Foundational Economy

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Flintshire County Council: Investing in ‘micro-care’ to strengthen the foundational economy

Like other counties in Wales, Flintshire faces the interlinked challenges of austerity, an ageing population and a care sector struggling to meet the rising demand for care. With help from Welsh Government’s Foundational Economy Challenge Fund, Flintshire County Council has been piloting the development of community-based ‘micro-care’ to help grow the supply of care; create well-paid sustainable jobs; expand choice and deliver high quality care services.

The Covid pandemic has highlighted the importance of social care to vulnerable people and yet, compared to other professions with similar skills requirements, this work is often poorly paid, with challenging conditions and limited opportunities for training and progression. The recruitment and retention of care staff therefore is a challenge, particularly in rural areas.

The Council’s strategic review of the care sector in Flintshire in 2019 highlighted ‘micro-care’ as a potential solution to some of these challenges. Micro-care is defined as care delivered either by a small team or an individual, to a small number of clients, usually at a localised level.

Micro-care offers a number of benefits to both carers and those receiving care services. The smaller caseload allows micro providers to deliver a more personalised, flexible service to those in their care. It also removes the need for lengthy travel times between multiple clients – for which carers are often not paid – making the work less stressful and more financially rewarding.  

Micro-provision also offers an opportunity for self-employment, potentially attracting those wishing to work for themselves – such as informal carers or those in part-time employment- who may not otherwise have thought about joining the care profession.

The Council therefore approached the Challenge Fund to support a 2- year pilot project to grow and support micro-care in Flintshire, with the aim of increasing the number of carers in the county and providing sustainable, well-paid, local jobs to help meet rising care demand.

Funding was awarded in 2019 for a project to directly support micro-carers to start-up, with advice, seed funding and marketing. The grant also enabled the Council to develop networks of micro-providers and to create structures that ensure their practice is safe, legal and high-quality and which will enable the local authority to directly commission services from them.

Micro-care at this scale is new for Wales. While Flintshire County Council was influenced by work undertaken in Somerset and elsewhere in England to support micro-care, because there are differences in legislation and models of care between England and Wales, it was necessary to build a model from scratch that suited the circumstances in Flintshire.

Rob Loudon, one of 2 Micro-Care Development Officers at Flintshire County Council, explains: “In England there is a greater percentage of people needing care who receive a Direct Payment to purchase their own care. In Wales more care is provided by local authority commissioning care agencies. This has influenced how our model has been developed”

The key aim of the Flintshire project was to expand the overall supply of care available. Fundamental to achieving this was to find a way of developing the micro-care market without jeopardising the existing supply of care provided by care agencies and Personal Assistants (directly employed by people in receipt of a Direct Payment).

In England there was evidence to suggest that the growth in micro-care enterprises was creating supply issues for the care agency and personal assistant sectors, as significant numbers of people left those sectors to become micro-carers. This may have been due to a number of factors including a desire to “be your own boss” but also due to significantly higher hourly rates that micro providers were able to charge. 

To address this challenge, and to help ensure the best possible outcomes for all stakeholders, the Council decided to take a pro-active role in micro-care commissioning, setting hourly rates for micro- providers providing care either via a direct payment or a direct commissioning arrangement.

The rate decided upon was £12.63 per hour for 2020/21– well above the minimum rate of £9.50 per hour advocated by the Living Wage Foundation – sufficient to attract new people to the care profession without micro-care jobs being taken exclusively by people already working in other parts of the care sector. Council control over the rates for charging out services also prevented ‘over-charging’ compared to traditional services. This proved a delicate balance between ensuring that micro-carers were paid fairly for their work and not creating such a disparity with wages in other parts of the care sector that there was a mass exodus from one to the other.

A combination of all these measures has contributed to the creation of 14 micro-care businesses in Flintshire, 9 more than initially anticipated. An additional 6 are also in the process of being set up as a direct result of the Challenge Fund project.

As of yet, none of the staff for these new micro-providers have come from other care agencies and, although it is early days for these ventures, Rob believes this is a great sign that the active role the Council is taking in micro-care is bringing more people into the care sector overall.

This in turn is having a positive impact on the people needing care services. As Rob explains “the bottom line is that if we didn’t have these micro-carers in Flintshire there would still be a number of people potentially on our waiting list for care.” In other words, micro-carers have been able to fill the gaps, particularly in rural areas, where care agencies did not have capacity to meet care demands.

