South East London Primary Care for Bromley CCG Primary Care … 6 - SE... · Title: Quality &...

Primary Care South East London’s CCGs

South East London Primary Care for

Bromley CCG Primary Care Commissioning Committee

DATE OF COMMITTEE: 6 July 2017

ENCLOSURE 6

Title: Quality & Performance Report

AUTHOR: Jill Webb, Head of Primary Care, South East London Team SUMMARY: The last report was considered at the February 2017 SEL PCJC. This report includes:

• A summary cover paper • An accompanying high level analysis of the reportable quality metrics for primary care

services • Appendix 1 which includes NHS England’s reportable quality metrics for primary care

services The report is generally produced quarterly, although not all supporting data sets are refreshed quarterly, However, where this is the case, that section of the report will be repeated (and clearly labelled) based on the previous quarter, until fresh information is available. It should also be noted that data sets are refreshed at different points, and cover differing time periods. The report is produced for Part 1 of the newly established SEL primary care commissioning committees. The information is therefore at a summary level. Specific issues will be sensitive and confidential. They will be considered in Part 2 of the meeting, if a decision is required. Underlying detail behind this data would be used to assure delivery, i.e. all sources would be used to triangulate to identify potential practice level issues. The report provides information on quality and performance, at a CCG level. It is a draft format that is being developed between NHS England and CCGs, to provide an enhanced, standardised report to support commissioning committees.

The report draws on available data sets: - GP Patient Survey (pages 4-9 of appendix 2); - Friends and Family returns (pages 10-11 of appendix 2). - Quality & Outcomes Framework (page 13 of appendix 2); and - CQC reports (page 14 of appendix 2); An explanation of what these datasets include and measure is set out on the relevant section of the annex to the report. A summary of GP contractual variations are also included in this report (page 20-21 of Appendix 2), which have previously been reported on separately, in line with NHS England’s Operating Model. It also draws on information collated by the Medical Directorate (performer reporting on page 16 of appendix 2) and Contract teams (contract information on pages 18-21 of appendix 2) at NHS England. The analysis within this report has currently been developed between SE London Primary Care Commissioning and NHS England’s Medical Directorate, the latter of which continue to be responsible for Performer issues. This will ensure the most relevant information and associated analysis is factored in to determining what actions may be needed to address what appear to be outlying concerns.

RECOMMENDATIONS: The Committee is asked to consider and note report contents.

CCG CONTACT: Name: Relevant to all CCGs E-Mail: AUTHOR CONTACT: Name: Jill Webb E-Mail: [email protected]

2

1. Introduction and Context This report is prepared to support information sharing in relation to patient experience and quality for the commissioning of Primary Care by the CCGs within South East London (NHS Bexley CCG, NHS Bromley CCG, NHS Greenwich CCG, NHS Lambeth CCG, NHS Lewisham CCG and NHS Southwark CCG) for the 232 practices within the combined CCGs areas. This report details the current level of quality information routinely collected and collated by NHS England. Additional data may also be available to the CCG. This report contains data on the GP Patient Survey information as at July 2016, CQC inspections as at 22nd May 2017, Friends and Family Test data as at March 2017, QOF data as at October 2016, high level performer information, and any contractual issues up to the end of March 2017.

2. GP Survey (pages 4 - 9, appendix 2) This section has not been updated since the last report. The annual GP survey covers aspects of patient experience for primary care services, including access to services, waiting times, satisfaction with opening hours, the quality of care received from GPs and practice nurses, out of hours GP services, and NHS dental services. It also captures information about the general population state of health. The GP survey is now updated annually. The latest available information is as at July 2016. Overall positive experiences of GP surgeries are slightly lower in SE London, than the national average. Overall, the position has improved since the last GP Patient Survey in January 2016, although this is not marked. SE London reported results at or near the national average on satisfaction, for ease of getting through on the telephone, with the exception of Bexley and Lewisham which are reporting results lower than the national average. Satisfaction levels are generally steady across all CCGs, with marginal changes. Satisfaction with the overall experience of making an appointment is at or near the national average across SE London, with the exception of Bexley, which is some 8% below the national average. Satisfaction levels are generally stable, with marginal changes. Confidence and trust in GPs and Nurses is at, or is near national levels of satisfaction across SE London. Satisfaction levels reported have all increased significantly, as a result of the exclusion of "don't knows" from the results by IPOS Mori. Satisfaction with opening hours is near the national average for most of SE London, and is slightly ahead of the national average in Lambeth CCG. Satisfaction in Bexley is 6% below the national average. Satisfaction levels are steady, showing marginal changes.

