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3.2 Hubs and collaboration - Steven Haigh

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NHS England
NHS England

The Enhancing Primary Care Programme aims to improve access to primary care services across Sheffield by expanding availability of services in the evenings, weekends, and through satellite units. The programme has established 4 satellite units that have provided over 30,000 additional appointments in their first year. These satellite units have improved access in more deprived areas and reduced emergency department utilization by an estimated 10-15%. The programme is working to better integrate services and develop primary care at larger scale to improve patient care and support primary care workforce challenges.

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Enhancing Primary Care Programme Steven Haigh, Programme Director www.primarycaresheffield.org.uk
Programme aims • To enhance access to Primary care services for patients throughout the week, evenings and weekends - ensuring consistency across the city. • To stimulate change across the health and social care system that results in better integration of services for patients. • Support the development of general practice at scale to improve patient care and respond to pressures facing the primary care workforce.
Schemes of Activity Scheme 1. Enhancing Primary Care Contract 2. Satellite Units 3. Social Workers out of hours assessment and crisis response home support 4. Single Point of Access (SPA) – increased clinical triage, signposting 5. Expansion of the Florence system to primary care 6. Community Volunteer Scheme 7. City Wide Rapid Access Team 8. City Wide Acute, Same Day Appointment Service 9. Primary Care Access to Psychiatric liaison 10. Weekend Specialist mental health support (general and older adults) 11. Training Community Nurses to provide Improving Access to Psychological Therapies (IAPT) 12. Primary Care Pharmacy Programme (PCPP) 13. Interoperability and use of the Medical Interoperability Gateway (MIG) 14. WebGP 15. Integrated Care Management Teams (ICMT) 16. Roma Advocacy and Health Project
Satellite units – the approach • Started 1 October 2015 • Urgent evening and weekend GP appointments, routine appts for practice nurses • Four satellite units across city in existing GP practices • Open weekday evenings 6pm-10pm and weekends 10am-6pm. • Staffed by Sheffield GPs and practice nurses. • Appointments booked through registered GP or 111 if out of hours.
Satellite units – the impact • First 12 months delivered 30,000 additional appointments • Now at c80% utilisation • 90% positive rating • Impact on ED – 30% self reporting, evidence suggests 10- 15% • Improved access for the more deprived areas
Satellite units – the impact • Insert ED attendance map
Satellite units – the impact • Insert overall satellite attendance map
Satellite units – lessons we are learning • Successful engagement with practices – with caveats • Successful engagement with our population – with caveats • Successful engagement with our commissioners – with caveats • Successful development of a service model but in isolation
Satellite units – the impact • First 12 months delivered 30,000 additional appointments • Now at c80% utilisation • 90% positive rating • Impact on ED – 30% self reporting, evidence suggests 10- 15% • Improved access for the more deprived areas
Future Urgent Primary Care A&E Minor Injuries Primary Urgent Centre at front of A&E Satellites to include in hours and out of hours, triage see/treat, home visits Practices, Community pharmacists, dentists within a neighbourhood infrastructure There is the opportunity in Sheffield to:  Simplify- the urgent care pathway for both patients and professionals  Consolidate- current services that are in place and could be maximised  Join up- fragmented services that create hand offs, delays, gaps in information  Maximise- skill mix and capacity across the pathway In order to do this the system could be redesigned with the development of an Urgent Primary Care centre at the front of A&E which would triage, assess and treat the current primary care activity that is managed by A&E. The satellites would have an expanded role with provision for in and out of hours with a wider skill mix and include face to face and phone triage. Primary care led to include WIC and GP collab Primary care led to include WIC and GP collab Secondary care led Secondary care led

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3.2 Hubs and collaboration - Steven Haigh

  • 1. Enhancing Primary Care Programme Steven Haigh, Programme Director www.primarycaresheffield.org.uk
  • 2. Programme aims • To enhance access to Primary care services for patients throughout the week, evenings and weekends - ensuring consistency across the city. • To stimulate change across the health and social care system that results in better integration of services for patients. • Support the development of general practice at scale to improve patient care and respond to pressures facing the primary care workforce.
  • 3. Schemes of Activity Scheme 1. Enhancing Primary Care Contract 2. Satellite Units 3. Social Workers out of hours assessment and crisis response home support 4. Single Point of Access (SPA) – increased clinical triage, signposting 5. Expansion of the Florence system to primary care 6. Community Volunteer Scheme 7. City Wide Rapid Access Team 8. City Wide Acute, Same Day Appointment Service 9. Primary Care Access to Psychiatric liaison 10. Weekend Specialist mental health support (general and older adults) 11. Training Community Nurses to provide Improving Access to Psychological Therapies (IAPT) 12. Primary Care Pharmacy Programme (PCPP) 13. Interoperability and use of the Medical Interoperability Gateway (MIG) 14. WebGP 15. Integrated Care Management Teams (ICMT) 16. Roma Advocacy and Health Project
  • 4. Satellite units – the approach • Started 1 October 2015 • Urgent evening and weekend GP appointments, routine appts for practice nurses • Four satellite units across city in existing GP practices • Open weekday evenings 6pm-10pm and weekends 10am-6pm. • Staffed by Sheffield GPs and practice nurses. • Appointments booked through registered GP or 111 if out of hours.
  • 5. Satellite units – the impact • First 12 months delivered 30,000 additional appointments • Now at c80% utilisation • 90% positive rating • Impact on ED – 30% self reporting, evidence suggests 10- 15% • Improved access for the more deprived areas
  • 6. Satellite units – the impact • Insert ED attendance map
  • 7. Satellite units – the impact • Insert overall satellite attendance map
  • 8. Satellite units – lessons we are learning • Successful engagement with practices – with caveats • Successful engagement with our population – with caveats • Successful engagement with our commissioners – with caveats • Successful development of a service model but in isolation
  • 9. Satellite units – the impact • First 12 months delivered 30,000 additional appointments • Now at c80% utilisation • 90% positive rating • Impact on ED – 30% self reporting, evidence suggests 10- 15% • Improved access for the more deprived areas
  • 10. Future Urgent Primary Care A&E Minor Injuries Primary Urgent Centre at front of A&E Satellites to include in hours and out of hours, triage see/treat, home visits Practices, Community pharmacists, dentists within a neighbourhood infrastructure There is the opportunity in Sheffield to:  Simplify- the urgent care pathway for both patients and professionals  Consolidate- current services that are in place and could be maximised  Join up- fragmented services that create hand offs, delays, gaps in information  Maximise- skill mix and capacity across the pathway In order to do this the system could be redesigned with the development of an Urgent Primary Care centre at the front of A&E which would triage, assess and treat the current primary care activity that is managed by A&E. The satellites would have an expanded role with provision for in and out of hours with a wider skill mix and include face to face and phone triage. Primary care led to include WIC and GP collab Primary care led to include WIC and GP collab Secondary care led Secondary care led