Practices hold a large number of policies and procedures that are required to manage their business. The Care Quality Commission (CQC) require practices to link policy documents to key lines of enquiries (KLOE) as evidence to ensure practices are safe, effective, caring, responsive and well lead and to ensure all polices are embedded into working practices.

policies and procedures within practices largely fall into the following categories:

• Human Resources (H.R.)
• Health and Safety (H&S)
• Infection Control (I.C.)
• Information Governance (I.G.)

Currently there is not an efficient way of managing core practice documentation across BNSSG. Neither is there a standard suite of core policy documents that could be managed centrally.

Potential benefits of this model  is the reassurance that practices are all working to the same high standard and  the core suite of documents, once approved by a primary care working group, would then be embedded into all BNSSG practices. These documents would meet the criteria required by the CQC, be legally bona fide and offered to all practices.

Objectives

1.       Identify key stakeholders or other existing document provider organisations that could assist in making a suite of core practice policy documents 

2.       Establish a core suite of policy documents to be managed and updated centrally, linked to KLOE whilst meeting operational and CQC scrutiny for all BNSSG practices. 

3.       Reduce the number of policy documents held by each practice, enabling individual practices or groups to efficiently manage documentation for operational purposes/ CQC requirements.

4.       Make available a core suite of policy documents agreed by practices in an electronic format, reducing the requirement of paper copies. Or to be held on a centrally managed Extranet system.

5.       Form a working group to support the development of a single suite of core operational/ CQC documentation that meets the minimum requirements that all practices adhere to and are approved by the CCGs. 

6.       Ascertain bulk purchasing power from existing document provider organisations on behalf of all practices in BNSSG.

7.       Seek CCG support to embed core documents into all member practices to ensure resilience. 

 Wellington Medical Centre is one of the largest practices in Somerset with a patient list size of just over 15,000 people.
 Like many practices in Somerset, we have a growing patient population, particularly within older age groups and are facing year on year increases in demand.
 In light of these, we have introduced a number of changes which include:
•Receptionists being trained in signposting skills so as to direct patients to the most appropriate help
•Introducing a broader multi-skilled team which includes 2 Primary Care Practitioners (Paramedic trained), musculoskeletal physiotherapist time and 2 pharmacists 

Southernhay House Surgery in Exeter has dramatically reduced time spent dictating and transcribing referrals thanks to a winning combination of cloud-based Lexacom Connect digital dictation and medical speech recognition software, Lexacom Echo.

Southernhay House Surgery is an 8100-patient practice operating from two sites. In 2016, a staffing shortage prompted the practice to review its reception and administrative functions. 

Sentinel Healthcare South West Community interest Company (CiC) is owned by shareholders of General Practitioners and Practice Managers in Plymouth. We provide services for patients and medical professionals in Plymouth, South East Cornwall, South Hams and West Devon.
We know that the NHS will not fund the removal of moles, cysts, lipomas, skin tags and warts unless they are detrimental to the patient’s health. We also know that patient’s still want them treated and they are currently limited in the local treatment options available. 

                                                                                                                                                                                                                                                                                                                            http://meneagesurgery.com/

  

                                                                                                                                                                  

Meneage Street Surgery launched an innovative community macular service

         ·             Launched 29 October 2014 it was the first in Cornwall (&, we believe, in the UK)

·               Ensures that patients remain within the NHS & are seen/treated within the (clinically) required time frame

·               Is operated completely by MSS

·               Patient consultations are entered onto Medisoft

·               Next appointment date given to patient at end of each attendance

Overview:

·           At Meneage Street Surgery we have a unique flexible facility; we extended our building to include a surgical suite comprising waiting room, consulting room, operating theatre with air handling (25 air exchanges per hour) plus sluice room, changing area & toilet

·           This area, courtesy of electronic key pads, can be used as a standalone unit (for non-core general practice hours) or  incorporated as part of the whole premises

·            In addition, we have refurbished our existing treatment & phlebotomy rooms (also with air handling/exchange)

·            Our aim is to offer services, in partnership with RCHT, closer to patients’ homes in a community environment within an   appropriate time frame

www.kernowccg.nhs.uk     @NHSKernow

The East Cornwall locality of 10 GP practices commissioned a consultant geriatrician to work in the community and provide seamless care for patients, breaking down the organisational barriers of primary care, acute and community services. 

The aim was to improve proactive care of our most vulnerable patients and their carers

We are a large practice with large staff. Our team works under pressure and is at full capacity. Developing a systematic approach to implementing proactive care to our most vulnerable individuals requires protected capacity to achieve this consistently

www.mountpleasanthealthcentre.co.uk

There are many recommendations included within the NHS England General Practice Forward View. At Mount Pleasant Health Centre a variety of initiatives were implemented and are reviewed within this case study. 

Seven different GP practices visit a large number of various nursing and residential homes to deliver flu vaccines to patients. This was identified as an inefficiency as some homes receive visits from multiple nurses.

Over the past couple of years Trescobeas Surgery has worked hard to be at the forefront of IT innovation, using it to enable us to help meet demand and increase income.  We have worked very closely with our GP IT system supplier, Microtest, in order to create solutions or shortcuts for areas we identified as problematic.

We have worked on a vast number of products and solutions. 

Improve Diabetes self-care in the Westbank Practice area.

Our Practice Participation Patient Group of the Westbank Practice designed and set up an in-house diabetes self-help support group in order to educated and support patients with diabetes, enabling them to take ownership of their disease and contribute to avoiding diabetic related complications.

It is now an established and very successful patient self-help group in one of the most challenging domains of medicine, namely diabetes. 

Like many other practices in Plymouth and throughout the UK, both Stirling Health Group and Chard Road Surgery had recruitment problems as GP partners either retired or relocated.  Both practices were under considerable pressure and the workload for the remaining partners was becoming unsustainable. 
 
We recognise the challenges of the modern health service and wanted to bring a new approach to the problems we were facing.  We needed to work in a new way if we were to continue to provide effective and sustainable services to our patients in the long term.
 
Before the merge Chard Road Surgery had changed their appointment system to ‘complete telephone triage’.   It was soon recognised that the majority of children needed to be seen for a face-to-face review by a clinician and that telephone triage was not the best way to assess them. Under the complete telephone triage system parents had to call, wait for a clinician to call them back and in most cases were then asked to bring their child to the surgery.  Developing the walk in clinic has meant parents have easier access. Parents can bring their children straight to the surgery without prior contact and they are seen quickly and easily and without unnecessary delay.  

Problem is we have an increased workload and no increase in GPs.

Our practice has helped reduce patient waiting times, reduce GP work load and improve team morale by up skilling the nurse team over the last 5 years. 

The challenges we were trying to address:

       DNA’s

       Reduction in Nurse & GP workload

       Patient Access

       Staff job satisfaction

       Reaching QOF targets

The Challenge - 

To improve the safety of medicines management and skill mix of the practice by pioneering the role of a practice pharmacist · Introduced a pharmacist into a GP partnership model