A blog by Joanna Ford from Network 4

Our Primary Care Network (PCN), known as Network 4, consists of nine GP sites in South Gloucestershire. We have been vaccinating patients from our Downend Health Group (Christchurch) site since December 2020, with thousands having passed through the doors. However, our patient data showed there were pockets of people in our area who were either totally unvaccinated or had not had their second doses. At Network 4, we know the community well and where to go to find people who might not have been vaccinated.

We know there are many reasons people may be unsure about getting vaccinated or having their first dose, including concerns about side effects; feeling that Covid-19 wouldn’t seriously affect them; or simply taking longer to decide whether to have the vaccine. We wanted to give people a chance to talk with us about their concerns.

We also know that working patterns and lack of transport were factors in limiting access to vaccination. So, we decided to take the show on the road – literally.

Our local Covid-19 Vaccination Programme’s outreach team offered us use of a St John’s Ambulance mobile vaccination clinic, and we began a series of pop-up outreach clinics in January 2022.

People power

Collaboration proved invaluable. South Gloucestershire Council and local businesses and organisations really got behind our efforts. With the help of the manager and staff at Longwell Green Leisure Centre, we advertised on their social media channels that we’d be popping up. And, unbeknown to us, a local school emailed their parents, which resulted in a 75% increase in vaccinations given on that day compared with our previous effort.

Other local organisations who got behind our community mobile vaccination effort include Morrisons in Fishponds, Asda Longwell Green, and Yate Shopping Centre. Sadly, our attempt to engage with the DIYers at B&Q was scuppered by Eunice…Storm Eunice, that is!

Major successes in the uptake of vaccinations came from having a presence in in supermarket car parks. Our ability to park up, engage with shoppers, and allow them to make their decision in their own time – usually have a chat, do their shop, come back to us and be vaccinated – was very helpful in giving people an opportunity to take up the vaccination offer.

Magnetic attraction

Although the ambulance was visible, it wasn’t clear we were offering vaccinations, and the pull-up banners we had kept blowing over in a slight breeze! The Vaccination Programme communications team solved this with magnetic signs for the sides of the ambulance, which improved engagement from the public, and markedly increased the number of vaccinations we delivered. You really couldn’t miss us in a car park!

Lessons learned

Making a vaccination clinic work on four wheels wasn’t without its challenges. This was a very different way for a PCN to work, and staffing and logistics were more complicated than we had imagined, but the impact we had on vaccinations in our community made it all worthwhile. We reached 337 members of the public who may not have been able, or wanted, to go to out of their way to a vaccination clinic. This included 33 first doses.

The feedback from the people we vaccinated was that they found it convenient, and the mobile clinic enabled them to get their vaccination while they were going about their daily business.

Was the clinic a success?

Vaccinating some of the most vulnerable and hard to reach members of our community wouldn’t have been possible without this approach. Staff members from our PCN were also able to engage with some of the misinformation surrounding the vaccine, which was incredibly useful in breaking down barriers, and keeping people safe from COVID-19.

Would we do it again?

Yes. Absolutely. Look out for us in a shopping centre near you during the summer. We look forward to meeting you.

On Wednesday 4 May, One Care held our first annual shareholder event in over two years. This was the first time since the beginning of the Covid-19 pandemic that we were able to come together in person as general practice in Bristol, North Somerset and South Gloucestershire at scale. It was a brilliant afternoon and there was a real energy in the room.

The event provided a fantastic opportunity for practices to network, hear about the support One Care and the GP Collaborative Board can offer them over the next year and learn about the work we have been doing within the BNSSG healthcare system.

Guest speaker Fiona Adamson, Chair of the Primary Care Federation Network and the NHS Confederation, joined us virtually to give a thought-provoking talk on the opportunities and challenges for GP federations in Integrated Care Systems.

We were also very fortunate to be joined by Shane Devlin, Chief Executive of BNSSG Integrated Care Board, who spoke alongside Dr Jon Hayes, Chair of the GP Collaborative board. They gave an overview of our BNSSG Integrated Care System and the role of the General Practice Collaborative Board within it. Attendees were also given a unique chance to ask Shane questions regarding the Integrated Care Board and the changes to the BNSSG healthcare system as we move towards the introduction of the new health and care bill in July 2022.

Ruth Taylor, Chief Executive of One Care, led the agenda throughout the afternoon. She gave an overview of the work One Care has done over the last year and what services we aim to provide in the future.

An exciting section of the day was our marketplace, where attendees were able to talk to the different teams at One Care, find out more about the support they can provide, ask questions, and provide much welcomed feedback.

One Care’s Chief Executive Ruth Taylor commented on the afternoon saying “The shareholder event provided a great opportunity to come together with all our member practices, ensure they are aware of the support we can offer them and answer their questions. We were able to celebrate the incredible work and progress we have made as general practice in the two years since our last shareholder event. It was an energising afternoon and amazing to see so many familiar faces in person after such a long time and meet new colleagues too. I look forward to continuing discussions and supporting our practices to survive and thrive over the coming year.”

