Agenda item

To receive an update from the Deputy Director of BSW ICB, Clare O’Farrell, and Deputy Director of Primary Care for the ICB Tracey Strachan.

If you wish to submit a question in advance please email matthew.hitch@wiltshire.gov.uk.

A number of attendees expressed disappointment that the Integrated Care Board were unable to attend the meeting. Alan Hill from Calne Town Council, also wished for the town council’s disappointment to be recorded in the minutes, stating that they looked forward to receiving first-hand information regarding the development of the new medical centre.

Diane Gooch, the Area Board’s Older Person’s Champion, and Cllr Tom Rounds, reported that they had received an update at Wiltshire Council’s Health Select Committee about the success of the Primary Care Network in Devizes, highlighting that they would welcome progress towards establishing a Primary Care Network in the local area. They also felt that it was important for the Integrated Care Board to attend to help to educate the public about how the Integrated Care System operated.

It was highlighted that Calne had seen a significant increase in population in recent years and that there were potential logistical issues if patients were to be directed to Yatton Keynell or Sutton Benger. 

It was noted that it was planned for a representative from the Integrated Care Board to attend the Area Board’s next meeting on 5 December when they would be in a better position to provide more detailed information. Further queries could be passed to the Democratic Services Officer in advance of the next meeting matthew.hitch@wiltshire.gov.uk.

The Integrated Care Board provided the following written statement on the Patford House Partnership and the proposed new medical facility in Calne:

1.    Update on Calne and Yatton Keynell (CaYK) PCN and Patford House Partnership (PHP)

Unfortunately, we have no definitive update to provide to the Calne Area Board as to the progress on the Primary Care Network (PCN).

In April 2023, the ICB [Integrated Care Board] made the recommendation to proceed with an allocation of PHP to the Calne and Yatton Keynell (CaYK) PCN which was seen as the only justifiable and sensible outcome for patients and the local population of Calne. Since then, there have been discussions with the Partners of CaYK PCN and PHP; and it was proposed that the allocation was taken forward in a phased way, with the initial focus on repairing and building relationships. A mediation support offer was made, with a very experienced individual but this was since been declined by CaYK PCN as “non-viable” and the PCN position remains that the allocation of PHP back into CaYK PCN is not accepted.

The ICB has considered the situation very carefully with NHS England (both regional and National colleagues) and wrote formally on 24th July to both PHP and CaYK PCN. Several options were considered but discounted as a continued split for this geography is not justifiable and so to allow both parties a final opportunity to find a solution that supports effective delivery of Network services to their population, it was put forward that CaYK PCN remains as is and that PHP is approved as a separate PCN on the basis that certain conditions were met. NHSE are supportive of this as a final attempt to encourage both parties to work together. These arrangements were only confirmed for the remainder of 2023/24 as the two parties must agree that from 1st April 2024, the two small PCNs will become one PCN delivering consistent coverage of the Network services for all the population of Calne. These conditions have yet to be agreed by CaYK PCN.

Meanwhile, PHP have continued to provide PCN DES [Directed Enhanced] services under a Local Incentive Scheme.

2.    Proposed new medical facility.

The initial business case for Patford House was approved by Wiltshire CCG [Clinical Commissioning Group] in 2019. There was further discussion by the ICB in June 2022 and in July 2023 which set out some further context and concerns which the ICB would expect to see being addressed to progress any decision making. This includes the application of the Primary Care Network Services and Estates Planning Toolkit which is the national direction and approach to delivering all revenue and capital estate schemes which helps to support the delivery of estates requirements to be able to deliver care to address local population’s health needs and priorities; support the development of the workforce, and plan for future service needs.

Only one toolkit will be accepted into the ICB estates strategy work comprehensively covering the entire town estate which is why we have been encouraging both GP Practices (Northlands and PHP) to work together to progress the outstanding estates toolkit work for Calne.

We have committed to taking an updated case to the ICB Primary Care Executive Group in December.

Acronym List:

ICB – Integrated Care Board

CAYK – Calne and Yatton Keynell

PCN – Primary Care Network

PHP – Patford House Partnership

CCG – Clinical Commissioning Group

DES – Network Contract Directed Enhanced Service