Our Enhanced Access Services

Within Leeds GP Confederation’s (the Confed’s) Enhanced Access (EA) service, we offer a range of primary care services outside of core general practice opening hours. Within EA we provide GP, Advanced Clinical Practitioner, Practice Nurse and Health Care Assistant appointments. On top of this, we also offer a wider range of services. Have a look below to find out more about our provision:

MSK

The Confed provides multiple EA services including First Contact Physiotherapy (FCP) Musculoskeletal (MSK) services, but what does that mean and where does it fit within other Leeds MSK services?

For Primary Care Networks (PCN’s) contracting the EA FCP service, it allows people with MSK conditions to access MSK physiotherapy expertise at the start of the pathway via GP surgery reception or triage systems. Anyone reporting MSK conditions to their GP surgery, such as neck, back, hip, knee, elbow, wrist & hand and ankle and foot pains, whether acute or chronic, can be booked an FCP consultation without seeing a GP or other healthcare professional. This ensures timely access to diagnosis, early management and onward referral if necessary. This benefits patients, as they see an MSK expert first; it increases primary care capacity for GP’s and other healthcare professionals to manage non MSK conditions and facilitates appropriate onward referral to other Leeds MSK services.

Initial consultations are often undertaken by telephone to provide greater capacity and quicker access. The MSK clinicians utilise exercise platforms that have video links to help explain prescribed exercise programs and have face to face appointments in centralised PCN hubs, to see in person patients who require physical examination. FCP clinicians will request investigations such as bloods (for example where inflammatory disorders, Polymyalgia Rheumatic or Diabetes are suspected), X-rays and Ultrasound scans to rule out or diagnose specific underlying pathology and direct management. Referrals can be made directly to joint injection clinics within specific practices/ PCN’s where arrangements are in place and EA Pharmacy is utilised to ensure timely prescription of medications to compliment physical management. All assessments are documented within the individual Systm1 or EMIS and face to face clinicians can provide fit note statements were indicated for that patient.

The Confed EA MSK FCP’s work closely with other Leeds MSK services such as Leeds Community Healthcare Trust (LCH) spinal treatment service, LCH MSK rehabilitation teams, Pain Management services, Leeds Teaching Hospitals (LTHT) Acute knee clinic, rheumatology, Hands and plastics, and Orthopaedics as well as other MSK service providers.

The EA FCP MSK services run evening and weekends over 7 days complementing the face to face provision through the day, each PCN has a different pattern of provision. The EA FCP MSK are the first point of contact for musculoskeletal conditions in primary care and help to manage the disability and pain this causes in an estimated 20% of the UK population (gov.uk stats 2023).

Sarah Jamieson is the Professional Lead for FCP MSK Services with the Confed. She has been a First Contact Physiotherapist (FCP) for 4 years and a qualified physiotherapist for 28 years. Sarah coordinates service development and undertakes quality audits to ensure clinical excellence is maintained. She also undertakes FCP clinics herself, keeping in clinical practice to fully appreciate the changing needs to practice itself.

Pharmacy

Over 50 pharmacists cover an array of remote clinics for PCNs across Leeds. First set up by Calibre GP Federation in 2018 when pharmacists in general practice were rare, the service has evolved to cover a wide range of clinical needs for patients from medicines reconciliation following discharge from hospital to full medication reviews. All our pharmacists are independent prescribers and have extensive primary care and general practice experience.

Our pharmacists work remotely, offering phone calls to patients to enable them to make the most from their medicines. This can sometimes mean effective deprescribing of medicines as well as dose changes and prescribing of new medicines where appropriate, with follow up either booked directly back with the EA pharmacist service or back with a patient’s GP practice or PCN service where appropriate.

The EA MSK service also books patients directly in with EA pharmacists when needed to review pain relief for patients undergoing physiotherapy, meaning a streamlined service for patients and less administration for practices and PCNs.

Ben Garner is the pharmacy professional lead for the Confed, working in general practice himself at City View Medical Practice in Beeston and Holbeck, with a background of working across general practice in Leeds with the Integrated Care Board/Clinical Commissioning Group. As well as the EA pharmacist service, Ben advises on medicine matters across other Confed services too such as the recently recommissioned Leeds Community Ambulatory Paediatric Service based in Harehills.

Healthy Minds

In EA we offer Healthy Minds appointments in specific EA hubs across the city. The purpose of Healthy Minds is to support patients who are experiencing temporary or long term, low level, mental health difficulties. We use two providers, Enhance and North Point, who both deliver services on behalf of EA.

Healthy Minds Practitioners offer a specialist service for these patients, and by doing so reduce demand on other mental health professionals within general practice.

Amanda Brook is the Clinical Services Manager for Enhance, who also works as a Clinical Nurse Specialist in Leeds. Below is her overview of Enhance:

The Enhance Healthy Minds Service is a well-established primary care Mental Health and Wellbeing service specialising in supporting patients 18 years of age and over who access their GP practice with concerns around their mental and emotional wellbeing.

Enhance Healthy Minds actively works with patients not only to deliver a prompt, safe and effective service but to address additional needs such as managing mental health related Fit Notes. Meeting multiple needs in one phone call has proven to be extremely valuable establishing remarkable feedback from many practices and patients.

The aim of the service targets early intervention with the purpose of prevention of worsening mental health. Enhance Healthy Minds currently consult with over 20,000 patients per year and have capacity to help more patients which in turn helps reduce unnecessary wait times to other services.