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New ways of working to free up doctors as part of the NHS Long Term Plan

Patients are set to get longer appointments with their family doctor thanks to new ways of working which start today.

Practices large and small will work to support each other and deliver a wider range of specialist care services for patients from a range of skilled health professionals.

Around 7,000 practices across England – more than 99% – have come together to form more than 1,200 Primary Care Networks.

GPs will recruit multi-disciplinary teams, including pharmacists, physiotherapists, paramedics, physician associates and social prescribing support workers, freeing up family doctors to focus on the sickest patients.

The initiative comes alongside efforts to recruit more GPs as part of the NHS Long Term Plan.

The latest figures show an increase of 300 more family doctors on the previous quarter, and the number of young doctors choosing to train as GPs now at a record high after increasing by 750.

There are also thousands more nurses, pharmacists and other healthcare professionals working in general practice than there were just a few years ago.

Another 20,000, who will also include social prescribing link workers, are being recruited to work alongside GPs.

Up to a third of appointments do not need to be with a family doctor, and the new recruits will free up GPs to spend more time with patients who need them most, offering longer appointments to those who need them.

Simon Stevens, Chief Executive of NHS England and Improvement, said: “Strengthening general practice is a central part of the Long Term Plan, and Primary Care Networks have the potential to bring about the biggest improvement for a generation.

“As the PCNs get up and running in the coming weeks and months, patients will begin to see the benefits, freeing up GPs to focus on the sickest.

“This new way of working allows us to keep all that’s best about British general practice, while future-proofing it for the decade ahead.”

The NHS Long Term Plan will see funding for primary medical and community care increase as a share of the NHS budget for the first time in the health service’s 70-year history, with an extra £4.5 billion a year invested by 2023.

Additional funding from the five-year GP Contract agreed with the BMA at the end of January includes £1.8billion to fund the recruitment of 20,000 more specialist health care staff to support general practices.

This builds on the increase of more than 5,000 extra practice staff working with GPs over the past four years.

Patients will also have a range of options when it comes to getting appointments at their practice, including the introduction of digital appointments.

This will build on the progress which saw evening and weekend appointments made available across the country at the end of last year, with an estimated nine million appointments a year now available at more convenient times.

It also means GP practices will be able to drive further action on detecting and preventing killer conditions such as cancer and heart disease, as well as doing more to tackle obesity, diabetes and mental ill health, and support older people at home and in care homes.

Dr Nikki Kanani, a GP and NHS England’s Acting Medical Director for Primary Care and a London GP, added: “People across the country will benefit from access to more convenient and specialist care through their local GP.

“As part of the Long Term Plan for the NHS, GP surgeries large and small will be working together to deliver more specialist services to patients.

“The extra investment, additional staff and more convenient care will be a game-changer for NHS patients and in thousands of communities across England, family doctors are coming together in networks which will not only deliver better care, but a more efficient use of vital NHS resources.”

While many of the networks are getting started today, and it will take some weeks or months for patients to see much change, some PCNs are already up and running and providing new services.

These include the Healthier South Wirral PCN, which is working with Age UK and has appointed a Personal Independence Care worker as part of a frailty pilot aimed at helping people in their own homes.

As a result, the network has reduced the need for GP appointments among those getting proactive support by more than half, and seen a 25% reduction in unplanned hospital admissions.

Dr Tom Wyatt, one of Healthier South Wirral’s Clinical Directors, said: “There is so much work going on out there and we wanted to have one collective approach to help people in our community stay well for longer.”

Dr Richard Vautrey, BMA GP committee chair said: “It is impressive to see how quickly GP practices across England have responded to the contract changes negotiated between ourselves and NHS England just a few months ago, with over 99% now being part of a primary care network.

“With recurrent funding this should support the recruitment of over 20,000 additional people to work directly in practices as part of our healthcare teams.

“It means a pharmacist in every practice, not only reducing GP workload but also improving the quality of care. It will mean connecting patients with physiotherapists directly rather than having to wait for months for a referral, and it means social prescribers helping to meet the needs of those who are lonely and connecting them with others in the community.