3

Two Key Performance Indicators (KPIs) focussing on patient experience are being introduced, as part of the London offer which has been developed and adopted by London CCGs, as part of the review of PMS contracts. CCG will be also offering these to GMS and APMS contract holders. It is anticipated that incentivising improvements in patient experience could lead to an improvement in performance in this area.

3. Friends and Family Test (pages 10-11, appendix 2) It is a mandatory requirement that practices report data to NHS England every month, as well as publishing their own results locally. The practices in the CCG have been participating in Friends and Family Test (FFT) surveying supported by the NHS England FFT team. The contractual requirement for practices is primarily to submit monthly statistical data to enable NHS England to publish numbers of response, % recommended and % non-recommended. Practices are also advised to publish results locally including feedback outcomes to patients via the You Said We Did poster.

This is based on monthly data, as at March 2017.

There was no return from 35 practices during this period. Overall individual response levels are significantly higher in March than for other points in the year. The number of practices submitting responses has increased across increased markedly in March for all CCGs.

Overall satisfaction levels are close to London and national levels, with the exception of Southwark, which is slightly lower. The February Q & P report had data on the number of practices not providing a return. The report was considered at the February 17 PCC, and in accordance with the recommendations within the report, CCGs were provided with information on the practices with no data return for 6 out of the 12 months or more to follow up. In turn, the Londonwide LMCs was provided with this information.

It is noticeable that the number of no returns that were not submitted reduced significantly in March 17, with only one third of practices making no return (35) compared to November 16 level (106). It is hoped that this trend of no returns will be maintained/reduce further in subsequent reports.

4. QOF (page 13, appendix 2) This section has not been updated since the last report. Quality and Outcomes Framework (QOF) is the annual reward and incentive programme detailing GP practice achievement results. Latest available information is as at October 2016. The Quality and Outcomes Framework (QOF) is the annual reward and incentive programme detailing GP practice achievement results. It rewards practices for the provision of quality care and helps standardise improvement in the delivery of primary medical services.

4

It is a voluntary process for all surgeries in England and was introduced as part of the GP contract in 2004. The indicators for the QOF change annually, with new measures and indicators been retired. For 2015/16, the QOF awards practices achievement points for: - managing some of the most common chronic diseases, e.g. asthma, diabetes; - managing major public health concerns, e.g. smoking, obesity; - implementing preventative measures, e.g. regular blood pressure checks Population growth is below or at national and London averages across SE London, with the exception of Lambeth, which outstrips both. QOF measures are static or improving for most CCGs, although there is a general drop in Public Health measures. There has been a notable drop on all measures for Greenwich CCG. The most significant deviation from average performance is in Greenwich currently lags average London performance (4.8%) and national performance (6.4%) on the clinical domain and on overall QOF (London by 4.6% and national by 5.9%).

5. Care Quality Commission (CQC) GP Inspections (page 14, appendix 2) At the time of this report, the CQC is progressing with visiting practices under their inspection regime introduced in October 2014, and has notably increased its coverage of practices. As at 22nd May 2017, for SE London 212 practices have had an inspection report published. 3 were rated as outstanding, 180 as good, 23 require improvement and 6 practices have been rated as inadequate. Overall SE London is on a par with London benchmarks, with 76.9% of practices rated as Good or Outstanding, compared to 76.6% for London as a whole. This is notably lower than the National benchmark of 84.7% for the same measure. Bexley CCG outperforms both benchmarks, recording 92.9% of inspected practices rated as Good. Lewisham CCG also outperforms both benchmarks, with 85.3% of practices rated as Good or Outstanding. Greenwich and Southwark are some way behind both benchmarks, with 64.1% and 67.6% of inspected practices rated as Good respectively (although it should be noted that 20.5% of Greenwich practices are still to be inspected/published). Practices rated as Requires Improvement or Inadequate are ahead of London benchmarks for SEL as a whole (12.7% of practices inspected compared with 15.8% for London), but is behind the National benchmark of 10.2% of practices inspected. Southwark (28.6%) and Greenwich (21.1%) are again out of line with both benchmarks, although again the point on practice inspection coverage for Greenwich should be noted.