The Council is rightly proud that the development of these new enterprises has not only attracted more people to the care profession but has done so in a way that is building local economic resilience through increasing well-paid and sustainable employment options, particularly in rural areas.

Although the project has laid a firm foundation for micro-care in Flintshire, the Council is still navigating challenges in the system – one being the issue of cover if a micro-carer is absent, for example through illness or holiday.

Currently legislation limits the number of people that micro-providers can care for before they need to register with Care Inspectorate Wales as a domiciliary care agency – a step that many small providers are not set up to do. This makes it more difficult for micro-carers to ‘cover’ each other if the number of people that will receive their services, even temporarily, exceeds the registration threshold.

Helping micro businesses develop robust contingency plans is therefore a challenge but one that the Flintshire team are determined to solve through continued cooperation and dialogue with stakeholders.

As the pilot draws to a close, Rob is confident that work will continue to grow micro-care in Flintshire, potentially serving as a model for sustainable foundational economy employment that can be adapted and replicated across Wales.

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ELITE Paper Solutions: Building bridges between the public sector and social enterprise

ELITE Paper Solutions is a social enterprise based in Merthyr Tydfil, specialising in document management storage and data shredding.  

As illustrated by its acronym – Equality Linked Into Training and Employment – ELITE aims to provide a fully inclusive workplace to support those traditionally furthest from the labour market, for example due to disability, health conditions or long-term unemployment, to gain skills and jobs. 

ELITE received a Challenge Fund grant to further develop its model to a point where it could deliver larger-scale contracts, which would in turn support more jobs, skills and volunteering opportunities. Part of this included influencing public sector stakeholders to change their procurement practices to allow them to place more contracts with social enterprises. 

The grant was invested in capital and revenue items to grow the team and build organisational capacity. This included an Employment Advisor to work with referral agencies and other support bodies to help individuals access and progress through ELITE’s training and work opportunities. 

These investments not only helped ELITE win 3 large public sector contracts but enabled it to respond quickly to the changing needs of its customers brought about by the Covid pandemic, increasing its revenue by £90,000 compared with the previous year. 

For example, one contract due to start on the cusp of lockdown increased its receptacles order by one third due to a pivot in ways of working which produced far more paper waste than first planned for. With its additional capacity ELITE was able to supply the extra collection bins required. 

At the other end of the spectrum, the move for many organisations away from the office environment, has led to a surge in demand for physical information to be made available online. The rapid rise in uptake of its confidential scanning services has allowed ELITE to hire nine new members of staff to assist its scanning section. 

ELITE is also proud to have increased other contracts, including for the NHS, in response to increased demand for the archive storage service that it provides, to safely store important records. 

Alongside its increasing commercial success, the grant has enabled ELITE to further develop its core activity of supporting those traditionally excluded from skills and work opportunities. Since 2015, the social enterprise section of the Charity, has worked with over 250 people, with a disability or disadvantage and believes that there is a job for everyone, regardless of their support need. 

As an example, ELITE CEO Andrea Wayman says, “Our scanning section is a fantastic place for people who are high functioning on the autistic spectrum, due to the need for attention to detail, supporting them to develop their social skills, which may have been a barrier to employment in the past. Their development has created a tremendous team.” 

In this regard, the Challenge Fund project also serves as a demonstrator of the role that social enterprises can play in the foundational economy. Andrea believes that the ELITE model can be adopted by any workplace, including larger SMEs and the Public Sector, to enable more diverse workforces, aid local economies and increase understanding of the contributions that can be made by people who are often overlooked.  

To support Challenge Fund grantees, Welsh Government also operates a community of practice to bring projects together to share learning and challenges. Andrea believes this has been a  

huge benefit for relationship building that has led to multiple new referrals as well as a new client. This has also been an opportunity for ELITE to speak as ‘the voice of social purchasing’ and positively inform and influence those who sit on the purchasing side of procurement. 

Speaking about the Community of Practice, Andrea shares, “I didn’t realise the bonus that the communities of practice would bring to us. I just thought it was something that had been thought about afterwards, whereas it’s been as important to us as having the grant itself.” 

As ELITE looks forward, its goals are to continue growing and promoting its model. This includes gaining more opportunities within the public sector – and paving the way for other social enterprises to follow suit. 

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Practice Solutions: A holistic approach to community resilience in Rhondda Cynon Taf

Practice Solutions is a training and consultancy organisation, providing flexible, out-of-the-box support for companies within the social care, health, voluntary and private sectors. Its aim is to help organisations to nurture well-being in their workforces and communities through implementing meaningful and sustainable change.  

