|
Problem |
Priority |
Resource implications |
Training needs |
Costs |
|
Access to primary care
- Nurse triage
- Some problems can be dealt with by phone by doctor nurse or
receptionist – how can these be filtered out?
- Doctors can’t cope with more phone calls but a lot of appointments
could be dealt with over the phone.
- PN on sat morning
- Later opening in evening
- Expansion of nurse practitioner role and replacement nurse
practitioner (current nurse practitioner will retire in a few years
time).
- Thursday afternoons - inadequate reception cover now nursing
appointments expanded.
|
High
|
- Nurse triage,
- 3hrs per day for home visits, telephone calls and same day
appointments (15hrs/wk G grade)
- extra terminal
- extra phone
- Evening opening (treatment room & screening)
- Extra nurse time
- Extra reception time
- Thursday afternoons
|
- Nurse triage training
- Protocols
- Further / replacement nurse practitioner
|
- Nurse triage
- 15hrs/wk G grade
- Computer
- Phone
- 4hrs/wk F grade
- 4hrs reception
- Thursday afternoons
|
|
Cardiovascular disease and the CHD NSF |
High |
- Cardiac rehabilitation program
- Cardiac support group
- Heart manual extension?
|
|
- Admin 2hrs per week
- Centrifuge to spin blood samples
|
|
Hypertension
Development of a nurse-led service using Prodigy 3
|
High |
-
Nurse time – half a day per week plus DN visiting time.
|
Training of practice and district nurses in
- use of Prodigy 3
- management of hypertension
|
- Increased responsibility and training will increase grade for Mandy
from E to F
- Replacement E grade nurse 4 hours per week
- Admin 2hrs per week
|
|
Cardiac failure |
High |
NSF protocol awaited |
? |
? |
|
Population health |
High
|
- Screening in the workplace
HAZ funding for 1 year to integrate occupational health screening with
primary care, and extend primary screening for under-45 males. (Fay
Martin)
- Weight management - subsidised?
- Exercise – subsidised @ Swan Centre, walking for health, aquanatal?
- Sat am nurse for access and well man screening
|
?
|
Sat am nurse
|
|
Diabetes |
High
|
NSF protocol awaited |
?
|
?
|
|
Medication reviews
Improving safety in repeat prescribing |
|
-
Doctor time initially
-
Older people NSF
|
- Computer training - doctors and practice nurses in-house
- Pharmacy input
|
|
|
Menopause/HRT clinic |
High |
Nurse-led |
Nurse training |
|
Better communications – patients and staff
- DN and HV use of email and S6000
- Appointments and prescriptions over web
|
High |
Training time (trainer and trainee) |
-
Email and S6000 training for DN and HV in-house
-
Email and S6000 training for receptionists in-house
|
|
|
Minor surgery |
High
|
Funding from secondary care awaited to expand service. |
BCS to train practice nurses in-house |
|
|
Research |
High |
|
Specific training via PMS R&D strategy: BNC and Jane Steven |
|
|
Information technology |
High |
- Workstation in Berwick Infirmary - HAZ funding
- Prodigy 3
- Framingham calculation
|
- Prodigy 3 training for all
- Framingham risk calculation for all
- Further training for doctors
- Further training for district nurses
- Further training for health visitors
- Further training for practice nurses
|
- Further IT funding via PCG
|
Teaching and learning
-
Expansion of the "learning organisation"
-
Explicit "time out" for doctors and
nurses for in-house/in-service training
-
Possibility of GP registrar training position in
BI
-
Undergraduate teaching
|
High |
No identified additional GP trainer in the practice Further protected time for undergraduate teaching Who runs the practice while everybody is learning?
|
- Teaching in educational theory and its application
|
- Computer projector (perhaps shared)
- Funded in time terms by extra nurse input (above).
|
|
Counselling |
Medium |
No funding |
PHCT training in cognitive behavioural therapy |
|
|
COPD
- What outcomes and process can be influenced?
- Funding
|
Medium |
Nurse and doctor joint input |
Some already done |
|
|
Impotence clinic |
Low |
Probably doctor led. Clinic available at Wansbeck. |
"Specialist" training |
|
|
Ear clinics (microscope) |
N/A |
Numbers of patients low - specialist ENT nurse in secondary care |
Not required |
|
|
Palliative care
|
N/A |
Already occurring collaboratively between primary and secondary care in
Berwick. |
Already occurring |
|
