Beyond Primary Care
Bridging the health gap
At Concordia we understand the importance of not only delivering high quality healthcare but also providing the extra support and assistance required by groups who are at risk of isolation, are vulnerable or have very specific or complicated needs. By integrating with a wide range of care providers, signposting to other services and supporting patients through the ‘daunting bureaucracy’ of NHS systems we have a track record of increasing access and significantly improving outcomes for our patients.
We focus on:
- Improving patient access to primary care services, particularly for those patients who are socially isolated and vulnerable
- Actively encouraging patients currently not registered for primary care services to register with us
- Diverting appropriate activity away from the A&E department
- Providing a service which positively meets the diverse needs of our patients
We provide flexible access to the right clinician, first time. We offer longer routine appointments to those patients that require it and deliver proactive, personalised care to meet the needs of all our patients. Our Melbourne Grove pratice is one of a handful of practices that host a Southwark Safe and Independent Living (SAIL) navigator to provide quick and simple access to a wide range of local services to support older people in maintaining their independence, safety and wellbeing.
Prevention is the best cure
We seek to reduce inappropriate use of secondary care services through proactive patient management. We encourage new ways of working to achieve improvements in the physical health of our patients, including access to chronic disease management and prevention.
With this in mind we have developed a number of clinics addressing various common patient needs including weekly clinics working with Lifeline, an organisation that helps patients with substance abuse and addiction, and a dedicated pain clinic to provide patients with access to medical therapy, resources and strategies to cope with chronic pain.
We send invitations to patients with long-term conditions for annual reviews by a nurse or GP. This includes patients who have COPD (chronic bronchitis), asthma, heart disease, stroke, mental health problems, rheumatoid arthritis, high blood pressure and diabetes. We invite patients in for annual health checks if they are carers or have a learning disability.
We also develop and regularly review personalised care plans for those patients that are deemed as being at a high risk of being admitted to hospital.
Culture of continuous improvement
Our Clinical Leads are active members in their local CCGs, working with local Federations to develop new pathways, including Holistic Health Assessments redesign and the Community MDT, offering training to locality staff.
We continuously seek to incorporate new technologies and innovative methods of working into our practices in order to deliver more efficient, convenient services for patients, including the facility to order repeat perscriptions electronically, SMS appointment reminders, telephone consultations and online appointment booking.
My overall experience with this practice over the past 7 years has been very positive. I have, for the first time after living in London for many years, found a really good doctor who treats me with empathy and respect and that is something I rate very highly.
Patient Review on NHS Choices