Cllr Ketan Sheth

The meetings of the North West London Joint Health Scrutiny Committee, which I Chair, don’t usually set the pulses racing but the recent one was an exception. 

My committee’s job is to keep a friendly but critical eye on how the NHS North West London Integrated Care Board (ICB) delivers its budget of over £4 billion to the 2.4 million population of the eight NW London boroughs.

What made my committee’s recent meeting special was that information had leaked revealing ICB plans for major changes in GP ‘same day’ services, replacing the system of individual practice reception staff passing calls on to GPs with a new system in which far fewer “hubs” would pass 93 percent of calls to other staff, with only 7 percent to be handled by GPs. The ICB had planned to introduce the hubs by April 1 as part of its ‘single offer’ local enhanced service, with practices obliged to sign up to access the funding — effectively mandating the hubs. They were forced to delay by a storm of protest from GPs and our residents.

While my committee meetings are held in public, the members of the public aren’t usually allowed to speak at meetings, but on this occasion, I thought it right to ask Merril Hammer, a Hammersmith resident, Robin Sharp, a Brent resident, and Dr Vishal Vala, a local GP, to set the scene.

Merril spoke eloquently about the risks of triage or assessment in hubs by care co-ordinators or others who were not qualified or experienced GPs. The lack of any analysis of the impact on different groups and of proper risk assessment and of any reports from pilots was also of great concern.

Robin stated that Brent Patient Voice had urged patient involvement in any trials when the pilots were first mentioned, but the ICB had failed to listen. What had emerged to be implemented without any consultation with GPs had caused a great surprise and undermined the role of GPs as established since the NHS began.

When members of my committee gave voice to their questions and concerns, there was heavy criticism of the way in which the scheme had been developed by management consultants behind closed doors and without any prior engagement with the local government. There was concern that only long-term patients with complex needs would be referred to their GPs, when practices were made up of patients of all ages with needs that varied from time to time.

The ICB has now apologised for ‘poor communications’, arguing there had been ‘misunderstandings’ about triaging. They now talk of “co-production” with residents and local government at local level. So we look forward seeing the ICB’s plan for this and for wider engagement with the public as a revised scheme is developed.

Cllr Ketan Sheth chairs the North West London Join Health Scrutiny Committee

Photo credit: https://www.flickr.com/photos/popfossa/