GPs to lead neighbourhood model splitting patients by health complexity

One ICB has named the GP practices that will pilot its new model, which is meant to shift investment into the community and enable GPs to focus on ‘proactive care’ for their most complex patients.

Two ‘innovator sites’ consisting of 23 GP practices will receive investment to deliver an additional 1,500 appointments per week through two new commissioned services from April next year, Northamptonshire ICB has announced.

It said that in this model GP practices ‘will remain as the front door for patients’ to access and book appointments, but that patients with ‘low complexity health needs’ may be offered an appointment in a ‘new service in their neighbourhood’, while patients with ‘more complex health needs’ will continue to be seen by their GP practice.

The business case was modelled on an average neighbourhood of 93,000 patients which correlates to a cost of £4,448,911 for two sites.

A timeline prepared by the ICB showed that contracts for the service will be signed next month and the programme is expected to start in April next year.

It said that there are two ‘key parts’ of the programme:

• A neighbourhood access service which will offer ‘same-day appointments’ for patients with ‘one-off illnesses or symptoms’;
• A complex care and long-term conditions service for people who need ‘ongoing support’ for ‘serious or long-term health issues’.

According to papers presented to the ICB, the ‘new models programme’ will support delivery of ‘neighbourhood health, as described in the Fuller and Darzi Reports, and the 10-year plan’.

Experts from across the ICB have been engaged in developing the service specification for the neighbourhood access service, and the specification has also been shared during a four-week engagement with all GP practices and the LMC.

According to minutes from a meeting of the health scrutiny committee at West Northamptonshire Council, this new service would be provided through ‘an at-scale model’, with the level of appointments required being matched to activity modelling.

Appointments would be provided from a central location, such as a GP practice, or split across the neighbourhood, ‘depending on the specific design’ and where geography permits, delivered from a central location ‘to facilitate development of an integrated neighbourhood team’.

The same-day appointments may take place in existing GP practices or in other locations across the neighbourhood, the ICB said, and patients who would normally be seen in general practice ‘may instead be directed to one of the services’, where they will still be seen by a GP or an advanced practitioner.

The ICB said: ‘It is hoped the services will free up time in general practice and enable patients with complex and long-term conditions to be seen more quickly and conveniently.

‘We are initially seeking to establish two innovator sites that will collaborate closely with the ICB to co-develop a care model tailored to the specific needs of patients within their neighbourhoods.’

The ICB’s chief executive Toby Sanders said: ‘These areas have been chosen as our first neighbourhood sites based on a number of factors including population need and readiness to trial a different approach to providing support and care in the community.

‘The services are being funded locally, so will initially run as pilots but if successful there are plans to roll-out to all nine identified neighbourhoods in the county which would provide additional general practice appointments and capacity.

‘Over the next few months, we are keen to work with local communities, providers and organisations to develop these services together to ensure they are the best fit for our local populations.’

Pulse has contacted Northamptonshire LMC for comment.

It comes after earlier this year one large ICB chose a number of hospital trusts, instead of GPs, to oversee the new ‘neighbourhood health service’ across its footprint.

And last week LMC leaders across England voted to boycott participating in neighbourhood services which are not specifically GP-led.

NHS England has recently urged ICBs to take a ‘bold’ approach to planning services, including decommissioning services from GP practices and looking ‘beyond traditional healthcare providers’.