PCN led same-day access hubs should be rolled out, says leading GP

An East Sussex clinical director has backed the mandatory roll out of same-day access hubs, planned in North West London, as the model has proved successful in his PCN.

Foundry PCN was highlighted in the 2022 Fuller Stocktake, for its success in managing urgent demand by separating patients who need on-the-day care from those with ongoing conditions or complex needs. 

A similar model is planned for North West London by the integrated care board (ICB) where, from April, it is introducing the requirement as part of its ‘single offer’ local enhanced service, with practices obliged to sign up to all services to access the funding – effectively mandating the hubs.

The same-day access (SDA) hub model will ‘deliver a single point of triage for same-day, low complexity’ demand for all patients in the integrated care system (ICS) and will be run with ARRS staff and at least one GP who will hold overall clinical accountability.

It has already been trialled with ten PCNs in the area with a push to get the remaining 35 PCNs on board so there is qual access across NW London according to documents seen by Pulse.

Foundry PCN’s Dr Phil Wallek said that he agrees ‘with the principle of rolling out in a mandatory way’ across a whole area, and that primary care has to ‘do things in a standardised way’ otherwise the ‘system just can’t work’. 

‘I agree with the principle of rolling out in a mandatory way. I do agree with that. [NWL is] saying it can be a PCN or a group of PCNs – it’s up to them to decide what that is,’ Dr Wallek told Pulse.

He said there is a balance to be met between allowing practices enough control but also recognising that A&E and urgent treatment centres operate at a wider level.

‘Therefore, we do have to do things in a standardised way, to some extent, otherwise the system just can’t work,’ highlighting challenges to working at scale with their local community trust because their neighbouring PCNs have not adopted the model.

He said: ‘The only way that could change is by mandating a model of care for general practice, across the whole area, which means then that the community trust also has to fall in line with that.

‘That is, I think, maybe what’s happening in London. So, I think that’s more sustainable as a way to approach it.’

However, Dr Wallek warned ICBs and PCNs in other areas to keep their urgent care teams ‘at a smaller scale’ in terms of the number of patients they are covering. This will ensure that colleagues maintain ‘that cultural aspect’ and their informal relationships.

‘My concerns are when you’re at that 50,000 to 100,000 population level – it’s too big for you to do it in that way,’ Dr Wallek said. 

Last year, an evaluation of the Foundry PCN estimated that by adopting the model there could be a reduction of 12,480 non-elective bed days, 751 fewer A&E visits and 720 fewer locum GP sessions over a three-year period.

To learn more about Foundry PCN read our Pulse PCN profile.