General practices across Cheshire and Merseyside are transforming the way they work to improve services for patients.

They are joining together as groups of practices working with community service providers and other health and care organisations – a partnership known as primary care networks.

The development of primary care networks was described in the NHS Long Term Plan, published last week (7 January 2019) and is key to the transformation of primary care and community services.

Primary care networks will plan and deliver services for populations of 30,000 to 50,000 people, which will enable them to focus on local physical and mental health priorities. They will build on the core services currently available from GP surgeries, offering more care closer to home in communities rather than in hospitals and supporting patients with long term conditions to better manage their own health.

By sharing resources, primary care networks will be able to employ additional staff, including newer roles like clinical pharmacists and physician associates. In addition, they may be able to extend services that are currently only be available in one practice within their group – such as physiotherapy – to all patients or offer new services such as ultrasound and mental health therapy.

NHS England (Cheshire and Merseyside) are investing £6 million over the next two years to support the development of 40 primary care networks. In total more than 60 local primary care networks have been established (see breakdown by CCG area in notes to editors), with the aim of having primary care networks in place for the entire population by June 2019.

With an ageing population and growing number of people living with long term conditions like diabetes and heart disease, strengthening primary care services through the development of networks is seen as key to helping people to stay healthier for longer.

Anthony Leo, Director of Commissioning, NHS England (Cheshire & Merseyside) and Senior Responsible Officer for Primary Care for the Cheshire & Merseyside Health & Care Partnership said, “Our aspiration is that every general practice across the region will be part of a geographically based network working collaboratively with other practices and wider services in the community to improve the care for their patients.

“Working in this way is not new for all practices; primary care networks have been forming across Cheshire and Merseyside in recent years.  The funding boost is intended to support established networks and encourage new networks to form.

“This will help primary care to be more sustainable and better able to continue to deliver high quality health services to the people they serve, now and for many years to come.”

Dr Kieran Murphy, GP and NHS England (Cheshire & Merseyside) Medical Director said “Working as a primary care network will offer practices the opportunity to care for the communities they serve in a more joined up way.  They will be able to offer more services like physiotherapy, ultrasound and mental health support close to home.”

Where primary care networks are in place there are clear benefits for patients and clinicians.  Practices are able to share workforce which gives the network back up to cover illness but also helps manage demand for services.  For example, if appointments at one of the networks practices are full, patients could be offered an alternative appointment at another surgery.

Case study

Schoolhouse Surgery in Disley, Eastern Cheshire, is part of the Middlewood Partnership serving just over 32,000 patients.  After seeing a rise in demand for their services, the practices are joining together to form a super-partnership and become a coherent, integral part of the emerging primary care network. The network is looking at how they could change the way they deliver care for their community to ensure they could offer a flexible and versatile service to patients.  They work very closely with health and social care colleagues from other NHS organisations and Cheshire East Council.

Working collaboratively has allowed the partnership to employ staff, like pharmacists and physiotherapists who work across all four practices seeing patients which in turn frees up GP time to see those patients with the most urgent need.  They include a physician associate (PA) – a new healthcare role in general practice in England – who can work alongside GPs and the wider medical team to diagnose and treat patients. PA Alex Facey joined the network in March 2018 and works alongside doctors to support patients.  Alex performs a number of different roles across the practices. He does regular care home visits, providing proactive care to residents to help reduce hospital admissions, he sees urgent cases in the GP surgery and does home visits.  All roles help to free up GP time to see other patients.

Dr Andrew Maurice, GP Partner at the Schoolhouse Surgery and member of the Middlewood Partnership, said: “Working together through a primary care network will allow us the freedom and versatility to offer more services for our local population and is encouraging and motivating primary care in our area.

“Working in a multi-disciplinary team of doctors, nurses, social care workers, pharmacists and physician associates has brought more optimism to our practices and in the future, will allow us to care for our patients closer to home, offering continuity and personalised care.”

A video explaining the work of Middlewood Partnership can be viewed here: https://youtu.be/E-S5As686E4