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GP Fellowship in New models of Care

2017 GP Fellowship in New models of Care

Are you a GP with an interest in improving your skills in a wide range of specialties including urgent care, frailty, leadership, education and secondary care traditional specialties like dermatology, gynaecology and cardiology etc

An innovative, salaried opportunity has arisen, for qualified GPs with an interest in enhancing their skills which is particularly suitable for new or recently qualified GP’s who want to develop their skills in new settings across Primary and secondary care..

The 12 month+, full-time Fellowship programme will enable you to work in local GP surgeries, plus integrated primary and secondary care teams in new ways of working that reflect the 5 year forward view., alongside two days in a mentored GP role. 

You will also have the opportunity to develop your leadership, educational and evidence based practice skills as part of a weekly Action Learning Set and to undertake a Postgraduate Certificate in the appropriate qualification that suits your interest.

Taurus are currently working with all 24 practices across Herefordshire to deliver the GP forward view in a Primary Care at Scale model, and are looking to new enthusiastic GP’s plus allied health professionals to work with us and stimulate our primary care community with new ideas. As such we welcome interest or applications that are new and innovative, whilst supporting the application for more traditional roles where gaining experience in specific specialties is the key motivation.

A Programme example;

Job title: Urgent Care / Frail Elderly GP

Duration of the Post

12 months

Lead NHS Hospital/Trust in which training will take place

Taurus Healthcare Federation Urgent Care Service and Wye Valley Trust Hospital

Institutions in which Post CCT training will take place

  • Taurus Healthcare 7 day access urgent care hubs
  • Wye Valley Trust Frailty Unit
  • Community setting to develop pathways and solutions for complex patients, and care homes.

Description of the programme

Herefordshire has 24 GP practices that have a strong tradition of good quality general practice and a thriving teaching community. In recent times, these practices formed a federation called Taurus Healthcare, designed to provide Primary Care at Scale for the future. Taurus are linking with the CCG and the local hospital WVT to provide an urgent care and frail elderly program, designed to support a system where new ways of working are essential to the future of the whole healthcare system, recognizing the changing careers and needs of newly qualified GP’s that reflect these developments.

Herefordshire currently has more than its fair share of difficulties in providing solutions to the current issues in urgent care. In the last 18 months Taurus, as one of the successful Prime Minister’s Challenge fund sites, has been running one of the highlighted exemplars in 7 day general practice. In addition Taurus has been running a number of pilots, one of which included the employment of an urgent care GP Dr Andrea Gibson who ran a successful pilot with the Ambulance Trust WMAS. It looked at the effectiveness of providing WMAS with direct access to an Urgent Care GP and was shown to reduce admissions. In addition carers of the frail and vulnerable are increasingly accessing 999 on behalf of their clients and a significant proportion of the workload in appropriate admission avoidance was in the frailty pathway. It is also known that a small number of patients cost the local health system a huge amount of money. Proactively managing such patients will improve the patient experience and reduce the impact on the system.

The programme will consist of 3 elements;

  1. 2 days a week in a local GP practice, with an allocated GP partner to provide support and mentorship.
  2. 2 days a week in an innovative new post. This will involve a number of activities that include;
    - Providing Urgent care in 7 day hub (evening or weekend)
    - Working in the new frailty unit at the local hospital, outreaching into the community.
    - Assessing and completing complex needs analysis of patients who are frequent attenders in secondary care, and providing solutions to commissioners and providers to optimize their care. This may also involve working with care homes.
  3. Education: 1 day a week to support your educational development. This will comprise of obtaining a further qualification in either urgent care (based at Worcester University – urgent care and long term conditions) or Frailty (urgent care and frail elderly, also based at Worcester). You will also have joint mentoring sessions with your colleagues on the programme where you will support each other’s CPD, plus be given opportunities to consider other educational activities that may include audit, care pathway development and care reviews, with the key theme of instigating impact on the system, thus reinforcing current service delivery or driving change. Such activities will be supported by your post CCT mentor Dr Mike Hearne, who will encourage you to develop leadership skills as you progress.

Description of clinical component of programme

Primary Care

A number of GP practices in Herefordshire have already expressed an interest in hosting these roles. Each practice will be finalised in keeping with the needs of the GP to match the practice. You will be expected to do the usual duties of a GP, which is likely to involve one day a week on duty, and the second day seeing routine patients or care home / nursing home rounds. A partner at the practice will be appointed your local mentor to support your development and ensure the role suits your needs as well as the practice.

Urgent Care Hub

Herefordshire has 3 hubs that cover 8am-8pm on the weekend and 6-8pm on weekdays. Patients receive a service in a similar fashion to seeing their own GP, since every practice in Herefordshire has Emis web, and Taurus have coordinated a comprehensive data sharing agreement so the full patient record can be viewed. Appointments are 12.5 minutes and patients are either referred from A&E, GP practices, 111 and paramedics. Supported by a practice nurse and healthcare assistant you will be the clinical lead of a hub.

You will be expected to do a minimum of 2 hours per week.

Complex Patients

The 60 most frequent attenders in a secondary care setting cost the service £7million annually. Pending commissioner confirmation, you will be asked to review such patients and assess their problems and write a detailed action plan to improve the quality of healthcare for the individual that transcends different healthcare providers and provides proactive care in the hope this will reduce the need for frequent secondary care intervention. This role will rely on excellent communication skills to assess the problem with the patient and family, and will involve communicating with different health and social care professionals.

Pathway Development / Audit / Review

The roles will inevitably expose issues within the healthcare system that you may be asked to assist with providing the solutions. You will develop leadership skills and may have the opportunity to attend meetings with commissioners, where business cases will often need writing and presenting. This will receive support from the appropriate teams and will not be as scary as it sounds. Such needs are often very dynamic so it is difficult to predict the exact nature of this work.

You will be expected to use a minimum of 1 session every 2 weeks of your CPD time in such activity.

Frail Elderly

The local hospital, Wye Valley Trust has just opened a frail elderly unit run by Dr Emma Wales, consultant in Age Care. You will expected to work alongside secondary care teams to provide an holistic, primary care influence that will involve developing links with a patients GP, community health and social care team, completing a comprehensive geriatric assessment of frail elderly on hospital admission. This will involve a MDT team with the aim of reducing lengths of stay and advance care planning including dementia screening.

You will be expected to do a minimum of 1 day (possibly 2 days) a week in this role.

Supervisor details

Dr Mike Hearne

Medical Director

Mike has a vast amount of experience in dermatology and leadership and has worked across primary and secondary care in Herefordshire. He is a skilled appraiser and experienced GP mentor with a huge enthusiasm for education.

Interested GP’s should email Dr Mike Hearne at mike.hearne@taurushealthcare.co.uk