Partnership working: small-scale collaboration that works

When the NHS launched its Releasing Capacity in General Practice plans, one of the most hotly-debated topics among the 10 High Impact Actions was number seven – partnership working.

The idea is that by creating partnerships and collaborations with other practices and other providers in the local health and social care system, economies of scale could be achieved and, crucially, efficiency boosted. It was viewed as the ideal opportunity to share admin functions and service delivery, boosting care delivery in the process.

As we discussed in Practice Index blog last year – click here to read more – this idea has become big news. Rarely does a day go by without talk of mergers, federations, and Multi-Speciality Community Providers (MCPs) – and various organisations seem to be constantly running research and trials on the subject, with various conclusions.

While the jury is still very much out on the success of super-practices and federations, Releasing Capacity in General Practice has prompted a number of successful smaller scale collaborations.

One example highlighted by NHS Networks is Morecambe, where a collaboration between five GP practices and the town’s 27 community pharmacies has led to the formation of a minor ailments service (MAS).

The MAS

The MAS was established to encourage patients to self-care and use local pharmacies for minor ailments. Practice receptionists have been trained to identify patients, from deprived communities for example, who may be requesting a GP appointment to receive a prescription for medication which can be purchased over the counter.

Under the MAS, these patients are signposted to 27 participating pharmacies engaged in the delivery of the scheme. As well as ensuring that GP appointments are used appropriately, this initiative is supporting the patient cohort to seek medication earlier, before conditions exacerbate.

The difference

In the first six months there were 819 MAS consultations from the combined practice population of 61,000 patients. Overall, 58% were for children under 13 years and 713 (87%) of these encounters saved a GP appointment.

Under the MAS, the total average cost of each consultation is approximately £5.50 (comprising £3 for each pharmacy consultation and the list price of the medication). This compares to an average cost per GP appointment of £45. Potential savings are therefore in the region of £28,000 over a six-month period of operation.

Top tips

The Morecambe MAS is clearly proving successful. Helpfully, the practices involved have provided some top tips to help those thinking about following suit:

• Building good relationships first with local pharmacies is essential – you need buy-in from them to make it work.
• It pays to think about staffing. Not all community pharmacies will be able to participate in a scheme like this, at least initially, often because of their staffing arrangements. Any obstacles should be movable though, given time.
• Agree with the pharmacists how you want to handle communication to the practice after a MAS consultation, and what arrangements will be in place for the patient to be directed smoothly to the practice where the pharmacy is unable to help.
• It is essential to ensure patients are well informed about the service, and that practice receptionists are confident in identifying requests where the MAS would be appropriate and in directing patients to it.
• Some schemes experience slow uptake, so don’t be surprised if it takes a while – but do make sure the advertising materials are being noticed and that receptionists are sufficiently confident in directing patients to the service.

Have you introduced new practices or have a success story to share? Join the debate here, we would love to hear your experiences.