Active Programmes

Primary Care Network

The Network Contract Direct Enhanced Services (DES) is a cornerstone of the five year framework for GP contract reform.

Through the DES mechanism Primary Care Networks (PCN) have been established to provide additional services to patients across a geography encompassing a minimum of 50,000 patients. The PCN's have been created to be effective from 1st July 2019 with annual evolvement and expansion until at least 31 st March 2024.

The PCN’s will access additional funding to support greater sharing of facilities and the efficiencies of operating from a large pool of resources.

A key element of PCN activity is the opportunity to access generous subsidy funding for additional services which have often not been provided in a primary care setting. For example in 2019/20 PCNs are able to secure the services of clinical pharmacists and social prescribers. These staff receive funding support from the “Additional Roles Reimbursement Scheme“ and the range of additional roles well increase over the duration of the DES initiative.

Alexin Healthcare have provided support and advice to PCN’s during the period of their creation. Principle amongst this, has been the employment of the “additional” staff who are providing the patient services. As an employer of numerous medical and administrative staff Alexin Healthcare have all the necessary policies, procedures, insurances, pensions etc in place to facilitate this.

The alternate of employing additional staff in a GP practice member of the PCN, places all the risks associated with staff employment on the single practice. This is an unreasonable burden when the staff members will be deployed across the many practices within the PCN and remote from the day to day control and management of their employer.

Alexin Healthcare are already employing a number of staff for PCN’s at no greater costs to them then employment via a GP practice.

Alexin Healthcare stand ready to extend this service across further PCN’s in our area, particularly as new additionality roles are introduced via the DES.

Clinical Pharmacists in General Practice

This programme, launched in 2015 by NHSE is a major component within the General Practice Forward View, it will be phased over a 3 year period and result in 1,500 pharmacists being recruited by 2020.

Senior CPs and CPs are allocated via the NHSE funding model which requires a ratio of 1:5. Senior CPs have at least 5 years post qualification experience and are usually a qualified Independent Subscriber (IP). CPs have a minimum of 2 years experience but will not already be qualified IP.

All CPs benefit from a comprehensive external training programme and mentoring from a GP within their placements in the pursuit of IP, with a target achievement of 18 months. Senior CPs are required to be available to give advice to their more junior colleagues.

All CPs are employed directly by Alexin Healthcare CIC who manage all employment related matters. Whilst Alexin Healthcare CIC are the employer an essential component for the scheme to succeed is that the CP becomes an integral part of the practice team where they are seconded throughout the 3 year duration of the scheme.

GP practices benefit from substantial subsidy funding and the addition of a new team member who widens the skill base of the practice. The patient facing role of the CP facilitates reallocation of the practice workload, especially to the benefit of GPs. They are also able to utilise their expertise for giving advice to patients and practice members, as well as efficiently dealing with some administrative functions.

The CP benefits from the training programme and achievement of IP which support their career development. Initial feedback from both CPs and practices has been very positive.

 

Derbyshire and Staffordshire

Alexin Healthcare CIC were a major beneficiary with our submission for the Phase 1 (Pilot) scheme which commenced in April 2016. We were allocated subsidy funding, payable over 3 years, for 12 clinical pharmacists (CPs) to become embedded within the practices of our Southern Derbyshire GP members.

Building on the success of the Phase 1 scheme Alexin Healthcare CIC made an application to Phase 2 of the programme, this resulted in a funding allocation for a further 6 CPs. These will be seconded to member practices in East and South East Staffordshire during early 2018.

A further application to Phase 3 of the programme was made in October 2017. This was approved with an allocation of 4 pharmacists (including 1 senior post). They are now working in practices within Southern Derbyshire who did not request CP support in our Phase 1 application. They have become aware of the cost effective improvements the scheme can provide to the efficiency of their practice by colleagues already participating. We are delighted we have been given the opportunity to meet these additional requests. 

NHS Health Checks Programme

Background

The NHS Health Checks programme is a systematic risk assessment and risk management programme for everyone between the ages of 40 and 74 with no underlying medical condition(s).

It identifies an individual’s level of risk of developing Cardiovascular Disease (CVD) and provides tailored advice on how that person can reduce that risk, through lifestyle changes and /or medication, and support them to achieve change.

People are recalled for a NHS Health Check every five years so long as they remain eligible.

Local Authorities have a statutory duty and responsibility for the delivery of the NHS Health Check programme.

 

Derbyshire

In 2013 Derbyshire County Council appointed Alexin Healthcare CIC as lead contractor for the delivery of the programme in Southern Derbyshire.

Alexin Healthcare sought to increase overall programme delivery and increase uptake within ‘at risk’ groups by the introduction of an innovative mixed delivery model comprising:

 

GP practices –The delivery of Healthchecks by all GP Practices within Southern Derbyshire. The improvement of the quantity and consistency of NHS Health checks delivered. Ensuring everyone who receives an NHS Health check is offered a brief intervention to support health improvement where necessary.

 

Community provision –Delivery from community in areas of deprivation and health inequalities. To offer brief intervention to support health improvement and where necessary signpost to lifestyle advice services or referred for further clinical treatment.

Since contract award Alexin Healthcare CIC has extended the scope of the programme to include areas within North Derbyshire.

