Biggest reform to GPs in a generation brings new services for patients in East Lancashire

The biggest transformation to the way family doctors work in more than a generation will be launched from today (Mon 1 July).

It will see general practices, large and small, working to support each other while offering a wider range of specialist care services to patients from a range of health professionals.

In the North West, Burnley East has been highlighted as a great example of how networks are already rolling out programmes of work which are having a direct benefit to the populations they serve. (More details can be found in the case study below.)

GPs will recruit multi-disciplinary teams, including pharmacists, physiotherapists, paramedics, physician associates and social prescribing support workers, freeing up family doctors to focus on the sickest patients.

Across Lancashire and South Cumbria there will be 41 Primary Care Networks, forming part of the 1,300 which will exist nationally, seeing around 7000 general practices coming together to deliver the best possible care in their communities. 

These will attract billions in extra investment to sustain general practice in the short term and improve access to family doctors, expanded services at local practices and longer appointments for patients who need them. 

This milestone for primary medical and community care, which forms a major commitment of the NHS Long Term Plan, will see neighbouring practices working more closely together and with other services in their area to provide more joined up care for patients. The additional funding from the five-year GP Contract agreed with the BMA at the end of January, includes £1.8billion to fund the recruitment of 20,000 more specialist health care staff to support general practices. 

Up to 40% of GP appointments don’t need to be with a family doctor and the new recruits will free up GPs to spend more time with patients who need them most, offering longer appointments to those who need them, as well ensuring patients can get a wide range of expert specialist services at their local practice. This builds on the increase of more than 5,000 extra practice staff working with GPs over the past four years. We will also continue to recruit more practice nurses and GPs, with the number of young doctors choosing to train as GPs now at a record high.

Patients will also have a range of options when it comes to getting appointments at their practice, including the introduction of digital appointments, which will build on the progress which saw evening and weekend appointments made available across the country at the end of last year, with an estimated nine million appointments a year now available at more convenient times. 

Anthony Leo, Director of Primary Care and Public Health for the NHS in the North West said: “Primary Care Networks allow the practices within them to think differently about the services they are offering to their patients.

“By working together, they can share the workload and ease pressure on the individual practice teams.  As primary care networks develop, they will work closely with other health and social care partners and the wider system to offer better access to a wider range of joined-up services more quickly for people who need them most.”

It means GP practices will be able to drive further action on killer conditions such as cancer and heart disease as well as doing more to tackle obesity, diabetes and mental ill health, and support older people at home and in care homes.
  
The NHS Long Term Plan will see funding for primary medical and community care increase as a share of the NHS budget for the first time in the health service’s 70-year history, with an extra £4.5 billion invested by 2023.

Dr Nikki Kanani, a GP and NHS England’s Acting Medical Director for Primary Care, added: “We’re delighted with the enthusiasm shown across the country with GPs, local medical committees and commissioners working together to establish Primary Care Networks.

“Of around 7,000 practices across England, 99.6% have joined a PCN with just a handful opting out. We would have liked full coverage but we respect the rights and reasons of those practices who have decided not to sign up and where they haven’t, commissioners will make arrangements to ensure that 100% of patients can access network services. The new PCNs will see GPs large and small working together to provide a wider selection of specialist services to patients. It’s a game changer and signals the start of a new era for general practice.”

While many of the networks are launched today, and it will take some weeks or months for patients to see much change, some PCNs are already up and running and providing new services.

Case Study: Burnley East Primary Care Network

Burnley East Primary Care Network is already seeing benefits for their patients by rolling out this way of working.

The network is made up of seven practices, including Yorkshire Street Practice, Prestige Medical Group (Oxford Road), Prestige Medical Group (Prestige Park), Burnley Wood Medical Practice, Briercliffe Surgery, Daneshouse Surgery, Thursby Surgery and Colne Road Surgery and together support around 50,000 people locally. 

The network covers an ethnically and culturally diverse footprint, with frailty and social isolation being key challenges for local residents.

Practices working more collaboratively as a primary care network will enable the whole area to benefit from an initiative that was initially established by one of the surgeries – Burnley Wood Medical Centre – working in partnership with Lancashire County Council’s public health team to improve local health.

Burnley Wood Community Action Network (CAN) brings together partners to address local health issues including high instances of deprivation, high smoking prevalence, childhood obesity and low life expectancy.

The area has gone through a period of regeneration which has resulted in a disconnect between those who have spent their lives in Burnley Wood and new people coming to live in the new housing. The community project aims to use resources available in the community to improve the health and wellbeing of people living in the area and bring community cohesion by everyone working together. 

The membership started in 2014 with a variety of partners including community voluntary services, local community centre, council, police, fire service, local schools and colleges, faith groups, housing association and residents. Over the years more and more groups and organisations have joined the group and shared their resources and knowledge.  

Working as a primary care network, Burnley East PCN were selected as one of five neighbourhood teams in Lancashire and South Cumbria to take part in an accelerated programme for population health management earlier this year. Healthier Lancashire and South Cumbria, the integrated care system for the area - which is a partnership of local councils, NHS, public sector, voluntary sector and community organisations - was one of only four areas in the country selected for the programme by NHS England and NHS Improvement, because it is recognised as leading the way in starting to improve outcomes, reduce inequalities and address the broad range of individual, social and economic factors affecting the health of local people. 

The accelerated programme looked at changes in working practices to develop a culture of cross-organisational working as well as how data and intelligence can be better used by GPs and community services to help people live longer, healthier lives.

Dr Santosh Davis, a GP at Burnley Wood Medical Centre and East Lancashire Clinical Lead for Integrated Care Lead said: “This was very much about establishing a grass roots movement which could make a difference to the people living in our community. It’s not about medicine, it is about using non-medical interventions to improve people’s lives.
“We have been able to make great progress as a single GP practice working with partners, but the impact will be even greater now we can work with other practices across the area as a primary care network.”

The group have worked together on a number of successful projects aiming to bring the community together and improve the health and wellbeing of those living in Burnley Wood which include a history project, Burnley Wood Big Lunch, Cycling project with local primary school children. 

Dr Davis added: “We are taking the concept of population health management to the people through community centres and churches and addressing frailty through community connectors: social prescribers who are employed by our Community Voluntary Organisation.  

“More than 70 patients have already received help and support through the scheme and we hope for that to increase even more across the whole primary care network over the coming months.”

Dr Sakthi Karunanithi, Director of Public Health for Lancashire said: “We are looking forward to working ever more closely with our GPs and primary care networks at a neighbourhood level. This gives us a tremendous opportunity to improve health and wellbeing of our residents.”

Watch our video

Dr Santosh Davis, GP Partner at Burnley Wood Medical Centre and Clinical Lead for Integrated Care East Lancashire CCG talks about the work that has been happening in the Burnley East Primary Care Network as part of the Population Health Management accelerated development programme. Focusing on a groups of patients with moderate frailty, the team of NHS, public sector and community and voluntary sector colleagues have been using data and Business Intelligence to develop tailored interventions for local people.