London has been leading the way to ensure everyone has easier and more convenient access to GP services, including appointments at evening and weekends. It was the first region in the UK to fully offer extended access services to the entirety of its 9 million population.
An example of practices working collaboratively at scale to provide GP extended access is the ‘One Health Lewisham’ GP Federation. The service offers bookable GP and nurse appointments to patients registered with a Lewisham GP, seven days a week, from 8am to 8pm.
One Health Lewisham is wholly owned by the GP practices in the borough and has grown out of four neighbourhood federations in the north, central, south east and south west areas of the borough with a total of 300,000 registered patients (2017). Their work remains rooted in these local communities, as well as across Lewisham to improve the quality of services for all patients, and by working together to deliver safe, effective and responsive healthcare services.
The story: working collaboratively at scale
In November 2017, the service relocated to a purpose built suite within University Hospital Lewisham, which enabled it to offer appointments for children and babies. As the service is located within the hospital, patients who need to see a GP are often transferred from the Urgent Care Centre, which relieves pressure on these urgent services. Patients can also access the service by calling NHS 111.
Lewisham CCG and One Health Lewisham wanted to make sure everyone registered with a GP in the borough knew about and used the service when they needed it. They worked together on some creative ideas to promote the new location and additional services, and embarked on a multi-channel communications campaign, which included producing a film to help patients and GP staff to understand the service. The film was promoted on websites and social media.
Receptionists were identified as a key audience to help promote the service. Receptionist were supported to do this with specific training to ensure they understood the service and how to access it. Front of house staff were also given promotional badges to wear which were designed to prompt a conversation about the service between patients and receptionists. The badges have proved to be very popular with both receptionists and patients alike and the concept has been adopted by neighbouring boroughs.
The benefits: working collaboratively at scale
By working together through the GP Federation, all Lewisham patients now have this access to additional GP and nurse appointments. This model also supports recruitment and retention with GPs/nurses having the option to include GPEA work as part of a wider portfolio.
Future plans now including maximising the usage of appointments for patients by reducing the amount of Did Not Attends (DNAs). Additionally, plans are in place to explore the possibility of expanding the range of services for patients coming into the service, for example there is now already provision for vaccinations and screening.
Working at scale in this way has benefited Lewisham GP practices by providing additional appointments. More routine appointments are being managed through the Extended Access Service which helpfully frees up GPs’ time to see patients with more complex and long term conditions who may need more time with their own GP.
Key findings and feedback from patients
- 90% of patients say they are very satisfied or satisfied with the care and treatment they received
- 87% say the location is convenient
- 90% of patients said they would recommend the service to friends and family if they need similar care and treatment
- 92% of patients rated the service ‘Very good’ or ‘Good’
- 34% of patients said they would have gone to A&E if not offered an appointment at the service
Find out more
For further information please visit One Health Lewisham online.
Find more information about our primary care work.
In: Case studies