Best Practice issue 9 | Page 13

INNOVATIVE THINKING ON INTEGRATION IS TRANSFORMING GP CARE IN BRIGHTON AND HOVE Moving every personal interaction from “what’s the matter?” to “what matters to you?” is the philosophy at the heart of The Brighton and Hove Integrated Care Service’s (BICS) vision for transforming healthcare. This innovative not-for-profit social enterprise and primary care federation of 44 practices has been leading the way in implementing new ways of working for a number of years. BICS is contracted by NHS Brighton and Hove to manage all GP referrals and these referral management services have been key to achieving integration of services. A team of over 20 local clinicians reviews 58,000 referrals a year from all practices in Brighton and Hove. Dr Paul Deffley, GP partner at Sackville Medical Centre in Hove and BICS clinical lead for primary care, says this ensures the right patients are seen in the right clinic at the right time and this in turn improves the efficiency of the local healthcare economy. From that objective BICS then developed a range of quality community services which are providing more convenient and accessible services closer to patients’ home. These community services include an award winning six day anticoagulation management service providing services to 2,500 people in community pharmacies instead of the hospital setting, integrated musculo skeletal services, a memory assessment service, a wellbeing service, community gynaecology, dermatology and ophthalmology services. More recent developments have focused on supporting the clustering process in Brighton and Hove and www.bestpracticeshow.co.uk working towards a federated model. A collaboration of 16 practices called Extended Primary Integrated Care (EPIC) has been working to improve access to care and support services, improve choice and help put patients in control of their treatment through five workstream after winning £1.8 million from the Prime Ministers’ Challenge Fund. THE WORK STREAMS ARE: Dr Paul Deffy, GP Partner, Sackville Medical Centre, Hove, will be speaking at Best Practice BICS is also working on implementing the multispecialty community provider (MCP) vision even though it missed out in becoming an NHS England vanguard project. They have set up an MCP board and over the last few months and have looking at how they can support people who are at risk of losing their independence by proactively working with other colleagues in the wider health and social care system. Dr Deffley says: “The initial organisation we set up was mainly involved with community contracts and developing those relationships but as we have grown our ambition has changed to being more about transformation of healthcare systems both for individual contracts and things like proactive care and MCP working. Our relationships with local healthcare providers and other organisations are helping us to change pathways and deliver outstanding care.” • Extended hours: Four clusters of four practices have been formed to offer routine appointments from 6.30am to 9pm Monday to Friday and 8am to 2pm on Saturday and Sunday. • GP triage: Telephone triage by GPs at the beginning of the day is ensuring patients are directed to the most suitable professional for treatment. • Pharmacy: Community pharmacy has been given access to medical records so that they can treat minor illnesses and common complaints to reduce the GP workload. “This was a very significant piece of work. We were the only Challenge Fund collaboration successful in delivering this quite radical shift of making patient records accessible to pharmacists,” says Dr Deffley. • Community navigation: Care navigators, who can socially prescribe, have been introduced into practices to help patients who would benefit from onward referral to community activities and personal support. • Redirection of workflow: Skilled admin workers are dealing with up to 80% of letters that come into practices, saving each GP 45 minutes a day. Join the conversation @BestPracticeUK 13