Having worked with many social care businesses since 1999, Practice Solutions recognised that smaller providers often struggled with ‘back office’ functions including finance, HR, marketing or tendering. In turn this reduced their ability to secure the larger-scale contracts they needed to grow. 

This led to the idea of a localised support network for these businesses that could increase their capacity to deliver services and to win larger scale bids through providing shared ‘back-office’ functions as well as advice, support and relationship-brokering, particularly with the public sector. 

This was felt to be particularly important for those working in social care, with SMEs and micro-firms already under growing pressure and a national campaign to recruit 20,000 more carers in Wales by 2030. 

If successful, the model could then be rolled out to all those other foundational businesses that supported these, and other, service providers.  

In 2019, the Practice Solutions team received a Welsh Government Foundational Economy Challenge Fund grant to test the appetite for such a model with businesses in Rhondda Cynon Taf.     

Initially focused around social care providers, the Connect4SuccessRCT project aimed to deliver a systems-wide approach to ensure that the rising care needs of the future could be met by boosting both the local care sector, and the wider foundational economy. 

The project would provide ‘back office’ support to local care sector SME’s including staff recruitment and retention advice, training to those working with vulnerable people, finance and marketing assistance and advice on tendering.  

It would also work to connect local firms with public bodies to try to ensure that more public sector contracts were awarded locally, instead of to large corporate providers.  This would include breaking down barriers to successful tendering and raising the profile of local providers to public sector audiences. 

Although the project started well with successful outreach to all parties, the impact of COVID-19 inevitably limited the ability of social care providers and public bodies to engage with it. 

In response, the project increased its focus on other foundational economy businesses that, by contributing to local community resilience, also support health and social care agendas and the community at large.  

A key tool was the Connect4SuccessRCT website that aims to allow local providers to market their services and also potentially to collaborate in order to secure and deliver large-scale public sector contracts that would otherwise be out of reach. 

To date, 54 local organisations have signed up including a radio station, cleaners, training organisations, builders, manufacturers and distributers of PPE. 

Although the pandemic caused the project’s primary audience to change, Connect4SuccessRCT has not lost sight of its original aims to support the health and care sectors nor its holistic outlook. 

 Dafydd Thomas, the project lead at Practice Solutions, explains: 

 “The model works on the basis of providing co-benefits to all parties.  Businesses are not only given support on how to tender, marketing tips, and other business advice when they join Connect4SuccessRCT but we’ll also be providing training so that their employees will be able to recognise when someone might be vulnerable, or at risk. This helps add to that business’ social impact and will ultimately help public services to intervene before the issues becomes more serious and costly.” 

This additional ‘early-warning system’ by local firms that have daily contact with large numbers of the county’s residents can not only help reduce preventable hospitalisations and suffering but it also enables the responsibility of care to be shared and grown throughout the community. 

Practice Solutions is also still working to bridge the gap between the public sector and service providers to enable greater collaboration and more public funds to be channeled through the local economy. 

Staff have been liaising with procurement officers and local authorities to understand all the elements that businesses need to successfully secure contracts. This includes updated policies, certifications and information on upcoming work and means that businesses will be more prepared to go out and get contracts even when the initial Connect4Success pilot comes to an end in March 2021. 

This work has also captured some valuable insights into how the process of tendering can be made more accessible, particularly for those who have less experience or who may not be as digitally apt.  

Practice Solutions has been able to feed back this experience to Sell2Wales, Business Wales, Rhondda Cynon Taf Country Borough Council, and other local public services to help them understand the barriers that local suppliers face.   

Dafydd Thomas went on to say 

“One of the many things that the pandemic has taught us is that local services are only as good as their supply chain – think of the different challenges with supplying PPE. We want to see more local businesses supplying more services to the local public sector – providing more local jobs for people closer to home and ensuring that more public money is kept circulating at a local level.” 

The team is also building a directory of all businesses in Rhondda Cynon Taf which in time, will help the public sector procurement teams to search for specific skillsets and approach businesses that meet contract requirements.  

Although Practice Solutions believes that the pilot has proven successful, it has not been without challenges. Connections with partners were hard to forge during the peak months of the pandemic and in one case it had taken more than 9 months to just get a meeting with one of the target public bodies. Dafydd explains that “partners were simply not in a place where they could engage” despite the additional resource that projects like Connect4SuccessRCT can offer.  

Similarly, economic pressures meant that the long-term holistic outlook of the project did not appeal to some of the target SMEs and micro-firms, with businesses being much more interested in ‘help me get something now’ than what may be available in ‘some golden future.’” 

