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‘One stop shops’ and community activation in Derby City

Derby is a city of some 350,000 people. There is a broad range of wealth and deprivation, but the city is significantly worse than national averages including emergency hospital admissions, hospital admissions for harm and injury, premature mortality, and children’s weight indicators.

Against this backdrop, in June 2018 we launched ‘Derby City Place Alliance’ to better enable the bringing together of health, social care and third sector to start to improve pathways and ’smooth out’ the patient journey. The following organisations have representatives on the Place Alliance:

  • Derby City Council Social Care
  • GPs/ Primary Care Networks (PCNs)
  • Derbyshire Healthcare United (OOH provider)
  • Public Health
  • Housing
  • Community Action Derby (3rd sector infrastructure organisation)
  • Derbyshire Community Health Services
  • United Hospitals of Derby and Burton
  • Derbyshire Healthcare Foundation Trust (Mental Health provider)

Key to this improvement is how we better utilise our ‘community assets’; these include our GP surgeries as these are places that are known and loved by the local people they serve. Currently, the condition and quality of GP premises in Derby are many and varied; some comprise relatively new builds, whilst others are in converted houses. A common theme that runs through all these buildings though is the lack of space to act as a truly ‘community based’ asset. As a system we constantly face constraints on how we might use buildings perceived as ‘community assets’, but which are, in reality, owned by the GP partnership, or leased from a private landlord.

Primary Care Ownership Reform is an ideal opportunity for Derby City to re-consider how we want to deliver services going forward. Not just GP services, but how system-owned premises can act as ‘one-stop shops’ for local people to access a whole range of support and information.

For too long we have had a fractured system, where people are passed from pillar to post to obtain information, or to speak to the right person. When we have access to system-owned spaces, there will be endless opportunities to build on local initiatives (such as local area co-ordination) that will empower people to help themselves; to raise the profile of what is available locally, to provide targeted support to people. For example, in areas of high childhood obesity, we could put on adult cookery classes or provide advice on how to shop for healthy food alternatives. At the same time, we could have available benefits advice to ensure that people were accessing financial support where eligible so they could afford to buy better food.

My hope and vision for Derby would be to see system-owned and controlled assets in each PCN that would cater for the specifically identified needs of that population. These would be places where the GP practice is totally integrated with wider NHS and non-NHS services in their local area, and places where people know they can go for advice and support on their health and wellbeing, even if it’s not for a GP appointment.

In fact, anecdotally, local GPs suggest that many appointments that are booked today would greatly benefit from a social intervention, rather than medical one. On this basis we would hope and expect to see appointments freed up so that GPs could concentrate on those people with more complex medical need.

So, for me, the reforms are hugely exciting! Yes, there will be challenges along the way; yes, some of these will be financial – but system-owned assets that belong to a community will drive the level of social change that is required to ensure we have sustainable health services long into the future.

Tina Brown
Tina Brown

Tina Brown is the Senior Place Manager working for Derby & Derbyshire Clinical Commissioning Group (CCG). As the Place Manager, she works closely with all the providers, and particularly with Clinical Directors of the emerging PCNs to ensure that the Place Alliance works towards delivery of objectives that are in line with the local and national direction of travel.

Over the last year the Alliance has been totally immersed in the response to the Covid crisis. However, the links and relationships that have been formed over the previous three years significantly helped in the delivery of that response. Tina is fully committed to the integration agenda and remains hopeful that we will get there in the end!

Last Updated on 20 June 2022