Providing timely, appropriate access to care delivered by a system which has enough  capacity; where processes are simple and take place in a neighbourhood which encourages prevention, self-care and works towards early diagnosis.

New ways of working are boosting patient experience and improving staff wellbeing at Hawkley Brook practice

This practice in Wigan introduced a single point of access – ‘Ask My GP’ – with all patients required to contact the practice this way. For those that are unable to use the online consultation system, patients can ring the practice for support, and a member of the administrative team completes the online form on their behalf.

Appointments are allocated equally to each GP partner who triage the referrals and book an appointment with the relevant practitioner – this could be a GP partner, trainee or with another service such as social prescribing or pharmacy.

Picture of Hawkley Brook staff

The practice guarantees that all patients will have contact from the practice on the same day and/ or see a doctor for all routine and urgent requests, with an average turnaround time of 37 minutes from the point of patient contact to receiving a message from the practice.

Patients with multiple health issues have time to discuss their health needs without being limited to a ten-minute appointment.

The new system has allowed for more flexibility, with partners able to stagger start and finish times to suit their needs and spend more time on staff development, with learner tutorials taking place every Friday. They won Employer of the Year at the 2023 Greater Manchester Health and Champions Awards for their commitment to staff wellbeing and career development.

In the 2023 national GP Patient Survey, Hawkley Brook received the second highest overall patient satisfaction result in Greater Manchester at 98%.

Greater Manchester Dental Quality Scheme improving access to dentistry

A new dental quality scheme was introduced in June 2023 with the aim of improving patients’ experience of access to dentistry. It’s the only quality scheme of its kind run by an integrated care system in the country. It was set up in response to lots of feedback from people that are finding it difficult to see an NHS dentist locally, whether they are in pain or not.

Around 22,000 new patients have been able to access NHS dental practices since the launch of the scheme, with 175 dental practices now signed up.

Practices signed up to the scheme are expected to:

• Be open to new patients and ensure their details on the NHS website reflects this, showing that they are accepting new adult and child patients.
• See and treat an agreed number of new patients.
• Be part of the wider urgent dental care system, which provides treatment for dental problems that cannot wait, when dental practices are closed or for those who do not have a regular dentist.

Digital tools when used well will work better for everyone including our staff, supporting more efficient and effective care that is experienced positively by all.

Transforming care through digital eye care referrals

A new referral process across eyecare services in Greater Manchester is improving patients’ care experience by making it easier for all referrers to send directly to the right service first time round.

Optometrists can now refer patients directly to hospital for treatment rather than asking the GP to make a referral. This saves time between referral and appointment, reduces the risk of lost referrals and is more efficient.

Girl receiving eye test

With over 55, 000 referrals made via the Electronic Eyecare Referral Service (EERS) over 2022 to 2023, and 99% of Greater Manchester practices signed up, the benefits have been felt by patients and professionals alike.

Ophthalmologists (eye-care consultants) can access the results of eye-care imaging tests, when available, at the point the referral is received. This means patients may not need to visit the hospital for a physical assessment.

Patients receive better care, as the service allows optometrists to share more information and high-quality images with the hospital to inform a patient’s treatment.

GPs are still informed when a referral is made, and their time is better used for more appropriate appointments.

The project is continuously evaluated for key learning areas, staff training and potential expansion into other areas.

Delivered from facilities which are appropriate for the provision of 21st century Primary Care

We want to transform our primary care estate to make it fit for purpose and the changing needs of local communities.  We want modern and flexible premises that are high quality and can support different teams to work together to meet local needs. These may be public sector, and voluntary, community and social enterprise organisations.

The blueprint outlines some of the challenges with addressing our current issues, but equally, the actions we can take towards progress. There is a lack of good data on what buildings and contracts exist, with many buildings being owned or rented privately, and investment opportunities to make improvements difficult.

We also want to strive to be energy efficient and reduce our environmental impact.

New Jackson Medical Centre opens to community with green credentials

New Jackson Medical Centre, located across the ground and first floors at Elizabeth Tower on Chester Road, houses new additional practice sites for Cornbrook Medical Centre, Vallance Centre in Ardwick and the Docs, in Bloom Street. It is the first GP medical centre to open in Manchester city centre since the City Health Centre in the Arndale shopping centre in 2009.

Funded with the help of a £2.6m grant from Manchester City Council and £1m from NHS England, and having taken four years to complete, it houses 16 clinical rooms and will eventually be able to serve more than 20,000 patients.

With a school and park also being built in the vicinity, the medical centre will be able to cater for an influx of new and existing residents in and around Manchester city. It will also free up capacity in Cornbrook, Vallance and the Docs, and offer more appointments.

A wide range of community health services will also feature, along with ultrasound and dermatology services. Thanks to the NHS Additional Roles Reimbursement Scheme (ARRS), GPs will be able to call on care coordinators, pharmacists, social prescribing link workers and physiotherapists in the new building.

The building’s green credentials are consistent with our commitment to achieve a net zero carbon footprint by 2038. It expects to achieve a ‘BREEAM’ environmental rating of ‘excellent’ with its focus on waste management, energy efficiency, transport (close to Metrolink stops) and pollution reduction.

The creation of the new Jackson Street neighbourhood by Renaker also supports the Council’s wider ambition of continued population growth within the city and the demand for quality and low-carbon homes, close to transport hubs and new local services.

New Jackson Medical Centre partners and NHS Greater Manchester

We have a system of shared accountability for creating fairer health and tackling the root causes of inequalities, working in partnership with our communities to create healthier, greener and fairer places.

The conditions we are born, grow, live, work and age in, affect our chance of having a long, healthy life.

