Agenda item

To receive an update on primary care facilities at the Arborfield Strategic Development Location.

Members received an update on primary care facilities at the Arborfield Strategic Development Location (SDL).

Dr Zylstra declared that he was a partner in the Finchampstead practice.

During the discussion of this item, the following points were made:

·         Mark Cupit, Assistant Director Delivery and Infrastructure explained that the Core Strategy 2010 had identified the four Strategic Development Locations (SDLs).  Berkshire West Primary Care Trust had advised that a new GP practice might be required.  Aborfield would be the largest of the four SDL’s at approximately 3500 new dwellings.

·         The Council had generated policy and S106s had been negotiated with developers.

·         Berkshire West PCT had been replaced and the way services delivered had changed.  Members were informed that the commissioning of the primary health services within the SDL would be via the Clinical Commissioning Group (CCG), with delivery by GPs on the traditional partnership model.

·         The CCG planned to address GP requirements via enhancement of existing surgeries at Lower Earley, Finchampstead and Swallowfield.  The CCG had bid for Estates Technology Infrastructure Funding and 66% of requirement had been awarded.  Katie Summers, Director of Operations, Wokingham CCG commented that some practices had taken out personal loans in order to complete the necessary works.

·         The Council had established an ongoing dialogue with the CCG.

·         Members were informed that the SDL S106 for Health was £865,812, which was awaited subject to commencements and triggers on site. Dialogue was in place with CCG for them to submit a bid for consideration by Members in respect of this S106 money. Any payment was likely to be subject to a legal agreement which would ensure retention or repayment of whatever facility was delivered through this process.

·         Mark Cupit explained that the Council had adopted the Community Infrastructure Levy from 6 April 2015.  Wokingham had one of the highest CIL levels in the country at £408 per m^2.  100% of CIL was committed on known capital projects.  Members noted what CIL could be spent on.

·         Katie Summers, Director of Operations, Wokingham CCG provided an update on General Practice.

·         The Committee was informed that demand for GP appointments had increased by 15% and that on average patients saw their GP 6 times a year.  Members were told that on average a GP dealt with 100 patients a day if they were the duty doctor.

·         The GP workforce was stretched.  The number of those entering General Practice had decreased massively over the last ten years.  Locally, Wokingham Borough had a number of GPs due to retire.  Brookside Practice had had four GPs retire the previous year whilst another practice had had to advertise seven times to fill a vacancy.

·         Patients’ expectations had also increased. 

·         Larger, more resilient practices offering a greater range of services over extended hours were being developed.  The whole of the health and social care sector would be brought together based on neighbourhood clusters.

·         Members were updated on Primary Care Estates.  It was noted that ownership of GP premises and land varied.  The CCG did not hold land or property assets.

·         The Borough’s population was anticipated to grow by approximately 30,000 because of the SDL’s and other growth.  The CCG’s priorities were to identify any existing spare built capacity available and to consider the potential to expand existing practice sites.

·         It was proposed that the Committee be sent copies of The Grimes Report, a needs assessment for primary healthcare requirements in the Borough’s Strategic Development Locations at Arborfield Garrison, South of M4, Wokingham North and Wokingham South, which had been carried out in 2014.

·         With regards to the South of M4 and Arborfield SDLs notable existing spare built capacity had been identified at Shinfield practice and Shinfield, Finchampstead and Swallowfield practices had capacity to expand.  There was potential extra capacity in these areas for 22,900 additional patients.  With regards to the North and South SDLs, notable existing spare built capacity had been identified at Wokingham Medical Centre.  Woosehill practice had scope to expand.  There was potential extra capacity for 14,800 in these areas.

·         Katie Summers highlighted the new model of care. 

·         The Committee discussed funding of general practice.  Dr Zylstra indicated that much of the new funding from the Five Year Forward View was predicated on practices with a footprint of between 30-50,000 patients.  Currently the largest practice in the Borough had approximately 28,000 patients.  Helen Clark emphasised that clustering was still evolving.

·         In response to a question regarding funding, Dr Zylstra indicated that the main funding stream was core service contract with NHS England (the “global sum.”).  The Carr-Hill weighting formula was applied to practice populations to calculate the global sum.  Wokingham received less per patient than many other areas in the country.  Councillor Jones asked how the Carr-Hill formula was calculated.  Helen Clark stated that various factors such as age of population were taken into account.  Councillor Jones suggested that it would be helpful receive further explanation as to how the Carr-Hill formula was applied.

·         Councillor Blumenthal asked how many patients were visiting their GP for social reasons.  She was informed that whilst this did occur, numbers were quite small.

·         Councillor Richards questioned whether there was a minimum size for GP practices.  Helen Clark indicated that there were no national set requirements.  Staffing levels were set by individual GP contracts; however practices would be unlikely to have less than 5,000 patients and ideally would have over 10,000 patients. 

·         Members asked about the number of patients per GP.  Helen Clark stated that the number of patients per GP would increase.  Nationally, on average there were 1850 per GP.  Helen Clark agreed to clarify the figures for Wokingham.  It was noted that Wilderness Road practice was the only singled handed practice in the Borough. 

·         Councillor Batth asked if there was sufficient dentistry provision within the Borough and was informed that this was commissioned by NHS England.

·         Nicola Strudley questioned how the message that patients may not always be able to see their GP and that there were other practice staff who could assist, could be better disseminated.  Dr Zylstra commented that a consistent message was needed.

·         The Committee discussed practice boundaries.

RESOLVED:  That the update be noted.