PCCC21/0005
PRIMARY CARE COMMISSIONING COMMITTEE – PART 1
Southampton City: Proposed relocation of GMS services delivered by Shirley Title of paper Health Partnership Agenda item 6 Date of meeting 19 May 2021
Director lead Stephanie Ramsey, Managing Director, Southampton Local Team
Clinical lead (if applicable)
Author Phil Aubrey-Harris, Associate Director - Southampton
For decision ☒
To ratify ☐ Link to Purpose strategic Enabler - fit for purpose estate To discuss ☐ objective
To note/receive ☐
Executive Summary
The purpose of the accompanying papers is to seek the approval of the Primary Care Commissioning Committee to the relocation of the primary care services delivered by the Shirley Health Partnership, presently operating from Shirley Health Centre, Grove Road, Southampton, to substantially larger new premises to be established by a third party developer in the shell of a former Lidl supermarket a short distance away at 355, Shirley Road, Southampton.
Shirley Health Centre was constructed in the mid-1970s and is currently owned and operated by NHS Property Services. Like many NHS buildings of its type and age, it has suffered from prolonged underinvestment and is now too small and ill-configured to meet the demands of contemporary primary and community care.
This scheme represents a strategically important investment in the health and care infrastructure in west Southampton and on completion it will deliver a key element of the estates enabling workstream of the Southampton City Health and Care Strategy 2020-2025 – the establishment of a primary/community care hub to serve the west Southampton Primary Care Network.
The attached papers include:
1. Expression of intent to move the practice site – the application 2. Annex 1 – providing a summary of patient engagement survey results 3. Annex 2 – summary of the proposals used in the patient & stakeholder engagement
This item is linked to an item to be considered for decision in the Part 2 meeting which addresses the legal, commercial and financial implications of the proposed relocation. This second item, which is considered in Part 2 of the Committee agenda due to it including commercially sensitive information, seeks the Committee’s approval to the associated increase in reimbursable rent attached to the new premises. It should be noted that if this increase is not approved, the relocation will not proceed.
The Primary Care Commissioning Committee is asked to consider and approve the application submitted by the Shirley Health Partnership to Recommendations relocate their General Medical Services from Shirley Health Centre to 355 Shirley Road.
Publication Include on public website
Please provide details on the impact of following aspects
Equality and quality Equality Impact Assessment undertaken: no adverse issues identified. impact assessment The Shirley Health Partnership has undertaken an extensive patient Patient and stakeholder and stakeholder engagement exercise. Details are shown in the engagement accompanying paper.
Additional annual revenue costs arising from the higher rent attaching Financial and resource to a brand new facility and a significant increase in space available for implications / impact primary and community care service. Legal implications None. If approved: affordability to the CCG Principal risk(s) relating to If not approved: insufficient capacity to deliver primary care and this paper related PCN and community services in west Southampton. Key committees / groups NHS Southampton CCG: Primary Care Commissioning Committee; where evidence 20 January 2021 supporting this paper has NHS Hampshire, Southampton and Isle of Wight CCG: Primary Care been considered. Operational Group (Southampton); 22 April 2021
Governance and Reporting – other meetings where this paper been discussed
Committee Name Date discussed Outcome
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PCCC21/005
SHIRLEY HEALTH PARTNERSHIP: Expression of Intent to move practice site.
Summary
Section 1 - Practice details Practice names Practice Opening Clinical Contract Registered and addresses codes hours system type population Shirley Health J82088 Monday to EMIS GMS 14,000 Partnership, Friday (Web) Shirley Health 0800 – 18.30 Centre, Grove hrs Road, Shirley, Southampton, SO153UA
Section 2 – Impact on patients
How will these changes The proposed relocation is required primarily to re-house impact on patients? e.g. services provided by Dr Ferguson and Partners of the Shirley opening and extended Health Partnership, currently located at the Shirley Health hours, transport, parking, Centre, Grove Road, Southampton SO15 3UA. This building is prescription collection, an aging facility that is believed to be over 40 years old and choice of health care has constraints in terms of space and layout required to meet professional, additional the requirements of modern integrated health and care healthcare services, services. boundary changes . The building is too small – and does not have enough rooms for the clinical services. . The building no longer meets current standards for primary care premises. . We want to offer our patients a wider range of expanded community-based services which is not possible in the current Health Centre building. . We are a teaching and training practice and are keen to continue and expand this activity but we are constrained by lack of space. . A key part of the NHS long-term plan, primary care networks (PCNs) will bring general practices together to work at scale. This will improve the ability of practices to retain and recruit staff to provide a wider range of services which will be more easily integrated
with the wider health and social care systems. . Primary care networks have the potential to benefit patients by offering improved access and extending the range of services available to them and these benefits can be realised with the additional estate space this proposal will create.
