Plans to increase access to primary care GP services in Bradford

The local NHS has plans to give patients in Bradford greater access to GP services by offering extended opening hours in the evenings.

NHS Bradford City and NHS Bradford Districts clinical commissioning groups (CCGs) will present their plans to Bradford Council’s health and social care overview and scrutiny committee (HOSC) at a meeting on 9 February.

Practices are already contracted to provide essential services from 8am to 6.30pm, Monday to Friday; but, starting this year, the CCGs will commission extended access, which could mean practices staying open until 8pm on weekdays. This will be on a phased basis, building to provide access for all patients by 2020.

The proposals are part of the CCGs’ five year primary medical care commissioning strategy which aims to improve access through extended opening hours, greater use of digital access and increased use of new technology to promote self-care and prevention. 

As well as improving access, the CCGs are also testing out new ways of reducing patient demand for GP services by providing alternative services appropriate to different people’s needs, such as social prescribing and practice health champions.

Dr Andy Withers, clinical chair of Bradford Districts CCG, said: “We recognise that GPs and practices continue to be under unprecedented pressure, with an increasing number of practices struggling to maintain existing services in the face of financial pressures, falling staff numbers and rising demand.

“That’s why we need to look at new ways of improving access, within a limited budget, for those patients who really do need to see a health professional, and provide alternative support for patients who have needs other than medical – such as befriending or welfare rights advice which will be addressed through our focus on social prescribing.”

The HOSC will also be updated about the CCGs’ proposals for GP services at Hillside Bridge Health Centre, in Bradford. These plans relate only to services delivered by Local Care Direct – they do not affect Primrose Medical Practice. 

Local Care Direct currently holds the contract to provide two services at Hillside Bridge: a GP practice for almost 5,000 patients and an ‘enhanced primary care’ service (formerly known as a ‘walk-in’ service).

The joint contract runs out at the end of March and the CCGs propose to hold a procurement process to re-commission the GP service, which will involve a public consultation.

The future of the ‘enhanced service’ – which offers GP appointments for non-registered patients from 2pm to 8pm, seven days a week, and, for patients registered with a Bradford GP, on weekday evenings and from 2pm to 8pm on weekends – will be reviewed as the CCGs want to increase capacity for people right across Bradford.

When it was first launched in 2008, the walk-in service, as it was then, was intended to provide services for some groups of people who may find it harder to access healthcare. This included people not registered with any GP, homeless people, asylum seekers and refugees, commuters and patients who have substance misuse problems.

However, since then extensive public engagement has been carried out which shows that most patients who use the service are already registered with another local GP in the BD3 area. Some use the service because they cannot get appointments with their own GP; and some even use it because they want a second opinion, after they have seen their own GP.

The service is rarely used by the most socially excluded members of the community and there is no evidence that people’s overall health has been improved as a result of using it.

Dr Akram Khan, clinical chair at Bradford City CCG, said: “We want to meet the primary care access needs of our patients by increasing capacity – but in ways that benefit everyone in Bradford, and make best use of the resources we already have.

“We’re already investing in extended GP opening hours, have commissioned an alternative service for our deprived and socially excluded population, and are going to bolster the urgent care service co-located at Bradford Royal Infirmary’s A&E department, so patients can access a primary care service instead of taking up an unnecessary A&E appointment.”

The CCGs plan to engage with the public to look at different ways to provide the most appropriate service in the future, and check that its previous engagement feedback is still current.