How health services are changing to meet the challenges in Northumberland

Primary care is the ‘bedrock’ of the healthcare system in the county, with more than 1.5 million patient contacts a year – nearly 29,000 each week, a meeting has heard.

GPs and related services are responsible for providing more than 90% of all care in the system, while the volume of patients seen has increased by 10% over the last five years.

NHS bosses set out some of the ways they are tackling the challenges facing primary care, both now and in the future, at a meeting of Northumberland County Council’s health and wellbeing committee.

Dr Robin Hudson, medical director for NHS Northumberland Clinical Commissioning Group (CCG), said sustaining primary care is a case of managing workloads, finding estates solutions that encourage co-location, and ensuring there are access models which meet patient need.

Workforce is a key challenge with almost half of the county’s GPs over the age of 45 and a decent proportion coming to retirement, while almost 75% of nurses are over 45 and more than a third are 55 or over.

This covers practice nurses and community nurses at a time when the NHS is encouraging more care to take place away from hospitals and in the community.

There is recognition that the traditional skill mix and a reliance solely on GPs has to change, with the likes of advanced nurse practitioners, clinical pharmacists and even community paramedics all having a role to play.

It is hoped that some of this will be made clearer and supported as the new Primary Care Networks (PCNs) – a national requirement which sees groups of practices working together for economies of scale and to deliver additional services – develop.

There are six up and running in Northumberland with the largest two in the rural north and west covering around 80,000 patients each.

PCNs are attracting additional national funding on top of the CCG’s budget of £47million for primary care and £65million in the primary prescribing budget, while there is also additional cash to spend on IT and digital innovation.

Embracing new technology is a key element of the strategy for primary care, with 38 GP surgeries in Northumberland already using two-way text messaging to interact with patients and 32 practices using online triaging.

It was emphasised that this is only for patients who opt in to these services, which are in addition to the traditional face-to-face contacts.

The other workforce trend is a move away from GP partners to salaried GPs with younger generations more reluctant to take on the responsibilities and liabilities involved in favour of a more flexible approach in terms of both career development and work-life balance.

One proposal to tackle this is to help GPs focus on the job at hand by taking away burdens such as owning buildings.

The CCG, which buys and commissions the county’s healthcare, is ‘quite passionate’ about this effort, according to senior head of commissioning Pamela Phelps.