1. How are we doing and what does the future look like? Allen Mawby – Director Vee Scott – Business Manager May 2016 81 Practices covering seven localities

2. What we set out to achieve GDoc was formed in 2012 to protect practice services and income All 81 practices in Gloucestershire are shareholders Successfully bid for £4m investment from PMCF for Gloucestershire Funding was for a number of projects:  Choice+ Urgent Care GP appointments  Specialist Nursing service  Video and E Consultation  Rapid Response+ GP advice line  Expansion of Social Prescribing  Development of a Health App 81 Practices covering seven localities

3. What were the challenges? National and local shortage of doctors National and local shortage of specialist nurses IT interoperability – practices on four different systems limiting access to patient records The high cost of indemnity insurance Access to an N3 network at pace CQC Registration Information Governance and data sharing 81 Practices covering seven localities

4. What have we achieved? Thanks to your contribution we have been able to: provide clinics in thirteen locations across seven localities offer 38,644 Choice+ appointments fill 81% of those appointments provide patients with such a good experience that 99% of them are ‘extremely likely’ or ‘likely’ to recommend the service 81 Practices covering seven localities

5. What have we achieved? Apart from Gloucester, which has been established for some time, this has been achieved in only seven months More appointments were offered in April than ever before – on average over 1300 a week 81 Practices covering seven localities LocalityGo live date GloucesterApril 2015 South CotswoldsNovember 2015 Forest of DeanJanuary 2016 TewkesburyMarch 2016 LocalityGo live date CheltenhamSeptember 2015 Stroud & Berkeley Vale December 2015 North CotswoldsJanuary 2016

6. What have we achieved? Patient questionnaires have shown that this has prevented:  5,350 patients attending A&E  14,476 patients attending their GP practice  6,294 patients calling Out-of-Hours  3,462 visiting a Walk-In Centre Recent data shows that A&E attendances in Gloucestershire are reducing and this bucks the national trend 81 Practices covering seven localities

7. What have we achieved? Specialist Nursing Nine nurses employed covering Diabetes and Respiratory & one nurse recently recruited for CHD 74 hours of specialist nursing is now being provided to 30 surgeries across the county Patient and practice feedback in respect of the service has been excellent. 81 Practices covering seven localities

8. What have we achieved? Specialist Nursing 8 study days offered across 2015/16 funded by GDoc. 240 places covering Respiratory, Diabetes, Sexual Health and Family Planning and Travel, dates distributed through’ What’s New’ for Practice Managers and Practice Nurses Good uptake of day courses. Excellent feedback from these via Access to Education, further Spirometry Day being offered Education of PNs x 90 places at Aspen Centre to Degree/Masters level with Education for Health. Courses commencing June/July and again in January/February 2017 81 Practices covering seven localities

9. What have we achieved? Our investments iStat near patient testing equipment has enabled the Rapid Response Team to save 16 admissions since November Funding has enabled the CCG to recruit more care navigators and expand the offering of Social Prescribing across the county 81 Practices covering seven localities

10. What have we achieved? Our investments Purchasing iPads has enabled four practices to pilot video consultation Have allowed 18 practices to introduce E Consultation Funding has enabled the CCG to develop the Health App – ASAP – Allowing users to ‘Search by Service’ or ‘Search by Condition’ – providing a step by step guide through symptoms, self - care and signposts to appropriate NHS services 81 Practices covering seven localities

11. So what next? GDoc has funding through to October 16 and in negotiation to continue this through to March 17 A business case is being developed for the Specialist Nursing service to ensure its sustainability GDoc is working with the localities and its shareholders to support them in forming federations and developing new models of care GDoc is looking to develop partnerships and open up opportunities in developing new services fit for the future 81 Practices covering seven localities

12. Questions and Discussion 81 Practices covering seven localities