Place Category: Health & Social Care
Primary Care 24 is an NHS out of hours primary care service for the population of Halton, Knowsley and Liverpool in Merseyside. As a Social Enterprise, we have no shareholders and operate strictly on a not-for-dividend basis where any surpluses are re-invested back into the service.
We are commissioned by NHS Knowsley and Liverpool PCTs to provide primary out of hours care to their residents. In addition, we run an initial health assessment service for Asylum seekers on behalf of Liverpool PCT.
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Social Impact Statements
The Social Enterprise Mark criteria includes a requirement that the applicant can demonstrate that social and/or environmental objectives are being achieved.
In support of this, new applicants and renewing Mark holders are asked to respond to a set of social impact questions, which are designed to help them think about the social impact they create, and to articulate this clearly and succinctly.
Updated January 2018
1) What social differences and changes have you aimed to create (or supported)?
UC24 seeks to provide high quality accessible healthcare to the populations it serves, to be a good local employer in Liverpool and to work collaboratively in order achieve positive system change.
As part of the delivery of those values U24 has:
- Become an accredited Living Wage Employer and, through expanding its services, provides high quality jobs with good development and training opportunities for local people.
- Worked with other local providers to provide care from the right professional, at the right time and in the right place. UC24 works with the Ambulance service to ensure that patients who call for an ambulance but do not require transfer to hospital are given care at home. A same day ‘overflow’ GP face to face service is available and UC24 provides primary care in the local A&E departments so that those arriving at A&E who are most appropriately treated in Primary can be treated by a Primary Care clinician, thus relieving pressure on A&E.
- Working to enhance and deliver integrated out of hospital care.
- Taken on a number of failing GP practices in a new geographical area, Sefton. UC24 was the third provider in 12 months for these practices which were largely staffed by locum clinicians. Each practice now has at least one permanent clinician and a plan is in place to introduce a new clinical model which will enable same day access for those needing it and longer appointments for those who have complex needs. UC24 is working with a local partner to see how mental health support can be delivered better for patients by providing local specialist sessions.
- Worked with a local employability project, offering interviews to users of the project who meet minimum requirements for UC24 posts and releasing staff to go to the project and do mock interviews with those on the scheme.
- UC24 has signed the Liverpool Charter, this sets out a number of specific commitments in relation to use of resources.
2) What actions have you taken to address the above social aims?
- Providing health services 24 hours per day through 7 GP practices, daytime primary care support projects and out of hours care
- Supporting the Employability and food bank project at Liverpool Cathedral.
- Home visiting across practice pilot scheme with a local partner.
- Working with acute sector in the delivery of GP services within the A&E unit, thus facilitating better patient flow in A&E and ensuring that those who require primary not secondary care receive the care they need.
- Being the first mutual society to join the NHS Leadership Academy and encouraging and funding staff to undertake development through accessing their education and leadership programmes.
- Buying local wherever possible.
3) What has changed and what benefits have been realised as a result of your actions?
- The community has benefitted from UC24’s work by the provision of a more stable clinical workforce in the GP practices which comes from the ability of the organisation to offer a portfolio of work both day time and out of hours.
- UC24 works with community partners which benefits both their projects and the UC24 staff.
- Other stakeholders have benefitted from the work UC24 has done to establish a stable clinical workforce when this is an area which is very challenged (as is seen from media reports).
- UC24 also works with local GPs in the delivery of extended hours services, pilot projects for home visiting and other out of hospital care projects.
- In the Asylum practice, UC24 ensures that individuals are treated with dignity and respect and that they are referred to any services needed including school services. This particularly vulnerable group require additional support with language which is provided through UC24, and practical assistance which is also offered.
- UC24 is in touch with more small businesses locally and using their goods and services.
4) How do you and other people know your aims are being achieved? Or how will you know?
All UC24 services are subject to regular patient feedback. In addition, for the new GP practices in Sefton there had been high levels of complaints but the number of complaints is reducing and the number of compliments received is increasing.
Staff remain loyal and are enthusiastic about supporting the organisation’s aims. UC24 is seen as a good place to work where staff are looked after.
UC24 undertook a survey of patients, staff and external stakeholders in 2016, this showed high levels of appreciation for the work being undertaken. A series of 360 degree reviews of the UC24 leadership in late 2017 included feedback from third parties (Commissioners, Cathedral employability, third sector) and the leadership of UC24 scored highly with these partners.
