THREE new projects have been launched through the Taurus initiative changing the way GP services are provided in the county.

The projects provide earlier morning GP home visits, a link nurse scheme to take patients from primary to secondary care and offer outreach options to schools and colleges.

Under the urgent care GP project, home visits are linked to Hereford County Hospital’s acute admissions team and clinical assessment unit to review potentially avoidable admissions, evaluate what services would have prevented admission and take an educational role on health and social care pathways, facilitating secondary and primary care joint education sessions.

The role will develop to look at assisting with slow discharges and reassessment of patients and work with the West Midlands Ambulance Trust to support  early intervention – even as early as the roadside.

Leading the project is Dr Andrea Gibson, seconded to Ledbury’s St Katherine’s Surgery and Market Street Surgery to explore innovation options for general practice.

Under the project, Dr Gibson will liaise with a patient’s own GP surgery and ask for consent to view GP held medical records and record the details of the consultation for inclusion in the patient’s home GP primary care records.

Dr Gibson is also mapping the experience of patients when they need to access care to try to improve the overall interagency response to urgent care service demand.

The Link Nurse project reviews all admissions for a GP practice, tracks patients through the secondary care system and then follows up all patients on discharge to ensure the care cycle is complete.

All patients are reviewed post discharge to ensure care plans, medicines and future care provision dovetails with long term needs and patient choice.

This ensures that all pertinent information and care planning follows the patient to ensure efficient and patient focused care is delivered regardless of care setting.

The Link Nurse holds the primary care record electronically which can be updated and shared when deemed clinically appropriate and with patient consent.

This enables collaborative working across primary and secondary care, and ensures that the patients’ needs, requirements and wishes are upheld, especially at the end of life.

The project, which has already highlighted opportunities for future service development, is led by Natalie Kempshall, a district nursing sister and Community Matron working with Taurus having helped set up the county’s virtual ward scheme having experience of starting a similar scheme in Dudley.

She is currently studying for an MSc in Ageing Health and Disease at the School of Medicine at Cardiff University.

The adolescent health outreach project provides primary care services through a range of methods including e-consults and online advice tools with GPs in colleges providing access to services not currently delivered by school nursing.

The project is being developed alongside the Herefordshire Health App, a tool that sits on, or is accessible through, mobile devices.

This service will include some adolescent specific consultations being booked through the hubs, while the App will offer locally specific details of what services are available, at what times, and for what needs, linked to educational needs - particularly for children and young people - and with the potential ability to book appointments directly.

Behind this project are two GPs well-established in Ledbury and the Kingsland/Wigmore areas respectively for providing weekly “lunch break” drop-in surgeries for young people to help them learn the value of primary care and to improve appropriate access to care.

They also cover a weekly session at the Hereford Sixth Form College.

The project will emphasize the sharing of concerns between  students and school or college staff - if appropriate – and good communication with other agencies.

Taurus already provides a year-round seven day 8am- 8pm ‘”Access to Primary Care” service” from three hubs in Hereford, Leominster, and Ross-on-Wye staffed by multi-professional teams that include a GP, an advanced nurse practitioner and/or practice nurse, a health care assistant and receptionist.

The hubs can be accessed via telephone, video-link, e-consultation, walk-in and A&E or NHS111 referral.

Personal primary care records are  accessible from all 24 GP practices in the county – subject to patient consent.

Last year, Taurus was one of the winners in a  £50 million national challenge fund to trial new ways of providing primary care services.