Enhanced Access

Enhanced Access represents a combination of two former services, Extended Working Hours and Extended Access.  It was transferred from an NHS England commissioned service to become a PCN responsibility under the PCN DES with effect from 1^st October 2022.  Bury GP Federation ensures delivery of Enhanced Access across 3 of the 4 Bury PCNs, namely Horizon PCN, Prestwich PCN and Whitefield PCN, sub-contracting the whole service through Tower Family Healthcare.  The service operates from three sites across the borough – Prestwich Health Centre, Moorgate Medical Centre and Radcliffe Medical Centre and is open Monday to Friday from 4pm to 8pm, Saturdays from 8am to 6pm and Sundays from 9am to 5pm. The service is currently under review to consider what services are provided, where they are provided from and how much is provided where.  The delivery requirement is one hour per 1,000 patients, although over a year the service provides slightly more than the contracted hours of 159 per week. All practices in the 3 PCNs can book in directly.

Respiratory Hubs

Across Winter 2022/23 non recurrent funds were provided across Greater Manchester to reduce demand in the health system.  Prompted primarily by the lingering after effects of COVID and a recent outbreak of STREP, all localities were encouraged to develop respiratory hubs.  From early December 2022, with 2 days’ notice and with the cooperation of local GP practices, Bury GP Federation developed a GP-led respiratory hub based at Uplands MC.  This service is available to all Bury practices.  Over time a further hub was developed at Woodbank Surgery to enable easier access for patients in the North of Bury. Feedback has been very positive and there are plans to re-commence this service with further additional monies across winter 2023/24.

Clinical Pharmacy Team

Funded via ARRS, Bury GP Federation employs a team of Clinical Pharmacists and Pharmacy Technicians to work closely with the Practices in the Primary Care Networks. This includes conducting structured medication reviews for priority groups, ensuring that patients are getting the most from their medicines and avoiding over medication. These include those living in a care home, living with severe frailty, prescribed multiple medications, and living with multiple long-term conditions, and those who may be at risk of harm from a prescribed medication. Our team will work with patients and their carers to help them manage their medication safely.

In addition, we will work with practices to support quality improvement, to ensure safe and effective prescribing and medicine optimisation, and support the national programs around antibiotic awareness and the greener inhaler initiative.

This service is provided to Horizon, Prestwich, and Whitefield PCNs.

Acute Visiting Service (AVS)

Funded via ARRS monies, Bury GP Federation employs a multi-disciplinary team of Paramedics and Care Coordinators, providing home visits to patients who require assessments of acute conditions. The AVS is able to provide on-the-day visits to those patients who are unable to attend their GP practice and use their extensive experience within the ambulance service as well as the skills and knowledge they have gained working within Primary Care to effectively assess if patients need to attend the local Accident and Emergency department, or if they can be effectively managed and treated at home or within the community. The AVS have been invaluable in enabling patients to remain at home rather than spending extensive periods of time in hospital, thus reducing the pressures on A&E departments. This service is provided to Horizon, Prestwich, and Whitefield PCNs.

E-derma

Commissioned by Open Medical in conjunction with Northern Care Alliance in Salford, the GP Federation is delivering a pilot Dermatology project, producing high quality dermatology images, and transferring these electronically for consultant review.  This service works in connections to the two week wait referrals from GPs across Bury, ensuring the pathway is as efficient and smooth as possible. Offering a local, safe patient service we have received positive feedback from our patients, Primary and secondary care colleagues.  This service is available to all Bury practices.

Quality Assured Spirometry

Quality Assured Spirometry has been introduced to primary care; this now requires hub delivery working to ensure a higher standard of spirometry measurement. Bury GP Federation is managing this process. Working under the GM guidance we work with Nurses that are ARPT registered or working towards this accreditation. As part of the national program to get spirometry back to pre-covid waiting times we offer clinics at evenings and weekends. We are continually developing and reviewing the service to offer convenient, local, safe patient care. Currently patients with a new diagnosis from April 21 are referred to the service via the Federation referral form, this is emailed, and the Federation admin team contact patients to book appropriate appointments.  This service is available to all Bury practices.

Supporting PCN Board membership

Bury GP Federation works alongside Horizon, Prestwich, and Whitefield PCNs to support delivery of the PCN DES and performance/achievement against the Impact and Investment Fund indicators.  Support includes provision of management and administration support, finance and banking, recruitment and HR, governance, and reporting.  The PCN Development Managers work closely with the PCNs and their member practices daily to promote greater collaboration between the Network’s practices, identifying opportunities to work together in support of local priorities and implement greater diversity and innovation in the care and support available to the registered patient population. They also monitor achievement against the DES/IIF indicators, working with PCN teams such as our Clinical Pharmacy team to ensure targets are met and opportunities to maximise achievement are realised.

Arden’s Investment

In collaboration with all four local PCNs, Bury GP Federation funded 50% of a suite of clinical and management tools called Arden’s. The contract is for three years commencing Feb 2023 and is available to all Bury practices. Arden’s has two main functions; firstly, at a GP practice level, the suite provides a comprehensive set of clinical assessment templates and patient searches enabling practice staff to capture both clinical and non-clinical information in a more consistent manner to better inform patient care; and from a PCN and Federation perspective, the Arden’s Manager platform enables senior clinicians and management to assess and monitor practice and PCN performance against local and national contractual obligations, such as the PCN Impact and Investment Fund, and the Locally Commissioned Services contract.

Covid vaccinations

Working alongside PCN leads and the local community, Bury GP Federation led the development and rollout of the COVID vaccination programme in Bury. Commencing in November 2020, the GP Federation managed the whole process, delivering from four sites spread across the borough. This was hugely successful programme with the second highest vaccination rate across the 10 Greater Manchester localities and more than 205,000 vaccinations delivered by March 2023.  Given the reduction in demand and the developed ability to co administer COVID vaccinations with flu, it made sense to hand the service to the PCNs to deliver from April 2023.