Developing, strengthening and investing in local primary care services

Despite Coronavirus being the greatest challenge the health service has ever faced, local Primary Care Networks (PCNs) in Doncaster have made great strides since they launched 12 months ago to help shape local health and care services.

Five PCNs exist in Doncaster, each led by a Clinical Director, supported and influenced by local health and care professionals, community and voluntary groups, as well as patients and members of the public.

In May this year, NHS England and NHS Improvement asked local practices to work with care homes in more complex ways than ever before, supporting care homes that were facing some of the biggest challenges to date due to the Coronavirus pandemic.

Within a matter of weeks and with genuine collaboration with health and social care colleagues and Primary Care Networks, a service was developed to provide this increased support.

This example alone highlights how Primary Care Networks have matured over the 12 months and as a result, are now in a stronger position to help drive forward initiatives such as this.

Not only has this model supported our care homes as part of the Coronavirus response, it has also helped to prepare PCNs for the imminent delivery of the national Enhanced Health in Care Homes programme.

PCNs in Doncaster have successfully developed a multi-disciplinary team model where individuals and organisations involved are equal partners, including staff working in our care homes.  It has strengthened stakeholder relationships across the PCNs, improved communication and supports the delivery of improved outcomes for residents and patients, as well as staff caring for them. 

In addition, a key area of development this year has been work to embed a number of new roles across each of the PCNs, such as Clinical Pharmacists; more than 15 are currently being recruited, which will be split across Doncaster’s networks.

Dr Nick Tupper, local GP and Clinical Director and Vicki Walmsley, Clinical Pharmacist, The Kingthorne Group Practice and 4Doncaster Primary Care Network said: “It is great to see that the skills, knowledge and expertise of Clinical Pharmacists continue to be recognised as a key feature of primary care networks.

“We were fortunate that in the 4Doncaster primary care network, we already had two full time and one part time Clinical Pharmacists before PCNs were rolled out across the borough.

“Clinical Pharmacists provide huge benefits for the networks in Doncaster, enabling GPs, nurses and other primary care staff to have direct access to a health professional they can call for specialist advice.”

Primary Care Networks across the borough are also investing in a variety of other roles to strengthen and enhance local NHS services.

More than 10 Physician Associates are currently being recruited; they will support practices across each of the networks. Physician Associates are generalists; medically trained across a wide range of conditions. This means they are able to diagnose and treat children, as well as adults, with a range of clinical issues.

Dr Kate Mansfield, local GP and Clinical Director for Doncaster Central Primary Care Network said:

“Physician Associates have an increasing role to play in primary care as part of a multi-skilled workforce, alongside pharmacists and advanced nurse practitioners.

“They can provide continuity of care for patients with long-term conditions, which we know patients value as they don’t have to keep repeating their medical history and where it’s important for them to see the same person long-term; often that can be quite difficult for GPs in terms of their time.

Doncaster’s networks have also used funding to improve back office functions in primary care, making administration functions more efficient and streamlined across local practices. 

Professor (Hon) Vijay Kumar and Dr Stephanie Teanby-Clark, local GPs and Clinical Directors for Doncaster North Primary Care Network said: “We’ve made great progress in the Doncaster North PCN to start streamlining administrative functions across local practices.

“Sharing services and functions is a key part of PCN development and the introduction of Microsoft Teams has been a valuable addition to safely and effectively communicate between practices. In addition, all practices in the network have started to use a new system to support clinical decision making and improve workflow to reduce duplication and share vital information securely and at speed.

“This work is vital as it helps free up time to develop additional services that provide added value for patients, improving their experience of accessing local NHS services.

“We have also been training NHS leaders of the future by recruiting alongside social prescribing, volunteers who have experience first-hand of care delivery.

“Our Community Pharmacists offer direct access to clinical issues in practice; the north PCN has worked closely with NHS Doncaster CCG during the Coronavirus pandemic, supporting marginalised communities and elderly patients, which will help our focus on protecting our vulnerable patients in nursing homes across in the north PCN and beyond.”

Working with patients and members of the public continues to be a vital part of PCN development across Doncaster.

On 30 July 2020, the first ever Doncaster East Primary Care Network virtual forum will take place to connect local patients and members of the public even further with the planning and development of Doncaster East PCN, enabling people to provide feedback on how local services.

Dr Rumit Shah, local GP and Clinical Director for Doncaster East Primary Care Network said: “I’m delighted that we are hosting our first virtual public forum for the East PCN; it will be a helpful way for people across the network to share their experiences, knowledge and ideas to help improve the way health services are delivered for patients, their families and others.

“Despite the Coronavirus pandemic having an impact on Patient Participation Groups meeting, some continue to meet virtually at local practice level to discuss individual practice issues and ideas. PPGs will continue to meet in the near future, but this new virtual forum will provide an important opportunity for people to speak and have their views on local NHS services in their community.”

Each of the PCNs are engaging with their patients and members of the public in different, innovative ways that are appropriate for local communities across the borough.

Across the Doncaster South Primary Care Network, a number of support groups have evolved in response to patient and public feedback to help manage a number of medical conditions; these are also available to other PCNs as well.

Local practices in Doncaster South have established a series of groups, such as fibromyalgia and chronic pain management and a diabetes support group, contributed by all practices across the network.

Dr Khaimraj Singh, local GP and Clinical Director for Doncaster South Primary Care Network said: “The development of PCNs over the last 12 months has been an exciting time for local practices, health and care staff, patients and members of the public.

“PCNs have enabled important conversations to take place about sharing services and coming together in a joined up way to enhance care and experiences for patients and members of the public.

“The roll out of peer support groups across Doncaster South PCN is an example of how neighbouring practices and their patients have formed a series of vital groups that enable patients with the same issues to meet, share experiences and ways of dealing with medical conditions such as fibromyalgia and diabetes.

“Despite not being able to meet in person at the moment due to the Coronavirus pandemic, the power of social media and online platforms means contact is still possible.”

Further development of Doncaster’s Primary Care Networks will continue at pace over the next 12 months, supported by Primary Care Doncaster and NHS Doncaster Clinical Commissioning Group.

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