12. Beacon Medical Group
The Beacon Medical Group in Plymouth – a very large practice across five sites – was frustrated with the fragmentation and dilution of local services and increasingly distant relationships with other health and care agents. It was also caring for patients with complex care needs in the face of a rising workload. There was high demand for appointments which didn’t need GP expertise, staff were overworked and suboptimal working with other partners.
Taking on the mantle of a rapid test site enabled it to innovate in many ways, improve services to patients, address unmet needs and transform relationships with other providers. Its vision has been to create an integrated health and wellbeing service which meets its population’s needs and inspired its staff.
How things are changing
Beacon Medical Group has cut the average waiting times for GP appointments by six days by expanding its urgent care teams across its sites. The teams comprising one or two GPs, a paramedic, nurse practitioners and pharmacists screen all patients seeking on-the-day appointments on the phone and invite those who need to be seen in. Over six months, the average waiting time for a GP appointment fell from 14 to eight days.
There is an enhanced service for the six largest care homes in their area. Each week a pharmacist and a GP carry out a ‘ward round’ at each care home visiting patients who are most at risk of hospital admission. They provide support to care home staff to help them support the patient better. The pharmacist conducts medication reviews to reduce the complexity and cost of medication where appropriate. The PCH has also refocussed its virtual ward, a monthly multidisciplinary team meeting involving the voluntary sector, physiotherapists, mental health staff and the community health team, who discuss patients they’re concerned about, mainly the frail over-50s, create treatment plans and monitor progress.
Research into its most high-intensity patients, who had the most contact with GPs found that often they had mental health needs which were not being treated and they were going to A&E, sometimes with unexplained physical symptoms. A liaison psychiatrist from Devon Partnership Trust is now based in surgeries two days a week to see patients and offer advice to GPs.
More services have been started for vulnerable groups. For young people a ‘takeover day’ was held encouraging them to redesign services and counselling introduced in the evenings. There are many armed forces veterans in the area who are vulnerable to mental health issues, diabetes, tinnitus and musculoskeletal problems. By running a campaign, the PCH now knows of some 90 veterans locally and can offer them greater support.
Beacon are working with community pharmacists on marketing campaigns around flu jabs, using media and social media and messaging on prescriptions to target those most in need. Lessons learnt include a willingness to take risks and take on new initiatives without waiting for full funding to drive visible change.
Beacon Medical Practice, Plymouth Hospitals NHS Trust, Devon Partnership NHS Trust (mental health), LiveWell SouthWest (community services), South Hams Community and Voluntary Services, Plymouth Octopus Project (support network for voluntary sector), Local Pharmaceutical Committee, New Devon CCG, Plymouth City Council.