All posts by Matt Woodman

Practices vote in support of One Care

We are delighted to announce that a significant majority of practices, over 90%, voted in favour of One Care becoming the GP consortium for Bristol, North Somerset and South Gloucestershire at yesterday’s general meeting.

Practices confirmed their support of plans for One Care to be the single consortium, representing General Practices, as set out in the One Care manifesto and business plan. The new organisation will be owned and driven by General Practices as its shareholders, with an LMC representative on the Board ensuring the interests of all practices are managed appropriately, equitably and fairly.

We can now focus on the future with confidence and continue to fully support the delivery of collaborative, innovative and sustainable primary care at scale.

Practices set to decide the future of One Care

Practices across BNSSG will come together for an extraordinary meeting of One Care on 21st June. We hope to receive a mandate for One Care to become the voice of GP practices across the region.

To ensure that all practices have all the information they need to be able to vote with confidence , please find below various helpful documents and information:

If you have questions or comments ahead of 21st June, we have set up a Survey Monkey. Alternatively, please ring us at the One Care programme office on 0117 941 0900.

If you haven’t yet done so, please register to attend on 21st June, or submit your postal vote. Please remember, you can only submit one vote per practice.

Mental health nurse specialists in GP practices

A further five mental health nurse specialists have joined practices across Bristol, North Somerset and South Gloucestershire (BNSSG) as part of One Care Consortium’s plans to pilot accessible, timely and appropriate mental health services to patients.

The objectives of the pilot, which will not duplicate existing mental health services, are twofold:

  • To demonstrate that it is possible to move demand away from traditional face-to-face GP consultations to a mental health nurse specialist for people with low mood, anxiety and depression
  • To improve patient care through accessible, appropriate and more timely mental health input

The pilot began in April 2016, and will bring important benefits to patients and practices. The nurses are intended to become integrated members of the practice team(s) to ensure continuity of care for all patients accessing the service and to reduce pressure on secondary care services.

Each nurse specialist will join one of the following practices or practice collectives

  • Winscombe and Banwell Family Practice
  • Fallodon Way Medical Centre, Westbury-on-Trym Primary Care Centre, Monks Park and Greenway Community Practice collectively
  • Mendip Vale Medical Practice
  • Locality Health Centre, Tudor Lodge Surgery and Longton Grove Surgery collectively

The service is set to run across One Care Consortium practices in each CCG area for 12 months and is available to patients aged 18 and over, who are registered with one of the practices involved.

This latest wave, which coincides with National Mental Health Week (w/c 16 May), brings the total number of mental health nurse specialists to nine. Wave three, which is set to commence in June, will see four more nurse specialists embedded in practices across BNSSG.

The future of general practice

Working with NHS England, the Primary Care Foundation has just completed four sessions for practices across Bristol, North Somerset & South Gloucestershire. These sessions explored:

  • What One Care has achieved so far
  • The successes and frustrations with the programme
  • The future of general practice
  • The opportunities for working together
  • An option for supporting practices to work at scale

There was also an excellent video from Robert Varnam, Head of General Practice Development at NHS England, setting out his views of the current challenges and opportunities for general practice. Robert’s video can be found here

Click here to download the slides from the day

Physios in surgeries ‘can save GPs time and money’

GPs could spend longer with their patients if physiotherapists worked with them at their surgeries, says the Chartered Society of Physiotherapy.

If patients with back pain, for example, were directed to a physio instead of a GP, an extra five minutes could be spent with other patients. Musculo-skeletal conditions are thought to make up as much as 30% of all GP appointments.

Physiotherapists say that if they could be the first point of contact for patients with these conditions, GPs could dedicate more time to people with other conditions.

Physios are already working in a small number of GP surgeries in England.

During a three-month pilot in West Cheshire, more than 700 patients who would otherwise have seen a GP, were seen by a physiotherapist.

The arrangement is now in place in 36 GP practices in the area. GPs’ leaders welcomed the initiative but said staff would have to be trained to the highest standards.

Read the full article here > 

Upcoming changes to Patient Facing Services

As you may be aware, the GMS and PMS contract agreements 2015/16 include the requirement for GP practices to offer patients access to detailed coded data in their GP records. This regulation takes effect from 31 March 2016.

It involves configuration of practices’ EMIS systems and putting into place polices and processes to comply with this requirement. A group has been created on Artemis, the One Care Intranet called Patient Facing Services (Online Access). In anticipation of the deadline, One Care will be updating the group with links to useful information, including the latest guidance available on this issue.

Further to these resources, practices can also request EMIS support to run a specific ‘Sam Earl’ report, which will provide practices with current numbers of patients using Patient Access and which areas of the service they use.

Please note that this is a very popular report and there may be a short delay in receiving it.

One Care Consortium AGM

AGM sets the stage for One Care’s next phase

On December 8th, the health service community of Bristol, South Gloucestershire and North Somerset  (BNSSG) were invited to attend the innagural AGM of the One Care PCMF programme. Despite traffic light malfunctions bringing Bristol to a standstill, the evening was well attended with presentations sparking interesting questions, and discussions carrying on until late around the information marketplace.

