Mid-Nottinghamshire GP Access

The Commissioner is seeking suitably qualified bidders for the service outlined below. Bidders should send their expressions of interest to the named buyer (sarah.trupp@nhs.net):

Both Mansfield & Ashfield CCG and Newark & Sherwood CCG (Mid Nottinghamshire CCGs) have a Primary Care Strategy that supports the General Practice Forward View (GPFV) in developing general practice to work at scale through Primary Care Networks (PCNs).

Improving Access to primary care for the registered population is seen as a key enabler to deliver the sustainability and transformation of primary medical services. This will be driven through services being delivered in an integrated way at scale and based around established PCN.

The Mid Nottinghamshire CCGs have six PCNs that are now well established and with full engagement of their GP practice members. They meet regularly and are led by GPs working in close collaboration with the GP membership provider organisation. PCNs have engaged appropriate skill mix within their delivery models.

The Mid Nottinghamshire CCGs wish to commission extended GP access services that form part of a fully integrated primary care service. This should build on existing strong primary care performance and established integrated links to other NHS and private sector healthcare services in the county. It is expected that, as a minimum, the delivery model will be based around the current PCN configuration.

• Delivering additional GP appointments to meet the national core requirements aligned to the established PCNS as follows:

- 30 minutes per 1000 weighted patients and possibly rising to 45 minutes at a future point.

- Appointment time evenly spread across 18.30 to 20.00 Monday to Friday and Saturday mornings, as per the national requirements.

- A mixture of Pre-bookable and on the day routine appointments with duration of 15 minutes.

- Ensuring equity of access to services is critical. Monday to Saturday appointments will be delivered in a minimum of six locations, one per PCN.

• Subject to the response to this PIN, the CCGs may be minded to commission by PCN for Monday to Saturday services.
• Additional appointment time to be provided covering 52 Sundays and every Bank Holiday event GP led clinical time per day. This service will need to meet the needs of the local population. As a minimum the CCGs expect to commission two locations: one in either Mansfield or Ashfield and a second in Newark. •Provision of 100% population coverage across both CCGs

•Providers must use local CQC-registered estate that is appropriate for a primary care service.

•All extended access appointments must be GP led with support from the wider nursing team.

• The current staffing model utilises a permanent workforce of partner and salaried GPs and employed nurses/HCAs giving quality and continuity of care for patients. We would expect future service delivery to continue to adhere to core requirements in this way.

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• All patients should be offered a choice of evening and weekend appointments on an equal footing to non-extended hours services. Demand to be flexed to meet patient/system if required within the core requirements set out above.
• Patients will be offered appointments through their registered GP practice accessing a shared booking system. Full access to the patient record (read/write access) ensuring continuity of care in a secure and governance led system. Prospective provider(s) are therefore required to relevant arrangements in place from go live to enable information sharing. Commissioners require all activity to be documented using SystmOne and the ability to task patient's registered GP within twelve hours of the extended hours appointment.
• There will be effective connection to other system services enabling patients to receive the right care from the right professional, including access from and to other primary care and general practice services such as urgent care services.
• Engagement with individual GP practices' Patient Participation Groups. The provider(s) will use patient surveys to develop the service model, meeting with other primary medical service providers within the locality to share best practice and new ways of working in line with the GPFV strategy.
• Prospective provider(s) will be expected to deliver enhanced services such as wound care and ear syringing.
• Issues of inequalities in patients experience of accessing general practice identified by local evidence and actions to resolve in place.
• Use of digital approaches to support new models of care in general practice. To include and not be limited to NHS 111 direct bookable, Directory of Services (DOS) to reflect extended access arrangements, use of Skype and other digital approaches when available.
• Services to be advertised to patients including, as a minimum, through practice websites, notices in local urgent care services and publicity across the local community to ensure that it is clear to patients how they access these appointments and associated services.