“With GPs leading the development of a reinvigorated primary and community healthcare team we are not only starting to tackle the pressures of workload levels but we are also enabling GPs to focus more time on those who need us most.”

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Buckinghamshire, Oxfordshire, Berkshire West (BOB) Integrated Care System

It has been announced by NHS England/Improvement (NHSE/I) that Buckinghamshire, Oxfordshire and Berkshire West (BOB) now becomes an Integrated Care System.

It was recognised by NHSE/I that the progress made by Buckinghamshire and Berkshire West as early pioneers of integrated care has shown the difference it can make to the care and health of local communities when NHS providers, commissioners, local authorities and other sector partners work together.

For us in Buckinghamshire, this signals the move to becoming an Integrated Care Partnership (ICP) providing us with the opportunity to focus on delivering local services for local people whilst getting the benefits of working at scale and sharing expertise and resources across the BOB ICS.

Our 12 Primary Care Networks will be the building blocks of more localised health and care in communities, bringing together primary and community services, such as GPs, pharmacists and mental health.

Martin Tett, Leader of Buckinghamshire County Council and Chairman of the Health and Wellbeing Board said: “I am delighted that NHS England has recognised the work we are doing in Buckinghamshire and the difference it is making to our residents. Together with our partners, we can continue to focus on the health and care needs of each community within Buckinghamshire.”

Lou Patten, Chief Executive Officer of Buckinghamshire Clinical Commissioning Group said: “It is important we continue our work in Buckinghamshire though our Integrated Care Partnership. Delivering larger projects across Buckinghamshire, Oxfordshire and Berkshire West, allows us to focus on local services in our county.”

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NHS Buckinghamshire CCG presents inaugural annual report

NHS Buckinghamshire Clinical Commissioning Group is pleased to present its inaugural annual report.

The CCG was created in April 2018, from the merger between NHS Aylesbury Vale and NHS Chiltern Clinical Commissioning Groups.

The annual report summarises the CCG’s achievements over the last 12 months and explains how its budgets have been spent. It also outlines future plans and the way the CCG is working with partner organisations to deliver its vision of everyone working together so that the people of Buckinghamshire have happy and healthier lives.

Please click here to view the 2018 report.

You can view the previous annual reports published by Aylesbury Vale and Chiltern CCGs by clicking here.

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Ask NHS app goes live in Buckinghamshire

The new app, Ask NHS, has now launched in our area. It is free to download on any mobile device and provides patients with a symptom checker, self-care advice and access to book the most appropriate GP appointment.

Using the app can help patients take more control of their health.  A virtual healthcare assistant, Olivia, asks a series of questions to assess a patient’s symptoms in a clinically safe way. Olivia will then recommend the most appropriate care for them.  This might be self-care advice via www.nhs.uk, a GP appointment, GP call back or direct them to urgent or emergency care.

For patients who need to see a GP, the app can prioritise patients into the most appropriate appointment slots based on their needs. Patients can directly book an urgent or routine appointment without having to call the practice.

The first practice to go-live with the app is the Swan Practice in Buckingham.  Fiona Walker, practice operations manager, is a great fan.  “We recognise our major challenge is handling the increase in demand.  Ask NHS does a great evaluation of the patient’s needs; do they need to see a doctor?  If they do, then they’ll be offered an appointment but, if they don’t, they’ll be directed elsewhere.”

Since mid-December the practice has had over 480 patients download and register on the app and over 20 patients have booked appointments.  “The GPs like Ask NHS as they’ve already got a detailed history of the patient they’re seeing from the app’s triage process.  They know that the patient is with them because they really needed an appointment.”

More practices will be live with Ask NHS over the coming weeks and months, providing Buckinghamshire residents with easy to access, secure and confidential healthcare support.

The Ask NHS app is available on both iOS and Android phones and smart devices. It’s free to download from the App Store (Apple devices) or Google Play (Android devices). Patients will receive an invitation from their practice to download the App once the practice is live with Ask NHS.

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Macmillan information and support service to visit Bucks in February

The Macmillan Cancer Support charity’s mobile information and support service will be visiting Buckinghamshire in early February – in their big green bus nicknamed ‘Bertie’.

