Tag Archives: General Practice

Voice of general practice strengthened as BrisDoc joins the GPCB

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

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 The service sees One Care’s Digital Support team remotely accessing practices’ systems and archiving the out of date and duplicate forms.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

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

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

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

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

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.

One Care assist in NHS soup-and-shake diet

Over 2,000 people with Type 2 diabetes have now improved their health through the NHS Soups and Shakes diet programme – with participants losing an average of 13kg (over two stone) in three months.

From this month, the diet programme will be accessible in Bristol, North Somerset and South Gloucestershire (BNSSG) as NHS Soups and Shakes is rolled out across 11 more regions following the early and life-changing success.

In conjunction with the programme’s second wave rollout, 500 spaces are initially being made available for referrals in BNSSG over the next two years.

One Care have helped the mobilisation of this low-calorie diet pilot in BNSSG by supporting the planning of the project, communications, practice engagement and creating EMIS resources. This improves the process for practices identifying and contacting eligible patients to see if they would be interested in engaging with the programme.

One Care’s Project Manager Bex Tilling said: “This pilot has seen excellent results in other parts of the country so it’s really exciting to help practices offer this life changing programme to patients in BNSSG.

“We’re looking forward to seeing the programme grow and to be involved in such an exciting and worthwhile project has been really enjoyable.”

Helping people diagnosed with diabetes to lose weight, and make better decisions about their health through the NHS low calorie diet programme, enables them to better control their blood sugar levels. This reduces the need for diabetes-related medication and potentially achieving remission of their Type 2 diabetes when their levels return to a healthy range.

Early data from the NHS programme shows participants losing on average 7.2kg (over one stone) after one month, and 13.4kg (over two stone) after three months.

New data shows people on the programme who are eating and drinking the low calorie alternatives not only lose weight but keep it off over time. These real-world findings are a significant step forward and come after trials showed that around half of people who had similar weight loss were able to achieve remission of their Type 2 diabetes after one year.

Diabetes is estimated to cost the NHS £10 billion a year, with treatment making up one in 20 prescriptions written by GPs. Projections also show that with the number of people being treated for diabetes continuing to grow – nearly 39,000 more people could suffer a heart attack in 2035, and over 50,000 could experience a stroke.

The year-long programme, which is fully supported and monitored by expert clinicians and coaches throughout, kickstarts weight loss through low calorie, diet replacement products such as shakes and soups for the first three months. After this, a carefully managed plan reintroduces healthy, nutritious food and participants can track their progress through virtual one-to-ones, group sessions and digital support – to help them maintain a healthier weight.

The NHS low calorie diet programme may be suitable for some adults aged 18-65 years, diagnosed with Type 2 diabetes in the last six years and living with overweight or obesity who also meet other eligibility criteria.

If your PCN or practice would like more information on the programme or be able to refer patients to the low-calorie diet, please contact bnssg.lowcaloriedietpilot@nhs.net.

Supporting new practice staff

A popular programme One Care offers to practices across Bristol, North Somerset and South Gloucestershire (BNSSG) is new staff support.

Launched in April 2020, the new staff support programme consists of six one-hour meetings to new staff joining key roles in the practice – such as a practice manager, partner or lead nurse. These sessions are delivered by our practice support team (PST) and are designed to introduce One Care and the expertise we offer in business intelligence, practice finance, practice operations and more.

Furthermore, the team also offers expertise on working in general practice in BNSSG for those that are new to the area, or are new to the healthcare sector.

One Care have provided ten new staff support programmes to date and a further 15 are currently running across practices and Primary Care Networks (PCNs).

A practice employee who completed the new staff support programme said: “Talking to the One Care experts about practice business, operational and finance management has really helped me to make sense of quite an overwhelming amount of information.”

As well as helping with many different aspects of running practices and offering mentor support to employees, these discussions help One Care to understand the reality and day to day challenges that practices are facing which helps inform and shape the services we offer.

Our One Care Senior Delivery Manager Linda Ruse (nee Buczek) said: “The new staff support programme is very popular and participants consistently tell us how worthwhile they find the support sessions.

“We monitor practice vacancies and contact practices when positions are filled to see if we can help.

“It’s a great opportunity for us to learn about the individual and their respective practice. We develop a positive and ongoing relationship with staff members to ensure One Care helps wherever it can.

“Our practice support team have supported all bar one practice and one PCN in BNSSG, providing more than 300 hours of time and expertise.

“It’s hugely satisfying to help an individual and practice with something they are unsure of, or need more of an insight into, so I would encourage practices to get in touch to see if we can help.”

The new staff support meetings can be virtual, or in-person. The frequency and agenda is very much led by the individual who often has a list of things to discuss. We can also update and answer questions on current BNSSG initiatives.

If you would like more information, please email practice.support@onecare.org.uk.

Number of GP appointments rising across BNSSG

Patient contact with GPs in Bristol, North Somerset and South Gloucestershire (BNSSG) continues to increase.

Last week (8-12 November), there were a total of 112,031 appointments across the 77 general practices in BNSSG.

The number of patients to see a GP was 60,237, which is higher than at any point in 2018/19 or 2020. This equates to 54% of all the appointments that took place over the course of the week.

Meanwhile, there were 19,074 appointments with nurses (17% of total appointments) and a further 32,720 with other clinicians (29% of total appointments).

Click here to enlarge the graph.

GPs, their teams, and patients have faced an extremely challenging time during the pandemic and face-to-face contact has been limited across all NHS services to protect patients from the risk of infection.

As the data suggests, not everyone needs to be seen by a GP. All practices offer appointments with a range of other healthcare professionals, and this ensures patients see the right person for their condition as quickly as possible. The general practice team continues to grow, and practices may offer patients an appointment with a physiotherapist, mental health nurse or pharmacist, among others.

To view the latest data around telephone calls, urgent appointments and flu and mass vaccination programmes representing practices across BNSSG up to 12 November, click here.

Receptionists continue to be a key part of the practice team and the questions they ask are to ensure you are seen by the right person at the right time.

This week is national self-care week and doctors and pharmacists in BNSSG are encouraging people to get ‘self-care aware’ by practicing a healthy lifestyle and familiarising themselves with how to treat minor ailments and illnesses at home.

The national campaign aims to help people to better look after their own health – including self-treating very minor illnesses or injuries with help from pharmacists and the NHS website, taking steps to manage long-term health conditions and making healthy lifestyle choices such as exercising and eating well.