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Mike Holmes

Haxby and Wigginton Health Centre, 2 The Village, Wigginton, York, YO32 2LL01904 7246000795 020 9939
Dr Mike Holmes

I am a GP partner at the Haxby Group Mike and Chair of the Humberside Faculty of the Royal College of General Practitioners. My main interests lie in developing At Scale primary care services with a collaborative philosophy in order to optimise patient care and system efficiencies.

I also recognise the need to evolve the clinical delivery of primary care and the role of the GP through the introduction of a collaborative multi-professional workforce. Furthermore I believe that the development of clinical leadership capacity is central to achieving a sustainable primary care service moving forward.

My role of Clinical Lead for the RCGP’s Supporting Federations Programme has given me a unique insight into what is happening nationally and the multiplicity of mechanisms that GPs around the country are using to deliver ‘At Scale’ working for the ultimate benefit of patients and populations. This work has been immensely enjoyable and our hope is to support all practices choosing whether or not to make this transition. Looking forward there must now be a consideration of how working ‘At Scale’ contributes to quality improvement in all aspects of Primary Care.

I hold/have held a number of organisational and clinical roles:

  • GP partner with Haxby Group, based in York and Hull – 2002-present.
  • RCGP Clinical Lead for their Supporting Federations Programme – 2015-present
  • Board Member – Local Education and Training Board at Health Education Yorkshire and The Humber – 2012-present
  • Associate Medical Director, NHS Hull CCG – 2013-2015
  • Clinical Director, Unscheduled Care, Harrogate and District Foundation Trust 2009-2014
  • Chair, Humber and The Ridings Faculty, RCGP – 2012-present
  • Alumnus, NHS Leadership Academy – 2014-present
  • Director, Nimbus Care Ltd – GP Federation in York – 2015-present

Nimbus Care Ltd is a Federation (Multi-Practice Organisation) of four large practices in York covering about 125,000 patients. The practices have come together to deliver clinical and non-clinical services. We have secured a telephony contract providing services to all practices in the CCG area and our intention is to unify back office functionality to create increased efficiency and capacity. We currently deliver an Integrated Care Team Service  for all our patients embracing a multi-professional cross sector team with the aim of supporting patients with complex needs in their own homes, preventing hospital admissions where possible – this has delivered early results – working collaboratively and providing appropriately governanced access to IT systems has demonstrated clear benefits for patients. We have successfully bid for resources to develop practice pharmacists as part of the NHSE scheme and that forms part of a wider strategy to develop our primary care workforce. As a Federation we are part of a CCG wide movement to unify all practices in our region in a programme to develop a series of ‘Primary Care Homes’ working with Key Alliance Stakeholders in order to deliver more coordinated services to improve patient experience and maximise the use of local NHS resources. We are the beginning of that process but are optimistic it will lead to collaborative working across all health and social care sectors.

Haxby Group is a ‘super-partnership’ covering 50,000 patients across the cities on York and Hull. It delivers care through 2 GMS partnerships and and an APMS contract run by Haxby Business Group Ltd – a company formed by the partners of Haxby Group for the prupose of bidding for an APMS contract. The practice has also diversified into Community Pharmacy and runs 4 such pharmacies in a number of different organisational forms. Over the last 7 years Haxby Group has evolved from a single GMS contract in a suburb of York to be an organisation that has 22 partners, 2 GMS contracts, 1 APMS contract, 3 Ltd companies, 2 LLPs and cares for 50,000 patients in 2 cities, 2 CCGs and within 4 local Authorities. There is a strong focus on patient care as well as training and education – the practice is an Advanced Training Practice Hub in both North Yorkshire and Humberside. The organisation is clear about the need to evolve the workforce and has actively taken steps to employ both pharmacists and paramedics as part of its clinical team. Haxby Group is now part of a large multi-practice organisation – Nimbus Care Ltd – and is now part of development to unify all the Practices/Federations in the Vale of York into a single not for profit organisation delivering patient care through a series of Primary Care Homes.

The complexity here is subjective – in reality organisations and corporate entities have been formed as required to deliver certain functions. Our key message is that the development of trust and relationships between individuals and organisations is absolutely paramount – having that in place with agreement to do something is the most important thing – the organisational form required to do that something is secondary.



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