Diagram below shows location of current and proposed site
There are no boundary changes to the agreed GMS contract.
What are your intentions to Most of our patients will already know the former Lidl site at mitigate the impact 355 Shirley Road having used it for their grocery shopping. It mentioned above? is a very short distance (0.2 miles) from the current Grove Road building and is within the Council’s High Accessibility Zone with frequent buses on several routes.
This development proposal is for a high quality modern new heath care building. It will provide an attractive, calm clinical environment which will benefit the health and well-being of both patients and staff.
The new building will provide:-
. Spacious waiting areas and improved toilet facilities . More clinical and treatment rooms . On-site pharmacy (tbc) . More space to allow for training and teaching . Large health promotion room for a wide variety of groups to use . Improved facilities for staff admin and welfare
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Benefits for patients – more services
The new building would provide much needed space and first- class facilities to enable the Shirley Health Partnership to deliver a wider and increased range of services including;-
. Antenatal services . Paediatric services . Obstetrics and Gynaecology . Minor operations . Palliative care . Ophthalmology . Dermatology . Musculoskeletal care
Alongside our local Primary Care Network teams, we will also be in a position to offer additional services provide by:-
. Social prescribers – embedded . Clinical pharmacists - embedded . Physicians associates . First point contact MSK - embedded . Paramedics . Care co-ordinators . Health and wellbeing coaches . Dieticians . Podiatrists . Mental Health professionals
Southampton Primary Care Limited (SPCL) provides enhanced access for patients to medical help from 8am to 10pm seven days per week. These services are offered from "Hubs" from which Shirley Health Partnership are a site provider. Included in these services are appointments with GPs, Nurses, Physiotherapist, Phlebotomy and Contraception services.
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Section 3 – Business case
Key reasons/benefits of the proposal The proposed development of a new Primary Care Centre at 355 Shirley Road is in line with and informed by a number of key local policies and key strategies including:
NHS England 5 year GP Contract Framework and development of Primary Care Networks – including promoting sustainability of Primary Care Southampton City 5-year Health and Care Strategy; Transformation Health and Care for the People of Southampton 2020 - 2025 Southampton Joint Strategic Needs Assessment
Indicate any innovative/transformational working that the proposal will support This proposed new development aligns with the CCG’s strategic aim of providing a multi- disciplinary primary care service from a Primary Care Hub in a central easily accessible location. Importantly, the new larger building will enable a wide range of additional services to be delivered by the increasing Primary Care Network workforce and Community Health Providers for the benefit of the Shirley, Freemantle, Millbrook, Redbridge, and Bargate patient communities. This has the benefit of geographically and physically expanding primary care services within the locality which houses pockets of deprivation. The central location is also ideally situated to service expected residential growth in and around Shirley and the adjacent wards.
Section 4 – Stakeholder Engagement Please summarise the work to be undertaken regarding stakeholder engagement. See Appendix 3 for guidance
A patient engagement was carried out over the period 24 February to 19 April 2021. There were over 2200 responses to the consultation which equates to 16% of the list size. The findings of the engagement are shown at annex 1. A patient information leaflet, produced to support the engagement, is shown at annex 2.