A huge thank you to all the practices who attended, the afternoon was a great success, and we look forward to coming together again next year.

The GP Collaborative Board (GPCB) is the newly established representative decision-making body for general practice in Bristol, North Somerset and South Gloucestershire (BNSSG). The membership is made up of voting nominated representatives from the Primary Care Networks in BNSSG, plus non-voting representatives from the six Localities, Avon LMC, and One Care, the GP Federation.

The GP Collaborative Board was formed as the fully representative body for general practice in our area to enable true engagement with the changing health and care landscape that will come fully into effect in July 2022. This change will see the formation of a new Integrated Care System, where organisations across health, care, and local authorities and voluntary sectors will come together as equal partners to meet the specific health and care needs of people living in their area. General practice will have representation on the Integrated Care Board, which is a key part of the overall Integrated Care System. For more information on Integrated Care Systems, please visit the NHS England website.

As general practice will be one of the partner organisations within the Integrated Care System, general practice recognised a need to come together as a unified voice. In February 2020, practices asked One Care and Avon LMC to work with them to develop and implement an ethical decision-making process and good governance framework for general practice. This work was put on hold due to Covid-19, but restarted in late summer 2020.

The GP Collaborative Board has come a long way since then. In September 2020, the Board first met in shadow form, becoming substantive in April 2021. During that time, each PCN nominated a representative to become a member and represent their PCN’s views at the meetings. The Board elected their Chair and Vice-Chair in June 2021 and recruited a Medical Director in March 2022.

During their first year, the GP Collaborative Board has focused on raising general practice priorities within our health and care system and establishing the Board as the ‘go-to’ place for our system partners to engage with general practice. The GP Collaborative Board has also enabled general practice leaders, including GPs and managers, to shape important transformation programmes, including urgent care, community phlebotomy, and mass vaccinations.

Looking towards next year, the GP Collaborative Board will work closely with other system partners to shape a shared vision for health and care in the area. The Board are also looking to increase general practice involvement in further system transformation projects, focusing initially on the outpatients and digital programmes.

Speaking about his involvement as Chair of the GP Collaborative Board, Dr Jon Hayes said:

“The GPCB is an important development for general practice in BNSSG, as it truly gives a single representative voice of general practice across our system. This means we can engage with system partners and ensure we are delivering effective and sustainable improvements in healthcare for our practices and our patients.”

If you’d like to learn more about the GP Collaborative Board please contact gpcollaborativeboard@onecare.org.uk or visit our website.

One Care is working with the University of Bristol, on their research project which looks at the use of AmiTritypline for the prevention of post-HErpetic NeuralgiA (ATHENA).

Shingles is caused by a virus, the same virus that causes chickenpox. It can make people feel unwell, cause pain and a rash can follow. Some people can develop nerve pain months after the rash has gone, called post-herpetic neuralgia. Researchers at the Universities of Bristol, Oxford, Southampton and Warwick want to find out if taking a tablet called amitriptyline can prevent persistent pain.  

Amitriptyline is a drug. To find out if using amitriptyline when the rash first appears prevents pain later, the clinical trial is recruiting 846 patients, aged 50+ who have been diagnosed by their GP with shingles. These patients will take tablets nightly for 10 weeks – half will be given amitriptyline and the other half will get a placebo tablet. Questionnaires will then be used to find out what happens to everyone over the following 12 months, especially whether they still have pain related to shingles at 90 days.  

Invited to take part in the study are 120 practices across three clinical research network (CRNs) areas – CRN West of England (this includes Bristol, North Somerset and South Gloucestershire), CRN Wessex and CRN Thames Valley. 

One Care is providing digital support to this clinical trial in the form of EMIS resource and data extraction. One Care has worked closely with the research team at University of Bristol, to understand the ideal process for identifying eligible patients at a practice and inviting them to the study. 

This has led to the design of an EMIS protocol which automatically alerts a clinician that a patient may be suitable to take part in the ATHENA study. One Care has also designed an EMIS search to collect the data needed by the health economists to undertake analysis for this research. 

The EMIS resources designed mean practices do not have to design their own, and a standardised design means higher quality data can be gathered. With One Care managing data extractions, it also reduces administrative work for the practices.   

Speaking about One Care’s involvement with the study, One Care’s Head of Digital Support Colette Buckley said “We’re really excited to be supporting this important research project. It’s a great opportunity to work with our academic colleagues to explore improvements to patient care. This is the first of many research projects we will be supporting in 2022.” 

If you’d like to learn more about how One Care is supporting this study, please contact emis.optimisation@onecare.org.uk  or call 0117 941 0900.