Despite these challenges, the project has proven flexible and responsive to local needs. Long-term, the organisation would like to adapt this model to become a formal membership co-operative and invite the community to be involved. In addition to the original aims of closer collaboration with the public sector, it would also connect local people with local, reputable businesses in property maintenance, transport or general support services. 

As well as helping boost the local economy, it is thought that this could particularly help the most vulnerable people in the community to live independently for longer, increasing individual well-being as well as further reducing the pressure on local health and social care providers. 

Practice Solutions: A holistic approach to community resilience in Rhondda Cynon Taf Read More »

Simply Do Ideas: Helping Wales lead the way in public sector innovation

Simply Do Ideas is an SME based in south Wales. Its purpose is to enable large organisations to crowdsource ideas to solve strategic organisational challenges. A key tool is its award-winning digital platform, an end-to-end innovation workflow which makes the process of managing innovation quicker, easier and more effective. It does this by enabling organisations to shape and share live, media-rich briefs in a secure portal designed to capture focused solutions from employees or external suppliers. This is known as challenge-led innovation. 

>> How Simply Do Works << 

The company recognized that the time, cost and risk typically associated with innovation are the three key barriers for most public sector organisations when developing creative and innovative solutions to their problems. Confident that their model could help, the company put forward a proposal to test their approach in the context of the social and economic challenges facing public bodies and communities in the South Wales Valleys. 

A Challenge Fund grant was awarded to build upon their earlier work in policing, advanced manufacturing and financial services to connect foundational economy challenges with crowd-sourced entrepreneurial solutions from two key stakeholder groups; the first, local colleges and universities and the second, local SMEs. 

The project was delivered in two distinct phases: 

Phase one aimed to address a shared problem between industry, education providers and their students. Time poor, risk averse employers need new ideas to survive and thrive, whilst students need access to ‘real-world’ experiences to be ready for the world of work. In the middle, further and higher education providers are tasked with heavy employability targets and stretching curriculum outcomes. 

During this phase, students from 8 colleges and universities in and around the south Wales Valleys were presented with live briefs and supported to generate innovative solutions to key marketplace challenges. The briefs came from organisations across foundational economy sectors, including those in hospitality, transport, housing and construction. 

More than 400 students engaged in these challenges, enabling the client organisations to capture early-stage ideas that could then be tested in the marketplace. At the same time, the students gained essential experience of working on a real-time business brief, something not otherwise easily accessible to them. 

As Simply Do Ideas moved into phase two of the pilot, the company turned its focus to supplier-led innovation, which encourages organisations to work with the expertise in their supplier network in order to bring new and existing products and services to market faster. In Wales the supplier network is predominantly SMEs and the company was confident that its expertise could be harnessed to help bridge the gap to the public sector. 

Choosing to focus on the healthcare sector, the company partnered with Life Sciences Hub Wales, which aims to help make Wales the place of choice for health, care and wellbeing innovation. 

Whilst working together, the need for PPE rocketed due to the coronavirus pandemic and demand on manufacturers reaching an all-time high. A rigorous procurement process put extra pressure on the Life Sciences Hub team, who were manually sifting and sorting through an unprecedented number of product and service offers from industry in order to procure the necessary supplies. 

This was the perfect opportunity for Simply Do to deploy its digital product, allowing it to co-create a customised workflow that, through automation, significantly increased the speed by which diverse providers and products could be sourced, qualified and purchased whilst maintaining a robust procurement process. 

Not only did this solve a huge time barrier for Life Sciences Hub in sourcing appropriate products but it saved time for potential suppliers who could communicate their offer more quickly and easily via the purpose-built innovation portal. Moreover, innovative new suppliers, products and services were surfaced through this streamlined, challenge-led process that may otherwise not have been. 

The output was impressive, with more than £6million of PPE products procured by the NHS from suppliers engaged on Simply Do, resulting in an approximate GVA to the Welsh economy of £34 million. NHS Shared Services also became a net-contributor of PPE to the broader, UK-Wide effort to secure PPE during the pandemic. 

In total, the Challenge Fund has enabled Simply Do Ideas to engage with more than 1,600 SMEs generating almost 1,800 ideas in response to 13 externally-sourced challenges relevant to suppliers and commissioners in the foundational economy. The organisation’s Senior Business Manager, Joseph Murphy, believes that this demonstrates that challenge-led innovation has a real contribution to make in terms of progressing the way that procurement is done in Wales. 