UC24 reports on these differences at its AGM. Where positive feedback is made in respect of individual staff members this is passed on to them.
The below questions are not mandatory, but Mark holders are encouraged to answer them where possible, to provide a fuller account of their social outcomes and the social value they create.
5) How many people have benefitted from your actions?
Numbers accessing services:
- Asylum 5,700 in the year;
- Out of Hours approximately 6,000 per month;
- GP practices provide services for approximately 19,000 people with approximately 5,000 patient encounters per month
Patient feedback indicates that over 60% of those accessing services are likely or highly likely to recommend UC24.
Work on a transformational model of care for day time General Practice is now underway after a period of necessary stabilisation. This model will seek to provide for the needs of patients more appropriately by delivering advice and treatment on a same day basis for acute issues and a longer appointment time for those with more complex needs of a chronic nature. Particular emphasis is being placed on providing access to specialist mental health professionals within the GP practice setting.
UC24 delivers services from 10 locations during the day and an additional 8 locations in the out of hours period, these services cover the communities of Liverpool, Halton, Knowsley and Sefton, approximately 750k individuals.
UC24’s services particularly benefit those needing primary care services in an out of hospital setting, and all those asylum seekers and refugees coming through Liverpool.
6) What examples can you provide of a typical service user experience, that helps illustrate the benefits they have experienced as a result of your actions?
Following a serious incident involving a man with learning disability, UC24 facilitated a multiagency review involving the patient’s family and all other professional groups involved with his care. As a result UC24 hosted a learning event for GPs disseminate the learning from the incident.
A tool for assessing capacity is now being provided in the mobile doctor vehicles to enable GPs to offer consistent assessment when undertaking visits in the community.
UC24 has taken a lead in the identification of sepsis in the community locally. Learning events for health professionals (open to all not just those working with or for UC24) have taken place for the identification of sepsis in adults and also children. GPs have taken part in a project which uses a specific tool to score an individual. As a result, GPs are able, if they encounter sepsis, to send the patient to hospital with the necessary pre-checks and scoring undertaken. This speeds up access to treatment in hospital and gives a baseline against which to measure improvement or deterioration. This simple process, introduced across the Out of Hours service, saves lives.
UC24 provided a car and driver to a pilot initiative working with a local GP practice, who provided the clinician, to deliver home visiting on a multi-practice footprint and not tied to the traditional post-morning surgery time window. Where patients need hospital transfer, this has enabled them to get there earlier while the full range of daytime diagnostic services is fully operational. As a result patients can be seen by the GP, visit the hospital and access diagnostic services and then return home rather than waiting in hospital overnight in order to access diagnostic services.
7) What additional social benefits have you been able to deliver within your core services that distinguish you from other “for shareholder profit” providers?
In the UC24 Asylum service, staff continually go the extra mile supporting individuals by providing additional support of a practical nature beyond the contracted service. This can be through making arrangements with third parties or collecting gifts, clothing etc where it is needed.
In the Sefton practices, UC24 has been able to take on the work when it would not have been economic for a ‘for profit’ provider to do so, investing in the service from reserves.
8) What other social benefits have you contributed that go beyond your core delivery activities (ones that are completely unrelated to your main services)?
- Engagement with a local food bank and employability project, financial investment has been in the release of staff from their work during normal working hours to attend the project and do mock interviews for participants. This has helped UC24 staff to become more aware of the circumstances of those without permanent employment and aided the project in delivering in excess of 60% of project participants into paid employment.
- Engagement with the asylum and refugee community beyond the provision of health screening. This has included staff contributing items gifted to individuals and contributions to the food bank which supports many of them. This has been through personal gifts of staff and periodic ‘shops’ for the food bank paid for by the business.
9) What social and environmental benefits have you created from internal operational policies and actions?
- Increased provision of recycling facilities in the offices, lights which switch off automaticallyafter a period of time, cycle purchase scheme
- Staff awards
- Employment of a health and wellbeing officer to put into place a programme of activities through the year to address health and well being issues eg visit from the Stroke Association to take blood pressure, weight watchers, staff food bank (for a number of staff work at UC24 is a 2nd or 3rd job and a number of the ‘other’ jobs are at lower rates of pay). Subsidised gym membership
- Financial investment has been in wages and in the cost of a telephone helpline for staff providing personal and financial advice including short term counselling.