Transforming Access to General Practice (North West London)
GP practices in North West London are working together to create 39 networks – covering 365 surgeries – to improve access for 1.8 million residents. Each network will offer appointments 8am to 8pm on weekdays and for six hours on weekends, with same-day appointments for patients who need them, within four hours. For people with non-urgent needs, they will be able to book appointments within 24 hours with a local GP, or at their own practice within 48 hours. Patients with more complex needs will have access to longer appointments and a named care co-ordinator, who will liaise with health and social care services, to co-ordinate their care. This pilot has been awarded £5,000,000.
Better Access, Better Care, Better Lives (Barking & Dagenham and Havering & Redbridge)
Patients across London will benefit from significantly increased access to GP services and a tailored care programme for patients with complex needs. Around 759,000 patients across 137 practices in Barking, Dagenham, Havering and Redbridge, will be able to book appointments from 6.30pm to 10pm on weekdays and 8am to 8pm on weekends, at central sites, starting with one in each borough. People can access services by calling a single contact number to talk to a clinician who can then guide them to the most appropriate service for their needs. This pilot has been awarded £5,608,550.
Extending Access to Primary Care in Southwark
In Southwark the PM Challenge Fund is supporting 45 practices, to give 300,000 patients better access to services and urgent care. Working in practice clusters called ‘neighbourhood networks’, this pilot is creating new ‘access clinics’ covered by existing practice staff, for urgent care. Patients will be able to book appointments from 8am-8pm, seven days a week, and creating more than 71,000 additional patient appointments a year. The facility will cover registered patients as well as non-registered patients that need primary care services, and are re-directed from A&E. This pilot has been awarded £975,278.
Moving Primary Care to a Wellbeing Approach (West Wakefield)
Six GP surgeries in Wakefield are working together to make services more accessible in practices and across the community. The practices’ 63,000 patients will benefit from longer opening hours, from 8am to 8pm seven days a week, and longer appointments for people with more complex needs such as frail older people. The pilot is introducing a new on-line signposting service to give patients better access to GP and other community based services, including consultations by email, ‘real time’ web chats or by phone, as well as being able to book appointments directly with a practice-based pharmacist or physiotherapist on-line. GPs will also be able to talk to hospital consultants, whilst the patient is in the surgery, and reducing the need for an additional appointment at the hospital. This pilot has been awarded £1,436,663.
Opening Doors – Aligning and Integrating Health and Care Services (Morecambe)
Practices in Morecambe will be opening 8am to 8pm seven days a week, to make services more accessible for 61,000 patients. This will include a GP-led phone-based triage system to guide patients on the right service for their health needs, and the option to book ‘remote consultations’ by ‘phone or email. Patients will also have access to an improved range of minor injury services, including treatments for fractures, cuts and sprains, to avoid hospital admissions, with an out-of-hours X-ray service, that in time, can also be used by Royal Lancaster Infirmary’s ambulance service on weekends. Technological advancements will make services more accessible including an “app” to guide patients on local health services and for patients with long term conditions, a new interactive messaging service which enables clinicians to ‘talk’ to patients remotely, to achieve better health outcomes. This pilot has been awarded £1,137,132.
Easy GP Project (Bury)
Thirty practices in Bury are working together to give 195,000 patients greater flexibility about how they access services. The new development aims to help working people and school children who might struggle to attend appointments during the day. Practices will be opening 8am to 8pm on weekdays, and 8am to 6pm at weekends to create an additional 150,000 appointments a year. Patients will also be able to use a new smartphone app to order prescriptions and book appointments direct. This pilot has been awarded £2,779,000.
Together as One Community (Hambleton, Richmondshire, Whitby)
Extended opening hours – 8am to 8pm, seven days a week – and a new focus on preventative care and care planning, will help to transform GP services in this North Yorkshire pilot, covering 22 practices. Over 142,000 patients, spread across 1,400 square miles, will benefit from community based teams that bring together GPs, the community hospital, community pharmacists and nurses, with IT support. For those patients in rural areas, it will reduce the need to travel long distances for health care. New patient services will include community IVs, pain management, management of stable prostate cancer and pre-operative assessments to provide care, particularly for rural communities, closer to home. Video technology will enable specialist clinicians to offer ‘virtual’ appointments at the patient’s own GP surgery, to provide a seamless service, delivered locally, across hospital and primary care. This pilot has been awarded £2,481,000.