 “There’s an opportunity here for Wales to be a global leader. Turning our size to our advantage, we can use our close proximity to one-another, our resources and public policy to ensure that we are at the cutting-edge when it comes to solving some of the biggest challenges of our time,”

Having concluded its Challenge Fund project with resounding evidence that this model works within the public – as well as private – sector space, Simply Do Ideas is looking ahead towards a new investment stage. Its aim is to continue working creatively, between and across sectors, to further cascade the benefits of challenge-led innovation. 

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Vale of Glamorgan Council: Changing public procurement

With the help of Welsh Government’s Foundational Economy Challenge Fund, Vale of Glamorgan Council is changing how they procure to benefit the foundational economy.

Procurement is where an organisation acquires goods, services or works from an external source. Often it uses competitive bidding. Very simply it is the shopping an organisation does to deliver its aims and objectives.

The Council is the biggest spender in the Vale, spending £186 million per annum. Council staff believe they have a responsibility with that spend to ensure they deliver the best value to the area including skills, health, well-being, environmental benefits and employment.

When the Welsh Government’s Foundational Economy Challenge Fund was launched, the Council saw an opportunity to strengthen their procurement practices to help meet these aims, including better support for SMEs (small and medium size enterprises) which are recognised as the ‘lifeblood of the area’.

Funding was awarded for a project that aimed to grow local SMEs and to increase the number of these delivering Council contracts. Maddy Sims, who leads the Council’s foundational economy work, realised that this would also require changing unhelpful perceptions that the Council’s procurement was a closed rather than open process.

Recognising that dialogue was crucial, the project focused on listening to local businesses, the use of data and trying to ‘humanise’ the process of bidding for Council contracts so that more SMEs could benefit.

SMEs often don’t have guaranteed income at the end of the month. Because of this, Maddy explains, it’s important to remove barriers to the bidding process as businesses cannot afford to be constantly bidding for contracts that do not materialise.

Through the Council’s conversations with local SMEs they found that many faced frustrating – though easily rectifiable – issues that prevented them from winning Council contracts. Many had not heard of Sell2Wales (an initiative from the Welsh Government helping SMEs work successfully with the public sector) whilst others had various small but disheartening problems – such as not having codes set up correctly.

Central to resolving these issues has been a proactive approach to building relationships with local business and asking ‘what can we do to help you work with us?’ rather than just assuming that SMEs would approach the Council for information or advice.

The Fund has allowed the Council to engage with more than 1,000 businesses since June 2020 through events with Business Wales, Sell2Wales and others to help understand and resolve tendering problems.

The Council’s new conversational approach also works to take away the ‘waste of time factor’ and the overwhelming feeling many SMEs currently face when tendering. Maddy explains that these factors not only lead to some SMEs not bidding, but also rushing bids, making them less likely to succeed.

To help encourage and reassure local SMEs therefore, the Council are making case study films featuring some of the local businesses they’ve worked with, including a story of one who, after gaining confidence in tendering through providing vending machines to the Council, went on to win a multi-million pound contract with the NHS. 

An animation to make procurement look simpler and more exciting has also been commissioned and the Council has also increased the number of mailshots sent to businesses to grow awareness of the contracts available.

As a result of these efforts, 100 new local businesses have registered with Sell2Wales and the Council has taken other steps to make its contracts more accessible to SMEs – such as breaking up a large-scale contract into smaller ones that SMEs are more able to tender for.

Conversations with local businesses not only identified barriers to tendering and winning contracts but also allowed the Council to better understand the local supply chain and gaps in the market. This understanding is vital for the Council to support the local area with its procurement, for example potentially through a supply chain policy or proactive procurement to help stimulate activity in a supply chain void.

The project has also helped catalyse other new ways of working. The Council’s procurement is not centralised, and the procurement is devolved to different directorates. Currently, there is no centralised reporting about how much is spent locally which makes it difficult to measure the full impact of Council procurement on SMEs or the local foundational economy in general. The challenge here is the lack of data. The Challenge Fund project has highlighted this gap, which the Council recognises as a positive first step in overcoming and rectifying it.

An important learning point Maddy would like to convey to others doing similar work is simply to “put yourself in their (SMEs) shoes and consider what they’re going through”. She explains “it’s a lot of listening, talking and then finding out if you can change your processes to bring mutual benefit. Anybody looking to do this kind of project, talk to as many people as possible.”

