1. The Breckland Alliance
The Breckland Alliance has seen three GP practices in two small towns within a deprived, relatively isolated community come together to provide mutual support in an area which has struggled to recruit and retain GPs as well as cope with demand. The vision was to collaborate to develop a sustainable primary care service for their population ensuring the most challenged practice remained open and offer improved services closer to patients’ homes where possible.
How things are changing
Shortly after creating a primary care home and a new structure, one of the alliance’s practices hit a crisis. The response was to put a funding proposal to NHS England to stabilise the Watton Medical Practice. The practice had been forced previously to redefine its geographical boundaries and was in danger of closing. The PCH enabled the practices to support each other and plan for the delivery of primary care at scale.
Patients still have a surgery in Watton which would have otherwise closed. Staff are now collaborating and working across all three sites. Partners from the two Thetford practices have been covering clinical and management sessions at the Watton practice to help stabilise it. A clinical board has been established to oversee its working, involving partners from all three practices. A clinical nurse manager works across the three sites and is working towards building one cohesive team across the PCH. To measure the impact, the primary care home is tracking patient satisfaction at Watton, which was previously very low, and the use of locums.
In the future, the alliance will enable the surgeries to invest in staff, improve back office services such as finance and IT and develop new services for patients. These are likely to include bringing hospital-based clinics into the community, so reducing travelling time for members of the public, as well as developing health and wellbeing services to stop people becoming unwell in the first place. A focus is likely to be on the large number of elderly care homes in the area. It is hoped that more proactive care and routine medication reviews for residents will be delivered in the homes to improve health and wellbeing and optimise prescribing.
Lessons learnt have included the need to break down a culture of each practice working in isolation and make them more open to collaboration.
Three GP practices, South Norfolk Clinical Commissioning Group, Norfolk and Suffolk NHS Foundation Trust, Norfolk and Norwich University Hospital NHS Foundation Trust, West Suffolk Hospitals NHS Foundation Trust, West Suffolk Clinical Commissioning Group, Norfolk Community Health and Care Trust, other local community providers and social services.