In response to pressures across the BNSSG healthcare system, and the predicted flu surge, the GPCB’s urgent care programme successfully secured an additional £20,000 of funding for PCNs to increase flu vaccination uptake among their at-risk communities and patients.

The funding was to support the delivery of additional, more focussed outreach work in those groups.

Ruth Thomas, GPCB urgent care programme lead, said: “Practices used their own vaccination data and knowledge of their local communities to identify which patient groups to target with their additional outreach work. All the identified patients had previously been invited for vaccination via the more standard methods, so practices had to use alternative ways to encourage take up.”

Approaches varied by practice. Some targeted patients with diabetes, respiratory conditions, and chronic heart disease, while others prioritised outreach to asylum seekers, non-English speakers, and ethnic minority groups with a lower uptake. Some practices also targeted younger age groups, who are typically less likely to get vaccinated.

To boost take-up, practices used a combination of phone call reminders, opportunistic vaccinations, and social media and website updates. Practices also engaged with local community groups online to help spread the message, held ad hoc vaccination clinics and drop-in sessions – some in community centres – and offered weekend and evening appointments. Patients were also reminded they could get vaccinated at their local pharmacy.

Ruth added: “We had to move quickly to secure the funding, and practices had to move quickly to put the additional outreach work into action. The whole project has been a great example of how we can all adapt and respond to support system pressures – especially at a time when PCNs were already busy managing winter demands and providing additional ARI slots too.”

The urgent care programme will now evaluate the initiative, looking at the number of vaccines delivered, what worked well, what could be improved, and any successful strategies practices can use in their future planning.

If you’d like to find out more about the flu outreach initiative please contact ruth.thomas@onecare.org.uk

One Care’s general practice support team has expanded to offer practices even greater expert knowledge and help.

In response to feedback from practices about the type of support they find most useful, the team has been joined by a development advisor, and a general practice quality advisor. Read on to find out more about our new team members and what they can do for your practice:

Zoe Turner – general practice quality advisor

In her new role at One Care, Zoe provides tailored support to practices helping them:

• achieve CQC compliance
• improve clinical quality outcomes
• embed robust governance frameworks

She also offers practical guidance on managing inspections, implementing quality improvement initiatives, and aligning practice operations with regulatory requirements.

By working with Zoe, practices can strengthen their operational efficiency and compliance processes, enhancing patient safety and care.

Zoe Turner is a healthcare transformation and improvement specialist with 10 years’ experience in general practice. More recently, she has worked with practices to implement modern general practice and enhance patient access, as well as helping them to comply with regulatory standards.

Contact Zoe: zoe.turner@onecare.org.uk

Judith Forde – development advisor

Judith can help with practices with:

• business process analysis, including process and patient journey mapping
• strategic planning
• change management, including adopting new ways of working
• project management

Judith is already our planned care project manager having joined One Care in 2023. Previously, Judith worked in social housing for over 25 years, including roles in strategic planning and service improvement.

As well as a postgraduate diploma in management, Judith is an APMG change management practitioner / agile change coach, and is on the NHS change management steering group.

Contact Judith: Judith.forde@onecare.org.uk

Steve Mowatt, general practice support and operations executive director, said: “As a member organisation, we want to help our practices in whatever way they find most useful. Our new team members will do exactly that, and will enhance the expertise we already provide in areas we know are vital to the efficient running of a modern, successful practice.”

Advice from the finance experts in our general practice support team can help you get ahead with your financial planning before details of the 2025-26 contract arrangements are confirmed.

Take a look at the team’s article here on how to make a financial plan; maximise income streams; and reduce costs. The article contains plenty of top tips, with links to other resources for more detailed information.

And don’t forget our general practice support team also offers practices a confidential and informal review of your practice’s finances. The reviews are available free of charge, as part of your One Care subscription.

For any finance questions, or to book a finance review, please contact practice.support@onecare.org.uk

Taking a careful look at how your practice’s appointment book is managed can help improve overall efficiency and future business planning. One Care’s business intelligence team can analyse how you utilise your slots, if use of your workforce is optimised, and how accurate your appointment planning is.

Read on to find out how an appointment analysis can improve your practice’s operations, and how the team helped a PCN improve use of staff time and demand mapping.

