‘I feel privileged by the opportunity that I have to make a difference with the care I provide'
In the second of his two articles, Dr Andy Hilton, GP partner in a Sheffield Practice and Chief Executive of Primary Care Sheffield, explores how General Practice is evolving to manage the increasing challenges it faces.
Expectations and Funding
As medicine has advanced so too has people’s expectation. General Practice still accounts for 90 per cent of patient contacts in the UK but with only a fraction of the overall NHS spend with which to do so.
As a result, practices have felt the strain over recent years as overstretched capacity struggles to meet burgeoning demand. Evidence suggests that patient consultation rates have risen by around 16 per cent over the last seven years.
As other parts of the health service have also come under pressure activity has shifted into community and primary care whilst at the same time GP and practice nurse numbers have fallen relative to those of hospital colleagues.
This has placed additional burden on practices and GPs are well aware of the consequences for our patients, from difficulty getting through on busy phone lines to delays in getting routine appointments or an inability to see the GP of their choice.
Ever resourceful, General Practice is seeking to innovate and to develop new models through which to deliver care.
Practices themselves are coming together in clusters covering populations of around 30-50 thousand, sharing best practice, creating joint resources and increasing the range of care on offer through working at scale.
By integrating with wider teams such as community nursing, mental health workers and with local voluntary organisations we can deliver more holistic, patient centred population health care.
Increasing the range of professionals from whom patients can receive care such as clinical pharmacists, physicians associates and first contact physiotherapists will allow GPs to focus on patients with the most complex needs and improve access in general.
We’re also trying hard to develop more online services, from booking appointments and ordering prescriptions to e-consultations and online access to records.
Over the next few years we’re likely to see a steady increase in the use of technology and digital access to care.
Primary Care Sheffield
Over the last four and half years as Chief Executive of Primary Care Sheffield I’ve had the opportunity to see first-hand the benefits to patients of General Practice and wider Primary Care working together at a greater scale.
Through the efficiencies of scale PCS can not only offer a supportive infrastructure, practical help and guidance for General Practice to flourish, we are also able to deliver services independently on a city wide basis, taking advantage of the wealth of knowledge and experience from our GP practice members and coordinating it across the city.
A good example of how we’ve managed to improve patient care as a result is through the increased access to primary care services we provide on evenings and weekends through our six Extended Access Hubs.
This working at scale has allowed us to offer both routine and urgent appointments with not only GPs, but also practice nurses, health care assistants and even physiotherapists making care more accessible for patients but without putting undue additional burden on already stretched practices.
As well as being beneficial for patients we’ve also had an impact on the wider system with reduced A+E demand and a contribution to system resilience over busy periods such as winter and bank holidays.
For health and social care services to be sustainable in the longer term there will need to be a shift of focus towards a more preventative approach. Building both individual and community resilience and supporting people to manage their own wellbeing can be achieved by greater integration of traditional health or care services with community organisations and voluntary groups.
As CEO of Primary Care Sheffield I’m aware of the responsibility I have as a system leader to ensure the finite NHS resources are used wisely and for the greatest benefit. The role proves both exciting and challenging. It’s allowed me to contribute to shaping services locally, regionally and nationally, but there is nothing more grounding than being back in my surgery seeing patients and feeling privileged by the opportunity I have to make a difference through the care I provide.