Tag Archives: General Practice

GPCB sets out principles for working in BNSSG healthcare system

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The General Practice Collaborative Board (GPCB) formed in 2020 to strengthen the voice of 24/7 general practice within Bristol, North Somerset, and South Gloucester (BNSSG).

The GPCB brings together all general practices within BNSSG, Avon Local Medical Committee and BrisDoc which provides the out-of-hours GP service. Hosted by One Care, the GP federation for BNSSG, the GPCB ensures the voice of general practice remains a ‘golden thread’ and is robustly represented within the new Integrated Care System (ICS).

The ICS was established on a statutory basis in July 2022, and brings together partners from health and social care, local authorities and the Integrated Care Board, which replaced the CCG in July 2022.

By bringing these partners together to work collaboratively, the ICS puts patients at the very heart of the system and builds services around their needs.

General practice is the bedrock for the health and care system, and deals with the majority of health interactions through multidisciplinary teams of GPs, nurse practitioners and other clinical and non-clinical staff members working within surgeries. GP surgeries care for patients from cradle to grave, and are uniquely placed to build trusting relationships with their patients.

General practice involvement is therefore essential to the success of an integrated care system. The GPCB has developed some key principles around how general practice works within the Integrated Care System in BNSSG. These will enable general practice to act as an equal partner in our system partnership, and will lead to proper general practice engagement in decision-making across healthcare in our area.

The principles the GPCB works to are:

  • The GPCB is the go-to place for the system to engage with general practice
  • General practice at-scale work should be funded by the system
  • General practice should be involved in all system programmes from the outset
  • Each programme requires programme management, as well as clinical and non-clinical input
  • General practice engagement in system work will be prioritised in line with GPCB priorities

By following these principles, we ensure the expertise and experience of general practice is involved in any design of pathways and services. The principles also ensure voices are heard from across all general practice, the right expertise is found, and any progress made is shared back across all 76 practices in the area. We are working closely with our ICS partners to embed these new ways of working across everything we do in our system.

Dr Katrina Boutin, GP in Inner City and East Bristol and the Vice-Chair of the GPCB, said “Agreeing the principles of general practice engagement with our partners is an important step in partnership working in the new Integrated Care System. This is so we can ensure all partners are working consistently and collaboratively together to support our local populations, improve services and reduce inequalities.

Currently the GPCB is working within the system on several programmes: digital strategy; mass vaccinations; outpatients and urgent care. These programmes are steered by committees comprising clinical and non-clinical general practice representatives with a specialist interest in that area, and led by a clinical lead and programme manager.

These programmes are supported by One Care business intelligence, communications and digital expertise to enable change management within practices.

Successes to date include: coordinating the successful general practice aspect of the Covid vaccination programme; working with secondary care on outpatients processes to support the patient journey; and developing an urgent care strategy that supports patients being seen in the right place at the right time.

 

New intelligence dashboards to support practices’ vaccine delivery

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One Care has launched its 2022/23 winter vaccination dashboards, to help practices track progress delivering vaccinations to eligible groups.

There are two dashboards – one for Covid-19 autumn boosters and one for flu vaccinations – which will show practices and primary care networks (PCNs) how many vaccinations they’ve delivered each week.

The dashboards have been designed specifically for practice staff to quickly gain insight on progress through eligible cohorts.

All practices will be able to see their own data, and PCNs can also view each of their practices along with an aggregate view.

Practices can see the dashboards using this link and their unique practice / PCN login.

Rhys Lewis, Head of Digital at One Care, said: “This is the fourth dashboard we’ve set up to help general practices track how many of their patients they’ve vaccinated. It’s a service we started providing during the Covid-19 pandemic, and it’s something we know works well.

“The data in the dashboards can be broken down in several different ways, including patient ethnicity and index of multiple deprivation (IMD) group, which will help practices know which groups they may need to target in their patient communications.

“We hope they continue to be useful to our practices, and as ever we welcome any feedback on them so we can make improvements.”

Work ramping up for autumn vaccination drive

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Preparations are underway for this autumn’s flu and Covid-19 vaccinations in general practice across Bristol, North Somerset and South Gloucestershire (BNSSG).

The vaccination programme is a huge undertaking, with around 345,000 people in BNSSG eligible to be vaccinated. There will be around 4,000 staff and volunteers involved in delivering vaccines this year, many of whom will need refresher training.

It will see general practice working in partnership with acute hospitals, community pharmacy and mass vaccination centres to reach as much of the eligible population as possible.

The programme will focus on those most vulnerable to Covid-19 and flu first, starting with health and social care staff, care home residents, those who are housebound, and the clinically vulnerable.