The service is open to everyone. Whether you have a cancer diagnosis, have a friend or relative affected by cancer, or are worried about cancer in any way at all, there are lots of ways that Macmillan can support you – medically, financially, emotionally and practically.

The bus will be crewed by a dedicated team of highly qualified Macmillan professionals, who travel across the area in Bertie – one of the charity’s fleet of six buses.

Bertie will be in High Wycombe’s High Street on 6 Feb, Aylesbury’s Market Square on 7 Feb and Aylesbury’s Tesco Superstore on the Tring Road on 8 Feb. It will be available from 10am to 4pm on each of these days.

The mobile team can help people with:

  • Screening and what to look out for –  for example, signs and symptoms
  • Different cancers, their treatments and side effects
  • How cancer affects your life – for example: finances or employment
  • Talking about your cancer, or talking to someone with cancer
  • Being there for someone with cancer, or the support available locally
  • Survivorship and recurrence of cancer

For more information on the service, please click here.

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Dignity in Care Awards 2019 – nominate an unsung hero

If you could publicly thank someone for the support they provided to you or a loved one who would that be…?

Buckinghamshire County Council is launching its 6th annual Dignity In Care Awards, searching for the best of the best in the county to say a great big thank you.

With thousands of people being cared for in Bucks by family, friends or professional health and wellbeing teams, there are sometimes those who go above and beyond.

Your task is simply to nominate and tell us what makes them special:

Nominate here

There are 8 different categories with an overall winner chosen from all entries:

  • Putting People First
  • Innovation Award
  • Learning
  • Community Engagement
  • Collaboration
  • Fulfilling Lives
  • Best Team
  • Most Improved Service

Last year’s award winners and shortlisted nominees produced some emotional moments which you can watch and read more about here – these really showcase the many ways in which these carer heroes provide the very highest level of dignity and respect to those most in need.

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Find out what’s happening in your community with the Buckinghamshire Online Directory

An online searchable map of community organisations and activities in Buckinghamshire is now live.

Called Buckinghamshire Online Directory (BOD), this brand new search engine contains nearly 2,000 things to do in communities across Buckinghamshire.

It shows a map with coloured markers representing different social and physical activities, support groups, and learning and cultural opportunities.

You can click on the coloured markers to see what’s going on nearby. If you’re looking for something specific, there are options to search by postcode, type of activity or support, day of the week, and key words such as lunches or music.

There is also a button at the bottom of the page to suggest groups or activities that are missing.

Click here to find out what’s going on in your community.

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Chiltern House Medical Centre – the next steps

Over the last few months, NHS Buckinghamshire Clinical Commissioning Group has been asking for the views of patients, public and the staff at Chiltern House Medical Centre about the future of this practice of 7,000 patients based in High Wycombe.

The survey was available online, with paper copies sent to patients over 65. Further copies were available at the practice and local pharmacies. Meetings were held with the Patient Participation Group and staff at the practice, as well as with other practices in the area that cover High Wycombe and Holmer Green.

1,124 members of the public took part in a survey. As a result of the feedback from this and other engagement, the CCG has agreed that Option 3 – reprocurement – is taken forward. This means another service provider will be found to run the practice.

Nicola Lester, Director of Transformation at Bucks CCG said: “The majority of people who took part in the survey, and those we spoke to at meetings, said that they preferred the option of keeping the practice open by finding another service provider rather than dispersing the list (Option 3).

“This option means that we will now look for a suitable provider who can provide high quality care for the patients registered at Chiltern House Medical Centre.

“This option will require us to carry out further engagement with patients, staff and stakeholders to see what services they need Chiltern House Medical Centre to provide.

“We are aware that, since July 2018, patients at the practice have undergone a period of uncertainty and change and we would like to thank everyone involved for their patience and cooperation.

“We will continue to work with Chiltern House Medical Centre to ensure that services continue as normal while we carry out these next steps.”

