Contact: 0191 4977710
Manager: Helen Lumley
Way back in 1992, a forward thinking GP in Gateshead, who felt that there must be a better way of providing out of hours care (ooh) for her patients, investigated the newly forming GP Co-operative option.
Her enthusiasm recruited other GPs and some financial support from the Health Authority and Gateshead Doctors on Call (GatDoc) was created in late 2003 and began operating in May 1994.
GatDoc membership grew as its viability and quality was recognised by more and more Gateshead GPs and soon we were covering 60% of the Gateshead area.
When the GP 24/7 responsibility for patients ceased in 2004 GatDoc successfully bid to the PCT to undertake 100% of GP ooh cover and we have retained that contract to date.
GatDoc changed it’s name to Gateshead CBC Ltd in 2012 to reflect it expanding into Pharmacy and Locum provision, but the GatDoc name has been retained as an operating division of CBC providing ooh care.
GatDoc’s strength has always been generated by it’s concentration on providing it’s service using local GPs, working together as a team and collaborating with the other ooh healthcare within Gateshead for the benefit of Gateshead residents. We are committed to continuing with this focus in the future.
Pharmicus was initially set up in response to local Medicines Management services going out to tender. A company of scale was required that would use a skill mix model of pharmacists, pharmacy technicians and other appropriately trained staff. CBC approached existing local practice pharmacists and Pharmicus was the result.
Pharmicus currently delivers Medicines Optimisation services to 3 local Clinical Commissioning Groups. We have been delivering services in Gateshead, as Pharmicus, since 2009 and have been working in South Tyneside and Sunderland since being awarded those contracts in 2013.
The team is made up of registered pharmacists and pharmacy technicians supported by CBC administrative staff. The variety of backgrounds as well as collective experience and knowledge throughout the team allow us to successfully implement and deliver the NHS Medicines Optimisation agenda.
Medicus
The Medicus division of CBC provides a range of long term locum cover e.g. maternity cover and ad hoc locum cover for practices in Gateshead and more recently South Tyneside. We also provide GP support to the urgent care hub at the Queen Elizabeth hospital from 8am til 6pm five days per week.
We currently have three salaried GP’s employed within Medicus and wherever possible we use these GP’s to provide locum cover. If, however, our salaried GP’s are unavailable then we have a regular cohort of locum doctors that we call upon. We also ensure that all necessary documentation for our salaried GP’s and regular locums are passed on to surgeries.
Primary Care Integration Network Pilot (PCIN)
Financial pressures on practices are increasing as each year passes with changes in QOF resulting in removal of income from practice with no associated reduction in workload. We are aware that practices need to investigate ways to economise without reducing quality of service delivered to patients.
With the Primary Care Integration Network Pilot, Gateshead CBC are exploring the potential for a “cost sharing group” across Gateshead practices. It proposes to look at back office functions that do not necessarily have to be delivered in each individual practice but could be delivered more effectively and efficiently from a central point. All practices would benefit from high level of expertise that may not be available at an individual practice level. This could also cut costs to practices whilst still delivering effective and quality clinical services.
Delivery of this service will require practices to be using EMIS Web. Deb Goodfellow is currently working with Kirsty Duff from EMIS to develop tools on EMIS Web to facilitate the delivery of proposed service in practice.
The first process has been to develop robust recall systems for patient on QOF registers to facilitate the delivery of “one stop shop” where patients will be reviewed in the practice for all current diseases at one appointment.
An intuitive EMIS Web data collection template is being developed to deliver a service which meets all the standards required for the various QOF, enhanced and other services. The way in which services are delivered will be standardised in consultation with participating practices in order to deliver a lean approach to service delivery and avoid duplication of effort. Once the concept is tested and proven, it can be offered to practices as they migrate to EMIS Web.
Delivery of this service will be reviewed regularly, initially focussed on development of service. Once the service is developed any practices wishing to participate can either second staff or make a financial contribution to allow CBC to engage staff to deliver the service on their behalf. This contribution will be based on practice size and the level of work they require the PCIN to deliver of their behalf. The more members the group has, we believe the greater potential savings are and the lower costs will become.
Standardisation of Referral Forms
Dr Jonathan Harness is the Lead GP in the standardisation of referral forms across the Gateshead area. In the past, referral forms were either not compatible with the EMIS system, or, were very slow to upload and complete. Therefore, in Gateshead, referral forms are based on the ‘referral form template’ and then tailored for each service.
Once the form is agreed with the service, they undergo quality control checks before they are added to the GIN website and distributed to practices.
Forms are designed to be flexible so that they can be sent through Choose and Book, faxed, posted or emailed; however, services not using Choose and Book are encouraged to obtain and provide a secure email address in support of the Department of Health initiative to make the NHS paperless.
The process to standardise the referral forms is initially a time consuming process which involves a multi-disciplinary approach and can involve liaison between primary care, secondary care or community based colleagues. However, this is more than compensated in the long term by the reduction in duplication of work, time saved completing referrals and the improvement in data quality increasing patient safety.
South Tyneside
CBC has been working with other areas to support them to deliver a federated approach and ensure that they are in a position to bid for services when they are put out to tender. South Tyneside practices have now voted to set up their own provider company which will work alongside CBC as a division within the company.
In the first instance, this gives South Tyneside the benefit of CBC’s knowledge and experience in bidding for contracts, and allows CBC’s financial history to be available to support this. By running South Tyneside as a separate division we minimise the risk to CBC and also provide some financial history for South Tyneside as activity increases which may enable them to become independent of CBC in the future, if necessary.
The South Tyneside Division will have its own sub-board which will meet around 6 times per year and look at the services which they want to develop or bid for. A representative from the South Tyneside sub-board will be in attendance at CBC Board meetings and will report on South Tyneside activity. Administration support and infrastructure for the ST Division will be provided from the CBC office at Team Valley by the current CBC team, and funded by the levy that ST practices will pay to join.
Supply of GP cover to Walk In Centres
CBC will begin supplying GP cover to the walk-in-centres at QEH and Blaydon during 2014.
Working closely alongside the GH NHS FT our team of salaried GPs, supported by cover from GatDoc, will work with the nursing staff of the QEH WIC to ensure that patients are seen as quickly as possible and by the right professional. This service will relocate from the current WIC to the new Emergency Care Centre (ECC) on the QEH site in the autumn.
Since 01.06.2014, we have been supplying GP cover at the WIC at Blaydon, 7 days a week and 14 hours per day. This will provide access for patients in the inner and far west and supplement the service provided from the WIC at QEH.