The primary care network handbook

This handbook offers options to groups of practices looking to establish a primary care network (PCN) British Medical Association (BMA)

PCNs are groups of general practices working closely together, with other primary and community care staff and health and care organisations, providing integrated services to their local populations. The BMA have created a handbook which provides advice and offers options to groups of practices looking to establish a PCN.

pcn handbook
Image source: http://www.bma.org.uk

It includes detailed guidance on

  • Governance structures
  • Internal governance and decision making
  • Potential PCN structures and employment options
  • PCN funding
  • PCN future workforce options

Full document: The primary care network handbook

Further detail: Primary Care Networks (PCNs) | BMA

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GP practices free up 3,000 extra patient appointments through Primary Care Network

GP practices in Luton have worked together to provide more than 3,000 extra appointments a year including halving the number of appointments lost due to patient non-attendance | via NHS England

As well as freeing up appointments, the Primary Care Network (PCNs) model has led to friends and family satisfaction with services being positive nine times out of ten, while complaints have fallen by 12 per cent and £50,000 has been saved.

To achieve this, the GPs made a number of changes including altering the types of healthcare professionals in the practice, offering alternative appointments where appropriate and introducing long term conditions clinics.

PCNs are one of the new national approaches unveiled in the NHS’ long term plan this week. In Luton’s PCN, groups of GP practices pool their skills and resources to provide patients with access to more health professionals including GPs, pharmacists, paramedics, physicians associates and specialist doctors.

They can treat patients for a wide range of illnesses, ensuring they see the right person from the start and freeing up the GPs to spend more time with patients who have complex needs.

Full story at NHS England

Primary mental health care

Filling the chasm: reimagining primary mental health care | Centre for Mental Health

This report explores local initiatives which bridge the gap between primary care and secondary care mental health services, supporting people have more complex needs, don’t meet secondary care thresholds, or present with multiple or medically unexplained symptoms.

centre
Image source: http://www.centreformentalhealth.org.uk

It finds that primary care services in many areas of England have developed a number of different approaches to addressing mental health needs that other services do not meet. The report describes promising approaches in eight local areas.

The report calls on NHS England to make primary mental health care a central strand of the long-term NHS plan, due to be published later this month. The NHS needs to identify effective models of primary mental health care and invest in local services to help them meet the needs of their communities. The report also calls on Health Education England to invest in the workforce for primary mental health care.

The report identified some key elements for future primary care developments:

  • Identifying the opportunities for prevention and promotion of mental health – including in the perinatal period; with children and young people; and through providing information and resources
  • Maximising social interventions for mental health – moving away from anti-depressants and therapy as the only solutions, improving awareness of community resources
  • Culture change – embracing the holistic approach – valuing social support and linking to physical health initiatives
  • Empowering the person – moving ‘from patient to person’ – enabling people to make their own decisions about what they need to focus on, addressing social factors and causes of mental health problems
  • Bridging the gap between primary and secondary care – co-locating services, employing senior staff to provide consultancy and supervision

Full report: Filling the chasm. Reimagining primary mental health care | Centre for Mental Health

 

Primary care quality assurance – South Nottinghamshire

NHS England | September 2018 |Primary care quality assurance – South Nottinghamshire

A new case study on the Atlas of Shared Learning shows how a  consistent quality assurance approach is being established  by Nurses in a CCG team in Nottinghamshire. This arose as nurses within the Quality Team identified unwarranted variation within primary care practices in the broad areas of quality, safety, clinical effectiveness and patient experience, where there was no uniformed process to review effectiveness and safety across GP practices across the CCG area.

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The implementation of a quality assurance and improvement framework enabled the CCG nurses to target resources and support towards GP practices that needed greater support to achieve effective and safe practice, which is driving improvements and enhancing safety within the practices.

Read the full news story at NHS England 

C the Signs – How artificial intelligence (AI) is supporting referrals

NHS England | August 2018 | C the Signs – How artificial intelligence (AI) is supporting referrals

C the signs is an app that uses artificial intelligence mapped with the latest NICE guidelines and other evidence to provide GPs with the ability to check combinations of signs, symptoms and risk factors of cancer in an easy-to-use format. The app can be accessed on desktop computers or mobile phones, GPs can access the tool during the consultation to identify which referrals and investigations patients need. This has led to improved GP consultations and a smoother referral process as the app is designed to support  GPs to identify patients at risk of cancer earlier.board-1364652_1920.jpg

As a result of a  successful trial of the app in Sutton, the app will now be piloted in other areas, meaning that GPs and practice nurses in 95 practices will be given access to the tool and be able to use in consultations with their patients (Source: NHS England).

 

Of interest:

Royal College of General Physicians Artificial intelligence (AI) in health
In the media:

OnMedica Guidance needed to evaluate AI used to support patient care

The challenge of ageing populations and patient frailty: can primary care adapt?

Reeves, David et al. The challenge of ageing populations and patient frailty: can primary care adapt? BMJ 2018;362:k3349

BMJ analysis notes in overstretched UK primary care system, acid test is likely to be whether GPs find that a focus on frailty helps to reduce, rather than increase, professional burden in dealing with their most complex patients, while also benefiting their older frail patients.

 

New model of Primary Care provision

New report from the Nuffield Trust evaluates an initiative called the Primary Care Home (PCH) model developed by the National Association of Primary Care (NAPC).

The primary care home model was developed by the National Association of Primary Care as a response to workforce challenges, rising demand and opportunities to shape transformation in local health and care systems across England.

pch
Image source: nuffieldtrust.org.uk

This report from the Nufield Trust suggests that the new models of primary care provision are showing early signs of success but will need more resources and support for these models to work well on a permanent basis.

The evaluation found that participating in the primary care home programme had strengthened inter-professional working between GPs and other health professionals while also stimulating new services and ways of working, tailored to the needs of different patient groups.

It was judged to be too early in the scheme’s development for the Nuffield Trust to quantify impacts on patient outcomes, patient experience or use of wider health services.

Full report: Primary Care Home. Evaluating a new model of primary care.

Related: New primary care model needs resources, say experts | OnMedica