5

The following actions are taken for practices rated as Inadequate: - The Standard Operating Procedure (SOP) ‘Policy Book for Primary Medical Services’

Chapter 7 ‘Contract Breaches and Termination’, outlines the approach to be taken by NHS England when a contract is considered to have been breached. It does not cover the process of investigation, roles and responsibilities leading up to that decision. i.e. “Remedial Notice: 3.4 Where a contractor has breached the contract and the breach is determined to be capable of remedy, the Commissioner may issue a Remedial Notice to the contractor setting out the actions that must be taken to remedy the breach.”

- In the first instance, NHS England, the CCG and the contractor will work together to resolve the matter;

- The issuing of a breach notice, application of a sanction or a move to terminate a contract will be considered as the final stage in a process;

- The approach taken will be designed to mitigate risk to patients and ensure continued patient confidence in the local NHS and primary care services.

CQC overall ratings and their definitions Outstanding - The service is performing exceptionally well. Good - The service is performing well and meeting our expectations. Requires improvement - The service isn't performing as well as it should and we have told the service how it must improve. Inadequate - The service is performing badly and we've taken action against the person or organisation that runs it.

6. Performer Performance Issues (page 16, appendix 2) Performer performance issues are summarised for information, as these remain the management responsibility of NHS England. There are currently 92 live cases out of 2056 practitioners in SE London. This represents 4.5% of the total number of practitioners. 5 are flagged as highly likely to lead to contractual action. Key thematic issues of performer issues being investigated are: - Clinical issues; - Inappropriate behaviour; - Financial probity; - Criminal allegations; - Manner and attitude; and - Health issues.

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7. Contractual Issues (pages, 18 to 21, appendix 2) A summary of contractual changes is included on the Contractual tab of the attached spread sheet. Between November 2016 and March 2017 there were: 17 partnership changes; 9 retirements; 3 terminations; and 1 merger. There are 12.5% of practices operating as single-handed practices, compared to a national average of 7.7%. This has reduced from 18% in the last report. The highest percentage of single handed practices is in Southwark at 20%, although this has reduced since the last report. There were 8 contractual breaches by the 232 practices in SE London between November 2016 and March 2017, as follows: Greenwich PMS CQC Breach & Remedial X 4 Southwark PMS CQC Breach and Remedial X 4

7

DRAFT South East London CCGs

June 2017 GP Commissioning and Contracting

Quality and Performance Report


2

June 2017 SEL Primary Care CommitteesQuality and Performance Report

Prepared By: NHS EnglandDate: 09/06/2017

Section Title Page Data Source1.0 Patient Satisfaction 31.1 GP Patient Survey 4 GP Patient Survey1.2 Friends and Family 10 NHSE FFT data

2.0 Primary Care Quality Data 122.1 QOF Performance Data 13 HSCIC QOF report2.2 CQC Assessment Data 14 CQC

3.0 Performer Data Summary 153.1 Summary of Performer Performance Concerns 16 Medical Directorate

4.0 Contractual Data Summary 174.1 Summary of Primary Care Service Provision 18 Contract team4.2 Summary of Contractual Issues and Concerns 20 Contract Team

Index


3

PATIENT SATISFACTION


4

GP PATIENT SURVEY

Overall Experience of GP Surgery

National Bexley Bromley Greenwich Lambeth Lewisham Southwark

Ease of Getting Through on the Telephone


Overall positive experiences of GP surgeries are slightly lower in SE London, than the national average. Overall, the position has improved since the last GP Patient Survey, although this is not marked.

SE London reported results at or near the national average on satisfaction, for ease of getting through on the telephone, with the exception of Bexley and Lewisham which are reporting results lower than the national average. Satisfaction levels are generally steady across all CCGs, with only marginal changes.

85%

5%

80%

7%

83%

6%

82%

6%

85%

6%

79%

9%

84%

5%

70%

26%

61%

36%

67%

29%

70%

25%

73%

21%

68%

26%

63%

31%


5

Helpfulness of Receptionist


Overall Experience of Making an Appointment


SE London reported satisfaction levels at, or marginally lower than national averages on this measure. Satisfaction levels with the helpfulness of receptionists are largely steady across SE London.

