South Tyneside Primary Care Strategy – progress highlights and our plans for e-consult rollout South Tyneside Local Engagement Board Thursday 8th March 2018 Jo Farey, Head of Commissioning (Primary Care) John Bulmer, North of England Commissioning Support Unit

General Practice Strategy – 5 Work Streams In Place Stakeholders working together to deliver primary care at scale Reducing variation Changing the focus of primary care Improving Access to Primary Care Workforce planning General Practice Strategy initially developed summer 2016 5 workstreams remain in place to focus work Time to refresh and refocus Changing world ……. Investment and Initiatives via GP Forward View Increased scrutiny and reporting Aspiration nationally to reduce services delivered in secondary care & increase the community offer Path to excellence

Progress – key highlights  Continued rise in the number of patients using Think Pharmacy First and excellent working relationships with our local community pharmacies  Attracting a skilled workforce to South Tyneside Student Nurse and Physicians Associate placements  Patient navigation/signposting Most administration and clerical staff trained in Active signposting Level 1 and level 2 Some of our practices now have a welcome telephone message from the GP telling them the receptionist will ask them for a brief nature of their need for an appointment

Progress  Extended access in place and live from September 2017 312 extra appts per week Mix of appointment types GP’s, Nurses and Healthcare professionals So far 8000 additional appointments have been offered across South Tyneside (Sept 17 to Feb 18 position)  

Progress  Prescribing spend is forecast to be below budget for the first time in several years  Electronic Prescription Items are the highest in the North East at 75%  COPD admission rate has fallen - at the current rate, end of year predictions could see 19 fewer patients admitted across the year

Cancer diagnosis at stage 1 and 2

Challenges We still have over reliance on urgent care via the A&E route Primary Care Access can be variable and we have ‘hotspots’ of areas with known access problems Increasing patient expectations Workforce remains a pressure – we need to concentrate on skill gaps Telemedicine implementation is slow and can be complex but could help us with many of our challenges and help patients to better access services

Enhanced Access E-Consultations Presented by John Bulmer

Primary Care Consultations The use of technology to support GP appointments is growing in popularity: Video Consultations e-Consultations 2 way SMS messaging

Aims Focus will be on E-consultations What is an E-consultation? How does it work? Highlight potential benefits

What is an E-Consultation? It is a patient communicating with their GP online Condition-based questionnaires Via a mobile app or online portal Replies are not instant but are expected by a certain time frame

How it works? Patients make practice website first point of contact Range of options open to the patient Find out about symptoms, conditions, treatments Request call back from 111 clinician Send details of problem/query to GP GP will receive information as a task Deal with online, make face-to-face appointment, call patient for further details or prescribe

How it works? Cont…

How it works? Cont…

How it works? Cont…

How it works? Cont…

How it works? Cont…

Potential Benefits Reduce unnecessary appointments Patients receive the right care Better health outcomes Improved efficiency Free up GP Time Reduce A&E admissions

What are your initial views about e-consult What are your initial views about e-consult? Do you think patients will like it? What are the barriers?