Ruth Hughes, One Care’s Programme Manager for PCN-based vaccinations, said: “The mass vaccination programme for flu and Covid-19 is a big commitment for general practices, so it’s fantastic all 20 of BNSSG’s primary care networks are taking part. Their involvement, plus that of our partners in community pharmacy and the mass vaccination centres, is crucial and means people shouldn’t need to travel far for their vaccination.

“The programme is also a huge opportunity to maximise the population’s protection against flu and Covid-19. We have vaccines for both that are safe to administer at the same time – including a new version of the Covid-19 vaccine.

“Our hope is that we will be able to offer everyone who’s eligible a vaccination before Christmas.”

 

Voice of general practice strengthened as BrisDoc joins the GPCB

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The General Practice Collaborative Board (GPCB) has welcomed BrisDoc as its newest voting member.

The GPCB is the established representative at-scale decision-making body for general practice in Bristol, North Somerset and South Gloucestershire (BNSSG), and is formally recognised as the “go to” place for the system to work and engage with general practice at scale.

Following the annual review of the GPCB’s terms of reference, the Board looked at its membership and invited BrisDoc to join.

BrisDoc joins representatives from the Primary Care Networks, the six GP localities, Avon Local Medical Committee, and One Care (the GP Federation) as members of the GPCB.

BrisDoc is an employee-owned social enterprise, which has been delivering NHS primary care services for over 20 years, including the Integrated Urgent Care Service for BNSSG. It also provides a number of GP practices and Bristol’s Homeless Health Service.

Dr Jon Hayes, Chair of the GPCB, said: “We’re delighted to welcome BrisDoc to full voting membership of the GPCB. Having BrisDoc as a member strengthens our role, as it enables us to properly represent both in and out of hours general practice in our area. It enables us to work more cohesively across 24/7 general practice for the benefit of our patients. We hope joining the GPCB will also strengthen BrisDoc’s voice in the local healthcare system.”

Dr Kathy Ryan, BrisDoc’s Medical Director, said: “BrisDoc is delighted to become a full voting member of the GPCB. Uniting the voice of 24/7 general practice in BNSSG will provide a strong platform for consolidation, development and innovation in primary care in the new Integrated Care System.”

One Care service helps practices save time on referrals

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One Care’s Digital Support team has been helping practices across Bristol, North Somerset and South Gloucestershire clean up their referral resources.

Since the introduction of a centrally managed document hub, Resource Publisher, in August 2021, many practices found they had old or duplicate referral forms stored on their systems.

To solve this problem, One Care began offering a form consolidation service to practices. The service sees One Care’s Digital Support team remotely accessing practices’ systems and archiving the out of date and duplicate forms.

Stephanie Hatton, One Care’s Digital Consultant said: “This service brings a lot of benefits for practices. It saves clinicians and administration staff time, ensuring they are only using the latest forms so they can be confident the referrals they send have the necessary information.

“Because we can do the work in the background, practices can keep using their systems as normal, and their administration staff can work on other things.

“So far, we’ve delivered the service to 30 of our practices, and the feedback has been positive. We’d love to help any other practices who’d like it.”

The consolidation service is available to all One Care practices in BNSSG as part of their subscription. If you would like to find out more, please contact digital@onecare.org.uk

 

 

 

General practice information campaign launches today

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Your GP surgery team cares for you – that’s the message from our new public communication campaign, launching today.

The campaign aims to explain the changes in general practice in recent years, and what they mean for the public.

It showcases how GP surgeries continue to provide the same level of care they always have, and are working hard to ensure everyone receives the right support when they need it, whether that’s a face-to-face appointment, a phone consultation or a video call.

It also aims to highlight the range of healthcare professionals now based at local surgeries, including nurse practitioners, clinical pharmacists, and physiotherapists. It explains their roles, what they can do for patients, and how they work as part of the general practice team.

The campaign is being run by One Care and Bristol, North Somerset and South Gloucestershire Integrated Care Board (BNSSG ICB).

Ruth Taylor, Chief Executive for One Care, said: “General practice has seen a number of significant changes recently, including the introduction of digital and online services, and the integration of different healthcare professionals into general practice.

“We want to help the public understand how their GP surgery team is here for them throughout their lives, and how their GP surgery provides them with proactive, personalised and convenient care.”

As well as activity across social and traditional media, the campaign features a microsite with information about the changes in general practice, and explanations about the roles of the different healthcare professionals patients may see at their GP surgery.

Later this month, campaign adverts featuring staff and patients from practices across BNSSG will start to appear on buses across the area.

For more information about the campaign, or to find out how you can support it, please email enquiries@onecare.org.uk.