Primary Care Home (Warrington)
The Warrington pilot, covering 29 practices, is creating eight new virtual ‘Primary Care Homes’, each covering three to six surgeries in the area. Each Home will provide an integrated service hub that includes primary health, community services, social care and psychological therapies. The innovative approach will benefit 209,000 patients – covered by the pilot’s practices – to provide more integrated health and social care services, closer to patients’ homes. Every ‘Primary Care Home’ will take advantage of shared services across practices including heart monitoring and blood testing, and have dedicated care coordinators for patients with complex needs. They will also offer patients extended access from 8am to 8pm, seven days a week. This pilot has been awarded £3,291,157.
Better Together (Workington)
This pilot will establish a new team providing dedicated services for residents in local care homes, focusing on proactive (rather than reactive) care, including scheduled visits, care planning, end of life care and medication reviews, to meet residents’ needs. The pilot will also offer more GP-led clinics at Workington Community Hospital including ophthalmology, minor surgery and dermatology, reducing the need for patients to travel to the acute hospitals in Whitehaven or Carlisle. For older people in the community, a new frailty assessment unit at the community hospital will offer rapid assessments by community geriatricians closer to home, rather than traditional out-patient appointments, including urgent assessments, diagnostics and home visits. Patients will also get greater access to GP services with the introduction of a new Primary Care Assessment Centre, offering same-day appointments, 8am to 8pm, seven days a week, for acute problems and minor injuries. This pilot has been awarded £511,292.
Caring for Darlington Beyond Tomorrow
Around 94,000 patients at ten practices in Darlington, will have greater flexibility on booking appointments at selected practices on weekdays, and 8am to 6.30pm on weekends. A new multi-disciplinary specialist team of GPs, nursing and social care staff, will provide additional support for frail, older patients to provide care closer to home, and prevent unnecessary hospital admissions. This pilot has been awarded £448,400.
Extended Primary Integrated Care (Brighton and Hove)
Care navigators are being introduced in 18 practices in Brighton and Hove, for patients who require health guidance rather than medical care. Working with voluntary care organisations Age UK and Neighbourhood Care, specially trained navigators will provide proactive advocacy and support for patients in community settings, particularly for those who are living on their own. The practices are also working with local pharmacists to create four ‘primary care’ centres, covering 137,551 patients, to give patients a more responsive and flexible service, with same-day appointments, from 8am to 8pm, seven days a week, at a GP practice, in a pharmacy or at home. This pilot has been awarded £1,871,149.
Integrated South Kent Coast (Folkestone and Dover)
This pilot brings together 13 practices and will offer extended and more flexible access to services for 94,940 patients, backed by enhanced community care and specialist services for people with mental health needs. Patients will be able to book appointments at any of the 13 practices from 8am to 8pm, seven days a week. Outside of core practice hours (8am-6.30pm) patients can access urgent home visits and if required, short-term residential facilities in the community, to avoid hospital admissions. For patients with urgent mental health needs, this pilot is also introducing a new rapid assessment service delivered by a primary care mental health specialist, either at a patient’s home or at their GP. This pilot has been awarded £1,894,267 from the Challenge Fund.
One Care Consortium (Bristol)
Patients in Bristol will be able to see their GP from 8am to 8pm on Saturday and 11am to 5pm on Sunday, as part of the One Care Consortium, as well during the week. The service will increase access for 270,000 patients across Bristol and South Gloucestershire, registered with 24 GP practices. . This pilot has been awarded £2,900,000.