 How can your practice benefit from this?

Our BI team can investigate the appointments your practice offers and books. This will help you to:

• adjust your slot provision to suit patient demand
• structure appointments based on the actual duration rather than an assumed duration
• consider refining the types of slots you offer
• book additional patients to fill slots
• plot staff working patterns against the appointment data

The analysis can be specific to clinicians and roles, or it can be a broad investigation of all users in your appointment book. It can also look at specific cohorts of patients – the nature of the work they generate and the time it takes, DNA rates, and planned and actual appointment durations.

Slot analysis case study

 Background: The BI team analysed the appointments for all mental health clinical roles across a PCN, to understand appointment availability and planning, how the appointments were being used, and appointment duration and DNA rate.

Findings: The analysis took two months and results were really positive. The findings, presented to the PCN in a user-friendly format, showed:

• appointments for all staff were well-used, with a high volume of face-to-face slots
• DNA rates were acceptable
• the planned appointment duration of 29 minutes was inaccurate. Appointments were taking an average of 37.5 minutes, eight minutes more than planning allowed for

The findings helped the PCN’s practices improve their appointment mapping based on patient demand, and rethink their staff allocation to better meet that demand.

Contact us

If you think your practice would benefit from an appointment slot analysis, please get in touch: business.intelligence@onecare.org.uk

Following a competitive interview process, Dr Jacob Lee has been appointed as the new chair of the GP Collaborative Board (GPCB), for a three-year term.

Jacob is a GP partner at Horfield Health Centre in North Bristol since 2018, and qualified at Southampton University in 2005. He is the locality clinical lead for North and West Bristol, and has a longstanding interest in promoting continuity of care and its benefits.

He will begin his new role on 1 December 2024. He takes over the role of chair from Dr Jon Hayes, who has led the GPCB for the last three years, and represented general practice on the Bristol, North Somerset and South Gloucestershire Integrated Care Board since 2022.

Jacob said: “I am excited to be taking on the role of GPCB chair, and I’m looking forward to working with the GPCB members and wider system partners to improve patient care, and ensure general practice is at the forefront of the development of out of hospital care.”

Jon said: “I regret I was unsuccessful in securing re-appointment as Chair of the GPCB.  While I am disappointed, I have said from the outset it is important for all of us to have the right senior leadership representing us at system level, and I am pleased I will be succeeded by Dr Jacob Lee. I have no doubt Jacob will excel in this role and will enjoy it as much as I (mostly) have. I’m sure you will join me in getting behind him and supporting him in this role.

“I would like to thank you all for your support during my three-year term. It has been a pleasure to serve the GP membership in this role and I am proud of what we have achieved to date. We are at an interesting point of evolution in general practice and wider primary care, and I look forward to witnessing the further successes of the GPCB from a comfortable seat in the auditorium.”

One Care and the GPCB would like to thank Jon for his exceptional hard work, leadership, and unwavering advocacy on behalf of all BNSSG general practice as chair of the GPCB.

One Care is leading a project to increase the use of online medication ordering in our region’s care homes. The aim is not only to save valuable staff time in the homes, but also to benefit GP practices by improving accuracy and reducing the administrative burden.

Historically, to order medication for care home residents, staff filled in paper forms and sent them to the relevant GP surgery. As well as being time consuming for the homes, manual ordering of medication is open to potential errors such as incorrect dosage or frequencies, overordering, and difficulties with tracking and auditing.

Morgan Daly, One Care’s digital transformation lead, said: “Our project is encouraging care homes to accurately order their patients’ medications online through Patient Access. We manage the entire set up process, so general practices don’t have to take on any additional workload.”

The project team collects the details of every member of care home staff who requires proxy access to order medication – approximately three per care home. One Care contacts the relevant GP practice and arranges EMIS access for each proxy user, linking them to the resident’s patient record. Once access is granted, One Care completes all work on behalf of the practice, relieving it of any accompanying tasks.

Morgan said: “One Care setting up the relevant access saves practices on average a whole day of admin time. Across BNSSG to date, this works out to over £11,000 in savings.

“Proxy access also halves the time care home staff spend ordering each resident’s medication, reducing the time spent from approximately one hour to 30 minutes.”

