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Why we converted a bus into a touring GP practice


By Awil Mohamoud
Reporter
25 February 2020

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A health bus is touring Doncaster this month, giving patients the opportunity to board and see a GP or nurse without an appointment.

The bus health service, which started last week, is being parked at local town centres and markets on scheduled dates throughout February.

The CCG is doing this in a bid to promote and encourage the use of its extended appointment hours – something it has found not enough people are taking advantage of. Doncaster CCG director of strategy and delivery Anthony Fitzgerald speaks to Healthcare Leader about how this quirky endeavour is helping to change the way people interact with primary care.

The problem

Doncaster has made 160 extra hours of appointments available during early mornings, late evenings and weekends as part of the national extended access service. However, Doncaster CCG has found that only 50-60% of the out-of-hours appointments are used each week.

NHS England, early on, urged practices nationwide to advertise the extended hours service online and on notice boards, which it expected would increase take-up over time.

‘We’ve had some feedback from patients that there is a little bit of a reluctance or fear of seeing a professional outside of their normal GP practice’, explains Mr Fitzgerald.

‘There is a fear about what their GP is going to think if they see someone else. We need to dispel some of those myths. This has been a good opportunity to do so.’

The extended hours requirement was brought in with ‘working people’ in mind, making it easier for them to schedule appointments around their busy lives.

‘We do need to be honest, there is pressure in primary care across Doncaster in terms of accessing appointments anyway,’ says Mr Fitzgerald.

‘We’ve got 39 practices and there is variation across Doncaster in terms of that but sometimes there can be pressure on general appointments to get something quickly – hence the reason to increase the number of hours available and to make them more convenient.’

Solution

The CCG has loaned the converted bus, which belongs to the local mental health trust, on several occasions for promotional reasons. This time, it decided to use it to offer patients on-the-spot appointments with a GP or nurse in busy parts of the community.

‘We have found that people are going there and being seen really quickly. It is essentially general practice. Services range from anything like blood pressure checks to advice and guidance and if there are any worries, patients would be referred as they would be usually,’ explains Mr Fitzgerald.

‘The idea of the bus was two-fold. Firstly, to get out to our local communities and advertise the fact that there are these extra hours appointments available in the system. They are available across five hubs across Doncaster. Secondly, as part of a new and more novel approach, we wanted to see if people would take up the opportunity.’

This decision followed a large engagement exercise with the community, carried out by the local Healthwatch. The feedback found that people wanted ‘more convenience’ around appointments. However, it also highlighted that some people feel an inherent ‘loyalty to their practice’, preventing them from travelling to other surgeries at more convenient times.

Benefit

More than 80 people saw a GP or nurse on the bus in its first three days.

‘We are going to do more qualitative analysis but people reacted really well to the convenience of just dropping in. The feedback we are getting from the GPs on the bus is that they are seeing people who wouldn’t necessarily always access a GP surgery. The convenience, the very fact that it is there has given them the opportunity to take the plunge to see somebody,’ explains Mr Fitzgerald.

‘This all tells me that perhaps this has some legs for the future and we will evaluate to look at whether it has the potential to be run again. It also tells me that people are willing to see other professionals, they are willing to go to other areas for their care and advice. What I’m really hoping for out of all of this is that we see a better take-up of those extended hours that we put on.’

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