The network of seven practices serves around 34,000 patients within South Sefton, Merseyside. The teams recognised that to keep essential immunisations and screening on track during this time of crisis, they needed to offer patients attending appointments a safe space or ‘green area’ where they wouldn’t have to mix with other patients who may be unwell.

Some of the PCN practices had large enough premises to allow for such green areas within their own buildings. However, three practices running from smaller sites within Bootle – the Concept House Surgery, the Strand Medical Centre and Bootle Village Surgery – came together to create a shared green area. Together, the three practices serve a population of around 19,300.

Making sure preventative care didn’t take a back seat

The Concept House Surgery is fortunate to have two sites and was able to allocate its smaller building on Sefton Road to be a green site for its own patients and those from the Strand and Bootle Village practices, offering clinics dedicated to immunisations and prioritised cervical cytology and phlebotomy.

Bootle is an area of marked deprivation and has historically low levels of preventive health care such as immunisation and cervical screening uptake, and the PCN partners wanted to ensure that these areas of care didn’t take a back seat during the early days of the pandemic.

Gina Halstead, GP Governing Body Member and Clinical Quality Lead, Concept House Surgery/South Sefton Clinical Commissioning Group, said: “The PCN members agreed that it was hugely important that we keep up the flow of immunisations and screenings. Our history of joint working allowed the members of the network to develop solutions together, and the linking of the smaller Bootle premises is an excellent example of collaboration across practices.”

Working across boundaries

The green area saw two practice nurses and a GP running immunisation and screening clinics. Appointments were set at 30 minutes to allow for additional time between patients and for additional cleaning.

Fifteen dedicated baby immunisation clinics ran from late April to the end of July, plus four cytology screening clinics, benefitting around 100 patients who may otherwise have missed out on this important preventative care.

Gina added: “It was incredibly easy for the PCN partners to work across the boundaries with some give and take – with staff from other practices working in our Sefton Road building. It was a really positive experience, although we probably need more formal arrangements in the future.”

Staff and patients have said they are very happy with the robust and safe service for immunisations and cervical cytology.

“Moving forwards the plan is to build on this success to drive up immunisation and cervical cytology uptake, while supporting and developing roles such the practice nurse,” said Gina.

Building on experience with the flu vaccination programme

The PCN partners have also been developing new ways to collaborate on delivering the annual flu vaccination programme. In 2019/20, they jointly employed nurses to vaccinate patients who were housebound or in care homes. However, this proved problematic as vaccine batch numbers were allocated to individual practices, making it difficult to vaccinate all residents in one session if they were not all registered with the same practice.

This year the practices have moved to pooling their vaccines so the nurses can use a single batch number at a time for all residents during a vaccination session, no matter which practice each patient is with.

Gina added: “We are now seeing demand for routine care increasing again. We continue to work closely with the community infection control team on patient safety and with partners on sharing agreements to get business continuity in place for what may be a more challenging winter than we’re used to.”