There is a national shortage of primary care nurses, so many practices experience difficulties in recruiting and retaining nurses. Practices may also experience short-term workforce shortages, as a result of unplanned absence. In addition, practices may choose to use sessional clinicians alongside their permanent staff, to enhance flexibility and reduce workforce costs.
GDoc, as the Gloucestershire GP Consortium, employs a bank of nurses with primary care experience who are able to work for short, or longer term, periods within practices, supporting the sustained delivery of nursing care.
This service specification covers the requirements of these placements and sets out the responsibilities and requirements of practices and GDoc.
GDoc became a part of this service in October 2017.
The aim of the service is to assist patients who present themselves at the Hospital ED and although they would benefit from being seen by a GP, they don’t require ED services.
GDoc Locum GPs cover regular hours within the Emergency Department of Gloucester Royal Hospital and see patients that are triaged to them by the Hospital Nurse.
The service has been very successful from the start and the Hospital and patients are benefiting from the service.
GDoc are supporting those member practices that have requested support with the development and implementation of their plans and in providing GPs and other clinical staff where required. We are also providing support through a Countywide service at weekends.
In the past, practices have tended to open during the core hours of between 8:30am and 6:30pm, but this is changing to offer increased access at more convenient times for patients. The newly formed sixteen GP clusters are now working together to offer more appointments in the evenings, early mornings and at weekends.
Previously these extended access GP appointments have been provided by GDoc and funded through the GP Access Fund. It is now being delivered via the NHS England ‘Improving Access to General Practice’ initiative. To support this move, in October 2017, the CCG commissioned four early cluster pilots in St Paul’s in Cheltenham; Gloucester; The Forest of Dean and Tewkesbury, Newent and Staunton.
These clusters are now offering more appointments to their patients outside of core hours (after 6.30pm or at weekends) which means that if there isn’t an appointment available at the patient’s registered practice, they may be offered an appointment at another surgery within the cluster situated in the same area.
Patients will be able to access these new appointments by calling their own practice as normal. Alongside the improved access appointments, these clusters are also piloting new approaches, using different clinicians, such as Advance Nurse Practitioners, Specialist Nurses and Physiotherapists, to improve the range of services they provide.
We currently offer support to: Cheltenham Peripheral, Central Central Cluster and North Cotswolds.
In August 2018 we provided 627 of GP cover including the Countywide Service at Weekends.
GDoc is able to provide support to hospital wards by offering regular Locum GP sessions. The main purpose of these sessions is to see all patients on the hospital ward on a daily basis, providing care and rehabilitation to the patients. Other services include (but are not limited to) ensuring a medical plan is in place for their care to support discharge planning, create drug charts on admission and to review and monitor polypharmacy.
GDoc started providing the ENT Microsuction on the 01st July 2019. We currently offer this service in 2 ‘hubs’ – Leckhampton Surgery in Cheltenham and Kingsway Surgery in Gloucester.
Initially this service will be for 4 conditions which are:
- The removal of ear wax via microsuction
- Nasal cauterisation to prevent nose bleeds
- Otitis externa (inflammation of the external ear canal between outer ear and ear drum.)
Patients can be referred by their GP to the service, so long as they meet a set of certain criteria.
GDoc aim to provide around 40 hours of GP cover to patients across Gloucestershire.
There are 3 main hubs that provide this service. These are:
- Stroud Hospital
- Gloucester Health Access Centre in Gloucester
- Overton Park Surgery in Cheltenham
Urgent appointments are bookable from Wednesday’s by the Out of Hours (OOH) service, NHS111 and Gloucestershire Practices.
Patients have been extremely satisfied with the service and utilisation has been good.
The aim of the service is to enhance the current service and provide physical health care for people with an eating disorder. GDoc’s responsible for providing clinical support to the Eating Disorders Service (EDS).
The Eating Disorders Service will be able to take on responsibility for physical health risk management related to an eating disorder, but this needs to be undertaken in a planned and safe way. GDoc has agreed to work with 2gether to provide GP sessions to help manage the risk and assume medical responsibility for requesting tests and interpreting the results.