News 2018

Current year's news can be found in the 'News' tab above


Frailty MDTs

Frailty is at the root of many hospital admissions, and long hospital stays  can increase frailty. Frimley Park Hospital Frailty teams conduct Frailty MDTS to get patients out as quickly as is safely possible, but it's important we reach and support more frail patients before they become hospital admissions, hence the setting up of Community based Frailty MDTs.

A Frailty MDT is being held monthly in each locality, with a locality GP Lead and initial support from Frimley Park Hospital Geriatrician Michelle Carr.

Vanguard 2015-2018: The Summative Evaluation Report

Wessex have evaluated the 23 Vanguard services introduced across North East Hants & Farnham. There were three aims:

Targeting action to prevent ill health and promote self care

Strengthening local primary and community care

Improving services for patients in a crisis/those who need specialist care

The ICTs in each locality have been key to this. Read sections 5, 7 and 9.3 to see how the Integrated Care Teams performed, or the full report to see how joined-up, accessible local care has made a difference locally.

Locality Access Points

There is now a Locality Access Point (LAP) in place for referrals to ensure there is a single, 'no door is the wrong door' route to help get patients the most appropriate support with the least delay. ICT team members are integral to this process.

Initially referrals will be taken from GP practices only to manage the workload whilst the core team grows to support this work. Practices have been contacted to introduce this process and referrals are coming through - contact your Practice Manager if you want more information on using the LAP for referrals. The team will be phasing in referrals from partner organisations during the coming months.



Frimley Integrated Care System (ICS) and Network Plans:

New opportunities to empower Primary Care

"We have already seen what improvements can be achieved in our area through adding skill mix and working collaboratively.... the ICS represents an opportunity to build on this."

In this ICS Newsletter, ICS Rep Nick Hughes explains what’s happening over the autumn months, and how practices and localities can benefit from developments that will build on the work of the last few years.

This is a perfect opportunity for General Practice to influence where care is targeted to best serve patients, in a way sustainable both locally and across the Federation. Make sure you let Nick know your thoughts.

Service Awareness Videos - MSK Self-referral and TalkPlus

This month we have two awareness videos, one for a Salus service and one to promote the TalkPlus service, provided by North Hampshire Urgent Care.

Take a look at the Aldershot Centre For Health waiting room screens, or check out the videos below and let us know what you think:

MSK Assessment Awareness

TalkPlus Awareness

Salus have moved office!

The office on the 4th floor has moved: we are now in PCT08 opposite the carpeted dining room.

The ICT Hub Room at Aldershot remains where it was on the 3rd Floor, next to the Aldershot Community Nursing Team.

Pop along and see us!

Meet the Staff - Shannu Pudaruth

Aldershot Health Coach

Shannu joined Salus Medical Services in January 2018 to create a pilot Health Coach service for the practices in the Aldershot locality.

Here she talks about her role supporting people as they self-manage their way to better health and fitness.

Mental Health online guidance for GP Practices

Work has started on creating a Mental Health Website that all practices can easily link to from a home page tab. The aim is that, no matter what your mental health issue from just seeking information to being crisis, the user can find the appropriate help within three clicks. A pilot group including everyone from funders through to Mental Health Service users is involved, and will be drawing in more people to comment and develop this in the next few months.

We'd love to hear from more GPs interested in reviewing the proposals at a lunchtime workshop, probably on 16th October. If you are interested in being involved, please contact the Project Officer at

Reach Out Art Exhibition

Launch Event Mon 3rd September

Exhibition Tue 4th to Thu 27th September

at The West End Centre, Queens Road, Aldershot GU11 3JD

In partnership with the Domestic Violence Forum and local organisations, this exhibition is to raise awareness of domestic violence and mental health.

On 3rd September you are cordially invited to the Launch Event.

There will be a short drama performance at 6.45 followed by speakers and the opportunity to see the artwork and chat to the artists involved.

Refreshments will be served.

Places are limited so please RSVP to to book your place.

If you can't make the Launch Event, you can drop in any time during the West End Centre's opening times between 4th and 27th September.

ICT OD Days Survey - You Said...

Salus Business Manager Andy Smith sent out a survey recently to ICT members in Aldershot, Farnborough and Fleet to get a feel of what people got out of/wanted from OD Days.

A significant number have been unable to attend a full OD day due to work commitments. Asked about future OD days, the majority preferred:

Half day morning sessions (with lunch)

Shared sessions with all NEHFCCG ICT localities

Sessions approximately every two months

For content, ICT members requested topical items covering service changes and learning topics with relevantly experienced external speakers, providing tangible outcomes or actions attendees can take away.

Sarah McCulloch, Commissioning Manager for Integrated Care Services, says:’ feedback is also being collected from the other localities, and a plan is being devised for ICT OD sessions in October, November and the new year'.

