Bracknell and Ascot Patient Assembly Local Primary Care Developments Helen Snowden 17th January 2019

BPC Project Update Extended Hours GP Service Homeless project Bracknell and Ascot Transformation Plan Bracknell and Ascot Network Plan New way for funding to be released / services to be commissioned

Extended Hours GP Service update Christmas uptake Phlebotomy Cervical smears Near Patient Testing Anything else?

Homeless project update Night shelters re-opened on 1st December. Evening clinics commenced every other Thursday evening. Kerith session continues on Tuesday lunchtimes Discussions underway regarding use of HealthWatch’s bus to provide additional outreach

Bracknell & Ascot Transformation Plan General Practice Clinical Pharmacists Paramedic Home visiting service General Practice Physiotherapists

General Practice Clinical Pharmacists Full team now in place 1 Senior Pharmacist 5 Pharmacists Protocols developed: Hypertension Lipids Asthma Medication reviews COPD Diabetes Contraceptive Pill checks

General Practice Clinical Pharmacists Working closely with practices: Processing patient discharge summaries Medication reviews Anticipatory care planning Polypharmacy patients

Paramedic Home visiting service Shared Team across 11 Bracknell & Ascot Practices Specialist Paramedics Early visits – reduced admissions Long Term Conditions trained Direct links to Practice Team Joined up IT Share staff with South Central Ambulance Service

Paramedic Home visiting service Funding for 3 Paramedics 28th January start date Pathway in development – want your input Practices given allocation of visits based on list size Visit requests triaged by Duty Doctor Referrals given priority ranking Hub allocate Soft launch 3 clusters / neighbourhoods eventually when full team

Version 1 presented at December GP Council

Version 2 presented at today’s GP Council

Main changes On the day demand based on priority Triage by practice Duty Dr or Clinician Duty Dr to book the Appointment Added in need for communication / feedback between referring clinician and Paramedic Slow start with 1 WTE starting in January

Essential Information Reason for Referral – what is it you want the paramedic to do Priority rating (no emergencies) Up to date Key safe numbers / carer contact details EMIS template or Document?

How should the appointment book work?

Proposal: No timed appointments – 8 slots a day No definite No’s – down to triaging clinician Slow start with on the day demand initially – open to all practices but each practice will have and know their own weekly quota so once they’ve used it they shouldn’t refer anymore into the service that week. Allocation will be based on priority and this will be coordinated by the hub.

Proportion of visits per month Proportion of visits per week Practice Allocations per week 1 Paramedic = 25% of your practices visits in November. Practice Proportion of visits per month Proportion of visits per week Crownwood 7 1 FHG (incl. BH) 28 6 Easthampstead Great Hollands Green Meadows 14 3 Heath Hill 9 2 Kings Corner 10 Magnolia House 13 Ringmead 22 4 Sandhurst 27 5 Waterfield 17

General Practice Physiotherapists Pilot project for Binfield, Evergreen & Gainsborough Practices – not led by BPC but Physiotherapists in place Any feedback from patients?

Primary Care Network Bracknell & Ascot Agreed Priority Areas Workforce Shared Back Office / Resources Immunisation and screening uptake Paediatric clinics or additional support Improved Access to Primary Care for hard to reach patient groups Learning Disability Health checks

Workforce – An ICS priority New primary Care workforce to be provided at scale to improve resilience and capacity Clinical Pharmacists Paramedics First contact Physiotherapists Mental Health workers Bid to move transformation projects from pilot to business as usual

Shared Back Office / Resources – Bracknell & Ascot Priority Many practices are currently having issues recruiting and there is potentially duplication within practices with staff doing the same duties in each practice. There is now the IT and the logistics available and therefore an opportunity to look at current duties of Administration staff and possibly share roles across practices or across the patch.

Reduce variation and improve outcomes for Learning Disability patients – Bracknell & Ascot Priority Learning disability health checks Only 63% completed in Bracknell & Ascot - Less across East Berkshire CCG Standardised recall / information / invitations Value added consultation Training for Clinical staff Buddying up / ability to outsource

Reduce variation and improve the Immunisation and screening uptake – An ICS Priority Improve the uptake of immunisations, vaccinations and screening using Public Health data

Improved Access to Primary Care for hard to reach patient groups - A Bracknell & Ascot Priority Continuation and expansion of homeless / vulnerable patient outreach clinics Development of outreach clinics for traveller community Development of outreach clinics for sex workers

Happy to take any questions

We are working hard to make improvements We are working differently to create opportunities We are working together to do things better We want to work with you to help make it happen