An insight into general practice

Last week (Monday 8 May) I was delighted to spend a morning with primary care colleagues in the city, hearing about the challenges, changes, and talent within their multi-disciplinary teams. General Practice in Newcastle serves over 300,000 patients and ensuring its sustainability is crucial to the future of the NHS as a whole.

Newcastle GP Services (NGPS) has been supporting primary care for ten years and is now the federation of 28 GP practices in the city. Practices are also members of one of seven primary care networks (PCNs) and the clinical directors of each PCN make up the NGPS board, giving an integrated voice for general practice in the city. I was welcomed to a discussion meeting at the NGPS headquarters by Dr Natalie Crowe, the NGPS Chair and Clinical Director of the East PCN, and Rebecca Haynes, NGPS Chief Executive.

We discussed the role of NGPS and how it is focused on efficiency – doing things once on behalf of all member practices when this makes sense to do so, for example developing the primary care nursing workforce and organising training placements and education, or supporting primary care patients’ participation in research. NGPS also represents primary care within the health system, working to make sure that decisions about strategic developments in healthcare are made with primary care’s input and perspective.

Primary care is a crucial partner within Collaborative Newcastle, and I was pleased to discuss how we can continue to develop our partnership working in the city to focus work where it will have the most impact, for example in improving access to the most appropriate care and helping get patients home from hospital.

We are all conscious that the landscape in primary care is challenging, and it was helpful to hear about the difficult issues of high workload, workforce and infrastructure challenges, directly from those working in Newcastle. What struck me was the positive attitude and improvement approach that colleagues had brought to these significant challenges. By pooling resources between practices, PCNs have been expanding the number of ‘additional roles’ working in the system to support a more sustainable way of meeting demand – for example, by employing pharmacists and paramedics to use their skills to carry out medication reviews and home visits.

Later in the morning I visited the Thornfield Medical Group, located in the Molineux Street Centre, Byker, to see how that large practice has increased its capacity to appropriately respond to patient need. Recently there has been some national debate in the media about public experiences of accessing GP services, including lamentation of the ‘8am rush’ for appointments that some patients experience.

Thornfield employ a team of ‘care navigators’ who use an electronic clinical triage/prioritisation system and is constantly updated by the practice GPs. I saw how every new contact from a patient is assessed and guided to the most appropriate form of care, whatever time of day the patient contact is made. Coupled with a daily duty GP and nurse rota, this provides a sustainable approach to meeting patient need that does not burn-out staff by having them work implausibly long and heavy shifts.

Primary care will continue to change in coming years, with shifts in workforce, technology, and expectations likely to shape an evolving delivery model that sees practices increasingly working in partnership and at scale with a wider, multi-disciplinary workforce. Such changes are essential for a sustainable, modern NHS. As a Trust, we will support PCNs and NGPS in their important work to support collaboration within primary care and also continue to explore areas in which we can partner with them to work together providing estates, IT, and workforce support in the future.

Celebrating our activity and mobility support volunteers

Our wonderful team of activity and mobility volunteers were celebrated at a graduation event last week (Friday 12 May).

Activity and mobility volunteers are a group of 45 students from schools and colleges across Newcastle. They work alongside the physiotherapy team on ward 14 at the Freeman Hospital to help get patients ready for discharge.

As well as helping get patients up and ready for the day, they support staff with mealtimes and offering drinks and also encourage patients to engage in mobility, chair and bed exercise sessions, 1-1 and group activities.

The volunteers all have a keen interest in a career in a variety of healthcare roles so the experience they’re gaining is so valuable. They have also been a huge asset to the ward and the feedback from the staff and patients reflects this.

A huge thank you to everyone involved in this programme and congratulations to all our graduating volunteers. You can hear first-hand from some of our volunteers, the staff they work with and the patients they support in this video.

Future-proofing UK Health Research: The Academy of Medical Sciences Report

On 10 May, The Academy of Medical Sciences (AMS) published its report on the UK health research sector: Future-proofing UK Health Research: a people- centred, coordinated approach. The report rightly acknowledges that health research saves and improves many lives.

