A key feature of 2016/17 has been local GP practices working in closer partnership and grouping themselves into 16 GP ‘clusters’ across the county. This approach has been agreed by the system and community and mental health staff are working with the practices to support the ‘place based approach’ to care.

And in many areas of Gloucestershire, other health professionals, such as clinical pharmacists, paramedics, physiotherapists and mental health staff, are working more closely with GP practices to support local people.

This approach aims to support greater resilience and sustainability of GP services. The joint working with health and care partners allows for a wider range of services to be provided to meet the specific needs of local communities.

For example, one pilot scheme under development across two inner city clusters will see GP practices identifying patients who would benefit from seeing full time mental health workers, rather than GPs.

In some rural clusters, GP practices are working together to support the health and wider social needs of more elderly, frail patients, meaning that they can stay at home and be cared for in the community. The practices can deliver better care for patients, co-ordinated by local nurses and GPs who understand their needs.

The ‘people and place’ model, which is now starting to take shape, involves joined up health and social care teams working alongside the GP clusters – providing care in peoples’ own homes and in the community, supported by specialist staff if needed. Closer partnerships are also being forged with the community and voluntary sector.