Dr Gemma Moore, Lead GP of Stay Well Healthcare, the federation of all GP practices in South Worcestershire said: “We’ve got great GP services in South Worcestershire. This opens the door to more patients, more of the time so they can get that same standard of care in new ways at new times.
“We’ll be trialling evening and weekend appointments to see a GP through hubs in key locations across the south of the county as well as piloting a virtual hub, with phone, Skype and email consultations 7 days a week with a skilled team of GPs and nurses.
“Too many people are turning to A&E – we want to trial alternatives that work better for people through greater access and new technology.”
Beverley Priest, Director of Operations at SW Healthcare, who led the bid, said:
“Whether you use your GP a lot or a little this is a real change for people in South Worcestershire. Our pilot takes the quality of GP services in South Worcestershire to deliver more joined up care with wider choice and rapid access to GP support. Over the next year, we’ll be trying out new ways to help you look after yourself and get the right care where and when you need it.”
South Worcestershire is diverse – a city with mixed demographics, pockets of deprivation, then large rural areas with an increasingly elderly population. We are intending to influence how patients use our local health system, avoiding urgent care, offering different types of extended access beyond traditional core hours, and new routes to attract people into primary care in the way that suits them best.
The essence of the pilot
Our pilot takes the quality of GP services in South Worcestershire to deliver more joined up care with wider choice and rapid access to GP support. Over the next year, we’ll be trying out new ways to help patients look after themselves and get the right care where and when they need it.
We are focusing strongly on demand management, the use of technology, patient education and influencing behavior. The emphasis is on benefiting patients without creating more work for practices.
We anticipate that patients will feel the benefit without all practices having to be deeply engaged – it is a choice for a practice as to how much they want to be involved. The bid creation process clearly showed our members want the federation to front the delivery, and then practices and individual clinicians opt in. We will be operating a hybrid model combining salaried GP/local GPs contracting.
This is the earliest stage – we have yet to define outcomes with NHS England – but it is a priority for us to clarify for members what the levels of engagement (and the finances) might look like. We will then have a clear delivery plan. This document is not definitive, but captures what was in the bid.
We are told the monies will end in March 2016.
The content of the bid
Patients will be able to get same day primary care consultations seven days a week through a multi-disciplinary virtual hub (8am – 9pm on weekdays and 9am-9pm weekends). Using a range of methods – phone, email, appropriate tele-conferencing mechanisms etc, they’ll get same day consultations with a team of skilled health professionals who will have access to their patient records. If a face to face appointment is required during practice hours (8am – 6.30pm weekdays), the hub team will have the ability to book same day appointments in community pharmacy or with GP practices, wherever possible with a patient’s own GP to ensure continuity of care.
Patients will also be able to get evening and weekend appointments face to face as practices will be coming together through four locality based hubs across South Worcestershire. Open from 6.30-9pm on weekdays and meeting the busiest times locally at weekends, they’ll be able to get the same high quality care at other times close to home, with clinicians who can access their records directly.
The bid entails the following. Please note that the timescales and the detail of delivery are subject to negotiation with NHS England; this is an outline, not a blueprint for delivery.
• Multi-disciplinary virtual hub
• Sharing patients’ records
• Utilising community pharmacy
• Interactive website
• Web GP for self care/smart phone apps
• Email and teleconference consultations
• Better connections between A&E, 111, community teams and out of hours services
Virtual Hub – opening summer 2015
- 8am-9pm weekdays/9am-9pm weekends
- Telephone, email, tele-conferencing
- Can book you an appointment with your practice if you still need it
One practice per locality to be determined through a collaborative process; Open 6.30-9pm on weekdays/to meet local need at weekends. Three hubs have phased introduction across the pilot.
In Worcester, this will be 8 hours a day to meet the increased need of A&E. The Worcester hub will open partially (evenings and some time at weekends), in advance of the IT systems and governance to share patient records. This is to meet pressing local need, probably June.
Same day community pharmacy appointments for minor ailments/prescription advice.
Online access and self-help
Smart phone primary care app/mobile internet site, with self help/self-care tools (Web GP) available to every GP practice for their website, helping patients navigate around the local health system.
