Sheffield people grill health chiefs on GPs and waiting times at CCG's annual meeting

Members of the public grill the board of Sheffield Clinical Commissioning Group.
Members of the public grill the board of Sheffield Clinical Commissioning Group.
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Sheffield people have urged the city's health chiefs to improve access to GPs and give equal treatment to mental illness.

Questions covered mental health, waiting times, GP appointments and collaborative working.

Sheffield CCG chairman Dr Tim Moorhead.

Sheffield CCG chairman Dr Tim Moorhead.

Board members admitted difficult decisions would have to be made in light of a funding shortfall, but pledged to listen to the people of Sheffield as they shaped the strategy for the city.

A key theme that came up several times was the pressure faced by GP practices, and the problems this could cause patients when trying to book appointments.

One member of the public asked what the CCG was doing to ensure all patients could see their GP within a reasonable amount of time.

CCG chairman Dr Tim Moorhead said the number of appointments available had rise by 40 per cent over the last five years - but demand had gone up even faster.

Members of the public at Sheffield CCG annual board meeting.

Members of the public at Sheffield CCG annual board meeting.

"We are confident that if you have an urgent problem and you need to see a doctor, you will be able to," he said. "I accept that it might be a bit more difficult if your problem is not quite so urgent or you are keen to see a particular GP."

The panel was asked about the £9.7 million the CCG secured from the Prime Minister’s Challenge Fund to improve patient access.

Dr Moorhead said it was used to offer extra appointments, but said they had not proved as popular as hoped.

And he said it was important to have a greater skill base in GP practices.

Sheffield CCG meeting at Bramall Lane. Lay member Mark Gamsu, chairman Dr Tim Moorhead, The Star editor Nancy Fielder, accountable officer Maddy Ruff, medical director Dr Zak McMurray

Sheffield CCG meeting at Bramall Lane. Lay member Mark Gamsu, chairman Dr Tim Moorhead, The Star editor Nancy Fielder, accountable officer Maddy Ruff, medical director Dr Zak McMurray

"Other parts of the country have a range of people, such as nurse practitioners. They are really good at treating people. They have clinical pharmacists. We don’t have a lot of those extended roles.

"In a sense we are kind of missing something. We are hoping as we move services from hospital closer to home we will have these other types of people with a range of skills."

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Medical director Dr Zak McMurray said that if he was being 'brutally honest' only a third of patients at his own practice really needed to see a GP.

"That’s a very small practice and they struggle with the skill base," he said. "In a bigger practice they could have the skill base but we also need patients to be prepared to be managed differently."

Acknowledging budget pressures, The Star's editor Nancy Fielder asked the panel what was being done across the city to help make things better for patients.

Accountable officer Mandy Ruff said much of the CCG's work was not about health.

"We do work on really close partnerships with the local area, the police, the voluntary sector, the fire services, a whole range of public sector and private and voluntary sector organisations," she said.

"For example, the police complain that officers’ time is taken up by looking for people with mental health problems. We are looking at putting a mental health specialist out with police at peak times.

"We don’t want them to be put in custody or taken into accident and emergency. That’s just one example of a whole range of things we are doing."

The issue of waiting times was also raised. Mrs Ruff said Sheffield was 'lucky to have excellent hospitals' and the majority of the city's services were performing well.

"For things like the 18-week target, which is about people being seen within a specific time, we are meeting it," she said.

"We are also meeting targets for things like psychological therapies."

Sheffield Children's Hospital is also doing well - 'one of the best in the country' for waiting times - but accident and emergency across the Sheffield Teaching Hospital trust was struggling.

"The teaching hospital has experienced some difficulties but we have been working really hard with them and they are improving dramatically," said Mrs Ruff. "In August we met the four hour target of 95 per cent. We are looking on track in September."

Mrs Ruff put the problems partly down to increased demand and partly down to issues with a new computer system, but she added: "There are a whole range of services out there. Don’t go to accident and emergency unless it’s actually an emergency. The clue is in the title."

Another issue raised by members of the public was mental health. The CCG invested £1 million in children and young people’s mental health services in 2015/16.

Dr Margaret Ainger, lead for children and maternity, said £1 million was 'not enough' but added: "That was on the table so we are trying to use it as wisely as possible.

"The big aim for Sheffield is to try to improve provision and early help for people with mental health problems of any sort. We are using schools as a focus to do that, because that is where almost all our kids are.

"We had a very successful schools pilot on lower level support. We are looking at rolling that out and encouraging all schools to sign up.

"Within the clinical setting we are prioritising the new urgent wards for young people with eating disorders psychosis to be seen far more quickly. We wants a two week wait if it's urgent and four weeks if its routine. We are looking to redesign services to meet that challenge.

"We also want to improve waiting times for the Child and Adolescent Mental Health Service (Camhs). There have been such long waits in the past.

"Our ambition is to have people seen in 18 weeks, which is a big improvement. Some parts of the country are struggling to get their kids seen in anything under a year."

Responding to a question on the lack of mental health leaflets available in the city, the CCG's lead on mental health Dr Steve Thomas said more GP practices were displaying the new Sheffield mental health guide poster.

"We want that to be the first port of call," he said.

The session ended with a discussion on how to stop 'firefighting' in Sheffield's health services.

Director of public health Greg Fell said it was important to look at lifestyle, and highlighted schemes such as Move More, which encourages people to get outside and get active through an app.

He mentioned 'social prescribing', a way of linking patients in primary care with sources of support within the community, calling it 'a massive open goal which we are nearly about to kick the ball into'.

And emphasising the need for all sectors to work together, director of commissioning and performance Matt Powls said: "It’s not just about the commissioner trying to drive through changes, it’s about the partners as well. The experience that we have got is actually, we are now being driven to do something different. We can’t just put our heads in the sand any more.

"It’s going to take time and we are not always going to get it right first time, but this is the first time I have seen organisations, commissioners and partners coming together to make a tangible change."

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