Primary Care Networks have been given new money to invest and increase both the number and type of workers that can be employed in General Practice.
The additional roles that North West North Tyneside have invested in have led to the development of the following services which can be accessed through your GP
We have a large Pharmacy team within our Primary Care Network whose skills and expertise in all medication related issues adds quality and safety to the prescribing across our area. They perform many tasks including structured medication reviews for patients in care homes and those on multiple medications to ensure prescribing is safe and appropriate, initiation of medications recommended by both primary and secondary care clinicians and also assisting in reducing medications as clinically required.
The Pharmacy team may contact you by telephone or recommend a clinic appointment to meet with them to discuss your medications further and perform some clinical tests.
Care Home Service
We have a Care Home Team that are aligned with local care homes. The service aims to be an integral part of how local NHS services support the care home sector to provide person-centered care for the most vulnerable older people, with complex needs and frailty.
A hybrid model has been developed across our care homes in order to cover all sites:
The Evergreens: a weekly ward round and multi-disciplinary team (MDT) meeting is provided by Forest Hall Surgery with pharmacist, carer and doctor input when needed. Other people are invited as appropriate. Further weekly telephone contact is also availble during the week.
Park View Care Home: for this large care home weekly input is split between Mallard and Wellspring GP Practices. A weekly ward round and multi-disciplinary meeting is provided by these GP Practices with pharmacist, carer and other expert input when needed.
Ashfield Court , Heatherfield, West Farm Residential Care and Woodley Hall: all get the input of our expert Care Home team of highly skilled Frailty Nurses who provide proactive and reactive care on an almost daily basis to these facilities. This team is led by GP with a special interest, Dr Nixon, who provides and coordinates multi-disciplinary team (MDT) meetings for all the Care Homes. Each home has a named GP Practice as the preferred practice for residents to register to with their own aligned expert Frailty Nurses.
Their roles and responsibilities include, but are not limited to:
- Carry out reactive care for those care home residents who are unwell (as a result of notification by care home staff)
- Co-ordinate with care home residents’ GP Practices
- Liaise with the relatives of and others close to care home residents
- Build relationships with day time, evening & weekend teams at Care Homes
- Develop & carry out integration with Out of Hours service providers, such as Northern Doctors Urgent Care, to ensure better relationships & better co-ordination, with the aim of ensuring good care for care home residents out of hours, e.g. by ensuring access to the Enhanced Summary Care Record where necessary.
- Attend GP Practice Multi-disciplinary Team (MDT) meetings
- Deliver training to care home staff as per the requirements for the home
Each month a session is spent with all staff providing care within the Nursing and Residential care homes in North West North Tyneside for shared learning and case discussion.
First Contact Physiotherapists
Working together with our local healthcare trust we have a team of 3 First Contact Physiotherapists covering the North West Primary Care Network. Their role is to assess and support adult patients who have new musculoskeletal conditions in order to a determine the appropriate management plan. They may suggest self-directed exercises, medication (for which they would liase with the Pharmacy team or your GP) or a referral to the Musculoskeletal team for further care.
Your GP surgery reception team will arrange this specialist appointment directly without the need for you to speak with a clinician at the practice.
Learning Disability Care Co-ordinator and Health Coach
We are working with LD North East in order improve the care and support we offer patients with learning disabilities in our area. We have two experts from their team working across our Primary Care Network and their input is enabling practices to understand challenges and consider new ways of working in order to reduce barriers to medical care for this patient population.
The LD North East Team works with GP surgeries to identify patients who would benefit from some additional support to manage their health and wellbeing, particularly people who are anxious or have concerns about attending health related appointments.
Care Co-ordinator Lesley supports patients to attend annual health checks, make sure everyone is provided with accessible information and assist patients who may need to link in with additional health and care services.
Health & Wellbeing Coach Michelle supports and motivates patients to make healthy lifestyle choices, maintain long term behaviour changes and start to look after their own health and wellbeing.
Lesley and Michelle's expert input enables GP practices to understand challenges and consider new ways of working in order to reduce barriers to medical care for this patient population.
Click below for more information:
Social Prescribing Link Worker
Working in conjunction with the social prescribers allows patients to be linked with non-medical sources of support within the local community. These can include opportunities for activities, volunteering, befriending and self-help as well as support with problems (e.g benefits, employment, debt). The involvement of social prescribers within the primary care community provides much wider holistic care and is invaluable for supporting patients.
Your GP surgery may suggest a referral to this team.