Primary Care Services
East Lancashire Clinical Commissioning group is responsible for planning and buying health care services in this area. We have been working with patients, GPs and others who provide health care (out of hospital in communities) for some time now to consider how we can improve access to health services in GP practices and closer to patients’ homes. These services are called Primary Care Services. We have listened to a wide range of views about the services and have worked together with patients to put together a range of key principles or values for these types of services in the future. These principles were approved by our Governing Body in January 2015. If you live or work in East Lancashire, we want you to tell us if you agree with these or if there is anything else we need to include or consider. We are particularly interested in hearing from people who may find getting access to health care more difficult, e.g. because of difficulties with English, disabilities, working patterns or for other reasons. Everyone’s views are important. The principles fall into three main areas:
- Getting access to appointments and services closer to home
- Better information about services and appropriate access for health care professionals to their patients’ medical records.
- Increasing the number of primary care health professionals and ensuring they have the right skills to meet patients’ needs into the future.
Primary Care - what services are available
Please select a service for more information
What service is the NHS expected to provide for patients through local GP surgeries?
Each member of our community has the right to be registered with a GP practice. The practice is available to provide a service to residents from 8.00am to 6.30pm Monday to Friday. This service includes the provision of advice as well as surgeries.
What services does a practice have to provide?
Your practice will provide “general medical services” led by a qualified doctor. The practice is available Monday to Friday 8.00am to 6.30pm for the provision of urgent care same day or book in advance appointments within the surgery or through a home visit, and support to patients for other none urgent conditions or management of longer term conditions. These services may include GP consultations, asthma clinics, chronic obstructive airways disease clinics, coronary heart disease clinics and diabetes clinics.
Can my practice provide any other services?
Yes. Most GP practices provide cytology screening, contraceptives services, child health surveillance, maternity services, certain minor surgery procedures, vaccinations and immunisations. They can also provide a number of non-NHS services including insurance claim forms, passport signing and private sick notes.
What if I have a condition that my practice does not provide?
If your practice does not provide the service you require, you can be referred to either a hospital based service, a local community service or, where arrangements have been made, to another practice who provide the additional care you need. These referrals may cover child health and development, counselling, dermatology, dietician support, end of life care, stop smoking support, men’s health and women’s health.
Are there any standards about how quickly I can be seen at the practice?
There is no minimum time set within which you should see your GP. If your problem is urgent your GP should see you as soon as possible. Your practice can advise you of their booking arrangements to either the surgery or to a nominated doctor.
What staff can I expect to see at my practice?
In addition to your GP, practices can provide a range of services from administration through to comprehensive clinical services. At your practice you may find receptionists, practice managers, practice nurses and health care assistants. Other staff, who may be visiting the surgery, can include phlebotomists (specialists in collecting blood for examination), mental health practitioners or health visitors.
What does extended hours mean for patients?
Extended hours services bring two important benefits for patients. Normally these hours provide additional appointments within the surgery. The hours may be more convenient for patients who have work or other commitments which make daytime access more difficult.
What are the extended hours?
The current NHS scheme allows practices to open from 8.00am until 8.00pm from Monday to Friday and on a Saturday morning. Each practice can decide how many additional hours it wishes to open above their normal contracted hours of 8.00am to 6.30pm Monday to Friday. Some practices have flexed these guidelines to provide an early morning surgery as an alternative to evening opening. Details of these services are available from your practice.
Who decides if extended hours are available in my practice?
Whilst the NHS is willing to support the provision of extended hours in your surgery, it is for the surgery to decide what the needs of their patients are. If they feel that the additional hours, which may vary from one hour to the full eleven hours available under the contract, would benefit their patients and they have the staff available to provide the service, they can ask for the service hours to be extended.
What services are available during extended hours?
The services within extended hours are determined by each practice and the provision of available support services. They normally provide for urgent access (same day) but can be helpful in managing longer term conditions or assisting patients who may find it easier to visit the surgery at these times.
What are my options if my surgery does not provide an extended hours service?
Every patient has access to a GP service for “urgent” care when their own surgery is closed e.g. after 6.30pm or at the weekend. Patients who need this service will be referred to their local “out of hours” service. Patients can obtain advice from NHS 111, the NHS website www.nhs.uk, attend a walk in centre where they are available or use a “GP open access service”. This is a provision within each clinical commissioning group area which is open 8.00am-8.00pm each day staffed by GPs, and possibly other staff, who can provide an alternative to using your own GP. Each centre has their own arrangements for either booking appointments or have an attend and wait service.
Are there any other services available for me to use?