Online ordering also means both the care home and practice can easily see all medications, doses and frequency, which helps with tracking and auditing.

To date, One Care’s team has visited 58% of care homes in BNSSG, and of those homes 32% now have proxy access.

Kate Francis, practice manager at Air Balloon Surgery in St George, said: “We were aware proxy medication ordering for care homes was something many practices had found really helpful. We were struggling to find the resources to work it through and to get the care homes up and running. The homes all struggle a lot with digital development, so we knew they would need a lot of time and support and our resources are very stretched.

“It was reassuring to have expert leadership from One Care. The team was able to get things in place and make it all happen in a way we would not have been able to do.  We did not need to understand the care home end of things, as the One Care team did all of this.

“We know without the One Care input we still would not have this in place.”

Robotic process automation (RPA) technology mimics human actions and interacts with digital systems to carry out basic manual and repetitive tasks. But does it work in a general practice setting? And will it really release time and save money? 

Last year, our digital team assessed GP Automate’s RPA system to see if it was safe and useable for practices. It was a relatively new system, and a practice considering using it requested a full emerging technology review.  

Following the review, the GPCB’s digital strategy group (DSG) agreed to examine the general suitability and usefulness of RPA for practices in BNSSG. This pilot aimed to be a ‘proof of concept’ of the application of RPA in general practice, to inform and promote understanding of the technology and how it may be applied. 

Morgan Daly, One Care’s digital strategy transformation lead, said: “We invited expressions of interest from practices, and asked them to highlight the challenges they were hoping to overcome using RPA. The survey responses showed practices were hoping to free up administrative and clinical time, while maintaining high quality care for patients 

“Based on these responses, it was agreed our pilot project would test the benefit of GP Automate’s filing of lab results. Thirteen practices have now signed up to take part.” 

Practices could benefit from GP Automate’s system, as it removes the need for staff to process normal lab reports with enhanced features (see image below). Patients can be sent the results via AccuRx and their records are automatically updated. This all means reports are filed and actioned quickly and accurately in line with practice preferences, releasing time for clinical and admin staff.  

Morgan added: “We have bi-monthly meetings with the practices involved in the pilot to share feedback and any issues or concerns, so any problems can be fixed quickly. To date, 29,588 lab reports have been filed using RPA, saving estimated total costs of £49,000 across the 13 practices.” 

During a recent clinical review session, one practice agreed the pilot had been a positive experience. The team was fully supportive of the changes and was excited about the potential. Another practice appreciated having fewer results to action as a large portion are now automated. Other practices reported that the implementation phase was somewhat challenging, as it required the clear mapping and standardisation of practice processes. However, there was general agreement that once implemented, refinements to get the most out of the product should be more straightforward. 

Dr. Arun Notaney, the CEO of GP Automate said: “Our company is dedicated to transforming primary care through automation, with a mission to give valuable time back to general practice teams. Our automation solutions are crafted by GPs, for GPs, ensuring the technology is tailored precisely to the needs of the healthcare professionals. By automating manual tasks, we streamline workflows, reduce administrative burdens, and ultimately enhance the quality of patient care.” 

As the pilot progresses, work is starting on evaluating the suitability and advantages of RPA to general practice and potential other good ‘use case’ for the application of this technology. The results will be available in spring 2025. 

 One Care has negotiated a cost reduction for any BNSSG practice wishing to adopt GP Automate, from 28p to 23p per patient. 

 The following video is a demo of GP Automate, showing what its automated lab results process offers:

If you are interested in learning more about the project and how your practice could benefit from RPA, please contact our digital team: digital@onecare.org.uk 

More information on GP Automate is also available here. 

In our next good ideas Q&A, we’re sharing steps taken by two BNSSG practices to help improve the wellbeing of their staff.

Debra Spencer, practice manager at Birchwood Medical Practice, and Paula Allen, health and wellbeing coach at Downend Health Group, discuss simple changes which have made big differences:

Tell us about the changes you’ve made to support your staff wellbeing?

Debra: we’ve introduced paid daily breaks for our staff. The regular breaks are now scheduled into our staff rotas to make sure all team members have time away from their work and desks.

Paula: we have invested in improving our staff spaces by adding sofas to make the break out area more inviting. We encourage all staff to take breaks.