The following stakeholders were formally written to on 2 March 2021: Dr Alan Whitehead, Member of Parliament for Southampton Test Cllr Satvir Kaur, Shirley Ward, Southampton City Council Cllr Hannah Coombs, Shirley Ward, Southampton City Council Cllr Mark Chaloner, Shirley Ward, Southampton City Council Cllr Steven Galton, Millbrook Ward, Southampton City Council Cllr Graham Galton, Millbrook Ward, Southampton City Council Cllr Sarah Taggart, Millbrook Ward, Southampton City Council Cllr Steve Leggett, Freemantle Ward, Southampton City Council Cllr Dave Shields, Freemantle Ward, Southampton City Council Cllr Vivienne Windle, Freemantle Ward, Southampton City Council Cllr Cathie McEwing, Redbridge Ward, Southampton City Council Cllr Sally Spicer, Redbridge Ward, Southampton City Council Cllr Lee Whitbread, Redbridge Ward, Southampton City Council
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Chair Healthwatch Southampton - Harry Dymond Manager Healthwatch Southampton – Rob Kurn
The response from local Freemantle councilor was supportive of the scheme as was the Chair from Healthwatch Southampton. None of the stakeholders above expressed objections to the relocation proposal.
There was also coverage in the Daily Echo newspaper:
Link: https://www.dailyecho.co.uk/news/19220885.letter---say-southampton-doctors-surgery-lidl-move/
Section 5 – Future model of service provision
Please provide as much detail as possible as to how the current registered patients from the existing practices will access a single service, including consistent provision across the following:
Home If our patients are unable to attend the Practice for medical reasons a request visits for a home visit can still be made. Booking No change in service provision. Appointments will be available to be booked appointme for both urgent and routine care both in advance and on the day via telephone nts and our online platform. We also offer e-consult platform for routine non- urgent advice. Additional The PCN Additional Roles Reimbursement Scheme (ARRS) will continue to and expand with new roles expected including Mental Health Workers, Podiatrists Enhanced and Health Care Navigators. These roles will build upon the newly recruited Services roles of First Contact Physiotherapist, Clinical Pharmacist and Social Prescribers which are already embedded in the Partnership. This proposal will provide the much needed additional space these new roles to be integrated with the wider team providing services to our local and PCN wide community. Extended Extended hours access will continue to be provided via the PCN contact for Hrs our patients with a mixture of face to face and telephone consultations. These appointments will be available to our patients from our premises. Screening These will continue to be provided as part of the NHS national screening services program.
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Single IT EMIS Web is the current embedded clinical system. Access to System One is and also available on site and these systems are supported by Ardens telephony management system for primary care. It is the intention to continue with the system duopoly of both systems.
Digital technology is transforming how patients and health professionals interact. This proposal will help us move towards a digital first approach,
where patients can easily access the advice, support and treatment they need
using digital and online tools such as online consultations including video consultations, booking appointments, requesting prescriptions and viewing the medical record.
It is our intention to embed a new communication system X-ON (Surgery Connect) as part of the longer term integrated communication platform across the PCN and Federation.
Links: https://www.emishealth.com/products/emis-web/emis-web-for-primary-care/ https://www.tpp-uk.com/products/systmone https://x-on.co.uk/
Premises See floorplan below which forms part of submitted planning application: facilities
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Links: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_d ata/file/148509/HBN_11-01_Final.pdf https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_d ata/file/170705/HBN_00-09_infection_control.pdf https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_d ata/file/316247/HBN_00-01-2.pdf
Other There will also be ample car and bicycle parking facilities on the site including drop off points. The site is a short distance (200m) from Shirley High Street and is within the Council’s High Accessibility Zone with frequent buses on several routes.
Section 6 – Risk Analysis
Please include any complexities that you have identified as part of the application process e.g. location, screening cycles
Key Risks associated with relocation Mitigation Staff not giving out a consistent message to All staff was given an outline briefing of the patients at the consultation stage proposal from the outset and were signposted to our website which contains up to date information. Staff were encouraged to signpost patients to this resource and an information booklet was also made available to all patients.
Staff not feeling involved or feeling there is a All staff has received an email appraisal of Page 7 of 9
Key Risks associated with relocation Mitigation lack of information forthcoming. the proposal from the executive partner and all staff has received an individual information booklet detailing the proposal.
There is also an internal display and all staff have been invited to express their views through their line manager.
Patient Engagement As part of the process an information booklet was produced for our patients and interested parties. In addition an internal display containing information about the proposal including the opportunity to provide feedback and complete a survey was available. Our virtual PPG and consenting patients was invited to complete an online survey about the proposal and a FAQ was made available both online and to all patients visiting the Partnership.
