On Friday (3rd March 2023) Amanda Pritchard, Chief Executive of the NHS, visited Surrey Heartlands Health and Care Partnership to see how, as a system, we are enhancing access to primary care and joining up services for patients as we take forward the recommendations of the national Fuller stocktake, led by Surrey Heartlands Chief Executive, Professor Claire Fuller.
As part of the visit to Greystone House Surgery in Redhill, Amanda joined a clinical team meeting (where the team meet daily to discuss clinical cases and share the wealth of experience and knowledge that exists as part of the clinical team) and heard from members of the practice team, talking about the initiatives they had put in place to improve patient experiences and reduce call answering times and how their expanded practice team - now with other roles including first contact physiotherapists, social prescriber link workers and clinical pharmacists - is helping to enhance the support available to local people.
The visit was an opportunity to talk about how new roles in place across GP practices in Surrey Heartlands (such as physiotherapists, pharmacists and paramedics, where over 300 new roles have been created) and how these new roles are enhancing the primary care offer. It was also a chance to showcase integrated care in action through an innovative new same-day access integrated call handling hub, supported by a new cloud-based telephony system, which is now available in 94% of practices across Surrey Heartlands, following recent investment.
The integrated care access hub service, which receives hundreds of contacts each day (by phone or via the practice website), is delivered by a multi-disciplinary team – including GPs, nurses, pharmacists and care navigators – works by quickly identifying whether requests are routine in nature or if someone needs access to urgent, same day advice or treatment. If urgent advice is needed, their needs are quickly assessed and they are passed seamlessly into the care of the wider team and the support they need – whether that’s a conversation with a nurse or doctor, pharmacy advice, a follow up appointment, a referral into a respiratory or anticipatory care hub or a referral to urgent care at a walk-in centre or A&E if needed.
The hub also embraces digital technology, using imaging software to help diagnose conditions virtually, using photos uploaded by patients themselves to identify skin conditions, throat infections and other common illnesses that can then be easily treated, with medication sent straight to a pharmacy of choice – all without the patient needing to visit the practice.
The approach is new and involves integrated ‘teams of teams’ coming together from local Primary Care Networks to work collaboratively to improve the health and wellbeing of the local population. The aim is to wrap integrated neighbourhood teams around practices so they can provide continuity of care to patients. The service includes both a reactive service for people who need urgent or same-day help and advice and a proactive element that focuses on prevention and helping to identify people who may be at risk of health conditions so that support can be provided much earlier. The anticipatory care hubs focus on patients with complex needs who would benefit from a multi-disciplinary team and holistic approach that provides continuity of care across both health and social care.
The Surrey Heartlands ambition is for our Place-based partnerships (or Alliances) to transform the way family doctors and other health and care professionals offer care locally as Primary Care Networks transition into locally-designed Integrated Neighbourhood Teams to support people, communities and patients at a very local level – and the integrated care access hub is just one example of how services are being transformed across Surrey Heartlands.
In addition to meeting staff, Amanda met with members of the local health and care system – including Professor Claire Fuller, Dr Pramit Patel, Lead Primary Care Network Clinical Director for Surrey Heartlands Health and Care Partnership and GP Partner at Greystone House Surgery, Nikki Mallinder, Director of Primary Care for Surrey Heartlands, Jack Wagstaff, Place Leader for the North West Surrey Alliance and Katherine Saunders, Chief Executive of the Alliance for Better Care Federation.
NHS England chief executive, Amanda Pritchard, said:
It was great to spend time with the wonderful team at Greystone House Surgery to see and hear about the innovative work going on there and across Surrey Heartlands to make sure local people can get the right care when they need it.
The team here are showing the benefits that can come through embracing the power of technology, making best use of the skills of a wide group of clinicians and other professionals, and forging strong links with communities and other services – and it is exactly these benefits which the NHS is working to ensure people across the country can enjoy.
Commenting on the visit, Professor Claire Fuller added:
There is some incredible work happening across Surrey Heartlands to improve the patient journey from start to end and this was a great opportunity to showcase the improvements our clinical teams are making on the ground by working differently through multi-disciplinary and neighbourhood teams. These teams bring together a range of expertise - they know local communities and local people and we’re already seeing the benefits in how they are working together to improve health and wellbeing.
These new integrated teams are just one example of how we are starting to work in new and innovative ways and, with pharmacists, physios and other staff now working in primary care, and investment in new advanced telephony systems, we are really starting to see transformation happening that will improve access and ensure people get the care they need. These areas are all fundamental to improving care for patients – and over the coming months we will continue to drive forward improvements like these across Surrey Heartlands as we deliver the recommendations of the stocktake locally.
Background to the Fuller Stocktake
In November 2021, NHS Surrey Heartlands Chief Executive, Professor Claire Fuller, was asked by NHS England Chief Executive, Amanda Pritchard, to lead a review into integrated primary care – looking at what’s working well, why it’s working well and how the NHS can accelerate the implementation of integrated primary care (including general practice, community pharmacy, dentistry and optometry) across systems.
The result of the review was The Fuller Stocktake.