Brailsford & Ednaston Parish Council Notes of the Public Meeting held 6 April 2022
120 members of the public present including representatives from Hulland Ward, Dalbury Lees, Shirley, Hognaston, Rodsley, Mercaston, Muggington, Sutton, Kirk Langley, Millington Green, Sutton on the Hill, Radbourne, Mackworth, Cross of the Hands, Ireton Wood, Ashbourne
Brailsford & Ednaston Parish Council: Pat Laughlin, Katie Barrett, Gillian Woodhouse, Simon Thompson, Lucy Thompson, Keith Cragg
South Dales Health Group: Dr Penny Blackwell, Danny Smart, Marian Jones
The primary purpose of the meeting was to discuss the current status and future plans for the Brailsford and Hulland Ward surgeries which provide services to a wide range of villages outside the Brailsford & Ednaston and Hulland Ward Parishes (as shown by the representation) but also to identify and consider other matters of concern to residents of Brailsford & Ednaston.
In surveys conducted in Brailsford & Ednaston Parish in connection with the approved Neighbourhood Plan, residents (at the time) rated the surgery and pharmacy the most important local facility.
GP Surgery – Presentations – Dr P Blackwell – Healthcare Issues
- In early summer 2021 the Care Quality Commission (CQC) conducted a review of the Surgeries and issued a public report. This followed complaints from the public and interventions from the CCG (Clinical Commissioning Group). The Surgeries were placed in 'special measures': the outcome at that point was a list dispersal and practice closure unless an alternative provider could be found.
- In August South Dales Health Group (a collective of The Hannage, Wirksworth, Ashbourne Medical Practice, Clifton Road Surgery, Ashbourne NHS practices) were approved as the new managers of the surgery which would form part of the South Dales Health Group (SDHG) and the Primary Care Network required by the Dept of Health and Social Care. The aim of the Group is to retain the surgery in the locality and for the people of Brailsford & Hulland Ward and its services as an NHS practice.
- Since that time the new management has been working to undertake the improvements required by the CQC. These included management, administration and staffing practices. In November 2021 the CQC moved the practice to 'requires improvement' status following a second review and recognising some significant improvements.
- The practice currently serves c 6300 patients from Brailsford and Ednaston and Hulland Ward but also a number of other Parishes including Kirk Langley and Mackworth.
- There is a shortage of experienced clinical staff nationwide and this has contributed to delays in the recruitment of a permanent staff of GPs and nursing staff, resulting in an increasing reliance on locums. The Group know that this is not a satisfactory long term solution. A practice of the current size requires a minimum of 3 fulltime GPs.
- New systems have now been put in place and recruitment of clinical, pharmacy and administrative support staff is underway.
- Some key appointments have been made both to the practice itself and to the SDHG to provide additional support.
- The provision of ongoing dispensary services has been particularly challenging. The expectation is that a full service and operating hours will be restored after the Easter break but there is a lot of catch up work to do.
- Additional services such as first contact physiotherapy and home visits for those who need them has now been instated, the other 3 practices, negating their own access to these services to enable B&H surgery to benefit.
- Unfortunately, it has not yet been possible to upgrade/improve some systems, such as the surgery's telephone system because long term contracts have been put in place which would be extremely costly to break
- SDHG recognise that there is still much work to do. Their planning recognises an 18 month improvement programme to 'reinstate' the service to 'Good'. An investment of c £250k has already been made by the Group to deliver the ongoing improvements.
- The SDHG recognise the anxiety and frustration caused to patients (with obvious personal concerns about health care) by ongoing failures in the services and that communication could have been better. Some of this was due to COVID regulations preventing the running of open forums. The plan is now to hold a series of regular community 'update' events. However, in the meantime, the Group's management team ask that patients respect the efforts of the staff working at the surgery and work with the team to help deliver the expected improvements as fast as possible.
- Note: a review of booking time for appointments across SDHG showed Brailsford & Hulland performing relatively well within the Group:
- Ashbourne Medical Practice offering appointments this week
- Brailsford & Hulland booking appointments for this week and next week
- Clifton Road surgery booking appointments in 2 weeks' time
- The Hannage – telephone consultation booking in 2 weeks' time.
GP Surgery – Presentations – Danny Smart, Chief Operating Officer, Henmore Health – Property Issues
- GP surgeries are run under the NHS as independent businesses. Practices may own but usually rent their properties.
- SDHG rent the current surgery premises from the former GP practice partners.
- A premises review has been undertaken by SDHG and shows that the existing buildings are inadequate to provide modern healthcare services and house the range of staff and associated facilities needed.
- In many cases the staff find the existing layout of the buildings, particularly Brailsford, to be unsuitable/unworkable
- The SDHG recommended improvement is to develop a new surgery building at an anticipated cost of c £2m. One way to finance this would be to make a case for the allocation of S106 monies from any future development in Brailsford and Hulland Ward (and possibly other parishes served by the surgery).
