Programmes of work
Everything we do is designed to support our constituent GP member practices and the PCNs to which they are aligned, so they can provide the very best care in the localities where we operate.
By working collectively, we:
Develop and share information about the health needs of the local population, so that services are carefully matched to these needs.
Help our clinicians connect with each other and with colleagues in our local hospitals, community services, social care and the voluntary sector.
Minimise duplication and workload by providing business management support.
We are also happy to provide business management support to other organisations across a wider geography, in Dorset and across the UK, so they can use our expertise to develop efficient organisations which develop a strong voice locally and innovative clinical services.
We alleviate workload by supporting with business management support, including:
HR, recruitment and legal advice
Management of programmes
Engagement and communications.
We have set up a new body called the Dorset General Practice Alliance, which represents general practice within the new Dorset ICS structure.
This involves putting in place the people, systems and processes needed for an effective membership organisation, representing practices across Dorset. We are providing:
Finance management support
HR - recruitment and employment support
Programme management and governance input as required.
Strong voice locally
We help our clinicians connect with each other and with colleagues across the local health system.
We have a strong voice locally when discussions take place on how services should be planned to improve the patient journey.
We deliver several programmes and services to benefit local people, practices and partner organisations and have adapted these to match the changing and challenging needs of our communities.
RESPIRATORY DIAGNOSTIC SERVICE
A waiting list of over 400 patients for Spirometry diagnosis to confirm COPD, built up during the pandemic, has now been tackled through a dedicated Respiratory Hub.
With many practices unable to offer this service and meet the infection control restrictions in place, we put in place arrangements at St Leonards Hospital which met stringent national guidelines e.g. allowing rooms to remain fallow for an hour between appointments.
Our approach was so successful in reducing the original waiting list that the service was expanded to include FeNO testing. Castleman’s Respiratory Lead Nurse, who runs this service, played a key role in assisting with the development of regional guidance on how to adhere to national guidelines when delivering diagnostic respiratory tests. To support and develop this work further Castleman continues to provide specialist nurse and HCA time.
During the pandemic our lead nurse was an integral part of the Covid remote monitoring service.
INTEGRATED COMMUNITY AND PRIMARY CARE SERVICE (ICPCS)
The ICPCS programme is now aligned to the national Ageing Well Agenda and this supports practices and the PCNs respond to the needs of patients through:
• Urgent community response.
• Enhanced health in care homes.
• Anticipatory care.
The ICPCS East Dorset Integrated hub team, based in St Leonards Hospital, sees patients with multiple co-morbidities and those on many medications so a personalised plan of care is developed. They take time to complete comprehensive frailty assessments which proactively address health and social care needs, using an anticipatory approach to reduce the likelihood of an acute crisis. They also support the PCN Care Home DES. The Alderney Hub supports patients in Poole.
The team is a great example of true collaboration with Dorset HealthCare (DHC) and includes a GP employed by Castleman and Advanced Nurse Practitioners and an HCA employed by DHC.
Two specialist nurses employed by Castleman and a health care assistant provide non-urgent advice and support to clinicians and complex diabetic patients; a visiting service for housebound patients and an educational programme for clinicians.
This team was instrumental in supporting practices with their diabetic caseload during the pandemic, ensuring the most vulnerable patients continued to be prioritised and proactively contacted.
More than 20 clinicians attended an 11-week programme on diabetes care run by this team, with others attending a 3 hour refresher webinar on diabetes care.
ENHANCED ACCESS SERVICE
The three PCNs are taking on responsibility for the local delivery of a national programme to improve patient access to general practice services from October 2022. This comes with funding to expand workforce capacity, so that primary care services can be developed to meet the health needs of our local population.
Castleman is currently working collaboratively with the PCNs and other stakeholders to develop a robust delivery plan. This has included scoping and planning the service, followed by phased implementation.
It is anticipated that Castleman will provide ongoing support in the delivery of this programme which as well as providing improved access to care, offers the opportunity for clinicians locally to develop innovative models of care which will alleviate some of the current pressures on them.
Castleman holds the contract for Public Health services locally. We lobbied for NHS Health Checks to return to practices and these were restarted in April 2022. We are running a pilot of post-Covid NHS Health Checks.
Many practices have extensive waiting lists for long-acting reversible contraception (LARC) and so some PCNs are working together to deliver this service at scale. Castleman continues to support practices and PCNs to make this a success, so that waiting lists can be reduced.
During the pandemic we supported the practices and PCNs with reactive activity during a time of unprecedented pressures. The pandemic continues to impact on our working lives including those directly employed by Castleman.