Patients can obtain advice from NHS 111, the NHS website www.nhs.uk, attend a walk in centre where they are available or use a “GP open access service”. This is a provision within each clinical commissioning group area which is open 8.00am to 8.00pm each day staffed by GPs, and possibly other staff, who can provide an alternative to using your own GP. Each centre has their own arrangements for either booking appointments or have an attend and wait service. Patients using these services need to recognise that these services will not have full access to their health record and that the service will advise the patient’s own practice of the treatment or advice provided at the appointment.
What home visits can I ask my GP to provide?
If you are housebound or too ill to visit your GP practice you can request a home visit.
Who decides if a home visit goes ahead?
Your request for a home visit will be considered by a clinically qualified member of the practice staff. Each practice has guidelines to ensure that patients are treated in the most appropriate way.
What if a home visit is declined?
If the practice feel that a home visit is not required they will explain to you the options available for you to obtain the treatment you need which may require you to attend the surgery. The surgery may also recommend other health professionals more appropriate for you to help manage your condition at home.
When do home visits take place?
Home visit times will be determined by clinical staff based on the “urgency” of your condition. Home visits are normally within the same day, but may be longer where the condition is for an existing ongoing condition.
Out of hours
These are the services provided by a qualified doctor outside of the core opening hours of your practice which are 8.00 to 18.30 Monday to Friday. These doctors act for your own GP and mainly provide an “urgent” care response. Mainly provided from a clinical base, some home visits may also be available.
What services can I use if my surgery is closed (after 18.30pm and weekends)?
All NHS patients can access a GP service for “urgent care” 24 hours a day seven days a week. When your own surgery is closed (e.g after 18.30 and at weekends) your clinical commissioning group has made arrangements for another doctor to provide the help you need. These are called “out of hours services” They are available outside of your normal practice hours.
How do I arrange to use these services?
If you feel you need an “urgent appointment” when you contact your own practice you will be given a telephone number to contact for this replacement GP service. You can also get advice from NHS 111, who can provide information about your local service or arrange for you to attend.
What happens when I use the “out of hours service”?
You will be seen by a qualified doctor, who if required, can start the treatment you need. This can range from advice, prescription, referral back to your own doctor or other services including hospital care. The service will contact your own GP surgery to advise them of your visit and any assistance they have given you. The service may not have full access to your medical records to help them understand your needs.
Where are “out of hours services” based?
The location of the “out of hours” base varies across communities, where some may be based near your local hospital to allow patients access to the most appropriate “urgent care” service they need. All bases will meet the needs of the Disability Discrimination legislation for access and facilities.
Primary care walk in services
Primary care walk in services can be provided by a dedicated walk in/health access centre offer the ability for patients to present on the day and wait for a doctor or other member of staff to be available to see them.
What is a walk in service?
Primary care walk in services can be provided by a dedicated walk in/ health access centre service to offer the ability for patients to present on the day and wait for a doctor or other member of staff to be available to see them.
Where can I find my local service?
You can find details about your local services from your own practice, from NHS 111, your local clinical commissioning group or from the NHS website www.nhs.uk.
What happens when I attend the service?
Depending on your condition you will be seen by the most appropriate member of staff. You can receive assistance for both “urgent” care and support in managing non-urgent conditions or longer term health concerns. Whatever help you are given will be passed back to your own practice to make sure your health records are fully up to date and that your own doctors knows which services you need. The service will not have full access to your medical record if you are presenting with an existing condition.
When are they open?
Walk in centres are normally available 8:00 to 20:00 seven days a week. Please check with your local services for any variations.
Have do I arrange to use these services?
Patients can self-refer to these centres to “attend and wait” or arrange an appointment where these are available.
Primary care services
Primary care services are provided by your GP, Dentist, Optician and Pharmacist. In addition a number of services previously provided from hospitals are now available in your local community. Details about these are in Extra or enhanced GP services section.
What are primary care services?
Primary care services are provided by your GP, Dentist, Optician and Pharmacist. In addition a number of services previously provided from hospitals are now available in your local community, see extra or enhanced GP services for more detail.
How can I use them?
Dental services normally require you to register with them. Each practice has their own arrangements for registration, the services they provide and hours they are open. Opticians often offer a drop in service. Again each practice decides what services they offer and when they are available. Pharmacies offer a drop in service. Here too they can decide if they wish to provide a service outside of normal hours. For the extra community based services, you will normally be referred to these services by your GP or through Choose and Book.
When are they available?
Most GPs, Dentists, Opticians and Pharmacies provide a service to the NHS which has times decided by the NHS. In addition to these the service can opt to open for longer hours. Details can be obtained from each service provider.
