Dr Claire Fuller Visits Leicester, Leicestershire and Rutland

On Tuesday 16^th April 2024 Dr Claire Fuller, Medical Director for Primary Care for NHS England and the author of the Fuller Stocktake Report, made her latest stop on a tour of ICBs to NHS Leicester, Leicestershire and Rutland (LLR), to hear how the recommendations of the report are being implemented in practice.

The meeting covered a wide range of topics including access, workforce and training, quality, research, and place-based plans. Among the many examples of fantastic local initiatives, four key areas stood out in discussions.

Out of hospital care

LLR has a growing population of significantly frail older people living in long-term residential care, as well as in the community. Where a hospital admission is being considered for a patient with significant frailty, a swift clinical discussion is held with a consultant geriatrician, to explore safer alternatives (Pre-transfer Clinical Decisions Assessment). It brings together partners from primary and secondary care, community care, the ambulance service and social services, all working together to provide an effective community-based response system, thereby preventing duplicate assessments and ensuring optimal care coordination.

Health Equity Payment

The Health Equity Payment is additional funding paid to practices who are relatively under-resourced by the traditional practice funding formula know as Carr Hill. This additional, local investment in primary care has been made to practices since 2021. The ICB have been successful in securing this funding again for 2024/25, during a financially challenged time for the NHS. A focus for 2024/25 will be looking at outcomes linked to this additional funding.

Caring for adults with chronic kidney disease (LUCID project)

Around 16 PCNs in LLR provide LUCID clinics for patients with CKD. The service integrates primary and secondary care in a consultant-led MDT within a PCN, supported by virtual management of the patient’s condition. At-risk patients are detected earlier, and their treatment optimised, preventing hospital referrals and disease progression.

Interface working

To improve transfers of care across providers, the transferring care safely group was established in 2016. This group allows clinicians from all providers to share any concerns they have and suggest areas where improvements could help. Submissions are reviewed monthly, identifying common themes for improvement. This might lead to changes in procedures, pathways, or the offer of extra training where needed.

Dr Nil Sanganee, Chief Medical Officer for the ICB said: “It was fantastic to welcome Claire to our system. It was a highly positive experience for all those who took part and Claire’s enthusiasm shone through. We were delighted to be able to showcase the great work we are doing in LLR and hear ideas for how we might develop our local schemes further. “

We hope we will be able to welcome Claire back for a return visit in the future to see our progress.