Primary Care Hubs Provide Extra Capacity for Patient Appointments in Cornwall

Did you know that every week GP practices in Cornwall provide a service to over 90,000 patients? That does however mean that sometimes our patients struggle to get an appointment, which we know can be frustrating. After seeing how other areas were dealing with growing demand for appointments local GPs agreed that it would make sense to work together to set up Primary Care Hubs in Cornwall. A successful request for funding to pilot this way of working was agreed by the ICB to help deal with winter pressures. Its early days but its already helping by creating more appointments each week so we are now seeking longer term funding to secure and expand the service.

The hubs are set up to provide on-the-day appointments for people who need to be seen for an episode of illness but are generally healthy without complex needs. The hubs are staffed by a mix of GPs and Advanced Practitioners who can diagnose, prescribe (if required), and have access to the patient's clinical records, but are usually located on a site shared by several practices often a community hospital, but not always. It is important that our GP’s and their teams prioritise continuity of care for those patients who have long term and serious illnesses enabling people to remain in their own bed (or home), avoiding unplanned (emergency) ambulance calls and hospital treatment, unless absolutely necessary. The hubs are designed to protect capacity in the practice for those patients by providing extra ‘overflow’ appointments in a hub setting.

When a patient contacts their practice there is a process called triage, which aims to match the most appropriate service to meet the person's request.  Often people can be supported without a face-to-face appointment (for example over the phone or by email) by their practice but where they need to be seen for a routine illness and are generally healthy without complex needs, they may be offered an appointment at the hub rather than in their own practice.

Getting funding for the hub service was great but the biggest concern is staffing. National as well as local shortages of GP’s and other primary care clinicians creates the risk of ‘robbing Peter to pay Paul’ by increasing the pressures on local practices. We have managed to recruit extra staff from among people who work part-time and are willing to do more sessions, including some clinicians who live in Cornwall, but were not working and have been attracted by the type of work offered in the hubs – but we still need more! Staff in one practice do a mix of work in the hubs and the practice (a portfolio job), and we hope more people will find this an attractive option.  Feedback from some of the clinicians working in the hubs includes: “Quick turnover of patients with single straightforward illness, focussed consultations with problems you can help with.  Comfortable working environment.” “Steady manageable patient list, helpful relaxed environment.”

Any staff interested in working in a hub can find more details on the Kernow Health CIC website www.kernowhealthcic.org.uk/primary-care-hubs/.

Hubs are currently being run in nine sites – Launceston, Bodmin, St Austell, Newquay, Truro, Mount Hawke, Helston, Redruth, and St Ives and we know other areas are keen to do so, once longer-term funding is in place. We do however need to decide if it's better to have fewer sites running a regular fully staffed service or set up more sites which can only be staffed for a few sessions each week.

This initiative is all about delivering more care closer to home for local people. The hubs are great example of joint work between Primary Care Networks and their practices, Kernow Heath CIC (who deliver the Out of Hours Service and organise the staffing and equipment for the hubs), and Cornwall Foundation Trust, as some of our hubs are running out of community hospitals.