Agenda and minutes

There were no Declarations of Interest.

Briefing Note

The Board considered a Briefing Note and presentation of the Chief Integration Officer, Director of Primary Care and Head of Communications, Coventry and Warwickshire ICB, regarding an overview of the Primary Care Strategy, including an overview of general practice in Coventry and Warwickshire, an introduction to the Primary Care Strategy and an overview of the Primary Care Access Recovery Plan.

Within Coventry and Warwickshire’s Primary Care Landscape, there were 119 GP contracts and 20 Primary Care networks. The way general practices were contracted and funded was complex and very different from other parts of the health and care system.  General practices were small to medium sized businesses whose services were contracted by NHS commissioners to provide generalist medical services in a geographical or population area.  Most GPs in England were run by a GP partnership involving 2 or more GP’s owning a stake in the business. GP partners were jointly responsible for meeting the requirements set out in the contract for their practice and share the income it provided.

Responsibility for commissioning primary care services including general practice sits formally with NHS England. However, Integrated Care Boards (ICBs) had taken on full delegation of these commissioning powers for General Practice. ICB’s had responsibility for commissioning general practice in their local area, while keeping to national guidelines to ensure consistency.

Core GP services were contracted through a nationally agreed contract which the ICB could not make changes to. Payment for the core element of the contract was based on an annual per capita payment. In addition, a GP contract also contained a number of optional agreements for services that a practice might enter into, usually in return for additional payment. GP Out of Hours Services (6.30pm – 8am) were commissioned by the ICB separately and currently provided by Practice Plus Group Ltd.

Primary Care Networks (PCNs) were groups of practices working together to focus local patient care. Since April 2019, individual GP practices could establish or join PCNs covering populations of between 30,000 to 50,000. 

Within the Primary Care Network funding, each PCN provided:

• A Clinical Director role
• Extended hours – to provide core general practice on a PCN footprint.
• Provision of Care Home Support
• Additional roles to work across the network including e.g. physiotherapists, paramedics, pharmacists, occupational therapists and social prescribers.
• Population Health Management
• Online consultants

The Primary Care Strategy included general practice, pharmacy, optometry and dentistry with a large focus on general practice. The Primary Care Group held multiple primary care engagement and clinical leadership events to listen to key messages and understand the key issues from over 300 primary care clinicians and staff.

Consultation had taken place across the system to capture the views of Primary Care in Coventry and Warwickshire, with 6 key areas impacting on primary care providers identified as follows:

• System Integration,
• The Voice of Primary Care
• Resource Allocation
• Activity and Demand
• Workforce
• IT and digital

Operating model key ambitions were urgent non-complex care, urgent complex care, non-urgent planned care and non-urgent proactive care.

The  ...  view the full minutes text for item 39.

Briefing Note

The Board considered a Briefing Note and verbal update of the Deputy Chief Medical Officer, Coventry & Warwickshire ICB, regarding the Coventry and Warwickshire Integrated Care systems progress on the Women’s Health Strategy.

Public health concerns for Coventry residents included health inequalities faced by those living in the 10% most deprived areas in Coventry which impacted on the wider determinants of health such as education, housing, and employment. Studies had found that women were among those had reporting loneliness and social isolation and those with a disability had often faced discrimination in the workplace. There were 173,300 women and girls living in Coventry (just over 50% of the population). About 45% of the local population identified as being of an ethnic group, up from 33% in 2011. Coventry had a young population with the largest group of residents being in the 25 – 39-year age group. However, the health and wellbeing of Coventry’s population was below the national average being in the 46th most deprived borough in England. Life expectancy in Coventry as lower than the national average for women, and women could expect to live on average for 82 years (vs men 78, Eng 82.8). However, the number of years a woman could expect to live in good health in Coventry was to age 64 years above the national and regional average (vs Eng 62.6, Regional 63.9, Warks 83.

The National Women’s Health Strategy was published in 2022 to address the inequalities women faced in accessing services of good quality and having a good experience of care. The strategy aimed to improve support for women and girls from age 15 years and over. This also included people who did not identify as women but may require women’s health services.

In response to the strategy, ICBs were tasked with developing Women’s Health Hubs by December 2024 to focus on eight key priority areas i.e. Menstrual health issues, menopause, cervical screening, prolapse, STI and HIV screening and treatment, preconception support, breast pain management.

Coventry and Warwickshire ICB had delivered a Women’s Hub model that included the joint working of multiple existing services including, but not limited to, the Primary Care Gynaecology Service, Integrated Sexual Health services, Domestic Abuse services and public health universal services.

A Women’s Health Steering group was set up with key stakeholders to deliver the Hub model and foster partnership working. There was also a Health Inequality subgroup, a Women’s health community forum and a preconception task and finish group with representation from Coventry public health and community representatives. A women’s health webpage was in development to improve awareness of women’s health services in Coventry and Warwickshire.

The Primary Care Gynaecology Service, which covered 5 of the 8 Women’s Hub priority areas, delivered 6 clinics across the system, with 2 clinics in Coventry at Longford Primary Care Centre and Forrest Medical centre. The services offered both face to face and virtual support to women in Coventry.

There were over 1200 women (as of Nov 2024) seen in the Coventry  ...  view the full minutes text for item 40.

Report of the Scrutiny Co-ordinator

The Health and Social Care Scrutiny Board (5) noted the work programme.

RESOLVED that the Health and Social Care Scrutiny Board (5):

1)  Notes the Work Programme 2024-2025.

2)  Primary Care to be brought back to SB5 within 1 year.

3)  Digital Access to Health to be included on the agenda for the additional meeting in May 2025.

4)  Community pharmacists and trans/non-binary/intersex health to be included on the Work Programme.

Any other items of public business which the Chair decides to take as matters of urgency because of the special circumstances involved

There were no other items of public business.