2. Larwood and Bawtry
Larwood and Bawtry Primary Care Home covers several villages in Nottinghamshire and South Yorkshire, some of which have high levels of deprivation and disease. Two practices wanted to build a new primary care team to care for their local populations and work in partnership with other organisations to ensure services improved and remained sustainable. The primary care home is improving the way the practices work together and bringing in new partners to improve services to patients. It has three aims: to improve staff support and wellbeing so they can cope and stay well doing an increasingly difficult job, improve patient outcomes particularly by identifying issues before they become acute and find increasingly efficient ways of working.
How things are changing
The two GP surgeries have created integrated teams co-locating community and voluntary services in the practices. Community matrons and community nurses work with practice nurses in integrated neighbourhood teams. The practices provide administrative support to the community service staff, resulting in better exchange of information between GPs, practice nurses and the community teams.
Community advisors funded by the voluntary sector now work from the surgeries, running citizens advice clinics signposting patients to voluntary and non-medical services in the area. They provide a vital link to services that can address some of the underlying causes of anxiety and depression including debt and unemployment. Close working with the district council has led to improved support in care homes and for people with housing needs. Social care clinics are held on site enabling patients to receive quicker needs assessments.
There’s been a 5 per cent reduction in prescribing costs following the appointment of an in-house practice pharmacist who carried out medicine reviews for care home residents. Analysis over a seven-month period found a significant reduction in prescribing costs and projected £229,000 annual savings, as well as reducing the risk of side-effects for patients. Emergency admissions dropped by 8 per cent over the same period with the clinical commissioning group estimating savings of £277,000.
Staff are working together better and find work more fulfilling (87 per cent of staff surveyed felt the PCH way of
working had improved job satisfaction). Patient care has improved with better information among staff and care plans integrated across services.
Lessons learnt have included the need to engage staff and have a ‘do and build’ attitude.
Two GP practices, Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust, Nottinghamshire Healthcare NHS Foundation Trust (community and mental health services provider), Nottinghamshire County Council (social services), Bassetlaw District Council, Bassetlaw Community and Voluntary Service and Bassetlaw Clinical Commissioning Group (CCG).