“It was a very good evening, with interesting and like-minded people all talking passionately about One Care, what’s happening now, and it’s future.” – Pragnya Gill, Patient Reference Group member

Alongside presentations from the Chair on future work streams and the Programme Director summarising work to date, two films were shown to give an overview of the programme so far, and the next phase of delivery:

Video: Wave One of the Programme

Video: Wave Two of the Programme

The AGM was also an opportunity for the then Programme Director, Helen England, to welcome Ruth Taylor to the role, taking the Prime Minister’s Challenge Fund (PCMF) programme forward, into 2016 and beyond.

For further information on how One Care Consortium is supporting primary care across BNSSG, please contact us.

Top tips to reduce missed appointments

“Most clinicians know, when it comes to persuading patients to take their medicines, do a little more exercise or simply turn up for scheduled appointments, it often takes more than just a spoonful of sugar to sweeten the deal.” Martin et al. (2015).

DNAs are a familiar problem to many practices. However, the solution can be simpler than you might think according to recent findings published in the Journal of the Royal Society of Medicine (Martin, Bassi & Dunbar-Rees, 2015).

Increasing engagement with patients is key, and this can be done with minimal effort and some clever nudge tactics:

  • Simply asking the patient to repeat the time and date of the appointment over the phone led to a 3.5% drop in DNAs the following month, in the practices taking part.
  • Asking patients to write the time and date of their follow-up appointment (instead of nurses filling it out themselves) led to an 18% DNA reduction compared to the previous 6 month average in one nurse-led clinic.
  • Communicating on posters how many patients had attended over the past month (rather than had not attended) positively framed the message and promoted the desired behaviour instead of normalising DNAs. This, combined with the other two interventions, reduced DNAs by 32% overall.

Let us know if you decide to implement these tactics at enquiries@onecare.org.uk or tweet us at @onecaretweets

The new ‘accessible information standard’

Practices may need to make changes to ensure they comply with the Accessible Information Standard…

On 24th June 2015 NHS England advised that the new ‘accessible information standard’ was approved. NHS service providing organisations, which includes GP Practices, must comply with the standard in full by 31st July 2016.   There are also some preparation and implementation tasks that must be in place before that date.

The aim of the Standard is to establish internal processes so that patients and service users (and where appropriate carers and parents) who have information or communication needs relating to a disability, impairment or sensory loss receive Information in formats that they can understand, and that they receive appropriate support to help them to communicate.

It is of particular relevance to individuals who are blind, deaf, deafblind and / or who have a learning disability, although it should support anyone with information or communication needs relating to a disability, impairment or sensory loss, for example people who have aphasia, autism or a mental health condition which affects their ability to communicate. This includes making sure that people get information in different formats if they need it, for example in large print, braille, easy read or via email or perhaps have longer appointments with their GP.

As part of the accessible information standard, organisations which provide NHS or adult social care must do five things.   They must:

  1. Ask people if they have any information or communication needs, and find out how to meet their needs.
  2. Record those needs clearly and in a set way.
  3. Highlight or flag the person’s file or notes so it is clear that they have information or communication needs and how to meet those needs.
  4. Share information about people’s information and communication needs with other providers of NHS and adult social care, when they have consent or permission to do so.
  5. Take steps to ensure that people receive information which they can access and understand, and receive communication support if they need it.

 

The implementation timetable is as follows:

Organisations MUST have begun to prepare for implementation of the Standard By 01 September 2015.
Organisations MUST identify and record information and communication needs when service users first interact or register By 01 April 2016.
Organisations MUST identify and record information and communication needs as part of ongoing / routine interaction From 01 April 2016.
Full implementation of the Standard is required. By 31 July 2016.

 

NHS England has produced an excellent and comprehensive implementation toolkit which is available www.england.nhs.uk/accessibleinfo

One Care has produced a brief summary of the standard, which is available here.  The summary includes links to other useful guidance and support.

One Care may be able to offer additional support to practices in their implementation and compliance of the standard.   If practices feel additional information, implementation guidance or training would be helpful, please let the One Care team know on enquiries@onecare.org.uk

Transforming general practice: what are the levers for change?

‘Transforming general practice: what are the levers for a change?’ is a report from The Nuffied Trust that was published on 17 June 2015.

The Prime Minister’s Challenge Fund Waves 1 and 2, and ‘The Five Year Forward View’ demonstrate that both the government and NHS leaders believe that “general practice has a key role to play in the reform of the NHS…. But if general practice is to advance with the pace and ambition implied within the ‘Five Year Forward View’, it also needs to develop greater scale and to morph… into larger organisations”.

The report explores how to achieve sustainable change and improvement in general practice and is based on a workshop held at the Nuffield Trust.

It contains a number of case studies and concludes with 6 recommendations:

  1. Strike a different balance between financial micro-incentives for small-scale change and investment for sustainable improvement in general practice
  2. Create a coherence between existing workforce strategies and training curricula that ensure exposure to new ways of working
  3. Develop realistic estimates of the costs of transformation programmes, including the cost of the professional participation
  4. Invest in information and data linkage to support transformation
  5. Set realistic time frames for delivering outcomes and managing risk
  6. Avoid excessive policy to guide primary care transformation.

 

Read the full report.