Agenda item

The Chairman invited the following to the table:

• Colette Wood, Director of Integration, North Central London Clinical Commissioning Group (NCL CCG) Joined virtually
• Dr Charlotte Benjamin, Vice-Chairman North Central London Clinical

           Commissioning Group (NCL CCG)

• Ms Janice Tausig – Chairman of the Dr Azim and Partners Patient Participation Group (PPG)
• Two Carers – Mrs Shah and Mr Gallagher

·         John MCLINDEN, Divisional Director of Nursing and Therapies, North Central

       Division, Central London Community Healthcare Trust (CLCH).

·         Denis Enright, Director of Operations at Central London Community Health Care

       NHS Trust (CLCH)

Mrs Shah provided an account of her personal experiences when trying to access her GP. Mrs Shah explained that she was still waiting to receive her hearing aid, with long delays since 2019 having arisen due to referrals from her doctor not being properly processed. She advised that she had received batteries for a hearing aid in the post that did not belong to her, because of messages not being properly conveyed between medical departments.

Mrs Shah also explained that her husband had been allocated both a nurse and a doctor due to his disabilities. Since being allocated these two professionals, the doctor had only visited her husband on one occasion in the last two years for an introductory meeting. Mrs Shah said she had not received any assistance from them since the first meeting, with her messages and calls going unanswered or without response.

Mrs Shah said she had tried numerous ways to contact her GP using the phone and computer but was not very confident with computer use and so she had to rely on family to assist. The situation was making life difficult and distressing.

Dr Benjamin thanked Mrs Shah for bringing her personal story to the attention of Members and Officers and apologised for the difficulties she had faced. Dr Benjamin explained that long delays were being seen in audiology because of Covid. She advised that Covid had meant that many staff working in the department had been redeployed elsewhere in the hospital to help with covid patients and that audiology was one of the last services to be set back up, due to the risks surrounding transmission and infection.

Dr Benjamin acknowledged that some patients found using technology like E-consult or Patches difficult and that alternatives for accessing GPs was important. She noted that the entire medical system was overloaded and that Officers were working to deal with the issues as efficiently and effectively as possible.

The Chairman then invited Mr Gallagher to the table to share his personal experience. Mr Gallagher explained that he was a Carer for his father who had vascular dementia. His father had had a fall last year and was admitted to hospital and during the stay he was taken off his medication. After returning home, Mr Gallagher tried to sort out getting his father back onto his medication but found the experience very difficult. He contacted the GP by both phone and email but found getting through to a doctor took too long. Mr Gallagher was also advised to take his father back to hospital to have his fracture assessed. However, due to the distressing experience and very long waits experienced during the first visit, the family were not happy to take their father back.

Mr Gallagher also told the Committee about his daughter having to wait 13 hours in A&E to be seen and being left waiting on a plastic chair the whole time. Once seen, the daughter was diagnosed with having a bleed on her brain, but the process of getting transferred to Great Ormond Street from Barnet Hospital was traumatic. He also advised that the security guards at Barnet Hospital were rude and unhelpful, which made the situation worse for vulnerable people attending. Mr Gallagher said that the Royal Free hospital was much more organised and the A&E department functioned far more efficiently. Therefore, he would be very reluctant to take his father or daughter back to Barnet Hospital.

Mr Gallagher also commented that elderly people found using technology very difficult and had to rely on family or friends to book appointments for them.

Dr Benjamin thanked Mr Gallagher for raising the issues. She explained that plans were being worked on across North Central London to ensure patients were being discharged as efficiently as possible, which in turn would enable patients coming through A&E to be seen at a much more reasonable rate. She explained that the long waits were a symptom of the huge pressure on the system.

Ms Wood explained that ways to manage the demand on the system were being investigated and that everyone was aware that there was currently immense pressure and that not all patients were receiving the best quality service. 

A Member provided an account on behalf of another Carer whose husband had been suffering from urinary tract infections. The Carer stated that she had telephoned the GP every day at 8.30am to try and get an appointment but was unable to get through for three weeks. When she finally got through on the phone, she was asked why she had taken so long to book an appointment. The Carer had also attempted to use the on-line system but was locked out and asked for authorisation which she was unable to complete. The Chairman further introduced a written statement from a fourth Carer about their difficulties getting their mother a booster jab and the worry and frustration this had caused. Mr McLinden agreed to investigate this issue.

Action: Mr McLinden

A Member raised concerns that carers had been expressing anxiety around the fact that receptionists were taking control and making decisions about care, despite not being qualified to do so.

Dr Benjamin explained that there was a large infrastructure surrounding the online packages and acknowledged that E-Consult could be clunky to use. However, it did have the benefit of additional safety features, which more simpler applications did not. She advised that GP surgeries were not able to make changes to the system themselves, but that feedback could be given to the companies so that issues could be addressed. She also explained that vaccines could not just be administered by Community Nurses when making other visits, as the solutions were made up via dilutions that had to be administered within six hours.

Dr Benjamin said that training for receptionists across North London was being investigated. Receptionists often felt they were holding the fort and frequently experienced abuse on a daily basis, making their role very difficult. She said that work was taking place between the Royal Free, CLCH and the Local Authority to be as efficient and effective as possible within a pressurised system, which had been exacerbated by Covid.

Mr McLinden stated that a specific team was deployed to deliver booster vaccinations and that due to the practicalities it was not possible for Community Nurses to provide these boosters at the same time as making visits for other reasons. The Committee was told that GPs were and should be undertaking home visits when asked about this matter.

Janice Tausig, Chairman of the Dr Azim and Partners Patient Participation Group (PPG), explained that her Practice had originally been using E-consult and patients had found the system very difficult to use. Following conversations with the lead Partner, the system was subsequently changed to Patches. Ms Tausig said patients were not notified about the change, which led to confusion when they were presented with a new interface. However, feedback in general was that Patches worked well and Dr Azim had subsequently asked that every Practice in PCN5 move to Patches. Ms Tausig felt that the elderly, disabled and other groups that had found online platforms difficult would find Patches much easier to operate. She said that often the complaints relating to the online systems were associated with the way in which the surgeries were operating. Ms Tausig felt the Healthwatch report gave an excellent summary of the issues and that the recommendations provided should be implemented. She also felt that the main issue was the lack of communication between GPs and patients and suggested that the CCGs should be working with the Barnet Primary Patient Network and the Patient Participation Groups as this would reduce patients’ anxieties around change. 

Ms Wood agreed that communication was key and that this would continue to be built on moving forward. She said that the Primary Care Networks (PCNs) were very keen on resident and patient engagement.

The Chairman complimented the Healthwatch Report on behalf of the Committee and re-iterated that the recommendations should be implemented as quickly as possible.

RESOLVED that the Committee noted the verbal update on Remote Access to GPs.