BPC Project Update

1. Bracknell and Ascot Patient AssemblyLocal Primary Care DevelopmentsHelen Snowden17th January 2019

2. BPC Project Update • Extended Hours GP Service • Homeless project • Bracknell and Ascot Transformation Plan • Bracknell and Ascot Network Plan • New way for funding to be released / services to be commissioned

3. Extended Hours GP Service update • Christmas uptake • Phlebotomy • Cervical smears • Near Patient Testing • Anything else?

4. Homeless project update • Night shelters re-opened on 1st December. Evening clinics commenced every other Thursday evening. • Kerith session continues on Tuesday lunchtimes • Discussions underway regarding use of HealthWatch’s bus to provide additional outreach

5. Bracknell & Ascot Transformation Plan • General Practice Clinical Pharmacists • Paramedic Home visiting service • General Practice Physiotherapists

6. General Practice Clinical Pharmacists • Full team now in place • 1 Senior Pharmacist • 5 Pharmacists • Protocols developed: • Hypertension • Lipids • Asthma • Medication reviews • COPD • Diabetes • Contraceptive Pill checks

7. General Practice Clinical Pharmacists • Working closely with practices: • Processing patient discharge summaries • Medication reviews • Anticipatory care planning • Polypharmacy patients

8. Paramedic Home visiting service Shared Team across 11 Bracknell & Ascot Practices • Specialist Paramedics • Early visits – reduced admissions • Long Term Conditions trained • Direct links to Practice Team • Joined up IT • Share staff with South Central Ambulance Service

9. Paramedic Home visiting service • Funding for 3 Paramedics • 28th January start date • Pathway in development – want your input • Practices given allocation of visits based on list size • Visit requests triaged by Duty Doctor • Referrals given priority ranking • Hub allocate • Soft launch • 3 clusters / neighbourhoods eventually when full team

10. Version 1 presented at December GP Council

11. Version 2 presented at today’s GP Council

12. Main changes • On the day demand based on priority • Triage by practice Duty Dr or Clinician • Duty Dr to book the Appointment • Added in need for communication / feedback between referring clinician and Paramedic Slow start with 1 WTE starting in January

13. Essential Information • Reason for Referral – what is it you want the paramedic to do • Priority rating (no emergencies) • Up to date Key safe numbers / carer contact details EMIS template or Document?

14. How should the appointment book work?

15. Proposal: • No timed appointments – 8 slots a day • No definite No’s – down to triaging clinician • Slow start with on the day demand initially – open to all practices but each practice will have and know their own weekly quota so once they’ve used it they shouldn’t refer anymore into the service that week. • Allocation will be based on priority and this will be coordinated by the hub.

16. Practice Allocations per week1 Paramedic = 25% of your practices visits in November.

17. General Practice Physiotherapists Pilot project for Binfield, Evergreen & Gainsborough Practices – not led by BPC but • Physiotherapists in place • Any feedback from patients?

18. Primary Care NetworkBracknell & Ascot Agreed Priority Areas • Workforce • Shared Back Office / Resources • Immunisation and screening uptake • Paediatric clinics or additional support • Improved Access to Primary Care for hard to reach patient groups • Learning Disability Health checks

19. Workforce – An ICS priority New primary Care workforce to be provided at scale to improve resilience and capacity Clinical Pharmacists Paramedics First contact Physiotherapists Mental Health workers Bid to move transformation projects from pilot to business as usual

20. Shared Back Office / Resources– Bracknell & Ascot Priority Many practices are currently having issues recruiting and there is potentially duplication within practices with staff doing the same duties in each practice. There is now the IT and the logistics available and therefore an opportunity to look at current duties of Administration staff and possibly share roles across practices or across the patch.

21. Reduce variation and improve outcomes for Learning Disability patients – Bracknell & Ascot Priority Learning disability health checks Only 63% completed in Bracknell & Ascot - Less across East Berkshire CCG Standardised recall / information / invitations Value added consultation Training for Clinical staff Buddying up / ability to outsource

22. Reduce variation and improve the Immunisation and screening uptake – An ICS Priority Improve the uptake of immunisations, vaccinations and screening using Public Health data

23. Improved Access to Primary Care for hard to reach patient groups- A Bracknell & Ascot Priority Continuation and expansion of homeless / vulnerable patient outreach clinics Development of outreach clinics for traveller community Development of outreach clinics for sex workers

24. Happy to take any questions

25. We are working hard to make improvements • We are working differently to create opportunities • We are working together to do things better • We want to work with you to help make it happen