Satisfaction with the overall experience of making an appointment is at or near the national average across SE London, with the exception of Bexley, which has seen a slight improvement in patient satisfaction levels since the last report, but currently remains some 8% below the national average. Southwark reported satisfaction levels are steady at 6% lower than the national average. Satisfaction levels are generally stable, with only marginal changes.

87%

11%

85%

13%

86%

11%

87%

10%

87%

11%

85%

13%

87%

10%

73%

12%

65%

17%

70%

13%

70%

12%

72%

12%

67%

16%

70%

13%


6

Confidence and Trust in GP


Confidence and Trust in Nurse


Confidence and trust in GPs is at, or is near national levels of satisfaction across SE London. Satisfaction levels reported have all increased significantly, as a result of the exclusion of "don't knows" from the results by IPOS Mori.

Satisfaction with confidence and trust in nurses is at or near the national average for SE London. Satisfaction levels reported have all increased significantly, as a result of the exclusion of "don't knows" from the results by IPOS Mori.

95%

5%

95%

5%

95%

5%

94%

6%

95%

5%

93%

7%

95%

5%

97%

3%

96%

4%

97%

3%

95%

5%

95%

5%

94%

6%

95%

5%


7

Satisfaction with Opening Hours


Satisfaction with opening hours is near the national average for most of SE London, and is slightly ahead of the national average in Lambeth CCG. Satisfaction in Bexley is 6% below the national average. Satisfaction levels are steady, showing only marginal changes.

76%

9%

70%

12%

72%

13%

73%

11%

78%

9%

73%

11%

76%

9%


8

Key

Notes

This section has not been updated since this report was last presented. This represents the latest available information (Jully 2016).

The GP Patient Survey (GPPS) is an England-wide survey, providing practice-level data about patients’ experiences of their GP practices.

Ipsos MORI administers the survey on behalf of NHS England.

For more information about the survey please visit https://gp-patient.co.uk/.

Increasing levels of satisfaction

Stable levels of satisfaction

Decreasing levels of satisfaction

dissatisfied

satisfied


9

The GP Patient Survey measures patients’ experiences across a range of topics, including: - Making appointments- Waiting times- Perceptions of care at appointments- Practice opening hours- Out-of-hours services

The GP Patient Survey provides data at practice level using a consistent methodology, which means it is comparable across organisations and over time.

The survey has limitations:- Sample sizes at practice level are relatively small. - The survey does not include qualitative data which limits the detail provided by the results.- The data are provided twice a year rather than in real time.

All comparisons are indicative only. Differences may not be statistically significant – particularly when comparing practices due to low numbers of responses.However, given the consistency of the survey across organisations and over time, GPPS can be used as one element of evidence.

It can be triangulated with other sources of feedback, such as feedback from Patient Participation Groups, local surveys and the Friends and Family Test, to develop a fuller picture of patient journeys.


10

FRIENDS AND FAMILY

CCG

Practices Expected to Submit

Practices Submitting

Patient Responses

% Recom

% Not recom

Direction of Travel

Bexley 27 27 1,623 87% 7%Bromley 45 42 1,782 83% 10%Greenwich 40 34 2,918 87% 8%Lambeth 47 35 4,162 89% 7%Lewisham 41 36 2,297 87% 8%Southwark 41 32 7,520 84% 9%SEL 241 206 20,302 86% 8%London 1,361 799 33,034 87% 7%National 7,482 4,682 255,027 89% 6%

CommentaryThis is based on monthly data, as at March 2017.

There was no return from 35 practices during this period. Overall individual response levels are significantly higher in March than for other points in the year. The number of practices submitting responses has increased across increased markedly in March for all CCGs.

Overall satisfaction levels are close to London and national levels, with the exception of Southwark, which is slightly lower.

