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'WE are absolutely committed to providing care as close to patients as possible in their communities."
These are the words of Christine Outram, chief executive of Leeds Primary Care Trust, the woman who oversees the city's annual 1 billion healthcare budget.
Ms Outram is talking about Leeds's increasing move towards community-based healthcare services.
In the past year, we have seen the development of several supersurgeries – large localised health centres which house not just your traditional family doctor, but also offer more specialist care traditionally associated with hospitals.
GPs – who are working directly with the PCT to develop the new services – refer to them as 'one stop shops' for patients, and for most, it is a very welcome way forward for local healthcare.
Under this new way of working, a patient could walk into a community health centre in Wetherby or Beeston Hill and as well as getting that nasty chest infection seen to, they could get weighed, have their blood pressure checked and even be referred to a specialist diabetic nurse, stop smoking service or eye clinic based in the same building.
In the future, such centres could even house chemists, physiotherapists and all sorts of NHS and non-NHS healthcare clinics.
Traditionally many of these specialist services would have come from a hospital clinic and would have meant a sometimes lengthy trek to the hospital.
"We are supporting the development of care in the community setting closer to home, " Ms Outram explains.
Technologies
"There are more older people now, more people with long term conditions, and that combined with new and better treatments and technologies means people no longer need to go to hospital to get everything. It saves you the worry of going to hospital and frees up hospitals to concentrate on people whose needs are more complex."
"It's not cheaper," she adds. "It would probably be cheaper to do everything in a hospital and make people travel to it but that doesn't mean it's meeting people's needs. This is about maximising services in the community – having somebody qualified just down the road who is more than able to look after you in an environment you are familiar with."
Key to this ethos of 'your health in your community' is a thorough overhaul of many of the city's existing GP surgeries, which professionals admit are outdated, crumbling, and nowhere near suitable for the wider mission at hand.
GPs have always worked as independent professionals contracted out to the NHS, and they either own their surgery buildings or rent them.
But now, to meet Leeds' changing health needs, Leodis Care, a consortium of GPs in South and East Leeds, and Leodis Community Ventures (Leeds) have come together to form their own partnership, Leodis Community Ventures. This partnership will lead to more investment in both new and existing buildings.
Essentially a vehicle by which some of the city's outdated surgeries will be redeveloped into 'one stop shops' for health, the pumping of some private money into the buildings themselves will mean vital NHS cash is spent where it's needed most – on staff and on treatments.
Leodis Care itself is an example of 'practice-based commissioning' – GP practices working together to develop needs-based healthcare strategies for their particular patient lists. Clearly no-one is better qualified to know the needs of their patients.
Community Ventures (Leeds) Ltd has already helped to develop new buildings in East Leeds, Beeston and Wetherby.
Andy Harris, a GP at East Leeds Community Health Centre and one of the doctors at the forefront of Leodis Community Ventures, sums up the role of the organisation as "a vehicle by which practices can build new buildings".
But rather than de-personalising local healthcare, as some might fear, he says it's about improving services while retaining the traditional doctor/patient relationship which is a bedrock of the local NHS. "It's about shaping services so patients get the right care in the right place," he says. "There is real strength in the fact that as a GP you know the patient and you know the family for a long time. That is incredibly powerful and the outcome of that is better health."
The injection of cash from various streams – both public and private – is essential. But that does not mean your local NHS is being privatised – treatment is still completely funded by the NHS bank, as it has always been.
Spending
What it does mean, says Ms Outram, is spending NHS money where it most needs to be spent.
"For GPs to be able to make best use of all the skills they have and to be able to provide care closer to home, we need good buildings, we need high quality equipment, we need all the best equipment and the best professionals.
"But if all you've got is a room to practice out of you are limiting yourself. We have a huge programme of investment in primary care and community supported care and we want to continue doing that.
"But if we spend all the money on the new buildings we couldn't spend the money on the treatments. We want to put the money into what matters.
"I don't think people mind, as long as a building is there and the equipment is there, how it's funded. So we want to support 'go ahead' GPs who want to work together to provide a wider range of services.
"We want them to have excellent premises to work in, so we are happy with this development because it gives more doctors more access to the community.
"I could not possibly gripe about money. We have had a fantastic amount of money in the past 10 years and the challenge for us is to use it on the right things."
Three ways in which your Leeds NHS is changing for the better:
Developing specialist health services 'closer to home'
A number of projects have been introduced in Leeds to improve the quality of life of patients with long-term needs.
These can include stop smoking services, eye clinics for preventable diseases such as glaucoma
One of these is a new diabetes model of care which was introduced earlier this year.
Currently, around 26,485 people in Leeds are registered as having diabetes and figures from the Public Health Observatory project that by 2010 more than 37,000 people in Leeds will have been diagnosed with some form of the condition.
Extended opening hours
In Leeds, 74 per cent of GP practices are already offering appointments in the evenings or at weekends to their patients, way above the Government's target, which states that by December 2008 50 per cent of the GP practices should be providing this service.
One practice that has recently started to offer extended opening is the Street Lane Practice in Roundhay.
The practice, which has 12, 500 registered patients, now offers appointments up to 9pm and feedback from patients has been overwhelmingly positive.
"Our evening clinics are run in exactly the same way as our day time sessions," explained practice manager Petra Morgan.
"Patients can book appointments with one of two doctors or a practice nurse and the reception is open to help patients book new appointments and manage their prescriptions.
"We worked closely with our patients to identify what times they wanted the practice to open and the evening sessions are proving really popular."
In addition to extending opening times, Street Lane practice is also offering a range of new services to local people including dermatology, cardiology and general paediatric clinics.
GP Practices in Public Health Role
GP practices are increasingly taking on the role of health promotion with a number of innovative initiatives taking place across the city.
One project developed by a medical practice in Beeston (South Leeds) is helping local Asian women and their families to adopt simple lifestyle changes that could improve their health and wellbeing.
The Oakley Medical Practice has been working with ASHA, a neighbourhood community centre for local Asian women and their children, to hold a series of "Heart and Soul" workshops highlighting common health problems such as diabetes, high cholesterol and pain.
The five-week course, run by the Practice's Nursing and Strategy Manager Rhian Last, has focused on improving women's understanding of diet, portion size, exercise and heart health as part of a wider project to help the women lose weight healthily.
Rhian explains, "As a medical practice we are at the hub of the local community and we felt it was really important to make sure we played a role in helping local people access quality health information, advice and support in the most appropriate settings."
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Weather for Leeds
Thursday 24 May 2012
Today
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Temperature: 10 C to 25 C
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