Factors like our income, housing, jobs, education, relationships, access to green spaces and air quality all impact on our health; widening the preventable gaps between the people with the worst health and the people with the best health.

Part of a wider neighbourhood team, where individuals and communities are supported to take more control over their own health and where providers work together with the shared aim of improving the health of the population.

The importance of community organisations for health: VCSE and PCN partnership improving local links

Since January 2023, the Sale Central Primary Care Network (PCN) has worked with local voluntary, community, and social enterprise (VCSE) organisations to run regular drop-in sessions with a community health advisor.

Some people face specific barriers when accessing traditional services and feel unsure what services are available to them and what time and where.

The drop-in sessions for people living locally help tackle health inequalities by offering an alternative way for people to get help and support on health concerns.

The more informal setting removes some of these barriers and help residents feel more comfortable sharing any health issues they have, as well as specific concerns around smoking, weight management and diabetes. People are also supported to book cancer screening and vaccination appointments.

In one instance, an individual attended an appointment to get a blood pressure check but after speaking with the community health advisor, was given help to book vaccinations, and connected to Age UK Trafford who provided advice and support to help them as a primary carer for their spouse.

Working in partnership helps people get the advice needed to improve their health and wellbeing and be linked to services that can support further including cost-of-living advice, help as a carer, befriending and befriending services to combat loneliness.

Partnering with local VCSE organisations to deliver these sessions has helped community health advisors broaden their knowledge of the community services available in the area and build long-term relationships.

In Greater Manchester, we aim to deliver a primary care system which helps people to stay well and focuses on the prevention and early detection of ill health, and the effective management of long-term conditions.

In Greater Manchester, people become ill earlier, spend more time in poor health, and die earlier than the national average. Life expectancy and healthy life expectancy (living in good health) is significantly lower here than the England average. There are also significant health inequalities within the city-region. For example, a male born in Manchester can expect to live an average of almost five years less than a male born in Trafford. For healthy life expectancy, there is almost 10 years difference between individual local authority areas. Much of this is preventable and that’s what we are working towards – everyone living in good health for longer.

Tackling high blood pressure through community champions

Big Life’s Living Well service designed the ‘Community Champions’ project in Rochdale to deliver blood pressures checks at local events and raise awareness of cardiovascular disease. They wanted more people to be alert to the dangers of high blood pressure and know where they can go to measure it, such as a pharmacy or GP. Heart attacks and strokes can be associated with high blood pressure, with many people not realising their blood pressure is high.

Woman receiving a blood pressure check

Between February and August 2023, 1480 blood pressure checks have been carried out with over 29% of people (430) found to have a high blood pressure. 418 people received a follow up call, of those who answered (260), 89% of people accessed support from their GP, which for some included home monitors or medication. Others received urgent or hospital care.

Following a successful rollout, Living Well have created two new roles for community workers from South Asian communities to increase attendance at GPs for cholesterol checks. On street engagement has taken place to identify any barriers to attendance and improve uptake.

Delivering safe, effective services, with a focus on quality improvement

There are many examples of good quality in primary care across Greater Manchester. Our ambition is to continuously strive to find ways to improve and innovate.

A Primary Care system which is fit for the long-term, ensuring that services are available when and where needed – and

Achieving a Net Zero Carbon Footprint by 2038.

Reducing the carbon footprint of inhaler prescribing

Metered dose inhalers (MDIs) are the most common type of inhaler used in the UK, commonly used to treat asthma, COPD, and other respiratory conditions. When patients press the metal canister of the MDI into its plastic case, a gas is released that helps get the medicine to patients’ lungs. When this gas is released, it stays in the atmosphere trapping the sun’s heat, like glass in a greenhouse. This warms the planet which is a problem for the climate. Climate change also increases air pollution which can worsen lung conditions.

There is growing awareness and concern from health care professionals and patients alike about the impact of MDI inhalers on our environment. With over 300, 000 inhalers prescribed each month in Greater Manchester, with the equivalent climate impact of 28,000 cars; GP practices, pharmacies, hospitals, and patients have started making a difference through working together towards greener inhaler choices.

For many people, this can involve a switch to a dry power inhaler, or a combination inhaler. For all patients, it is ensuring they have the most appropriate treatment to get the best control of their illness; and when their inhalers are empty, returning to their pharmacy for proper disposal. So far, this has resulted the equivalent of 3,000 cars being taken off the road in Greater Manchester.

People should only make changes once they have spoken to health care professional and should continue to take inhalers as prescribed until then.

Greater Manchester Primary Care is recognised as a career destination for a happy, healthy and engaged workforce, trained to a consistent standard with knowledge and expertise to meet the needs of our population and provide excellent services.

Like many areas of the country, there are pressures facing the primary care workforce which impact retention and recruitment of staff. Some of these factors are outside of our control but where we do have the opportunity to make a difference, we will.

More support for international GPs to stay in practice

Attracting and retaining doctors to work in general practice in Greater Manchester is a key priority for the primary care workforce programme.

Under the current system, international doctors are sponsored by NHS England, formerly Health Education England, during their training, and must wait five years to apply for the right to remain in the UK for five years.  Once qualified, a doctor needs to find a GP practice who holds the relevant licence. This was previously a challenge with only four practices in Greater Manchester holding a licence and over a third of locally qualifying GPs being international doctors.

The primary care workforce team introduced a scheme that supports international doctors and GP practices to navigate the application process, access the right legal advice via a helpline, and even cover the cost of the licences.

Now, over 90 GP practices hold a licence which has enabled many of our international trainees to stay in Greater Manchester since 2019. Through professional word-of-mouth, it has also helped with attracting other international doctors to work in the area.