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“A leading example of integration”

5th April 2017

A Department of Health minister has visited Plymouth and praised its work with integrated health services across the city.

David Mowat MP, the Parliamentary Under Secretary of State at the Department of Health also commented on the impending closures of four Plymouth GPs, saying that a different approach should be adopted – including linking up practices to help maximises doctors' time.

It comes after The Herald revealed plans had emerged for a super health hub serving 60,000 patients across the region.

Invited to the city by Conservative MP Johnny Mercer, the pair met for a tour of Mount Gould's Local Care Centre to see how Livewell Southwest operate their integrated social care services, where professionals who would have previously worked in individual teams now work together.

This way of working to deliver the right care for people at the right time was labelled as a "leading example of integration" by Mr Mowat.

"What Plymouth is often described as is a leading example of integration and the living well facility that we have here is one of the few in the country that have gone this far," said Mr Mowat.

"You have social workers, nurses, occupational therapists – all of those disciplines working together.

"Right across the country we have an awful challenge facing [us] with more and more people who are increasingly frail and need care."

When questioned about the imminent closure of four GP practices across Plymouth at the end of this month, Mr Mowat said that he didn't think the answer to the problem was to have a lot of smaller GPs – rather having one larger base where better services and quicker appointments can be achieved.

MP David Mowat added: "After the consultation in Plymouth [on GP closures], most people are within a two mile radius of another practice, so it isn't as though they are going to [have to] go massive distances – I agree its not always ideal to move in that way.

"The other thing that we have to do with GPs across the country, and you are doing it in Plymouth, is to have more collaborative groups.

"You start to be able to share things – when you come together across several practices you can start to have pharmacists employed, physios employed in an easier way and community nurses and occupational therapists – what that means is that some of those [professions] can be used to leverage GP time better.

"A lot of things that GPs have done historically can be done by pharmacists working in GP practices.

"For example, I was at the GP recently where the pharmacist did all of the routine diabetes checks.

"If there is a particular issue, the patient will see the GP. But if it's just a monthly update and check [or] a test, we can do that in different ways.

"What [has been] done in Plymouth by putting together these collaborative hubs, is what we need to do more generally.
"But none of that stops the need to have more GPs.

"I don't think the answer is to have lots of small GP practices necessarily – there is a tendency across the country for smaller practices to merge into larger ones – in this case they have closed, [but] if you've got larger practices with the capacity and they're close enough, I don't think that's a particular problem.

"What matters is that people can get GP appointments quickly whether it's a small practice or a large practice and if we're not doing that, that's a problem.

"It's not the size of a practice or indeed the particular location of a practice that matters."

Both Mr Mercer and Mr Mowat went on to explain how despite the £2million social care funding gap, Plymouth will receive around 18 per cent more money for social care over the next three years, claiming that Government has "grasped the nettle and understood that social care is under pressure".

Mr Mowat went on: "It's under pressure [social care] because the number of people over 85 has increased by nearly 30 per cent over the last decade.

"It's not just about money, it's about how well people do things, it's about doctors and the teams [like those] that I've been meeting here today, how they work together."

Conservative MP Johnny Mercer touched on an area where he thinks Plymouth can do better – with mental health services.

"Some of the brilliant work we're doing around mental health is really exciting, so the idea of early intervention [and] treatment in [a] health and wellbeing hub [in Plymouth] is going to be the first in the country – and we're trying to launch the first one for Mental Health Week in May," said the Moor View MP.

"Essentially you can go there and you can get treatment for CBT, depression, and also take welfare advice and so on.

"It's an integrated hub where you can go and get access to all of these services on a much greater scale far earlier before people get extremely poorly and have to use the facilities like we have at Glenbourne – which are world class and brilliant – but very expensive.

"That's the direction of travel. We've only been able to do it because we've got the people here, a good local authority who are willing to work towards that integration.

"The closure of surgeries [in Plymouth] is a political issue because it looks like the Government is reducing the provision – the reality is that the demand on healthcare is only getting bigger, so if you can produce economies of scale where you can get GPs to work together to create bigger surgeries that provide better service, it makes sense.

"Others will try and use it for a political win to say that this Government isn't investing in health, which is simply not the case."