Primary care case studies

As England and its population have changed in the 70 years of the NHS, primary care changes too. These case studies showcase the work going on across England as practitioners experiment with New Care Models and across primary care to meet the evolving needs of their patients.

General practice

  • Health coaching – Patients regularly visiting GP visitors have been helped to manage their conditions through health coaching. Reduced visits by 61%. Patient case study – widow, isolated, now reconnected in community and built confidence to manage her conditions. Health and care without boundaries film available here
  • Care navigationGP practices in Wakefield (Connecting Care vanguard) are turning practice staff into care navigators to signpost patients to the right services. Now 220 navigators across 22 practices. 97% patients surveyed by Healthwatch happy with service.
  • GP experiences – Five GPs from across the country talk about their personal experiences of working in a vanguard on integrated care, including why their practices adopted a new model of care and how these changes will help sustain general practice for the future. Dr Arvind Madan, the NHS National Primary Care Director, talks about how working in new models of care benefits GPs and patients. Series of short films available here
  • GP accessGranta and Shelford, Cambridge – as a result of working at scale, patients now have access to GP appointments on same day from 6.30am until 8pm and in urgent cases same day appointments are achieved within two hours of patients making the call.
  • Multidisciplinary team working – Wide range of people involved including lots of health professionals who aren’t either doctors or nurses; people from outside the NHS such as councils, housing associations, care homes and voluntary/charity organisations – keeping care closer to home (Gateshead)
  • Leadership – Megan John, a GP in Frimley STP, was involved in a new care models leadership programme and has been a driving force for getting 8 practices working together as a ‘cluster hub’ looking at a number of workstreams including sharing people, skills and organisational functions; creating new and shared income streams; caring for patients together (e.g. extended hours services, and specialist skill sets, such as, GPs with specialist skills in minor surgery or dermatology); creating and sharing new clinical and non-clinical roles (such as paramedics home visit services, pharmacists or physicians associates)
  • Workforce – Tower Hamlets Together vanguard introduced an Enabling Quality Improvement in Primary Care (EQUIP) programme to build a stronger, more resilient workforce capable of delivering change. For one GP practice they have reduced demand on GPs callback lists by 15% despite growth in list size of 5.2%. They have increased GP appointment capacity by 540 improving access for patients without increasing GP resource. Increased patient use of online use by 38% reducing pressures on practice staff. They have also reduced document workflow to GPs by 61% which they hope will reduce spend on locums and increase appointment capacity. Full case study available on Future NHS and more information here
  • Care Redesign: Social Prescribing – Rural Living Well project aims to deliver a rural wellness project in conjunction with local GP practices, using an asset-based approach to community wellbeing. This includes creating sustainable classes and groups, maximising social prescribing – West Cheshire Way


Eye care

  • Community eye service enables patients with suitable eye conditions, to be seen by fully accredited optometrists who can deliver a number of safe and high quality services – Morecambe Bay