New app to boost staff sharing across BNSSG

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One Care is working with health system partners on an exciting new project to improve collaborative working across primary and community care in Bristol, North Somerset and South Gloucestershire (BNSSG).

The project – known as the collaborative bank – will enable sharing of staff across primary and community care in BNSSG. It aims to increase workforce agility, reduce the need to use agency staff, and give staff the opportunity to develop their skills and experience across the BNSSG health and care system. It will also enable a collaborative approach to using our limited staff resources where they are most needed.

The process will be managed digitally through a web and phone-based app, which has been developed by a company called Ryalto. Ryalto has experience of running similar projects elsewhere in the country, although this is the first time such a project is being led by general practice.

Through the app, staff will be able to book shifts at other practices and in community care settings, in addition to their core place of work. Available shifts can be filtered by competency or by role to give as much flexibility, choice and opportunity as possible for both employers and staff.

It is hoped the system will reduce the need to use expensive agency staff, which will reduce costs for the employer. Additionally, the staff member’s pay rate will follow them into the alternative place of work and they will continue to be paid by their usual employer.

The project is currently in the customisation phase, with practices and other partners providing feedback about their local requirements to Ryalto.

This feedback will support Ryalto to tailor the app and its functionality to the needs of local staff and employers for the best results.

Jim Hodgson, One Care’s Programme Manager for urgent care, said: “We are delighted to be working in partnership with Ryalto and colleagues from BNSSG primary and community care to develop this solution. As a health and care system, we need to address the 21st century workforce challenges we are now facing; it’s clear that 21st century technology will play a big role in solving these problems.”

One Care tool underpins successful cholesterol management pilot

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One Care recently supported a successful collaborative pilot project alongside the West of England Academic Health Science Network (AHSN) and University Hospitals Bristol and Weston (UHBW) to identify patients with cardiovascular disease (CVD) who could benefit from better lipid management.

CVD causes a quarter of all deaths in the UK and is the largest cause of premature mortality in deprived areas.

Reducing cholesterol through improved lipid management is a key way to address CVD. The project aimed to do this by making sure patients could be treated with the right medicines. In the pilot, these medicines included: High Intensity Statins (HIST), Ezetimibe, and PCSK9 inhibitors.  The NICE-approved lipid management clinical pathway has since been updated to also include Inclisiran and Bempedoic Acid.

To enable GPs to find the patients who would benefit most, One Care’s business intelligence and digital support teams developed and ran a CVD search tool. Over a year, they supported 10 practices across Bristol, North Somerset and South Gloucestershire to assess more than 149,000 patients and find those with existing CVD who had elevated lipid levels.

Using the tool, they then refined the data using criteria for PCSK9 inhibitor therapy – which treats very high cholesterol – to find eligible patients.

The pilot identified 444 patients who were eligible for medication reviews and referred seven of them to secondary care for PCSK9i therapy.

More broadly, primary care in BNSSG now has a sustainable, standardised way to improve the lipid management of high-risk CVD patients.

Colette Buckley, Head of Digital Support at One Care, said: “We’re really pleased to have been able to bring our digital expertise to the pilot. Delivering the tool has helped ensure  patients across our region are taking the most effective CVD medication, and provided a valuable pathway that can be used more widely in future. Enabling this kind of collaboration and helping to develop ways to help general practice and patients is at the heart of what we do.”

The pilot, led by Dr Paula Rostek, was part of the West of England Academic Health Science Network’s Rapid Uptake Products programme.

Clare Evans, Deputy Director of Service and System Transformation at the West of England AHSN said: “As a result of this pilot project, and the One Care tool, a sustainable pathway has been developed for Bristol, North Somerset and South Gloucestershire to optimise the lipid management of high-risk patients in primary care. This will support a standardised, evidence-based approach to manage those with established cardiovascular disease. Delivered alongside the pressures of the pandemic, the work of everybody involved is to be commended.”

Following the pilot, One Care will shortly launch the second phase of the tool. A second tool, to help identify patients who may have undiagnosed Familial Hypercholesterolaemia (FH), will also be offered. More information about these tools is available here.

One Care support for our practices: October-December 2021

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We have published our latest quarterly round-up of strategic changes, information about new One Care projects and a one page infographic showing the direct support we’ve provided to practices.

The last three months have continued to present general practice with extreme challenges and pressures. The highly transmissible Omicron variant of Covid-19 has driven unprecedented levels of infections globally, resulting in NHS England and the government asking general practice, along with the wider system, to focus on vaccinations and urgent care.