The new provider of services is expected to be in place by late summer 2019. In the meantime, we will be publishing regular updates on our website and www.letstalkhealthbucks.nhs.uk

A report containing our recommendation that went to the CCG’s Primary Care Commissioning meeting on Thursday (6/12) can be viewed there. The results of the survey are also contained within the report.

Please click here to view  the Chiltern House Medical Centre Options Appraisal for further information.

You can view more detailed feedback and results from the survey by clicking here.

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Do you live in south Buckinghamshire? We need your views on the GP out-of-hours service

The out-of-hours service for patients in south Buckinghamshire is changing and we need your views on where you would prefer to go to for these appointments.

An out-of-hours service offers access to a general practitioner from 6.30pm to 8am Monday to Friday, throughout the weekend and on bank holidays.

These appointments are for people who need to see a doctor urgently. They are not for routine appointments. These could be via a telephone call or a face-to-face appointment, usually at the out-of-hours base or, in certain circumstances, at your own home. The service is accessed by calling NHS 111.

Dr Rebecca Mallard-Smith, Clinical Director of Community Urgent Care, said: “We want to provide a local service for our local communities and are working with patients and practices in the area to make sure that the out-of-hours service we provide can meet their needs.

“We would like to know views on the current out-of-hours service and also where people in south Buckinghamshire would prefer the out-of-hours GP appointment to be held.

“Members of the patient participation groups from the practices in the area have been involved in helping to shape our proposed options. We have tried to provide patients with a solution that is easy to find and where parking is available.”

Currently the GP out-of-hours service runs from 6.30pm until 8am on weekdays and from 6.30pm on Friday evening until 8am on Monday morning. People who need an urgent appointment with a GP, after phoning 111, can go to Royal Berkshire Bracknell Clinic in Bracknell or the Herschel Medical Centre in Slough.

We are proposing that from 1 March 2019 patients who phone 111 and need to see a doctor out-of-hours will be able to book an appointment at a local base in south Buckinghamshire, as well as Amersham, from:

  • 6.30pm until 10pm Monday to Friday
  • 9am until 10pm Saturday
  • 9am until 7pm Sunday

On the very rare occasion when patients urgently need to see a GP overnight (from 10pm until 8am on weekdays; from 10pm until 9am on Saturdays; and from 7pm on Sundays until 8am on Mondays), they can book an appointment by phoning NHS 111 and will need to travel to Amersham or Wycombe.

To help us shape the future of your local out-of-hours service a short survey is available here.

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Please don’t ask your doctor for medicines like paracetamol or ibuprofen*

In Buckinghamshire, the NHS spent £1,610,952 in the 2017/18 financial year on prescribing items like paracetamol, remedies for indigestion or heartburn, allergy treatments, vitamin supplements and cream for dry skin.  We’ve calculated that in Bucks this could have paid for:

  • 40 nurses
  • 11,364 MRI scans
  • 7,895 general hospital appointments

Medicines like these are easily available over the counter, often at a lower cost than the NHS is charged for them. Where possible, health services are asking patients to obtain these medicines themselves – it is quicker, easier, and will mean the NHS can spend more money on other services that will have greater benefit for the Buckinghamshire population.

Dr Shona Lockie, Clinical Director for the Medicines Management team at NHS Buckinghamshire Clinical Commissioning Group, said: “Whilst we know that some patients genuinely need these medicines in regular quantities for long term conditions and they will continue to be able to have them prescribed; a lot of these medicines are available to buy over the counter from your local pharmacy often at a lower cost than would be incurred by the NHS.

“So we are adopting national guidance for our local GPs which we hope will reduce our spend on around 35 different medicines and treatments for minor conditions and ailments that are usually self-limiting or which lend themselves to self-care.

“We hope that we can free up resources which can be used for other, higher priority areas that have a greater impact for patients and help to ensure the long-term sustainability of the NHS.”

Speak to your pharmacist for advice on treating minor problems; e.g. coughs and colds, mild eczema and athlete’s foot. They will always tell you if you need to see a doctor. Patients who need these drugs in regular quantities or fall into an exception category can continue to get them on prescription.

If you visit your GP who then recommends you buy the treatment, please remember they are following national guidance.