Section 7 - Authorisation
Note: this expression of intent does not impose any obligation on NHS Hampshire, Southampton and Isle of Wight CCG to agree a variation to any existing primary medical services contract or agreement
Signed:
Print: Dr A Ferguson Executive Partner
Date: May 2021
Catchment Area
No change to the boundary
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Patient Engagement SurveyMonkey
Q1 Would you support a move to a new purpose built Health Centre within 0.2 miles of the current location (Please tick)?
Answered: 2,277 Skipped: 0
Yes
No
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
ANSWER CHOICES RESPONSES
Yes 88.45% 2,014
No 11.81% 269
Total Respondents: 2,277
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Q2 Thinking about the current location, how would you describe the current accessibility of Shirley Health Partnership in Grove Road (Tick all that apply)?
Answered: 2,277 Skipped: 0
Easy to access by car
Not Easy to access by car
Easy to access on foot
Not Easy to access on foot
Easy to access by bicycle
Not Easy to access by...
Easy to access by public...
Not Easy to access by...
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
ANSWER CHOICES RESPONSES
Easy to access by car 66.27% 1,509
Not Easy to access by car 20.55% 468
Easy to access on foot 77.34% 1,761
Not Easy to access on foot 3.69% 84
Easy to access by bicycle 57.93% 1,319
Not Easy to access by bicycle 1.76% 40
Easy to access by public transport 57.00% 1,298
Not Easy to access by public transport 7.64% 174 Total Respondents: 2,277
2 / 10 Patient Engagement SurveyMonkey
Q3 Thinking about the current building, do you consider the building to be appealing for healthcare services?
Answered: 2,277 Skipped: 0
None of the above
Yes
No
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
ANSWER CHOICES RESPONSES
None of the above 13.48% 307
Yes 50.51% 1,150
No 36.14% 823 Total Respondents: 2,277
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Q4 Thinking about your last visit, is there enough space to offer reasonable privacy at the reception desk (please tick) ?
Answered: 2,277 Skipped: 0
Yes
No
Other (please specify)
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
ANSWER CHOICES RESPONSES
Yes 27.84% 634
No 69.78% 1,589
Other (please specify) 2.81% 64
Total Respondents: 2,277
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Q5 Thinking about your last consultation/appointment, is the room where the Doctor or Nurse saw you maintained and in good decorative order in your opinion (please tick) ?
Answered: 2,277 Skipped: 0
Yes
No
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
ANSWER CHOICES RESPONSES
Yes 85.11% 1,938
No 15.06% 343
Total Respondents: 2,277
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Q6 How important do you think it is for a GP Surgery building to have space to offer other services under the same roof? i.e. Physiotherapy, Counselling
Answered: 2,277 Skipped: 0
Important
Not Important
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
ANSWER CHOICES RESPONSES
Important 85.95% 1,957
Not Important 14.49% 330
Total Respondents: 2,277
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Q7 Would you like to see the Shirley Health Partnership make more use of digital technology to help you use the proposed new building and access services?
Answered: 2,277 Skipped: 0
Yes
No
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
ANSWER CHOICES RESPONSES
Yes 78.79% 1,794
No 21.91% 499
Total Respondents: 2,277
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Q8 How important to you is Shirley Health Partnership in the local community?
Answered: 2,277 Skipped: 0
None of the above
Important
Not Important
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
ANSWER CHOICES RESPONSES
None of the above 5.80% 132
Important 91.30% 2,079
Not Important 2.94% 67
Total Respondents: 2,277
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Q9 What gender are you (please tick)?
Answered: 2,277 Skipped: 0
Male
Female
Don't wish to answer
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
ANSWER CHOICES RESPONSES
Male 38.21% 870
Female 60.17% 1,370
Don't wish to answer 1.67% 38
Total Respondents: 2,277
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Q10 What Age Category are you (please tick)?
Answered: 2,276 Skipped: 1
Under 18
18 - 25
26 - 59
60 - 79
80+
Prefer not to say
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
ANSWER CHOICES RESPONSES
Under 18 0.57% 13
18 - 25 4.17% 95
26 - 59 61.69% 1,404
60 - 79 29.61% 674
80+ 2.64% 60
Prefer not to say 1.41% 32
Total Respondents: 2,276
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