A S106 agreement is a legal agreement made under the 1990 Town and Country Planning Act by a person with an interest in the land and the local planning authority; or via a unilateral undertaking entered into by a person with an interest in the land without the local planning authority. These are commonly referred to as 'developer contributions'.
Planning agreements/obligations assist in mitigating the impact of unacceptable development to make it acceptable in planning terms. Planning obligations may only constitute a reason for granting planning permission if they meet the tests that they are necessary to make the development acceptable in planning terms. They must be
- necessary to make the development acceptable in planning terms
- directly related to the development
- fairly and reasonably related in scale and kind to the development.
S106 monies are most commonly acquired by the Local Councils for education (the new Brailsford Primary school was secured in this way); for affordable housing; and occasionally for healthcare, transport services or new or improved community facilities. There use is usually time constrained – 3 years.
Note: The Brailsford & Ednaston Parish Council helped to secure c £26k for the GP surgery from earlier rounds of housing development in the Parish. At the time this was a sum identified by the surgery management team as the sum required to undertake essential redevelopment in the building to service new patients from the development. A further £100k was secured for the redevelopment/refurbishment of the Brailsford & Ednaston Institute
- SDHG currently has some £46k of S106 monies – some of which could be allocated to Brailsford but this would only secure a short term fix.
Issues/Concerns Raised by the Public
- Prescriptions not available when expected – long queues to collect. Sometimes wait over an hour
- Dispensary only open on reduced hours – not convenient for many collections
- Phone contact difficult
- Regular repeat drugs often not available and need collection from other pharmacies – Ashbourne
- Is there a problem with obtaining some drugs or between the surgery and its suppliers
- Poor communication from staff.
Suggestions for Improvement
- Wider use of the online request system – more publicity to encourage greater use
- Better engagement with those requesting prescriptions – e.g. text messages confirming availability and timing of collection
- Better/greater use of Electronic Prescribing
- No regular GPs. Who are, if any, the regular GP staff.
- Poor 'customer service' and communication from some staff
- Very few appointments – especially face-to-face available
- Telephone booking difficult – calls not answered for upto 30-40 minutes
- Patients regularly referred to A&E.
Suggestions for Improvement
- The public need to know more about the CQC concerns and reports. Note: The reports are public documents.
- More flexible telecommunications
- Better general communication from the management team about the improvement plan and services on offer
- Smaller patient lists
- Close patient lists now and not spread services too thinly.
- Emphasis for Group should be on creating high standard of primary healthcare and not on property issues
- Public expectation is that funding for buildings and services comes from the public purse – why a total reliance on development funding
- If SDHG is a business – why cant it obtain a loan or mortgage to redevelop property as with any other business
- How will SDHG make the case for S106 monies? Is this already happening. When will the public be consulted
- What are the standards which need to be met at each surgery building. Which facilities need improvement and why
- Better use should be made of under-utilised facilities as St Oswalds Hospital in Ashbourne
- A better understanding is needed as to:
- Why the current building cannot be reconfigured to the 'standards' required
- What would constitute a £2m redevelopment
- What are the alternatives to a full redevelopment. Is it closure and transfer patients to other existing practices. Many patients will have difficulty with transport
- Can other practices in the Group accommodate more patients.
Result of Public Vote – Key Issues (Show of Hands)
Q 1 – The importance of retaining a surgery in Brailsford/Hulland Ward. Agreed by >than 90% of those present
Q2: Support for funding from encouraging more large developments. Against by >than 90% of those present.
Other Brailsford Issues
- New Developments: Derbyshire Dales District Council's call for new sites has identified 2 new sites to the East and West of the Luke Lane/Mercaston Lane junction. 50 houses anticipated. Comments to Cllr Michelle Morley at Derbyshire Dales.
- Speeding Vehicles: Ongoing concerns about speeding through the village – PC is requesting regular Police speed surveys and the setting up of a new Community Speed watch system. Traffic calming measures for Ednaston under consideration
- Speed Control Measures: A request for permanent Speed Indicator signs. Parish Council Policy. Funding available. Awaiting permission from Derbyshire County Council.
- Release of sewage into local watercourses. Residents to inform Parish Council Clerk of all incidents with timings, photos/other evidence wherever possible. Surface runoff, road and garden flooding and sewage escape (thought to be increased by potentially inadequate measures taken on new developments are all part of ongoing discussions with Severn Trent, the Local Planning Authority and our MP Sarah Dines.
- Dog Fouling – Brailsford Park: A recognised problem. Notices posted under local control measures. Very much reliant on resident behaviour.
- Improvements to the Institute: Under review by the Institute Committee. See its published Minutes.
- The Environment and 'Green Belt' Issues. Ongoing discussion for new Neighbourhood Plans.
- Road Surfacing – Luke Lane (raised after the meeting). To be inspected and referred to Derbyshire County Council and Cllr Steve Bull.
Posted: Sat, 16 Apr 2022 13:49 by Parish Clerk