Procurement is the main part of the Council’s spend and Maddy feels that the Challenge Fund project has really opened up the potential power of that spend to benefit the foundational economy. It has given the Council new insights into where they will go next, reshaping their procurement service, standardising it and measuring the locality of their spend in a more precise way.

Ultimately, the Council wants to support SMEs to deliver skills, jobs – and often many other benefits linked to a strong foundational economy. It also wants to give commissioners more confidence and awareness to spend with locality and value in mind.

This case study was compiled by Cynnal Cymru – Sustain Wales as part of supporting a community of practice of Challenge Fund projects sharing learning and collaboration.

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Community Care Collaborative: Transforming Primary Care in Wrexham

The Community Care Collaborative (CCC) is a Community Interest Company that provides an innovative and integrated approach to healthcare in Wales.

Founded by Dr. Karen Sankey in 2018, CCC developed a very clear vision for primary care after realising that the current model was failing at several levels.

Through research and testing, it found that patients often visit a doctor with an issue that has a social or mental health basis, which it believes GPs are not equipped to deal with in the best way.

Added to this, it’s thought that the volume of patients that a GP is expected to see in a day on top of other duties such as medicines, makes it impossible to provide an adequate service to every single person.

The solution is a model which delivers “an alternative model of health, social care and wellbeing in which GPs (doctors) are able to focus on providing medical care, and where, through working collaboratively at a community level with other agencies and patients themselves, the social and emotional needs of patients are given equal priority to their medical needs”, as its mission statement shares.

“The Challenge Fund seemed to me to be very much about trying to do things differently and about taking a chance to really give something a go to find out whether it works or not.”

Before receiving a Challenge Fund grant, CCC had already secured contracts to trial this model at three GP practices in Wrexham and had been granted permission to take over its first practice in September 2019 with the second and third following in January and April 2020.

However, the Challenge Fund grant has been essential in enabling CCC to develop its ideas further and successfully set up and recruit in a vast number of different areas of health and social care over the last 12 months.

Alison Hill of Capacity Lab, who assisted in bringing the model to life said that, “The Challenge Fund seemed to me to be very much about trying to do things differently and about taking a chance to really give something a go to find out whether it works or not.”

Firstly, CCC recruited a permanent emotional wellbeing team which is present at all three practices and aims to provide a first point of contact for patients that are in need of wellbeing support directly after booking an appointment.

What commonly happens in these cases is patients are referred on to other mental health organisations and can bounce back, so a key focus of this team is to reduce onward referrals by providing services in-house such as support groups, medication reviews, memory assessments and psychotherapy.

The organisation has seen that utilising this model alone has seen onward referrals reduce by over 57% compared with the previous evaluation period (Apr-Sept 2019).

Not only does this mean that patients are being provided a more appropriate and immediate response, but the cost savings to other health and social care services are likely to be significant. A social impact evaluation of CCC’s Emotional Well-Being Team found that it had delivered social value worth more than £1million in its first 12 months to November 2020, representing a social return on investment of 6.42:1.

More important to those involved is that 33% of people supported within this model (who were asked for feedback), said that without support they may have taken their own lives, further demonstrating the positive impact that the model is having.

To support the referral process, CCC recognise that as first responders to calls, front desk staff play a vital role in the patient process so it invested in training to develop them into ‘Care Navigators’. People within this role now have the knowledge to respond to individual patient needs and signpost them towards the relevant team, rather than automatically referring them to a GP.

Due to the high level of demand during Covid-19 and the huge upheaval of a system that has been in place for years, the booking system is an area that CCC is still working to make as effective as possible through continuous testing and experimentation.

Alison says, “We tried eConsult (Lite), which didn’t work out so we changed it and adapted it…it’s improving, but that is something that we haven’t got right yet and we still need to work very much on.”

Despite the obstacles faced by the pandemic, CCC is really proud of its progress this year, although there are some areas where work still need to be done, especially in recruiting full time salaried GPs.

Although CCC has been able to employ some part time doctors, Alison explains that a huge obstacle primary care is currently facing is that many GPs are working as temporary doctors known as locums, which she says, “In terms of finances, it’s going to destroy primary care.”

As they move towards the goal of recruiting more full time GPs in 2021, the team is confident that this integrated model will prove attractive to GPs, as it gives them more opportunity to concentrate solely on medical needs and to patients as they will be able to access a much wider range of inhouse support.

As CCC looks towards the future, it will be concentrating its efforts on recruiting full time salaried GPs, and building partnerships from within the Welsh Government’s FECF Community of Practice, as well as other organisations that can help to replicate this model across Wales.

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