Agenda item

Please note that Appendices C and D to this report are Exempt from publication.

The Board had before it the report from the Chief Officer, ACHSCP which presented an overview on the current position of one of the Partnership priority programmes (the remodelling of 2C General Practices) and sought approval for a recommended way forward.

The Chair reminded Members that he appendices to the report as at Article 15 had been declared exempt and that any discussions involving those items would require to be conducted in private.

The Chief Officer introduced the report and advised Members it presented the options for remodelling the 6 practices in the city which are currently managed by ACHSCP on behalf of NHS Grampian (NHSG), generally known as 2C practices.

Members were reminded of some of the media coverage that the proposals in the had caused some anxieties among patients, the GP practice teams involved and staff side including trade unions, all of which was understandable.

The Chief Officer emphasised that this was not change for change sake and that the remodelling had been focussed with a clear purpose to improve and enhance our GP services in the city and was not about reducing or removing services; it was about making services more robust and sustainable to meet the future needs as demand increases, becomes more complex and resources become tighter.

Members heard that Aberdeen, and the rest of Scotland had to future proof primary care services to respond to increasing demographic and workforce challenges.

Members heard a brief explanation and summary of the existing GP models and that most practices in Aberdeen City and across Scotland are managed as independent businesses by GP Partners. This independent contractor model was the one favoured nationally in the new General Medical Services JMS contract and locally by the Local Medical Committee (LMC). This was the standard model for delivering general practice since the birth of the NHS more than 70 years ago and as such the remodelling is nothing to do with privatisation.

Members were given assurance that a successful procurement process would result in revitalized, safe practices operating under the independent contractor mode still very much part of public sector delivery and that any tender which failed to deliver on this would not be acceptable to the Partnership, nor NHSG

The Chief Officer advised the proposed remodelling aimed to improve the sustainability about GP practices and to ensure the continued provision of safe, sustainable and person- centred care for patients.

Members heard there had been a considerable volume of consultation, engagement and workshops with all GP’s, the wider primary care community in Aberdeen, staff and with the IJB Members also.

Members engaged on considerable questions and discussions, during which the Chair intimated her Declaration of Interest as an employee of Unison, one of the recognised staff trade unions but that as she had no involvement from a Unison perspective in this issue at all, did not believe that the nature of interest required her to leave the meeting.

During discussions, Members expressed comment on existing process, procurement concerns, financial challenges and service delivery.

Councillor Cooke raised concerns on the proposal at several times and was assisted where possible by Members who had been exposed to further understanding of the intentions. Councillor Cooke expressed understanding of the requirement to develop and change but was unable to endorse the intended outcome.

The Chair moved to the recommendations whereby Councillor Cooke intimated he wished to propose the following amendment;

(a)  to consult widely with all GP practices to identify agreed mergers; and

(b)  to help those 2C Practices that wish to, to merge.

Councillor Cooke failed to secure a Seconder and the Amendment failed.

The recommendation was put forward by the Chair and on vote was approved by majority.

The report recommended :-

that the Board –

(a)          endorse, approve, and agree to proceed with implementation for the preferred option outlined in paragraph 3.7, to enable the remodelling of the 2C GP practices;

(b)          note the intended procurement process to implement the preferred option as at appendix B, C & D (exempt) to be delivered in conjunction with ongoing internal development with the 2C Practices, supported by ACHSCP;

(c)          make the direction as attached at appendix E and to instruct the Chief Officer to issue a Direction to NHS Grampian; and

(d)          request that an update on the outcomes of the procurement process is brought back to the IJB in March 2021.

The Board resolved :-

to approve the recommendations.