Steps to the Future (Slough)
Patients across 16 practices in Slough will be able to book appointments at their GP practice, or simply drop-in, from 8am to 8pm on weekdays and on weekends. Alongside extended access, patients can subscribe to receive free texts to promote wellbeing, as well as reminders about routine health checks. Sessions in local schools, led by the local GP or practice nurse, will develop awareness of health services and how they can be used. This pilot has been awarded £2,950,000.
Shaping Services to Meet Community Needs (Devon, Cornwall and Isles of Scilly)
Practices in Devon, Cornwall and the Isles of Scilly are giving 1.7 million patients the opportunity to help shape services, covering a diverse geographical area, from scattered rural communities to larger urban centres. The pilot’s 230 practices are trialling a range of options to make service more accessible, including: offering services in additional local venues, establishing new urgent care centres offering extended hours; more ways to access GP services including Skype, and a new case-management service where a lead GP co-ordinates a patient’s care across primary, community and secondary care. The learning will then be shared and rolled out across all practices, to meet local patient needs. This pilot has been awarded £3,575,000.
MIDS & EAST
Improving Access, Supporting Primary Care Integration and Whole System Change (Herefordshire)
Patients across 24 practices in this pilot will have greater access to GP services at new centres in Hereford, Leominster and Ross and Wye, up to 8pm, seven days a week. When this pilot is fully up-and-running, it will provide an additional 90,000 appointments for 185,000 patients, done either by phone, Skype or face-to-face. The centres will also work closely with the local hospital and local care homes. A&E staff will be able to book appointments directly for those patients that need primary care support, whilst care home staff can access the primary care team at weekends, using Skype, to provide care and support for residents. New community initiatives include training for carers, for example spotting the early signs of illnesses; health advice clinics for teenagers in colleges; and a heath app giving patients health advice and information, and the option to book appointments at their GP surgery. This pilot has been awarded £2,663,206.
Transforming General Practice (Derbyshire and Nottinghamshire)
Practices across Derbyshire and Nottinghamshire are trialling a number of initiatives to make services more flexible and accessible for over a million patients. They will be testing different approaches at different sites, including: offering extended hours in centrally located hubs, seven days a week; the option for patients to access services at any of the practices in the pilot area; new ways to access consultations, by phone, email and Skype, and introducing telecare to help people to better manage their conditions at home. This pilot has been awarded £5,252,463.
Transformational Innovations for Primary Care in West Hertfordshire (Watford)
The Watford Care Alliance, covering 11 practices, will ensure a seamless service between health and social care with a new integrated team that offers a social worker, community nurse, physiotherapist, occupational therapist and specialist palliative care nurse, alongside GPs. The team’s main focus will be on delivering better care in the community, to prevent urgent hospital admissions. New innovative ‘telemedicine triage hubs’ are also being introduced to provide a more immediate service for older people in care homes, using technology such as Skype to improve patient care, with virtual ward rounds. The practices’ 91,000 patients will also be able to access walk-in appointments to 8pm, seven days a week, at two practices in Watford and Rickmansworth, creating an additional 16,000 GP appointments a year. This pilot has been awarded £794,620.
Health United (Birmingham)
This pilot brings together two practice partnerships, covering 60,000 patients, and will develop two ‘primary care centres’ that open 8am to 8pm, seven days a week, to offer an additional 540 patient appointments a week. Patients will also be able to access services on-line such as consultations and provide ‘real time’ feedback on services, as well as access instant messaging from remote settings and at home. This pilot has been awarded £997, 216.
MULTISITE (ACROSS REGIONS)
Transforming the Access Experience at Scale across England (The Care UK Super practice)
Nine practices across England will be offering patients the facility to access services by ‘phone or on-line – using a single contact point – 24 hours a day. Patients will ‘phone a central number and talk to a GP or nurse who can handle routine queries, arrange prescriptions, and signpost them to the right treatment or service that best meets their health needs. Patients will also be able to access clinical advice on-line. This will free up more practice time for those patients that need to see a GP. The service will better integrate in and out of hours care, giving 50,000 patients one single point of contact for their primary care needs. This pilot has been awarded £960,000.
Source: Department of Health