Agenda item

The Bath and North East Somerset, Swindon and Wiltshire Integrated Care Board (BSW ICB) will provide a presentation on the workforce challenges being experienced in Wiltshire in the primary care sector. This follows a request from the Committee in September (minutes here), when it received a more general update on primary care provision.

Jo Cullen, Director of Primary Care, and Fiona Slevin-Brown, Director of Place, delivered a presentation outlining the workforce pressures being experienced across the Primary Care System.

An overview was given with the main pressures experienced being: increased demand in GP Practices, high levels of same day demand, demand for antibiotics, high levels of staff sickness and significant vacancies, ongoing impact of seasonal vaccination programmes, and increasing support for services such as ambulances, hospitals and mental health.

It was highlighted that Bath and North East Somerset, Swindon and Wiltshire (BSW) were in a relatively good position in comparison to others in the South West for GPs, General Practice Nurses and Direct Patient Care roles and that NHS England had rated BSW green with no concerns raised in each area. This was shown through workforce summaries for each area up to November 2022 bar Direct Patient Care Roles which was up to September 2022. Data and analysis with regard to vacancies and recruitment for GPs, Nurses, Director Patient Care roles within Wiltshire was discussed with some of the main areas of concern being: high locum costs, providing supervision and mentoring time to new staff, stipulations in national specification for Mental Health Practitioners and an ageing workforce. The Additional Role Recruitment Scheme (ARRS) was then briefly discussed. It was noted that the October Workforce Submissions estimated a 105% spend against the ARRS fund based on aspirational recruitment plans, as such, the ICB review the ARRS spend monthly with the finance team and two new ARRS roles were introduced from 1 October 2022 with a number of PCNs adopting them. Finally, the Training Hub was discussed, and the key areas of focus were highlighted, examples of which being: leadership, upskilling and retention.

Members discussed the vacancy rates, the ability for PCNs to meet service and demand, and the workforce summaries provided. Concerns were expressed with regard to some of the statistics shown but the positivity of BSW being classified as green was noted. Officers acknowledged that despite the green classification, the situation was fragile and as such, officers were continuing to seek improvements and solutions to the challenges discussed. Members then discussed PCN phone system contracts and the challenges it placed on admin staff across the County. It was noted that some PCN systems were not fit for purpose, yet they were unable to switch systems due to contractual obligations and high exit costs. Officers explained that funding had become available to ease the burden of such costs in order to provide PCNs with updated phone systems that have the ability to meet increasing demand.

At the conclusion of the discussion, it was then:

Resolved

1)    To note the detailed presentation from the BSW Integrated Care Board on the workforce challenges being experienced in Primary Care in Wiltshire.

2)    To note that while Wiltshire is in a fairly good position relative to other areas in the South West region, there are still significant challenges in the County’s Primary Care workforce.

3)    To receive a future item on work to expand the role of pharmacists, including prescribing medication.