Agenda item

To receive an update on the development and impact of the integrated care centres with a focus on Devizes Health Centre.? To understand how integrated care centres link to Neighbourhood Collaboratives and support the Wiltshire Alliance priorities. 

The Chair welcomed Dr Ian Williams and Helen Scott from the Devizes Primary Care Network and invited them to update the Committee on the work being undertaken at Devizes Health Centre.

The Committee heard how the Health Centre had addressed the increase in demand for urgent healthcare with a dedicated urgent care service available on the day. Dr Williams and Ms Scott informed the Committee that they had addressed staffing issues by recruiting several non-GP staff and had benefitted greatly from the acquisition of additional estate into which the Health Centre could expand. They explained that they were optimistic of reducing the demands on services like 111 and the Emergency Department (ED) by providing a more holistic service, stating that by freeing up GPs from dealing with urgent care matters, they would be more available to deal with those with more complex long-term needs.

The Committee discussed the availability of additional data, which Dr Williams confirmed needed to come through the Integrated Care Board (ICB) and had been requested, and the prospects for additional facilities. The Committee also discussed whether the model in Devizes would work in areas where there were fewer practices (or indeed only one), or where the practices were not as collaborative with each other. Similarly, the Committee noted the major barriers to widespread adoption of the model being space and workforce and discussed the challenges in addressing those barriers. Fiona Slevin-Brown joined the meeting and added that estate was an important enabler and confirmed that conversations were ongoing in places like Trowbridge to address that.

It was mentioned that the Secretary of State for Health and Social Care had recently visited the Devizes Health Centre and had been impressed by the changes they had made and was keen to support the ICB to deliver similar offers across BANES, Swindon and Wiltshire (BSW) using estates as a key enabler.

Questions were asked of where the idea of the model originated, to which Dr Williams confirmed that it came from their own assessment of a need to adapt to a demand based on convenience rather than need and was backed up by Dr Claire Fuller’s stock-take for NHS England, which asserted that attempts to juggle cradle-to-grave care with transactional care using GPs for both was an inefficient model. He added that part of the programme’s success was that it had been specifically modelled based on specific local needs and contexts.

Questions were also asked about the physician associate role being used in Devizes. Dr Williams explained that the role was adopted from the US model and had existed in the UK for approximately the last decade but was still reasonably small although growing rapidly due to government promotion. He explained that they dealt with exclusively secondary care but required a supportive training scheme after their two-year post-graduate course had concluded to thrive in the role.

Resolved:

·       To receive an update in 2024 on the impact of integrated care centres on primary care provision to include KPIs.

·       To receive an update on Neighbourhood Collaboratives in 2024.

Councillor Mike Sankey left the meeting at 11:40.