0%

20%

40%

60%

80%

100%

120%

% Not recom

%Recom

Percentage of practices recommended / not recommended in Friends and Family feedback


11

CCG Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb MarBexley 6 6 5 3 2 2 8 8 5 5 5 0Bromley 5 4 8 7 8 8 9 13 11 15 11 3Greenwich 13 15 15 13 14 15 15 19 18 12 14 6Lambeth 11 11 12 14 17 18 17 24 21 15 16 12Lewisham 14 11 13 13 12 12 13 21 18 19 15 5Southwark 11 13 9 18 17 17 17 21 12 16 18 9SEL 60 60 62 68 70 72 79 106 85 82 79 35

CommentaryThe February Q & P report had data on the number of practices not providing a return. The report was considered at the February 17 PCC, and in accordance with the recommendations within the report, CCGs were provided with information on the practices with no data return for 6 out of the 12 months or more to follow up. In turn, the LWLMCs was provided with this information.

The table above provides the no. of no data returns for the months of April 16 through to March 17. It is noticeable that the number of no returns that were not submitted reduced significantly in March 17, with only one third of practices making no return(35) compared to November 16 level (106).

It is hoped that this trend of no returns will be maintained/reduce further in subsequent reports.

No. of practices not submitting returns


12

What is GP FFT?FFT gives patients the opportunity to submit feedback to providers of NHS funded care or treatment, using a simple question which asks how likely, on a scale ranging from extremely unlikely to extremely likely, they are to recommend the service to their friends and family if they needed similar care or treatment. GP practices have been required to make the opportunity to provide feedback through the FFT available to their patients since 1 December 2014, and submit data to NHS England each month since the end of January 2015. Further information can be found on the FFT webpage: http://www.england.nhs.uk/ourwork/pe/fft/

Usage of the dataThe FFT does not provide results that can be used to directly compare providers because of the flexibility of the data collection methods and the variation in local populations. This means it is not possible to compare like with like. There are other robust mechanisms for that, such as national patient surveys and outcome measures. The FFT can help mark progress over time for organisations and still provides patients with useful data to inform choice, alongside other information. The real strength of the FFT lies in the follow up questions that are attached to the initial question, and a rich source of patient views can be used locally to highlight and address concerns much faster than more traditional survey methods. The comments are not submitted to NHS England but may be available from your practice locally to view alongside the monthly data.


13

PRIMARY CARE QUALITY


14

QOF PERFORMANCE

1 2 3 4

CCG

2014/15 2015/16 % Change 2014/15 2015/16 % Change 2014/15 2015/16 % Change 2014/15 2015/16 % Change 2014/15 2015/16 % Change

Bexley 231,958 234,253 1.0% 96.7% 96.9% 0.2% 97.6% 97.2% -0.4% 99.1% 99.3% 0.2% 97.0% 97.1% 0.0%Bromley 337,516 341,580 1.2% 93.4% 95.0% 1.6% 94.4% 96.5% 2.2% 98.3% 98.2% -0.1% 93.9% 95.5% 1.7%Greenwich 279,083 282,837 1.3% 90.4% 88.7% -1.6% 94.1% 90.9% -3.3% 96.4% 95.0% -1.4% 91.5% 89.6% -2.1%Lambeth 373,780 389,875 4.3% 94.3% 94.4% 0.1% 96.2% 94.8% -1.4% 97.3% 95.3% -2.0% 94.5% 94.5% 0.0%Lewisham 308,162 316,479 2.7% 92.8% 93.6% 0.8% 94.6% 96.4% 1.8% 97.6% 95.8% -1.8% 93.6% 94.3% 0.8%Southwark 309,110 316,091 2.3% 91.9% 93.8% 2.0% 95.7% 96.5% 0.8% 95.8% 93.7% -2.1% 93.0% 94.4% 1.6%London 9,114,779 9,410,961 3.2% 93.0% 93.5% 0.5% 95.2% 95.5% 0.3% 95.7% 94.6% -1.2% 93.9% 94.2% 0.3%National 56,014,938 57,549,410 2.7% 94.7% 95.1% 0.5% 95.4% 95.7% 0.3% 97.4% 97.0% -0.4% 95.1% 95.5% 0.4%

Commentary

Quality Outcomes Framework

4. All Domains3. Public Health - Additional Services2. Public Health1. ClinicalList Size

Last updated 26 October 2016

This section has not been updated since the previous report.

Population growth is below or at national and London averages across SE London, with the exception of Lambeth, which outstrips both.

QOF measures are static or improving for most CCGs, although there is a general drop in Public Health measures. There has been a notable drop on all measures for Greenwich CCG.

