Agenda item

The Chairman invited the following to the table:

·         Sarah D’Souza - Director of Commissioning, Barnet CCG

·         Jenny Goodridge - Director of Quality and Clinical Services, Barnet CCG

·         Beverley Wilding, Deputy Director, Urgent and Emergency Care, Barnet CCG

Ms D’Souza presented her report, together with a map and slides which are also part of the pre-consultation engagement.

She explained that the Cricklewood Health Centre comprises two contracts: one is an Alternative Personal Medical Service (APMS) and the other is a Walk In Service. Both contracts are coming to end in March 2020. The APMS contract is currently out to consultation and is managed through NHS England. Every five years, there is a standard process to either recommission as a GP Practice or to disperse the service. Many factors are considered such as capacity and demographics. The consultation ends on 19 July 2019. The Walk In Service decision making will take place after the decision regarding the GP practice is made.

The CCG’s intention is to do some early engagement on wider national changes around urgent care. The consultation on the Walk In Service is scheduled to start on 29 July for 12 weeks, finishing on 18 October. A final decision is due to be made in December.  Any concerns of the HOSC would be taken into consideration by the CCG as part of the public consultation.

It was pointed out that there was a description in the paper of the changing environment around urgent care and key facts on Cricklewood. Cricklewood Walk In Service is on the south west corner of the Borough close to both Brent and Camden.

Only 24% of the total number of patients using the Centre are registered with Barnet GPs whereas 58% are registered with Brent GPs, and the remaining 18% come from other boroughs. She also noted that the sort of care provided in the Walk In Centres was more limited than in other Walk In Centres as there are no diagnostics and the Centre can only provide episodic care in that it cannot refer to Secondary Care, provide prevention or access patient records.

Ms D’Souza noted that the CCG needs to consider the development of Primary Care Networks (PCNs) and the NHS Long Term Plan. Most of central Government additional funding would centre around PCNs. The funding would include additional community paramedics and pharmacists to support Primary Care and patients better. Care and Health Integrated Networks (CHINs) are already working well in Barnet. She added that the national picture involved changes to Urgent Treatment Centres including the renaming of Walk In and Urgent Care Centres. The national plan was for these services to become part of Community and Primary Care Services, with a focus on integration into local Primary Care networks. In addition, there had been heavy investment in additional Primary Care appointments with an extra 48,000 evening and weekend appointments being provided across ten hubs sites. There had been a 21% reduction in the number of people using the Cricklewood Walk In Service to under 20,000 annual attendances since 2016/17. She noted that the new Primary Care provision was probably absorbing some of the need for walk in care.

A Member enquired about the impact of the Brent Cross South development on the provision of a Health Care Centre in Cricklewood in light of this. Ms D’Souza noted that this would be considered as would the development in Colindale South. The Primary Care and Commissioning Team were working with the Council to ensure that Section 106 funds from developers are used effectively and in line with plans for a growing population. It would be important for the Primary Care Network in this area to be engaged in working in the context of this growing population.

Ms D’Souza noted that the current building for the APMS GP Practice was not ideal and there was no guarantee it would remain in the same location if the service was recommissioned.

A Member noted that £500,000 had been received by Barnet CCG for the Cricklewood Walk in Centre as the money follows the patient so, he was concerned at the idea that there is a problem if patients attend from other Boroughs. This would undermine the principle of the NHS which is based on need. The Brent Cross development was likely to take many more years to complete and there would need to be some provision in the meantime. Also, if the decision is made to move the Ravenscroft Medical Practice into Finchley Memorial Hospital, there would need be additional provision for any patients who did not wish to remain with the Practice.

The Member added that the developers’ original plans for the corner site (currently occupied by the Walk in Centre) included a new Medical Centre, with some diagnostics. Also stopping these services in March 2020 would put more pressure on A&E. The area was known to have deprivation and was in great need. The Member was concerned that the report gave the impression that a decision had already been made. He also noted that the Walk In Service could be developed to include an X-ray. Ms D’Souza reiterated that the APMS consultation would be considered as part of the standard process required by NHSE but she understood the Member’s concerns. She added that there were two excellent X-ray facilities in the Borough in community settings so the CCG would not look to replicate this elsewhere given the need, cost, staffing and estate required to develop such a facility.

A Member asked, that as Cricklewood had a growing and transitory population, why the CCG would not re-procure the GP Practice and use this to drive the provision of something like an Urgent Treatment Centre in the interim? Ms D’Souza responded that as there was currently a live consultation, it was difficult to respond on that issue but opportunities to develop local urgent care would come with additional national funding into the Primary Care Networks. 

The Chairman then invited the following to the table:

• Cllr Anne Clarke – Childs Hill Ward
• Cllr Peter Zinkin -  Childs Hill Ward

Cllr Clarke reported that from her contact with residents it was clear that many used the Cricklewood Walk In facility and it was a well-loved Centre which, if closed, would make the community feel insecure. The main reason residents gave for using it was that they could not get GP appointments. 5500 patients had registered with the Walk In Centre in the last five years. She added she would prefer if it could be recommissioned until the building was demolished – it could then be relocated. Cricklewood has a growing population with thousands more residents due to move into the area and she could not see the point in the Walk In Centre being closed. Those residents had no association with Finchley Memorial Hospital and other areas of Barnet and would not look to go there for healthcare.

Cllr Zinkin reported that as the Walk In Centre is at the edge of the Borough, it seemed impossible to provide for the population without joint working with Brent. Cllr Zinkin had had discussions with members of this distinct population about possibly travelling to FMH. He made the point that FMH is in a completely different part of the Borough and therefore this was unrealistic. Clarity was needed on the type of journeys patients would be expected to make to access healthcare. He did not get the sense that the CCG understood this community which was fairly itinerant and so the Walk In Centre concept was important. It was also one of the main areas of population growth in Barnet. Together with the proposal to relocate the Ravenscroft Medical Centre into FMH, there was concern that groups would be disadvantaged. He added that he had spoken to the Chairman of the local GP Association on whether some surrounding Practices could take extra patients if the relocation went ahead but he was told that this may not be feasible without them recruiting more GPs. There was huge local concern about this.

Ms D’Souza noted that there would be an equality impact assessment which would focus on the needs in the area and be part of the information considered before a decision was made. The CCG had put forward its view on what should happen to this contract given the national picture and now wanted to receive views on this before it made a decision. She also noted that Brent and Barnet CCGs were working together on this as demonstrated by the overview of provision in that area set out in the map provided by the CCG.

A Member queried the accuracy of the information in the Consultation such as bus journeys from Cricklewood to FMH. A direct bus (number 460) was available to Granville Road but this then required a long walk to FMH from the bus stop. The number 13 Bus would also require a long walk.

RESOLVED that the Committee noted the written and verbal report.