Over the counter medicines are widely available at your local pharmacy or in supermarkets and include:

  • Vitamins
  • Antihistamines and product for hayfever
  • Paracetamol and ibuprofen
  • Cough and cold remedies
  • Eyes drops for dry eyes
  • Cream for dry skin

When required in small quantities or for a short period of time, it would be quicker for you to obtain and will create less pressure on GP appointments if you were to buy these yourself without a prescription.

Further information about this, including a full list of items and exemptions from the change to prescribing, is available at:  www.buckinghamshireccg.nhs.uk/otc

A patient information leaflet is available at:

www.england.nhs.uk/publication/prescribing-of-over-the-counter-medicines-is-changing

* Patients who need these drugs in regular quantities can continue to get them on repeat prescription.


For further information please contact: Neil Phillips, on 01296 382444 or out of hours on 07825430978 

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Changes to the way you order repeat medication

Many of our residents have a ‘repeat prescription’ meaning that they can regularly receive certain medication without having to see their doctor each time. Some people order these repeat prescriptions themselves, while others choose to use a pharmacy or dispensing company to order medicines on their behalf.

Depending on how you request your medicines, the way that it works for you may change from 1 August 2018.

You can find further information in our patient letter and leaflet below.

Changes to Ordering Repeat Medication _Patient Letter

Changes to Ordering Repeat Medication _Information Leaflet

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Planned operations and appointments in secondary care

As you may be aware, a number of hospitals in England have cancelled or postponed some planned appointments in order to treat patients with the most urgent need, due to the extremely challenging circumstances currently being experienced by health services as we begin 2018.

However, we would like to advise patients of Buckinghamshire Healthcare NHS Trust and Frimley Park NHS Foundation Trust (Wexham Park Hospital) to attend appointments as planned unless they have heard directly from the hospital to the contrary.

As with other areas of the country, all our hospitals are extremely busy and they are redeploying some staff to care for those with the most urgent medical conditions. However, this does not mean all planned operations and appointments are cancelled. If your operation or appointment is affected, the hospital will be in touch directly with you to let you know.

 

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Pharmacy opening times for Christmas and New Year 2017

Please see below for details of which pharmacies will be open, and their operating hours, across the NHS Chiltern CCG area during the Christmas and New Year period.

Where possible, please also plan ahead to make sure you get any repeat prescriptions ahead of the Christmas break.

Please note – pharmacy opening hours on Bank Holidays are voluntary and are, therefore, subject to change. There may be changes to normal pharmacy opening hours between Sunday 24th December and Monday 1st January inclusive.

Patients are advised to check if pharmacies are open by telephone before making a journey.

Local pharmacy details can be found on the NHS Choices website at www.nhs.uk under ‘More Services’.

And remember, you can also check our Health Help Now web service for more information on pharmacies near you, and other health services available in Buckinghamshire.

If you are still not sure what health service option to use, and it is not an emergency, call NHS 111 for advice.

To see a full list of all pharmacy opening times across all of Bucks over the Christmas and New Year period, click here.

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Bucks CCGs statement on IFR data and policy

NHS Aylesbury Vale and NHS Chiltern CCGs adopt the same priority statements as the rest of the Thames Valley CCGs, in order to provide assurance that patients have equitable access to health care.

The Individual Funding Request (IFR) data for Aylesbury Vale and Chiltern Clinical Commissioning Groups is a count of all the referrals that the IFR team process on our behalf, however they also provide us with a referral triage service and these referrals have been included in error.

This wide variation in data across CCGs is a result of differences in what is actually being counted by individual IFR teams, some of whom, as in Bucks, are delivering a wider service than typical IFR management.

Our use of wording on our website is not helpful; on reflection we can see this is misleading and will take immediate steps to ensure the process is more accurately described. In addition, we will work with our Thames Valley CCGs to ensure we all apply the IFR terminology in a more standardised way in the future, which should better reflect correct IFR levels.

The actual clinical policies implemented by Bucks are the same as those implemented across the Thames Valley, based on clinical evidence available and with legal and ethical support. They are not unique to Bucks and are commonly used by other CCGs.