The Quality and Outcomes Framework (QOF) is the annual reward and incentive programme detailing GP practice achievement results.

It rewards practices for the provision of quality care and helps standardise improvement in the delivery of primary medical services.

It is a voluntary process for all surgeries in England and was introduced as part of the GP contract in 2004. The indicators for the QOF change annually, with new measures and indicators been retired. For 2015/16, the QOF awards practices achievement points for:

- managing some of the most common chronic diseases, e.g. asthma, diabetes; - managing major public health concerns, e.g. smoking, obesity; - implementing preventative measures, e.g. regular blood pressure checks


15

CQC GP PRACTICE INSPECTIONS

CCGNumber of practices

Bexley 28 0 0.0% 26 92.9% 1 3.6% 0 0.0% 1 3.6%Bromley 48 1 2.1% 34 70.8% 3 6.3% 2 4.2% 8 16.7%Greenwich 39 0 0.0% 25 64.1% 4 10.3% 2 5.1% 8 20.5%Lambeth 45 1 2.2% 36 80.0% 4 8.9% 0 0.0% 4 8.9%Lewisham 41 1 2.4% 34 82.9% 4 9.8% 0 0.0% 2 4.9%Southwark 37 0 0.0% 25 67.6% 7 18.9% 2 5.4% 3 8.1%SEL 238 3 1.3% 180 75.6% 23 9.7% 6 2.5% 26 10.9%London 1332 14 1.1% 1005 75.5% 169 12.7% 40 3.0% 104 7.8%National 7204 294 4.1% 5807 80.6% 508 7.1% 115 1.6% 480 6.7%

Commentary

Last updated 22nd May 2017http://www.cqc.org.uk/search/services/doctors-gps?location=&sort=default&la=&distance=15&mode=html

Overall SE London is on a par with London benchmarks, with 76.9% of practices rated as Good or Outstanding, compared to 76.6% for London as a whole. This is notably lower than the National benchmark of 84.7% for the same measure. Bexley CCG outperforms both benchmarks, recording 92.9% of inspected practices rated as Good. Lewisham CCG also outperforms both benchmarks, with 85.3% of pracices rated as Good or Outstanding. Greenwich and Southwark are some way behind both benchmarks, with 64.1% and 67.6% of inspected practices rated as Good respectively (although it should be noted that 20.5% of Greenwich practices are still to be inspected).

Practices rated as Requires Improvement or Inadequate are ahead of London benchmarks for SEL as a whole (12.7% of practices inspected compared with 15.8% for London), but is behind the National benchmark of 10.2% of practices inspected. Southwark (28.6%) and Greenwich (21.1%) are again out of line with both benchmarks, although again the point on practice inspection coverage for Greenwich should be noted.

No PublishedRatingOutstanding Good

RequiresImprovement Inadequate

0.0%

20.0%

40.0%

60.0%

80.0%

100.0%

120.0%

Outstanding

Good

RequiresImprovement

Inadequate

No PublishedRating

Percentage of practices in each CQC assessment category

http://www.cqc.org.uk/search/services/doctors-gps?location=&sort=default&la=&distance=15&mode=html


INDIVIDUAL PERFORMER DATA SUMMARY


17

Individual Performer Performance Issues

CCGNumber of

Performer live Contractual

ImpactHigh Med Low

Bexley 13 1 8 4 Bromley 11 2 6 3 Greenwich 16 1 11 4 Lambeth 9 - 9 - Lewisham 14 - 8 6 Southwark 29 1 23 5 SEL 92 5 65 22

Commentary

Dark Blue - potential contractual terminationMid Blue - potential breachLight Blue - monitor

92 live cases out of 2,056 practitioners in SE London (4.5%). 5 are flagged as highly likely to lead to contractual action.

