On-the-day hubs to be expanded in plans to ‘transform’ general practice

Exclusive Primary care hubs designed to ‘ease on-the-day demand’ on GP practices in Cornwall are set to be expanded, as part of plans to ‘transform’ general practice.

Last winter, Cornwall and Isles of Scilly ICB funded eight hubs, staffed by ‘recently retired’ GPs among others, to ‘provide extra GP appointments’ which surgeries can direct some patients to, following triage against a set minor-illness criteria.

Pulse was told that the hubs would run throughout last winter to begin with ‘to determine its success’ and that opportunities to extend running the hubs throughout the year were being explored.

Now, a document shared by Kernow LMC confirmed that the ICB has ‘committed to long term funding’ to ‘expand’ the capacity of the hubs.

According to the document, these currently provide ‘2,000 extra appointments each month’, which will be increased ‘in time for the coming winter’, to make it ‘easier for patients needing treatment for a minor illness to be seen on the day’.

‘As implementation moves forward, hubs will be provided on 11 sites, where possible, aligned to GP out-of-hours and local urgent care sites,’ the document added.

‘Longer term funding enables practices and Kernow Health to offer more portfolio careers including new fixed term jobs to increase the staffing of the hubs as well as increased security for those already working in them.’

The draft document, which sets out ‘transformation’ plans for general practice in Cornwall and was prepared by the General Practice Collaborative Board – comprising of PCN clinical directors, Kernow LMC and Kernow Health – also asks practices to complete a process of ‘patient segmentation’ to divide patients in different groups according to their needs (see picture).

This is currently being piloted in five practices across Cornwall, which are working to implement the segmentation.  

According to the plan, 50% of practice capacity ‘needs to be protected’ for patients with ongoing conditions and vulnerable patients (coded as ‘amber’ and ‘red’ in the segmentation), while ‘green’ patients (‘generally well’) would be given a hub appointment for minor illness treatment.

The document added: ‘Patient segmentation together with implementation of safe working protocols will inform future increased capacity required in hubs to help meet on-day demand to treat minor illness.

‘Early evidence from the hubs shows that some practices were able to see a higher proportion of patients who want a planned appointment within two weeks.

‘The hub project group will continue to take an evidence-based approach to developing the model.

‘This will enable the ICB to consider what further expansion to capacity is required in 2025/6 onwards.

‘This will also consider how the hub model should align to the wider urgent care system, particularly its links to out-of-hours GP services and Pharmacy First.’

Dr Stewart Smith, chair of the General Practice Collaborative Board, said the plan was developed to set out ‘the future of our service in Cornwall’.

He pointed out that none of the proposed measures are mandatory, and that are instead at practice/PCN ‘discretion to engage with’.

In an update shared by the LMC, he said: ‘There is a lot going on nationally with collective action. However, the Collaborative Board are acutely aware of the current pressures on general practice and have looked at what we can do now to support modern, resilient general practice in Cornwall with a longer-term aim of safe workloads and improved patient care!

‘We have asked clinical directors to discuss the draft plan locally and to feedback your comments.

‘Importantly, none of the proposed measures are mandatory and are at practice/PCN discretion to engage with, should you feel that they will help your working lives.’

Pulse has asked the ICB how much funding has been allocated to the hubs but the ICB has not yet confirmed this.

An ICB spokesperson told Pulse: ‘We have been working closely with the General Practice Collaborative Board to develop a plan for general practice.

‘The need for a new model of care for modern general practice is clear and we are fully supportive of this. A plan has been drafted by the collaborative board and shared for feedback from local clinical directors.’

Last month, Pulse revealed that North West London (NWL) ICB has drawn up first-of-its-kind plans to introduce ‘integrated neighbourhood teams’ inspired by the Fuller Stocktake.

The same ICB has also asked GP practices to come up with their own plans to improve access in order to access funding that had been tied to now-scrapped same-day hubs.

But LMC leaders in North West London expressed concern that over £5m of the funding for access improvement could be ‘lost’ to general practice due to ICB delays.