What impact have you noticed?

Debra: Making staff breaks more official and planned into rotas in this way has definitely helped our staff to feel more valued and part of the overall team. It has improved relations between the different teams by encouraging non-work chat and discovering shared personal interests.

Paula: creating a dedicated space where staff can have a cup of tea and chat during their breaks has made a big difference to team morale. The space brings staff together, our new starters get to know the rest of the team, and generally everyone seems happier.

On a scale of 1-5 effectiveness how would you rate these changes?

Debra: I give our official staff breaks a 4!

Paula: I would rate our change as a solid 4 too.

And how can you tell your changes have been successful?

Debra: People feel more able to speak to any colleague as they now know them as a person and not just a clinician. People can hear their colleague’s tone of voice in a task, so communication has improved as positive intent is assumed.

Paula: our staff encourage each other to use the space and that’s a real indication of its success. Regular breaks are now being scheduled in everybody’s templates, and partners are setting an example by ensuring they show other colleagues that they value their own health and wellbeing.

Any advice to practices considering doing the same?

Debra: Just do it – we have not experienced any negatives; goodwill and a positive team ethos improve wellbeing for staff and patients alike.

Paula: creating a staff relaxation space obviously costs money but for us the improved staff morale is definitely worth it. I would encourage anyone to do the same.

This is the first in a series sharing good ideas which may help practices look at their ways of working.

Our Q&A focuses on CQC and how to raise awareness of it across your wider team.

Catherine Farrington, practice manager at Westbury on Trym Primary Care Centre, shares the simple measures she’s implemented and the big impact they’ve had:

What is the single thing that has most helped raise CQC awareness in your practice?

We have put up two CQC information boards. We have one board dedicated to ‘who does what at WOT’ which lists all our lead roles, and another that has all the health and safety posters, Display Energy Certificates, and information on where, for example, our emergency equipment is kept. All the day-to-day things everyone needs to know about.

And you also pose a CQC question of the week on the board?

Yes, the question of the week is put up on the white board where we hold our morning huddles. This keeps the CQC as a topic of conversation, and shows staff the information they need to know. Here are some of the questions we have had and answered on the board:

• where is the accident book?
• where is the fire assembly point?
• where is the emergency equipment?
• where is the Employer Liability Certificate?
• where do we have the CQC rating on display? Do we have to display our rating?
• who is our health and safety lead?
• who is our SIRO?

At the moment I tend to update the question but I plan to move to the management team coming up with questions too. I’d really like to get to a point where the whole team can come up with questions.

On a scale of 1-5 (5 being the highest), how effective do you think the boards have been?

I’d say 4 out of 5! The boards gives our team one place to go for the key information they need, which saves them having to search for it or ask where it might be. It’s a great visual prompt.

Have you noticed any specific improvements or outcomes, by doing what you are doing?

We’ve definitely noticed increased staff confidence from having as much information as possible in one place. Our staff don’t have to remember everything, and the information is constantly familiar and familiarity breeds confidence.   The boards keep CQC as a continued subject of conversation and focus rather just than being something you only do in the run-up to an inspection. Our building looks better with lovely notice boards too!

What else do you do to make sure your team is kept up to date with CQC information?

A staff newsletter. We’ve found the key is to keep it to one side of A4 so staff can read it quickly. On occasion we have an accompanying one side attachment with a CQC focus on subjects like information governance, or summarising a policy such as antibribery and fraud. We currently produce it monthly with occasional additional notifications when something changes i.e. Covid-19 vaccination guidance. However, we flex with the needs of the team and provide more frequent communications if updates are coming through thick and fast!

If your approaches were adopted by other practices, what resources do you think they might need to implement them?

A large notice board on a wall that people walk past frequently. A white board or a place on the wall to write the question of the week works really well. It’s a simple fix but we’ve found that it’s made a real difference to levels of CQC knowledge among the team. Treat the boards like a member of the team; regularly check-in with them to keep them up-to-date and regularly remind people that they are in place to help. If a board isn’t helping and isn’t being regularly referred to, then it is not reaching its full potential and it’s time for a performance review!

If your practice has any good ideas it would like to share, please get in touch: practice.support@onecare.org.uk