A New Deal for Primary Healthcare

Category:              Scheme best addressing Health Inequalities

Name:                   Arboretum Health Team/Impact

Job Title:          

Organisation:        Nottingham City PCT

Email:                    judy.henderson-smith@nottinghamcity-pct.nhs.uk

Telephone:            0115 979 1204

Key team:             Gordon Dyne, Health Information Advisor, Diana Gordon, Health Information Advisor, Julie Smith, Community Health Practitioner, Caroline Forrest, Community Health Practitioner, Julie Deacon, Community Health Practitioner, Heather Fitton, Acupuncturist, Fiona Robertson, Homeopathic, Adrian Sity, Project Administrator

A new deal for primary healthcare providing complimentary medicine and alternative GP practice

The PCT had identified a need to offer services to asylum seekers, refugees and homeless people.  Local consultation and mapping confirmed needs were not being met.  PMS contracts and partnership with New Deal For Communities (NDC) provided the flexibility to deal with these needs in an innovative way by commissioning a brand new practice with a WTE GP and practice nurses.  This provided the best skills mix to meet the needs identified.  It was also identified that those working at the practice would need to be willing to adopt more innovative approaches to delivering primary medical care and to be more flexible.

Best practice from the Walk in Centre was adopted to get away from the more traditional receptionist role and employ Health Information Advisors.

Complementary medicine is also delivered from the same base through a group called Impact who currently provides homeopathy and acupuncture.  This has been funded by New Deal for Communities and takes advice from our D.P.H

Those struggling to access more conventional GP services as refugees, asylum seekers and people who were or had been homeless or rough sleepers.  The practice was established to attract people who were not registered with any other practice.

The Arboretum practice has adopted a flat structure.   The team ethos is that all members have an important part to play in the running of the practice.  They all play a valuable but different role in delivering the service is important, rather than being GP or nurse led.

Impact has attempted to combine delivering complementary medicine with the safeguards of support by the Primary Care Trust and New Deal For Communities.

They have combined access pathways through GP referral with the option of self-referral allowing the combination of the best conventional and alternative medicine so increasing patient choice.

Many agencies including homeless organisations, community representatives and the Prostitutes Outreach Team were involved in the original consultations.  Support from local GP practices has been crucial.  Patients have contributed by evaluating how complementary therapy has had an impact on people’s health through customer satisfaction questionnaires.  This will be a crucial part of evaluating the success of the project.  The Project has also shown how partnership working between IMPACT, NDC and the PCT can produce successful results.  The team has established an excellent partnership with the Trusts Interpreting Service.

The Arboretum staff team were themselves crucial to the success of the project because they were willing to consider working in an innovative way within an unconventional practice environment where all staff were salaried PCT employed.

Some agencies doubted that there was a significant unregistered population in the area – the practice now has 1,500 patients.

Both the Arboretum practice and IMPACT had to overcome scepticism and doubt about whether they could deliver alternative ways of working from temporary accommodation while they secured backing and support from NDC & the PCT for purpose built premises.

IMPACT:

• have had to overcome scepticism and to strive a balance between gaining respect and acceptance from more conventional practitioners without losing their distinct value base.  They have also had to demonstrate to their funders and stakeholders that they can evidence their success while still delivering high quality complementary medicine.

IMPACT:

• Benefits include improved partnership between complementary and conventional medicine.
• Next steps include expansion of the service through the recruitment of a chiropractor.

ARBORETUM

There have been opportunities for staff to extend their roles in a safe working environment.  Opening in the new premises, evaluating how to best utilise our existing links with other services, and possibly expand their involvement with our patients.  Other services are keen to work alongside the team in this new environment.