Many members of the public understand more about clinical trials because of the COVID-19 pandemic, but research is, of course, long established and many of our modern-day treatments exist because of research. Ultimately, every treatment was once a trial.

Newcastle is internationally recognised for its research expertise. We deliver research to thousands of patients each year and are consistently one of the best performing trusts nationally for research activity.

Despite this, research, like many other parts of the NHS, faces several challenges, and so the issues raised in the AMS report might sound familiar – an increasing workload, staff shortages, career progression, funding, and time pressures.

As a research-active trust, I’m pleased to say that we’re already addressing some of these issues in our clinical research strategy 2021-26, including how we embed research into standard clinical care, career progression, and encouraging everyone to play a part in research.

As we approach the two-year point in the five-year strategy, we have made some fantastic progress in several areas, including:

• Introduced new roles, including a clinical trials practitioner and research support manager to help staff progress their career.
• Streamlined our study set-up process which has resulted in a 57% reduction in the number of days it takes to set up a study.
  In 2022/23, an additional 4601 patients took part in clinical trials compared to 2019/20.
• The recent appointment of a research matron to one of only two senior research leader posts in North East and North Cumbria, helping nurses and midwives to develop and deliver research.
• Recognising the unique challenges faced by our nurses, midwives and allied health professionals in developing research within their clinical roles, there is a dedicated research priority within the NMAHP professional strategy.
• The flagship NMAHP Researcher Development Institute, funded by Newcastle Hospitals Charity and launched in 2022, marked a step change in our ability to enable our NMAHPs to get involved in research at any stage of their career.

This Infographic has been produced in support of this year’s International Clinical Trials Day tomorrow (Saturday 20 May), and shows some of our incredible research achievements from the last year.

These achievements are a timely reminder of the commitment, hard work, and passion of everyone delivering research to patients. Thank you to all involved and here’s to the exciting future of clinical research.

Chief Information Officer

Our Chief Information Officer, Graham King, will shortly be leaving the trust and I would like to thank him for his service over the years. I am pleased to confirm that Lisa Sewell has agreed to take on the responsibilities as Interim Chief Information Officer from 1 June and we will shortly commence a national recruitment process for a permanent CIO.

Our IM&T services continue to be an absolutely vital and valued enabler of patient care, and I am always very grateful for the outstanding efforts from the team.

Major incident planning

Last Sunday we ran the largest simulation exercise the Trust has seen as part of a test of our Major Incident Plan. Over 100 staff from across the Trust took part, as well as a number of volunteers from Newcastle University Medical School acting as simulated casualties. The fictitious scenario saw our clinical teams treat 25 casualties from a major rail disaster over two challenging hours.

Feedback from the exercise has been extremely positive from all involved, and with the planning team set to deliver a full debrief and report we will ensure that we can build on this great work, improve our preparedness and engage more departments in major incident planning.

Our Clinical Lead for Major Incident Planning, Dr Chris Johnson said “a tremendous amount of effort has gone in to delivering this exercise and we’re really grateful to all of the teams and volunteers for engaging so positively. Exercises like this are a robust test of our plans, and a great opportunity for clinical teams to practice their skills in a safe environment.”

Awards and Achievements

Congratulations to the following:

• Professor Naeem Soomro who has been selected as the next British Association of Urological Surgeons (BAUS) representative on the Royal College of Surgeons of England Council and will be taking over this role from Mr Jonathan Glass.
• Healthcare Scientist Wayne Hartley, who I featured in a previous blog, has returned from the World Transplant Games in Australia where he earned four medals – a gold in the triathlon relay, a silver in tenpin bowling (doubles) and in the men’s team 5k, and a bronze medal in the individual ten pin bowling. Team GB topped the medal table with 121 gold, 96 silver and 71 bronze medals.
• Ear nose and throat surgeon Dr James O’Hara, who is also a clinical senior lecturer at Newcastle University, has published the biggest study of its kind in The Lancet which has found that a tonsillectomy – tonsil removal – is both clinically and cost effective for adults who get recurrent severe sore throats. You can read more here.