Pharmacies also participate in a rota to allow patients to obtain urgent prescriptions when their normal pharmacy is closed. This service is advertised through your pharmacy and operates in addition to those pharmacies who have opted to open longer hours.
Do pharmacies provide additional services?
Apart from the extended hours for urgent prescriptions pharmacies can join the “Pharmacy First” scheme. This scheme allows pharmacists to prescribe a number of medications to help you manage a wide range of minor illnesses. Details of the scheme are available through the CCG website following the link to the East Lancashire Medicines Management Board or from your pharmacy.
How do extra services fit in to the overall provision of healthcare?
To improve patient services, the NHS is trying to maintain high quality clinical services and move them “closer to home” to provide a more convenient service to you. Further details are outlined in the following series of questions and answers.
Extra or enhanced GP service
To improve services to patients the NHS has been looking to develop alternative services to the traditional, hospital service provision. Enhanced primary care services enable your GP practice to provide new services, or example: diagnostic tests such as blood test and ECGs, minor surgery and other specialist services normally associated with hospital led services.
Enhanced primary care services, a fancy name what does it mean?
Enhanced primary care services enable your GP practice to provide new services, for example, diagnostic tests such as blood test and heart tests, minor surgery and other specialist services normally associated with a hospital. Enhanced primary care services can be provided by your own GP surgery, community health services, opticians, pharmacists, hospital staff using community settings, or authorised NHS clinical providers. This can include physiotherapists, mental health practitioners or advice and support services from community organisations.
Who provides these services?
These services are usually available through your GP practice but can be provided in a range of locations, depending on the service area they cover. Information about the services will be provided by your GP practice or from your “Choose and Book service” when you are referred to one of the services.
Where are they available?
If outside your GP practice each service will provide information about the help they have given you back to your practice to ensure your medical record remains current and accurate.
Where do I find out about these services?
NHS East Lancashire Clinical Commissioning Group is continuously looking to see which services can be safely provided in community settings. It is hoped this range of services will continue to grow and offer increased choice and convenience to patients, whilst improving the overall efficiency and value for money of the NHS.
Will these services be changed in the future?
You can suggest services you think might be suitable for community provision. You can comment on our services proposals about which services we think could move in to the community through our surveys on NHS East Lancashire Clinical Group website www.eastlancsccg.nhs.uk or other engagement opportunities. Opt for GP or community services when using the “Choose and Book” service and use local support services to improve your health.
How can I help the NHS with these services?
Please check with your practice about the services they offer, times of appointments and booking arrangements. If your practice cannot provide a service please ask where they may be available. If you need to have an urgent, or alternative, appointment keep a note about where these services are and how you can use them. Think about your own health, and consider whether a pharmacy might be the best place to start getting help from the NHS.
Wider primary care at scale
What services are included here?
This wide range of services cover everything you can do for yourself, managing your own condition, health screening, longer hours in your practice, additional access to GP services, all community health services and the contribution of pharmacists, opticians and dentists.
How can I help?
The NHS and many other organisations provide a wide range of information and support leaflets to help you understand an illness or manage that illness.
The NHS Constitution asks us all to “take responsibility for our own health and well-being”
Maintaining a well stocked medicines cabinet is recommended.
Have information about yourself, allergies, medication etc. can be helpful for you and others who look after you.
Self care management
What is self management?
We are trying to promote health services based on the needs of the patient. You are the best person to manage your condition and the NHS is here to help you do this. We can offer support through Expert Patient Programmes, personal care plans and support by community teams and services to make access to service as convenient as possible for you.
Health promotion and prevention
What services are available to help me stay healthy?
The NHS provides a wide range of screening services such as cervical smears, breast screening, and bowel screening. Access to these services may depend on your personal circumstances. Your practice can explain the services and access requirements to you.
Practices are also offering health checks, for certain ages, which can be provided by several members of the practice staff.
Which services do the NHS define as community services?
Community health services cover many professionals based in your local community. They include district nurses and health visitors, physiotherapists, occupational therapists, speech and language therapists, podiatrists, learning disability teams, mental health teams and treatment rooms.
NHS East Lancashire Clinical Commissioning Group is currently working with GP practices and community health service providers to develop Integrated Neighbourhood Teams; this will involve these teams working together to provide the care you need closer to home.
Some services previously only available in hospitals can now be provided in local communities. Please check with NHS East Lancashire Clinical Group website www.eastlancsccg.nhs.uk for information about these alternative services in your area.
How do voluntary sector services fit into the NHS?
The voluntary sector provides choice to patients and alternatives to NHS services. They can provide:
- Advice and helplines
- Advocacy and representation
- Support groups for different conditions
- Support for carers
- Foot care