New ‘primary care hubs’ are being set up across Cornwall in a bid to ease same-day demand on local GP practices.
Cornwall and Isles of Scilly ICB said that the eight hubs, staffed by ‘recently retired’ GPs among others, ‘will provide extra GP appointments’ which surgeries can direct some patients to, following triage against a set minor-illness criteria.
This is to ‘ease on-the-day demand’ on general practice during winter and ‘allow practices to focus on patients with long term conditions’, the ICB said.
Last week, Pulse reported the third-largest integrated care system (ICS) in England is effectively mandating the use of ‘same-day access hubs’, leaving GP practices with only ‘complex’ patient care.
From April, North West London ICB is introducing the requirement as part of its ‘single offer’ local enhanced service, with practices obliged to sign up to all services to access the funding – effectively mandating the hubs.
The Cornwall service will run throughout the winter period to begin with ‘to determine its success’ but Kernow LMC told Pulse that opportunities to extend running the hubs throughout the year are currently being explored.
The LMC also said that GP practices can refer ‘patients with urgent on-the-day needs’ to the hubs but when Pulse asked for clarification on this, Kernow Health, which is coordinating the project, said that the hubs are ‘for on the day demand’ and there is a criteria all practices are using which will identify if the presentation is ‘likely minor illness’.
The hubs are staffed by practitioners ‘with a minimum of three years’ experience of minor illness’, advanced practitioners and GPs, who work in addition to their usual working hours.
The LMC said the hubs have already delivered over 2,500 additional appointments, and invited GPs to spread the word about the initiative.
LMC chair Dr Nick Rogers: ‘Good progress is being made with four hubs already operational and others in the pipeline.
‘Inevitably, a new model such as this has thrown up logistical challenges, but these have all been addressed or, at least, partially resolved.’
Senior responsible officer for primary care hubs Dr Rob White said: ‘Aware that workforce availability was our largest challenge even amongst IT system interoperability and estates, a unique view was taken to fit the clinics around workforce availability with staff members being able to work flexible hours that suit around their commitments.
‘This resulted in 79 members of staff coming forward to work in the hubs with 40% of expressions of interest being from GPs.
‘Positive comments have been received by our ICB that indicate that this model will continue to run and evolve.’
According to Kernow Health, GPs working at the hubs are being paid £225 per face-to-face session ‘to reflect the nature of the work, i.e. minor illness post-triaged work’ while practitioner rates are £19.10 – £29.33 per hour.
The hubs are part of a wider winter plan for Cornwall and the Isles of Scilly’s health and care system which also includes extra places in Community Assessment Treatment units providing same day assessment to keep people from being admitted to hospital.
It comes after NHS England confirmed that no national funding will be directed towards ‘respiratory hubs’ this winter, despite GPs around the country saying these have significantly helped to reduce pressures.
Acute respiratory infection (ARI) hubs – 363 across the country – were put in place last year with national funding to relieve pressure on other parts of the system.
ICBs were asked to ‘consider the evaluation’ of ARI hubs from last winter, and weigh up whether to fund them themselves going forward, since no national funding has been confirmed, according to NHS England.
Presumably the ICB justifies this step by applying the principle of double effect in palliative care to general practice?
i.e. It is fine to apply a treatment (the Hubs) to alleviate suffering in general practice even if the treatment hastens the demise of general practice.
How are retired GPs going to keep up the GMC mandated learning and development, work required for annual appraisals, revalidation, their medical defence. All this extra unpaid time makes it uneconomic…
Hang on, isn’t Summer the busy time in Cornwall when the population doubles?
There is an error in the text:
‘According to Kernow Health, GPs working at the hubs are being paid £225 per face-to-face session ‘to reflect the nature of the work, i.e. minor illness post-triaged work’’
Should read
‘According to Kernow Health, GPs working at the hubs are being paid £225 per face-to-face session ‘to reflect the contempt in which General Practitioners are held by the commissioner’
how is this funded ? BY new money from ICB or from GMS and PCN DEs ?
It does seem like LMC at least integral in the process unlike NW London
If the GPs are working they aren’t retired are they ?
Assume the £225 is for less than a 2 hr session?
Agree if working then not retired.
Extreme caution please as the fragmentation of general practice has begun.
Recently retired at 56 and not planning on working in any hub anytime soon
The £225:pump-priming of GPs for hub shifts will disappear pretty soon. Patients will be seen only by PAs and other non-medical staff.
The arrogance, contempt for safe practice and potential harms to patients, remain ignored and unevaluated.
These KPMG and McKinsey plans will also prove significantly more expensive. So why do this at all?
The answer, when general practice has withered and died, will be industry-driven profit. The NHS and patients themselves will foot this bill, while private sector GPs will expand. ICBs are another foothold into NHSE and repeating their change rhetoric and comforting slogans doesn’t represent good Medicine or improved patient care.
Professor Tim Wilson once gave a talk on why we laugh at things which are not funny
So, the GP at the patient’s registered pratcice, will have to see the patient and triage them, so that they can either get a treatment from their GP, or be sent to see a GP at a hub who does not know if they are retired or not, but will know they don’t have any serious illness, because registered GP has already excluded this, but that government values them very little. What is the point?
Really PULSE – why are you publishing this SHIT???
Awful job
Recently retired GPs will soon remember why they retired, make their excuses and leave.
Abuse of taxpayer funds to cover up ongoing and monumental historic failures and negligence in my view perpetrated over substantial periods of times in multiple schemes including thinly veiled APMS and other NHS contracts have surreptitiously attempted to disguise the covert desired shift of some of the NHS work to private health care/companies in acts of sheer incompetence and world beating ineptitude of the CCGs, ICB,NHS England led by equally ill-informed publicity seeking health secretaries accelerated currently by the disastrous formation of failed money squandering PCNs. These fiascos have always been covered up by offering increased monetary income to those who chose to enter these lucrative yet destructive ventures and the continuing NHS decline is visible for all to see. We will see further monetary incentives as seen with the PCN clinical directors and now these high risk dangerous HUBs in my opinion with increased taxpayer funded sweeteners paid to those willing to take risks overseeing ARR replacements of doctors yet we should all remember the majority do not accept these cynical inducements and a BMA led campaign to outline this abuse of taxpayer funds used for pay offs at detriment to all is far overdue. Health inequality is exacerbated by these so called NHS bodies and nothing but a camouflage term for the reality that services to those most in need are actually being downgraded in quality.
No fragmentation without collaboration (by the LMC in this case!!)
Nick Mann you are spot on. On the surface though it looks like better value for money than paying pharmacists £1,000 a month for seeing 1 patient per month (increasing to 30 per month over six months)
I would like to be offered that kind of work… but I won’t be because I’m only a fully trained GP with years of experience.
It’s really very simple. Don’t do the work for these rates. You will drive down your own and other colleague’s value.
Retired GPs – if you’re participating in this STOP with your complicity in this shakedown of general practice by taking low pay simply because you’re bored and can subidise it from your pension – you’re undermining your colleagues pay and livelihoods.