Quick response and new jobs - how GP changes have hit Doncaster in the last year

The networks were rolled out back on July 19 2019, with the idea of linking all the health services locally in parts of Doncaster, pooling resources so that treatments could be available closer to home, and at more accessible times.

And officials at the Doncaster NHS Clinical Commissioning group now believe they have been important in dealing with the Covid crisis because it meant they were able to quickly create special units to help care homes.

Five of the networks – known as PCNs – now exist in Doncaster, each led by a clinical director.

In May, NHS England and NHS Improvement asked local GP practices to work with care homes in more complex ways than ever before, supporting care homes that were facing some of the biggest challenges to date due to the coronavirus pandemic.

Within a matter of weeks a dedicated service was developed to provide increased support.

Officials believe this shows how Primary Care Networks have matured over the 12 months and as a result, are now in a stronger position to run schemes like this.

The networks set up a multi-disciplinary team which included staff working in care homes. A spokesman said it had strengthened relationships across the PCNs, improved communication and supported care for residents and patients, and helped the staff caring for them.

Officials believe this is one of a number of things that they may not have been able to do as quickly without the new networks, which have seen health practices linked together within their locality, sharing some services.

The networks are also bringing in a number of medical staff to help deal jointly with some of the work which has been generated by a shortage of GPs in recent years.

An area of development in the networks this year has been work to embed a number of new roles across each of the networks such as clinical pharmacists; more than 15 are currently being recruited, which will be split across Doncaster’s networks. They will see patients who do not think they necessarily need to see a GP.

Among those who have been working within the new system is Dr Nick Tupper, a long serving GP at the Kingthorne Practice, near the town centre, and the 4Doncaster network

His network has a clinical pharmast working with its practices, Vicki Walmsley,

He said: “We were fortunate that in the 4Doncaster primary care network, we already had two full time and one part time clinical pharmacists before PCNs were rolled out across the borough.”

Vicki added: “Clinical pharmacists provide huge benefits for the networks in Doncaster, enabling GPs, nurses and other primary care staff to have direct access to a health professional they can call for specialist advice.”

Similarly, they are now looking to bring in a new category of health worker, called physician associates, again to take the pressure off GPs.

More than 10 physician associates are currently being recruited; they will support practices across each of the networks. They are medically trained across a wide range of conditions. This means they are able to diagnose and treat children, as well as adults, with a range of clinical issues. They cannot prescribe though, and would work under the supervision of the doctors.

Dr Kate Mansfield, a GP at the Scott Practice in Sprotbrough and clinical director for Doncaster Central Primary Care Network said: “Physician associates have an increasing role to play in primary care as part of a multi-skilled workforce, alongside pharmacists and advanced nurse practitioners.

“They can provide continuity of care for patients with long-term conditions, which we know patients value as they don’t have to keep repeating their medical history and where it’s important for them to see the same person long-term; often that can be quite difficult for GPs in terms of their time.”

A year since they were first set up, officials at NHS Doncaster Clinical Commissioning Group believe the networks have also used funding to improve back office functions in primary care, making administration functions more efficient and streamlined across local practices.

Professor (Hon) Vijay Kumar, a Conisbrough GP and clinical directors for Doncaster North Primary Care Network said that helped free up time to develop additional services.

Across the Doncaster South Primary Care Network, a number of support groups have evolved in response to patient and public feedback to help manage a number of medical conditions; these are also available to other PCNs as well.

Since the networks were set up, Rossington GP Dr Khaimraj Singh, has been clinical director for the Doncaster South network.

He said practices in his area had set up a series of groups, such as fibromyalgia and chronic pain management and a diabetes support group.

He said: “The development of PCNs over the last 12 months has been an exciting time for local practices, health and care staff, patients and members of the public.

“PCNs have enabled important conversations to take place about sharing services and coming together in a joined up way to enhance care and experiences for patients and members of the public.

“The roll out of peer support groups across Doncaster South PCN is an example of how neighbouring practices and their patients have formed a series of vital groups that enable patients with the same issues to meet, share experiences and ways of dealing with medical conditions such as fibromyalgia and diabetes.

“Despite not being able to meet in person at the moment due to the coronavirus pandemic, the power of social media and online platforms means contact is still possible.”

Doncaster Healthwatch, the organisation set up to give the public a voice in NHS issues, said it was too early for them to have had much feedback on any issues regarding the new networks.

Chief executive Andrew Goodall said healthwatch had been involved throughout the setting up of the networks, and the clinical directors had been keen to listen to public feedback.

He said: “I think it has taken a year to really get them up and running, but there does seem to be a commitment to listening to people. The clinical directors have come to meetings that we have hosted with the public. We will get more feedback as things move forward.

"Individual patients should still be getting services at their own GP practices, so may not have seen much difference yet.”