In mid-December, to support practices with their booster rollout targets, One Care staff temporarily stood down from normal duties to provide extra resourcing to practices. One Care staff offered their services to PCNs, helping with various administrative, marshalling and reception tasks. In total, 57 shifts were covered at 14 venues and the feedback we received from practices about our staff was fantastic. Similarly, members of the team enjoyed going into the surgeries and vaccination centres, meeting new people, gaining new experiences, and witnessing first-hand the demands of the booster programme.

Click here to enlarge infographic.

At the same time, One Care worked alongside NBT and VANS to create a more efficient process for PCNs and practices to request staff and volunteers for the mass vaccination programme. The newly-launched model sees One Care act as a single point of access for mass vaccination staffing requests rather than there being multiple avenues to request cover from, which often resulted in double bookings. This makes the process more efficient and time effective for general practice, staff, volunteers and system partners. This process was enabled by the staff sharing agreements One Care contributed to during the pandemic, which allow healthcare professionals to work across the different organisations in our region.

To help practices prepare for the potential impact of Omicron, One Care established an escalation framework to assist practices with a pragmatic checklist of operational considerations during the surge. To ensure general practice was well represented and involved in system decisions during this period of system pressure, we relaunched the SitRep to get a better understanding of the issues faced by practices. We used this information alongside the general practice activity report to represent general practice at all system bronze, silver and gold meetings.

It has been widely recognised that Covid-19, and the wider effects of the pandemic, have significantly impacted mental health, aggravating pre-existing conditions as well as affecting people who have not previously experienced poor mental health. One Care has been working with a PCN in South Bristol to identify patients with an active mental health condition who might benefit from a tailored intervention. The practice has provided us with great feedback about this piece of work, so please do get in touch if you would be interested in looking at something similar in your PCN.

Our business intelligence team have also added a Serious Mental Illness (SMI) dashboard to the General Practice Intelligence Dashboard. The dashboard shows what proportion of people on practices’ SMI register, who should receive a set of six physical health checks, have had each of the health checks and how many have had the full set. Easy access to this data supports practices to focus on where uptake of physical health checks can be improved, which will help maximise on available income and improve patient outcomes.

A key priority for One Care in recent months has seen the successful rollout of community phlebotomy – a new process for taking bloods in community settings. For many years, general practice has taken outpatient bloods on behalf of secondary care, despite not being contracted for the work. But the community phlebotomy programme has addressed the governance of this work, ensuring blood results are returned to the requester in secondary care and general practices are resourced for this programme.

One Care have further saved general practice time by creating, updating and sharing templates to the latest referral forms through Resource Publisher, meaning practices don’t need to maintain these templates themselves. To publish resources to a practice, technical data sharing agreements are needed. One Care now has these in place with 99 per cent of practices, as well as most PCNs and localities.

During this period, our subscription model for the next three years was signed off by our Board. We had intended to start meeting with PCNs in December to discuss this, but these meetings were postponed due to the booster programme and have been taking place throughout January and February. Many of you will have now responded to us regarding your intentions for next year. We’ve found these discussions really valuable and will be looking at how we can continue these discussions at more regular intervals moving forward.

We’re also inviting all practices to join us to hear about the work we’ve done throughout 2021/22 and our plans for 2022/23 onwards at our shareholder event on the afternoon of Thursday 28 April 2022. For now, please hold the date and we will share more details in due course.

We’re pleased to say that the One Care team has continued to grow in recent months in line with our development, and all current staff can be found on our website. In recent months, this has included particular growth of our project management capacity in our transformation team. As always, a huge thanks for your continued support. If you would me or a member of the team to visit your practice or attend a locality meeting to talk more about our work and how we can support you, please get in touch.

One Care helping practices benchmark telephony demand

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One Care has updated the telephony information available to practices in their General Practice Intelligence Dashboard (GPID).

The dashboard enables practices to benchmark themselves against other anonymised practices in BNSSG on incoming and unanswered call volumes, as well as the overall percentage of calls unanswered. The data can be tracked and measured over a week, month, quarter and year.

Practices will be able to see where they sit in comparison to each other, including in relation to patient demand and how it is being dealt with (using a rate per 1,000 patients).

This information may inspire a deep dive into practice call volume and how calls are being handled. It could also highlight specific time frames where demand has increased or decreased.

One Care’s business intelligence support analyst Kelly Hawkes commented on the new dashboard saying: “The analytics teams are incredibly excited to launch this dashboard as it offers something to practices that previously they’ve been unable to see.

“Practices are inundated with calls on a daily basis and this dashboard enables them to track this data in line with other practices. This dashboard is available to all Bistech practices and PCNs that have provided consent for One Care to process their telephony data.

“We would encourage as many practices to utilise this dashboard as possible as it offers a further insight into their practice.”

If you would like more information on the dashboard and how to use it, please contact onecare.analytics@onecare.org.uk.