Devolution set to propel seven-day primary care coverage across Greater Manchester

Devolution set to propel seven-day primary care coverage across Greater Manchester

• By end of this year everyone living in Greater Manchester who needs medical help will have same-day access to primary care services, supported by diagnostic tests, seven days a week
• Increasing coverage across Greater Manchester aims to help 2m people not already covered by a seven-day scheme
• Conference hears evaluation of sites that trialled seven-day services – showing 3% reduction in A&E activity compared with rest of Greater Manchester
• Move based on Greater Manchester’s plans to transform primary care – and builds on already established good practice, including its own set of primary care standards

Plans for local access to primary care – seven days a week across Greater Manchester, with ambitions to boost social care to help with hospital discharge have been announced today (Wednesday 10 June).

Last year, as part of the Healthier Together consultation process, a commitment was made that, by the end of 2015 anyone living in Greater Manchester who needs medical help will have same-day access to primary care services, supported by diagnostic tests, seven days a week. Today confirms that all parts of Greater Manchester will be covered by the end of 2015, with more improvements to come during 2016.

Currently 500,000 people in Greater Manchester are already covered and this will increase to 1.1m people, through new initiatives in Wigan and across the city of Manchester funded by over £8m from the national Prime Minister’s Challenge Fund.

Today’s announcement confirms plans to extend this provision across the whole of Greater Manchester (a further 1.7m people), with a further £7m of investment to facilitate this expansion.

Today’s conference will also hear the ambition to boost social care packages to help with hospital discharge and avoidable admissions. These discussions are being led by the directors of adult social services and directors of children’s services across the ten Greater Manchester local authorities.

The plans – which will be outlined at the GM Primary Care Summit this afternoon– are all part of a transformation programme in primary care across the region. They are also the first milestones after the region’s historic devolution of health and care announcement in February involving NHS England, 12 NHS Clinical Commissioning Groups (CCGs), 15 NHS providers and 10 local authorities.

Ian Williamson, Chief Officer for Greater Manchester Health and Social Care Devolution, said: “We now have a tremendous opportunity to build on established good practice and learning in Greater Manchester, so that we can close the health inequalities gap between our region and the rest of the UK. Devolution hasn’t created these new seven-day systems of working – but it can help to propel those results quicker across Greater Manchester, through a cemented regional partnership, increased freedoms and flexibilities to make local decisions – and less bureaucratic impediments.”

Dr Hamish Stedman, chair of Salford Clinical Commissioning Group, said: “Doctors want the best health outcomes possible for patients. New ways of working can bring flexibility and choice to both patients and primary care clinicians, so that we can make the best use of time, resources and expertise.”

The announcement also follows independent evaluation, which is published today, of the Greater Manchester ‘Demonstrator’ or pilot sites across the region, which tested new ways of working in primary care.

Conference delegates will also hear the impact of the Greater Manchester Demonstrator sites which all trialled seven-day access in Manchester, Bury, Heywood and Middleton. (See attached case studies). Research* shows that the overall effect of these Demonstrators led to a reduction of 3% in total A&E activity compared with the rest of Greater Manchester.

Key report findings include:

– Central Manchester’s scheme showed an 8% reduction in minor A&E attendance. This equates to a decrease of £425,000 in minor A& E costs;

– Bury’s Demonstrator showed a 38% reduction in usage of the out of hours service. It is estimated that Bury’s demonstrator may have contributed to a decrease of £43,000 in total A&E costs;

– Bury demonstrator site in particular was able to show improved patient satisfaction with opening hours, convenience of appointments and overall experience.

Sir Howard Bernstein, Joint chair of the Greater Manchester Health and Social Care Devolution Programme Board, said: “Seven-day access has the potential to transform health outcomes for the region – and it’s also part of wider measures to help take the pressure off hospitals.

“The evaluation of the Demonstrator projects has helped us gain great insight into what helps both patients and doctors. They were called Demonstrators – because their main aim was to trial different ways of working that help patients and GPs.

“Our main aim now is to ensure that we put people and place ahead of any organisational priorities in the region. This will be complemented by the efforts and dedication of collective action based on reforming public services so that we can focus on early, proactive help for the people of Greater Manchester.”

Simon Stevens, Chief Executive of NHS England, said: “This welcome ambition shows how devolution can produce tangible gains for patients right across Greater Manchester.”

Seven-day access also builds on the foundations of pioneering work across the region to improve standards within primary care and a joined up approach to physical, mental and social care. Within Greater Manchester there are nine quality standards of care – which CCGs have agreed to and will now implement in their own areas (see attached Bolton case study). These are:

– Improving access to General Practice (Monday – Friday)

– To improve health outcomes for patients with mental illness

– Improving cancer survival rates and earlier diagnosis

– Ensure a pro-active approach to health improvement and early detection

– To improve the health and wellbeing of carers

– Improving outcomes for people with long-term condition(s)

– Embedding a culture of medication safety

– Improving outcomes in childhood asthma

– Proactive disease management to improve outcomes.

Councillor Cliff Morris, Greater Manchester Combined Authority’s (GMCA) lead for health, said: “Today’s news affirms our commitment to a whole range of ambitious public service reform to improve people’s lives. By working together we have a powerful partnership that can promote well-being across all age groups.”

Seven-day access models differ from the established out of hours system as patients can pre-book an appointments and also because the seven-day system gives the GP access to the patient’s medical records (with the patient’s consent).

Most of the seven-day models are run through hubs or GP Federations. It is not compulsory for any GP to take part in the system.