Redirect high risk patients
Central access to all patient records means more support for those likely to need urgent care, like the vulnerable elderly by flagging them up in the system if they call an ambulance.
Reducing demand at A&E and improved pathways
Offering alternatives to A&E. Improving pathways, tagging patient notes to improve 111 services esp for complex patients. 111 to redirect to local hubs. 111 can book appointments with virtual and locality hubs.
Joining up services
GPs in and out of hours will have access to multidisciplinary community records, stepping up/down and using community teams better. A single point of access to primary care now til 9pm.
The University of Worcester is part of a Non- Medical prescribing Pilot that supports the development of Pharmacists in the skills of health assessment and prescribing. We are about to embark on phase 2 of the pilot.
There are 3 Pharmacists on this pilot from Boots Pharmacy who need an Designated Medical Supervisor (DMP).
For further information on this development, please contact Matt Aiello from HEWM who will be the contact for the funding related to undertaking this role – Matthew.Aiello@wm.hee.nhs.uk
The Federation are being approached by Clinicians who are looking to work in the patch. We currently have the details of one Nurse with prescribing experience who is looking for work. If you would like any further details, please contact the office on 01905 670330.
The Alliance Board – a joint initiative with the Health and Care Trust to co-direct planned care services – is moving on from the recruitment process, now underway, for the new £5 per head posts. We are now establishing how the board will work to co-ordinate, monitor and manage the wider planned care teams across the patch. For instance, the board is currently redesigning the community nursing teams’ structure in Droitwich and Ombersley with all the local practices.
Considering the general difficulty in recruiting these types of staff we have attracted some great candidates and the level of appointment is high. Repeat recruitment is already commencing where posts could not be filled. the new teams have attracted a lot of interest and encouraged experienced professionals into the patch.
The Pharmacy team are currently visiting Practices and local Care Homes to undertake medication reviews, in 5 weeks over 1000 patients have been reviewed which is a fantastic start. We would like to acknowledge that Practices are having to currently print off patient notes and input admin codes and we thank you for your support with this. EMIS mobile laptops will arrive shortly and this will then allow the Pharmacists to input codes, work remotely and give them full access to patient records. Some GP input will still be needed to action suggestions and funding for this is covered in the Medicines Optimization service spec.
SW Healthcare are managing the Medicines Optimization scheme for 14 of our Practices, ensuring Practices have support in house from a pharmacist to deliver the SLA’s required but to also support practices with their medicines optimization plans. Marianne Tucker is leading this for SW Healthcare and we currently have a team of 10 pharmacists delivering this to practices. If you have any feedback on this service or suggestions for improvement please speak to your pharmacist directly or contact Marianne.
SW Healthcare are pleased to see that our bid for the Prime Ministers Challenge Fund has been featured in the news. A big thank you once again to those of you that got involved. We are expecting to hear the results at the end of this month and we will update you as soon as possible.
After our meeting with the CCG last month, we are actively working together to ensure that quarter 4 payments will go smoothly and Practices are paid on time. We are pleased that the matter was handled efficiently and Tingley were chased on a daily basis to ensure payments were received as quickly as possible. Claim forms for Quarter 4 will be sent out towards the end of the month along with your annual claim. As always, please contact the office with any queries you may have.
SW Healthcare would like to welcome our new apprentice Libby Pountney to the team. Libby joins SW Healthcare at a busy and exciting time and has been of great help providing the office team with vital support in her first few weeks. Welcome Libby!
Practice Managers last year also identified Safeguarding as an area for the Federation to offer some help. We have been looking at this with the help of Ellen Footman, designated nurse for safeguarding across the county, in the hope that practices can better understand the responsibilities for Child Safeguarding Training and that it should become more accessible to them.
We have now completed a guide as to what is required for all levels of staff safeguarding, how you can book onto the courses and lots of useful links. Courses are available with Worcester County Council and are generally held twice monthly across Worcestershire. All Safeguarding course dates have now been added to the Events Calendar on our website along with instructions on how to book. More dates are due to be added, so do look at the calendar.