As Mark Twain said “the secret of getting ahead is getting started”. Bolton GP Federation began its journey in December 2015. It has been a slow and steady journey but an interesting one. Two years on and the learning and growing continues!

As the clinical lead for the Extended Primary Care service, my learning curve has been phenomenal! This role has improved my communication and negotiating skills and has helped me to network across practices and polish my team working skills.

The Extended Primary Care service

This service – Federation’s first project – offers appointments at weekends and bank holidays, showcasing the Federation’s commitment to support joined up working between practices, which seems to be the way forward.

The Extended Primary Care service has provided over 11,000 appointments in the last 18 months. This has been valuable as practices have been under pressure with an increasing and ageing population, widespread changes in the NHS as well as recruitment problems.

So what have we learnt?

• The GPs and nurses value the opportunity to work flexibly and work at the weekend – and that they value the support from the Federation in doing this.
• Staff feedback has shown that workload is reasonable and manageable with 15 min appointments, access to notes, and fairly remunerated.
• Working across three computer systems in Bolton has been a challenge and limitations with the Vision software has not helped.
• Dealing with services out of our direct control can be frustrating and challenging.
• It has provided us with an opportunity to look at the implications of data sharing across practices.
• Having quarterly staff meeting to share learning and involve the wider team in performance monitoring has helped with engagement, bonding between the team and encouraged staff involvement.
• Regular newsletters are useful for communication and feedback, helping us to make changes.
• Patient feedback has been exceptional with 98% recommending us to friends and family. Well done to the hard work of all the staff!
• Demands – It is sometimes questioned, even with A&E bursting at the seams, whether there is there really a need for a weekend GP/primary care service? Patient feedback shows that this is a valuable service, not just for people who work but for those who work away from home and whose carers work. We have worked at reducing our DNA rates by using text messages and engaging receptionists so patients can cancel appointments appropriately.
• Collaborative working – A true multidisciplinary approach with involvement of hospital pathology services, ERS for referrals, out of hours for deflections, and the CCG as the commissioners.
• Working out a method of fair shift allocation has been challenging

Thanks to all of you who have been involved at the various stages; we wouldn’t be where we are without your hard work.