RCGP Bright Ideas: Red Kite Health Solutions, a social enterprise approach to sustainable general practice

Red Kite Health Solutions Team

Image: Red Kite Health Solutions team

20 December 2019

At the Royal College of General Practitioners, we want new approaches to be recognised, celebrated and spread. Recently the College awarded a Bright Ideas Award to Red Kite Health Solutions, in Powys, Wales for its social enterprise approach to providing sustainable general practice in the county.

The county of Powys, Wales is very diverse and geographically elongated, with no district general hospital. It requires a different approach to patient care and services for patients to be seen closer to home. Four in five of its GP partners are aged 50 years and over. With current low levels of interest when recruiting GPs, it is imperative that GP time is spent on patients who clinically need to see a doctor and to improve access to healthcare for patients.

South Powys has four GP surgeries, which had been meeting to develop cluster working and were keen to develop services through a multidisciplinary approach that would improve patient outcomes and the whole cluster.

Because the GP representatives were finding it hard to commission and provide services they wished to implement at pace, they agreed to create a formal joint working relationship based on the social enterprise model.

The Bright Idea

In 2015, Red Kite Health Solutions, a social enterprise company was created in South Powys, with four GP representatives sitting as directors. The remaining 40 cluster GP partners became members of the company. The ethos behind this was to have a separate organisation to source and commission services based on the cluster’s priorities. This allowed several sourcing and funding options to become accessible. A separate entity was also able to integrate new services at pace. A social enterprise was selected as it would be open and transparent and incorporate relations with all sectors across primary, community and social care as well as with patients.

In 2015, the cluster prioritised several innovations that its members wished to take forward, following closely with what was then known as the emerging model of primary care and Welsh Government priorities. This included the introduction of:

  • Telephone first – nurse triage
  • Call lists triaged for urgent on the day appointment requests
  • Call lists triaged for routine appointment requests in one practice
  • Remote triage – cluster practices providing triage remotely for neighbouring practices
  • Pharmaceutical team – the employment of eight Red Kite pharmaceutical employees, providing chronic disease management clinics, medicines reconciliation and leading to cost savings
  • Musculoskeletal (MSK) service – on the day physiotherapy sessions are available within the cluster practices for acute MSK issues. Patients presenting with acute pain issues can be triaged directly in to a physiotherapist usually within a few days
  • MIND – the introduction of active monitoring in-house, treating low level mental health issues in-house
  • Point of care C-reactive protein testing supplied to cluster for the antibiotic prescribing of upper respiratory tract infections

Impact

Cluster reports are generated monthly and quarterly to the practices to evaluate services. All staff have worked tremendously well with a very different approach compared to how many have worked in the past. Staff morale has improved greatly, and it has further supported relations between the cluster practices who now look to provide services and create opportunities as a group and how this can be shared between all 45,000 patients within South Powys.

RCGP Bright Ideas

The RCGP recognises and celebrates GPs their teams, practices and patients who come up with ideas to improve efficiency and improve workload through the RCGP Bright Ideas Awards. They are part of the College’s Bright Ideas project – an online platform where people can share ideas for small changes that can have a big impact on general practice. You can submit your Bright Idea by emailing the Bright Ideas Project Team.

In early 2020, the RCGP will deliver webinar masterclass sessions with selected Bright Ideas winners. The sessions will explore the local challenges faced by the team or individual, how they developed and implemented their Bright Idea, the impact it had and how it might transfer or scale in different contexts. There will also be an opportunity for a question and answer session. The one-hour long webinars can be accessed via your computer or tablet and are open to all (but particularly relevant for GPs and wider general practice teams). The first webinar, 'The Cancer Maps' will take place on 11 March 2020. Register here

 

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