Issue - meetings

5.1.        The Committee considered a report on the procurement of a Sussex-wide Out of Hours (OOH) Home Visiting Service. The Committee then asked the witnesses present a number of questions.

5.2.        The Committee asked why the OOH Home Visiting Service was being procured separately to the new NHS 111 service.

5.3.        Colin Simmons, Integrated Urgent Care Programme Director, Coastal West Sussex CCG, explained that the procurement that was paused last Summer had been for a Sussex-wide NHS 111 service. He said he could not go into all the reasons why it was stopped, due to procurement confidentiality, but it did include an OOH Home Visiting Service. The reason for the changes included:

• the proposed NHS 111 service now includes Kent, where there is a different home visiting arrangement in place; and
• separating out the service and commissioning a shorter contract for the Home Visiting Service allows testing of what model of home visiting works best with the new NHS 111 service.

5.4.        The Committee asked whether there was a risk that recruitment to the service would interfere with attempts to recruit to other emerging urgent care services.

5.5.        Colin Simmons agreed workforce recruitment and retention was an issue but was also an issue across the whole of the NHS. To tackle this issue, the OOH home visiting service will have a mix of clinical skill sets – whereas the current service is predominantly GP-based – enabling patients to see paramedics, or advanced nurse practitioners in certain circumstances. Plans are also being developed to use the workforce in the most flexible, constructive way, for example, establishing whether clinicians in the NHS 111 Clinical Assessment Service (CAS) could work for a different provider, i.e., the provider of the Home Visiting Service, to enable the clinician to vary their workload in a way that suits them.

5.6.        The Committee asked how the CCGs can ensure that providers deliver on any promises to provide the workforce set out in the service specification.

5.7.        Colin Simmons explained that part of the role of all commissioning organisations is to hold providers to account to deliver on their promises, but CCGs can also encourage providers to work together to help ease workforce issues.

5.8.        The Committee asked how the service might overcome the issue of a shortage of GPs

5.9.        Colin Simmons explained that the shortage of GPs would be overcome in part by developing a multidisciplinary team including paramedics, advanced nurse practitioners and GPs. Whilst GPs will still be required for certain clinical interventions, these other staff could help support the GPs’ workload. It will also be necessary to develop ways of making the  service seem more attractive to prospective GP, given the traditional issues with OOH services appearing unattractive employment opportunities.

5.10.      The Committee asked about how oversight of this potentially complex urgent care system could be ensured.

5.11.      Colin Simmons explained that the CCGs’ role in ensuring different providers work together across the urgent care system will involve being clear about the expected outcomes  ...  view the full minutes text for item 6