The work of a Primary Care Network (PCN) and GP Practices in part of Mansfield is having a significant impact in reducing health inequalities.
The Rosewood Primary Care Network, covers five GP Practices in Mansfield town centre and the south of Mansfield District, with a combined total of more than 51,000 patients.
Dr Kathy McLean, the Chair of NHS Nottingham & Nottinghamshire Integrated Care Board visited the PCN in October to hear about their pioneering initiatives working with vulnerable patients in the area and some of the challenges local GP Practices are facing, with the aim of continuing to build upon their positive work.
Dr Milind Tadpatrikar, Clinical Lead at Rosewood PCN and his team described how they worked with practices to deliver a range of interventions with hard-to-reach groups in their area, including:
- Learning Disability (LD) patients – since employing a dedicated LD Nurse, the number of LD patients receiving a health check rose from 36% to 83% in 2023/24, which it is hoping to increase further in 24/25. The professional relationships developed between the LD nurse and patients have been instrumental in achieving this. The LD Nurse is a joint appointment with Mansfield North PCN and works across both areas.
- Housebound & Care Home patients – A dedicated team of nurses and care co-ordinators carry out weekly ‘ward rounds’ at care homes and have already delivered 61% of annual reviews so far in 2024/25.
- Severe Multiple Disadvantaged (SMD) patients – A dedicated PCN-funded care co-ordinator works with a range of local agencies to access specialist care and support for 335 registered SMD patients with variety of needs including homelessness, substance misuse and domestic abuse.
Following the visit, Dr McLean said; “It’s vital that health leaders, like me, spend as much time as possible speaking with the people who care for our patients, day-in, day-out, hearing about the challenges they face and the successes they have.
“Rosewood PCN and its practices is doing some great work to tackle health inequalities, working proactively with different groups of vulnerable patients who they have identified as having difficulties accessing good healthcare. Their work is a great example of how resources can be pulled together across health and social care to achieve excellent outcomes for patients.
“We are extremely grateful to Dr Tadpatrikar and his team for sharing their experience. Rest assured, all the learning from this visit, including the challenges faced by the PCN, practices and staff, will play a part in shaping future healthcare across our area.”