Thematic key issues:- Clinical issues:- Inappropriate behaviour:- Financial probity:- Criminal allegations:- Manner and attitude:- Health issues:


18

CONTRACTUAL DATA SUMMARY


19

Primary Care Service Summary

CCG

TotalPartnership

Changes GP RetirementsChange in

Practice DetailsContractual

Change Mergers Terminations PMS to GMS List Closure % Single HandersBexley 27 3 1 18.5%Bromley 45 1 1 11.0%Greenwich 36 3 2 3 16.6%Lambeth 44 3 1 1 6.8%Lewisham 40 4 3 5.0%Southwark 40 3 1 20.0%SEL 232 17 9 1 3 - - 12.5%

National proportion of single handed practices 7.7%

CommentsData correct as at 31st March 2017

CCG Change CommentsBexley Partnership Change

Bexley GP Retirement

Bromley Partnership Change

Bromley GP Retirement

Greenwich Partnership Change

Greenwich GP Retirement

Lambeth GP Retirement

Lambeth Partnership Change

Lewisham GP Retirement

Lewisham Partnership Change

Southwark GP Retirement

One partner joined All Saints Medical CentreOne Partner joined Burney Street PracticeOne Partner resigned from Burney Street Practice

One Partner retired from Sherard Road Medical CentreOne Partner retired from Dr V Aragwal's Practice

One partner resigned from Kingfisher Medical CentreOne partner joined Lee Road SurgeryOne non clinical Partner joined Woodlands Health Centre

1 GP took 24hr retirement from Dr R Sharma's Practice

One Partner retired from Clapham Family Practice

One Partner joined The Manor Health CentreOne Partner joined Streatham Common PracticeOne Partner resigned from Streatham Common Practice

One partner took 24 hour retirement from Baring Road Medical CentreOne Partner took 24 hr retirement from Triangle Group PracticeOne Partner retired from Parkview Surgery

One Partner retired from Lyndhurst Medical Centre

One Partner joined Eden Park Surgery

One Partner retired from Crescent Surgery

Agreed by nature of contractual change or actionThe following contractual changes have been actioned since November 2016. Where necessary, these changes have been discussed jointly with respective CCGs.

Three partners resigned from Barnard Medical Group.


20

Southwark Partnership Change One partner joined Forest Hill Group PracticeOne Partner resigned from Falmouth Road Group Practice 1 partner resigned from Forest Hill5 F t Hill P t hi R i ti


21

Variations Where There Was No Like For Like VariationCCG

Practice Type of Variation

Confirmation of sufficient Partners / Salaried GP’s remain to service the practice list of Yes/No

Bexley Barnard Group Practice

3 Partners resigned

Yes

Bexley Lyndhurst Medical Practice

1 Partner Retired Yes

Bromley Crescent Surgery 1 Partner Retired Yes

Greenwich Sherard Road Medical Centre

1 Partner Retired Yes

Greenwich Dr Agarwal's Practice 1 Partner Retired No

Lambeth Clapham Family Practice

1 Partner retired Yes

Lewisham Baring Road Medical Centre

1 Partner took 24hr retirement

Yes

Lewisham Triangle Group Practice

1 Partner took 24hr retirement

Yes

Lewisham Parkview Surgery 1 Partner retired Yes

Southwark Dr R Sharma's Practice

2 Partner retired Yes

Southwark Falmouth Road Group Practice

1 Partner resigned

Yes

A Locum and the remaining Partner covered additional sessions

3 partners remain on the contract and will be covering the work with salaried GPs

Comments2 of the Partners were Clinical Nurse Specialists. The remaining Partners, Salaried GP and a Locum are continuing to cover the sessions provided by the resigning GP.

Dr Agarwal retired and handed back her contract. The decision was taken by NHS CCG and NHS England to disperse the list

2 Salaried GPs will provide additional sessions to cover the sessions provided by the retiring Partner

The remaining Partner and 2 Salaried GPs will provide full services

A Salaried GP, Locum and the remaining Partner covered additional sessions

Practice used locums to cover sessions of the Partner on restricted leave

A Salaried GP was recruited to cover the sessions normally provided by the Partner

The remaining Partner, and Salaried GPs will cover the sessions of the retiring Partner

A Locum and the remaining Partner covered additional sessions


22

Summary of Contractual Breaches

CCG

November 2016 - March

2017Previous Period

Bexley 0 0Bromley 0 0Greenwich 5 4Lambeth 0 0Lewisham 0 0Southwark 4 4SEL 9 8

Commentary4 breach notices issued in Greenwich and 4 breach notices issued in Southwark out of 232 practices in SEL and 1,361 practices in London.

Thematic key issues:- CQC

Number of breaches

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