To receive a report from the East Leicestershire and Rutland Clinical Commissioning Groups.

A public report from the East Leicestershire and Rutland Clinical Commissioning Group (ELR CCG) was received.

The purpose of the report was to provide the Adults and Health Scrutiny Panel with an update on the public consultation being undertaken by Uppingham Surgery on its proposal to close Ketton Branch Surgery.

During his introduction, Mr Barrett confirmed the following:

·         The ELR CCG was required to follow a formal process in decision making pertaining to any contract variation; this could include any boundary changes, a relocation or an application to close a branch surgery. This formal process adhered to NHS England national policies and would be considered through the Primary Care Commissioning Committee (PCCC).

·         As the closure of a branch surgery was a major contract change it was deemed appropriate that a full public consultation over 90 days should be undertaken and this began on 1 February 2018. The consultation took the form of holding drop in sessions, writing to patients and asking them to complete a survey.

·         ELR CCG received a substantial amount of feedback, via correspondence and through the drop-in sessions that were held, that raised concerns about the survey questions and the level of information available about the rationale for the proposed change.

·         As a result of this feedback, the CCG advised the practice to amend the survey questions and extend the consultation period from 1 May to 1 June. Additionally the practice wrote to patients giving them more detailed information about the proposed closure and offering an extra drop in session.

·         Once the consultation period had finished a report would be presented to the PCCC which would take into account information gathered from the consultation, an equalities impact assessment undertaken by both the practice and the CCG and responses from stakeholders which would include any response from Rutland County Council.

·         It was anticipated that a decision would be made by July or August.

During discussion the following points were noted:

·         There was concern that the relationship between the CCG and Uppingham Surgery had been overly close and that rather than imparting advice, the CCG had been led by the practice into influencing public opinion. As an example of this, reference was made to the CCG’s open letter to Ketton ward members that had been sent to the Stamford Mercury and the Rutland Times without any prior consultation with them.

·         The CCG felt that they had been clear that it was the Practice’s plans and their consultation, and that their role had been to advise on the consultation. It was deemed acceptable that a letter could be sent to the press so that information about the business case could be disseminated more widely.

·         Feedback from the first questionnaire had highlighted that issues around transport and accessibility were not able to be fed in. The more detailed, additional questions around transport that were added to the questionnaire would enable the CCG to tease out if there were any mitigating circumstances that needed to be considered. It was felt that the questionnaire needed to be robust and comprehensive so that it would be seen as a reliable source of information on which to base decisions.

·         Patients as well as practices were ‘members’ of the CCG and their voice was channelled into the CCG through patient representative groups and through Healthwatch.

·         Members felt that as Rutland was one of the most rural and sparsely populated counties then transport considerations should have been uppermost when the questionnaire was devised.

·         Bus routes in the County were subsidised by the Council but even so bus routes had been cut. The CCG was removed from the problems with transport but encouraged any feedback regarding the availability of transport to be fed into the consultation process.

·         There was concern that the alternative GP practices in Stamford, which was the nearest town and therefore most accessible in transport terms, were already oversubscribed and would not have space for the 250 people affected by the Ketton branch closure.

·         The CCG verified that the Uppingham practice and its Barrowden branch, as well as Empingham surgery, all had an open list and the capacity to take on new patients. The CCG would contact the South Lincolnshire CCG to ascertain whether the surgeries in Stamford could take on additional patients from Ketton.

·         If the consultation produced a very large and clear one-sided response, the CCG would take it into consideration but would also look at any mitigations, for example whether the response was representative of the whole patient group.

·         The results of the questionnaire would be analysed by the impartial Commissioning Support Unit so that any conclusions were unbiased.

·         The GPs and clinicians that sat on the PCCC were there to give a clinical perspective and did not vote.

·         Dispensary services came under NHS England and did not sit with the CCG.

AGREED:

1.    The Adults and Health Scrutiny panel NOTED the report on Uppingham Surgery’s proposal to close the branch surgery in Ketton and the adaptation to the consultation based on feedback received.

ACTIONS AGREED:

1.    The Panel REQUESTED that the East Leicestershire and Rutland Clinical Commissioning Group inform the panel, after contacting the South Lincolnshire Clinical Commissioning Group, whether surgeries in Stamford had open lists and could take on additional patients from Ketton.