action plans and to assess and provide support to manage any risks. As well as supporting those practices rated as “Requires Improvement”, Croydon CCG are keen to see practices rated as “Good” move to ‘Outstanding’. The GP Quality Dashboard, designed by Croydon CCG, captures various quality data for all Croydon GP practice including CQC results. The Dashboard is presented at the bimonthly Primary Care CQRG meeting and has been designed to assess overall quality within Practices and Localities.
Governance:
Corporate Objective To develop as a mature membership organisation
To commission integrated, safe, high quality service in the right place at the right time.
To have collaborative relationships to ensure integrated approach
To achieve financial balance over five years
Risks
Risk relate to assuring consistent clinical services to the patient population
Financial Implications
Financial costs in line with allocation.
Conflicts of Interest
Conflicts of Interest have been managed where appropriate as per the Conflicts of Interest policy.
Clinical Leadership Comments This document has been discussed at Clinical
Implications for Other CCGs
N/A
Equality Analysis
N/A
Patient and Public Involvement
Patient and Public involvement will be sought where appropriate.
Communication Plan The new arrangements for monitoring quality will be communicated to Practices through a number of channels.
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Information Governance Issues
Discussions around specific quality issues will be undertaken within the boundaries of the CCG’s Information Governance policy.
Reputational Issues
Failure of the CCG to have oversight of the quality of care in General Practice could have an adverse effect on the reputation of the CCG.
Appendix below
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Summary of CQC end Quarter 3 - 2019/20
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Summary of CQC end Quarter 3 - 2019/20
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