 

Outcomes

Working with our local authority partners Alexin Healthcare provides a key element of the NHS disease prevention agenda. In areas of deprivation:

Approximately a quarter of attendees are smokers

Only a quarter are of a healthy weight

Almost one third of those attending are obese or morbidly obese.

Almost one fifth are pre-diabetic and without intervention are highly likely to go on to develop diabetes.

On average one in every ten people attending has been found to have a greater than one in five chance of having a heart attack or stroke within the next ten years.

Alexin Healthcare has developed an innovative model to deliver the Healthcheck programme and increase overall programme delivery and delivery within ‘at risk’ groups. We would be very happy to talk to any other local authority area seeking a lead contractor solution.

Integrated Working

Alexin Healthcare CIC was an early pioneer of the Integrated Working Agenda.

Working with our partners at Derby Teaching Hospital NHS Foundation Trust we created a joint venture organisation (JVO) that bid for both locally commissioned integrated diabetes services and urgent care services in Southern Derbyshire and Derby City respectively.

Resultant from this relationship the local hospital has recognised the contribution a GP can make within non-traditional settings and has engaged with Alexin Healthcare to provide services in the following areas:

 

Rehabilitation Wards- Working in London Road Community Hospital our GPs undertake the following duties:

Involvement in admission / discharge process

Assessment of patients, pathology, x-ray

Development of protocols, medical reviews, end of life care etc

Working as part of a multi-disciplinary team

Alexin Healthcare has been providing this service since 2015 and the role of the GP has developed since inception. They are valued and respected by all hospital staff and their understanding of community healthcare provision has enabled better processes, shared learning and the generation of improved relationships between primary and secondary care.

 

Accident & Emergency- Over recent winters Alexin Healthcare GPs have worked within the emergency department at Royal Derby Hospital in the provision of ‘out of hours’ support. This contract ended in 2016. To find out more about this contract please click on the link to historic services.

Business Support

Alexin Healthcare CIC has provided “back office support” for several years now, this service has expanded significantly.

We provide varying levels of support dependent on the requirements of the organisations we are working with.

We have access to a range of skills and partner organisations in the wider healthcare sector who can supplement urgent skill gaps with member practices.

We can help and advise member practices who recognise the increased efficiency and cost savings which can be achieved by sharing administrative functions between practices.

 

Training Courses for Member Practices

Training events are arranged for our member practices, the arrangement of these is led by interest from practices. We derive no income from these events and provide training at the best possible rates to purely cover costs.

We have held the following courses for practices which have all been very well received:

Vitamin B12 and Pneumococcal

Ear irrigation

SNOMED

Health & Safety

Fire Training

Auto-enrolment

CPR

Safeguarding

Courses require sufficient candidates attending to be practical, but we will always attempt to assemble sufficient numbers if we are aware of a need.

If any practices or staff members would like any further training to be arranged, then please contact us to discuss.

 

Derby Medical Society

We have been appointed to complete the administrative functions for Derby Medical Society since the start of the academic year’s programme in September 2017.

Our work for the society includes:

General administration including notifying the membership of meetings

Accounts management including collection of subscriptions

Maintenance of the list of members

Assistance with booking speakers for meetings

Co-ordination of social events / catering

Organisation of sponsorship within what is permitted by the GMC

 

We are honoured to be working with this prestigious society.

 

Healthcare Education Derbyshire Training Hub

Healthcare Education Derbyshire is managed jointly by Alexin Healthcare CIC, Macklin Street Surgery, Hannage Brook Medical Centre, Darley Dale Medical Centre, Avenue House Surgery and Whitemoor Medical Centre and is contracted by Health Education England.

Health Education Derbyshire is an educational foundation formed in May 2019 from a merger between the north and south Derbyshire training hubs. Our remit is to work with Health Education England, Health Education Institutions, and NHS Derby and Derbyshire Clinical Commissioning Group to develop educational placements for medical, social and allied healthcare professional students in primary care, in order to consolidate and expand our regional workforce.

We have developed close working relationships with the Universities of Nottingham, Derby and Sheffield, and work alongside other educational establishments such as the Derby and Chesterfield GP Specialty Training Programmes, University of Nottingham GP Training Academy and Derby Medical Society, as well as Derby and Derbyshire Local Medical Committee.

 

Primary Care Plus – Extended Hours Service through Place Based Working

This service commenced in April 2017 initially in one hub running 5 days a week and has now expanded to covering five hubs, 7 days a week. This service is available to 160,000 patients who are registered with practices in the Derby City Centre South & Derby North East places.

Alexin Healthcare CIC has been contracted by Primary Care Plus to manage the rota, communications and HR function for the service.

The service has been very well received by patients who appreciated the flexibility it provides. Delivery is based on a skill mix of GPs, Advanced Nurse Practitioners & Practice Nurses, various clinics are provided including Long Term Conditions, Dressings Clinics, Smear Clinics and Phlebotomy.

 

Derby City South Healthcare

Alexin was contracted from May 2019 by DCSH to manage the rota, communications and HR function of the service, and this increased to undertaking the role of Operations Manager for the PCN on a short term basis from July 2019.

Several service improvements have been made to ensure consistency and equitable access for patients registered with all practices. New sessions have been added to the service to both support practices and enable a better and more appropriate service is available for patients.

The PCN is now developing and taking strides forward in it organisation growth and position. Currently there are many different work streams taking place to ascertain the direction of travel and the priorities for this PCN.