As the year draws to a close, thoughts are turning to the Christmas period and a deserved break – and what 2018 holds in store for GP practices and practice managers.

One of the most talked about changes staking place is the amended CQC inspection programme. Further information on that can be found here. Others, meanwhile, are focusing more on funding, practice income and access/delivery of services – which makes the roll-out of a new service solution in Sussex of note.

Access hubs

In a bid to enhance access, a shake-up of health services is being made across Mid Sussex. New GP ‘access hubs’ have opened across the district and a pilot ‘paramedic practitioner’ service will be launched in January.

Interestingly, the Horsham, Crawley and Mid Sussex CCG says the GP hubs are aimed at providing additional doctor appointments for residents who are ‘generally well’ but need to see a doctor. The hubs opened in November and are based in Horsham, Crawley, Haywards Heath, Burgess Hill and East Grinstead.

Explaining more about the initiative, a spokesperson from the Horsham, Crawley and Mid Sussex CCG commented: “The extra appointments are aimed at people who are generally well, who have access to transport and do not need a continuing conversation about their health, and so can see someone who is not their usual GP.

“Patients continue to contact their own GP surgery, and if they fit the criteria they may be offered an appointment in their local hub.”

The idea behind the scheme is to even out demand for specific surgeries and GPs while making the most of any available spare capacity across the area.

Paramedic practitioners

Further supporting the initiative – with the hope of creating further capacity – is the roll-out, from January, of a pilot paramedic practitioner service across the district. The CCG says paramedics will provide home visits to patients with frailty, on behalf of GP practices. The paramedics will work in different parts of urgent and emergency care while remaining employed by the ambulance service.

Overall, there will be five paramedic practitioners involved in the scheme. One will work across all the GP practices in Burgess Hill, Crawley, East Grinstead, Haywards Heath and Horsham, delivering the home visiting service for at least 18 months – longer if the pilot scheme is successful. Meanwhile, the other paramedic practitioners will also work shifts in the ambulance service’s Crawley call centre, and respond to 999 calls to see patients with immediately life threatening and more complex needs who, say health chiefs, ‘will benefit most from their extended scope of practice’. Once again, it’s hope this will relieve pressure on GPs and free up further capacity.

Robust evaluation

Only time will tell how effective the new ‘shake-up’ will be – and if it delivers help where it’s actually needed and with the patient population that is actually the problem. The CCG says there will be “robust evaluation of the pilot that aims to establish patient and staff experience of satisfaction with the new arrangements, as well as the impact on usage of ambulance services and hospital – as well as community-based care and GP time.”

A common sight?

It’s well documented that by March 2019 the government has set a target of providing every citizen with improved access to GP services, including sufficient routine appointments at evenings and weekends to meet locally determined demand. That could make local access hubs much more commonplace in 2018 and beyond – and build on the various schemes already in place, most notably in London. Indeed, the BMA has published a detailed report into access hubs – or ‘locality hubs’ as it calls them. The report can be downloaded here.

While the idea of access hubs isn’t new, the fact that Horsham and Mid Sussex CCG is exploring an alternative skill mix in primary care to deliver additional capacity, highlights how primary care is having to think creatively in the face of the ongoing GP shortage. That may be the key talking point of 2018 – just as it has been for some time now.