Watch out for a ‘You said…We did’ article in the next newsletter.


Waiting Room Promotional Videos

The services that Salus provide are ones that the GP Practices have identified as most needed in their area, but it helps if patients have a good understanding of what is available to them before they get into the GP's/Nurse's/HCA's room. With this in mind we've made some videos to show on Waiting Room screens for some Aldershot locality services, and will be developing more for other services.

Take a look at the current videos and let us know what you think:

Health Coach Awareness, Aldershot

Mental Health Toolkit Awareness, Aldershot

Frailty Lunch and Learn

Developing closer working with Integrated Care Teams and Hospital Consultants across North East Hampshire and Farnham to improve Frailty Management.

Over 50 people from Community and Acute care teams, general practice and CCG clinical commissioning attended a Frailty Lunch and Learn launch event on Wednesday 4th July. The aim was first to refresh everyone’s understanding of the issues around frailty and the current approaches being taken in the Acute care setting, then to kick start a Frailty MDT process that ties into the existing ICTs to avoid duplication of work, but allows for differences between locality teams and the challenges they face, whilst keeping as much consistency as possible. Two of the localities are ahead of the game, so work is now ongoing, based on the feedback received, to get ICT-linked Frailty MDTs in the remaining 3 localities by Autumn 2018.

Click here to view the Frimley Park Hospital Frailty Integrated Liaison Team's presentation.

Getting it right in North East Hants and Farnham:

CQC's Beyond Barriers Report

The CQC have issued a very timely report, that ties up with the current work on Frailty MDTs. Beyond Barriers looks at how older people move between Health and Social Care in England, identifying the importance of systems-oriented leadership, cross-organisational working and implementing systems without barriers.

The study looked at 20 cross-organisational 'systems' across England, observing good practice that leads to beneficial outcomes but also highlighting some common issues. The good news is that we are already implementing systems in the CCG area that aspire to or are on the way to achieving the 4 key findings of the report. Because of the numbers of partner organisations involved we still have plenty of room for improvement, but the fact that all the organisations have seen, acknowledged and are working on breaking down remaining barriers should give us a lot to be proud of.

To read the report, click here.


North East Hants and Farnham CCG news

The CCG held its AGM on Wednesday June 27th. Among the topics discussed was the Innovation Conference, a scheme that lets local people present their ideas for boosting health and wellbeing with the aim of gaining funding. You can read more about the AGM here, and see how The Innovation Conference allowed local people to make a difference here.

Salus make an appearance at

Fire Station Open Day

Julie Burrows, Clinical Associate for the Farnborough ICT (pictured), spent Saturday 23rd June  making local people aware of the services Salus provides as a GP Federation. She said:

'The day was very well attended and I was able to spread the word of the various SALUS teams and how we working within the community. I was able to speak to other health care professionals, families who care for relatives, a worried neighbour and a lady who wanted to discuss the OASIS team and how they could help her. I also spoke to members of the  local police and other out of area paramedics who were visiting with their families. They were all very interested in everything we do.'


New Farnborough Paramedic Sarah Price

A new Paramedic has joined the Farnborough locality team! Sarah Price is a qualified Paramedic, and is currently undergoing her Paramedic Practitioner training. As the third member of Farnborough's team alongside Becky Groves and Greg Ashley-Buck, she will bring the team there up to full strength.

Oasis mental health drop-in centre - report and evaluation

Among the CCG contracts recently renewed with Salus is that for running the Oasis mental health drop-in centre in Cove.

One user commented: “This service was an absolute god-send. I was in a pretty awful state 4 months ago and found out about this service through my GP. I was treated with empathy, respect and compassion and just talking to someone openly left me feeling much better. An excellent resource in my community offering exemplary service”

Learn more on the successes of the first year and the feedback from users and referrers here, and read about the Open Day held in April 2018 here.

Frailty MDTs and Integrated Care Teams to work more closely

Frailty MDTs are developing closer working with Integrated Care Teams across North East Hants and Farnham. Statistics show that frail elderly benefit from leaving the hospital environment as soon as possible once their acute medical needs have been addressed. As this is already the aim of both Frailty MDTs and ICTs, an increase in collaborative working is expected to improve patient outcomes.

If you’d like to be part of the development process, or to attend the Launch event on 4th July at Holiday Inn Farnborough, please contact Sharon Boylett or Helen Bell at or

Phyllis Tuckwell Hospice Care  - NEW Advice & Referral Team

Phyllis Tuckwell Hospice Care (PTHC) have launched a new single point of access for all clinical advice and referrals, in order to streamline the process, and make it clearer and easier for both patients, their families and Health Care Professionals (HCPs).

This service will be staffed by PTHC’s Advice and Referral Team (ART) comprising of clinicians and administrators, whom HCPs will be able to contact directly should they wish to ask for advice about a patient with an advanced or terminal illness, or refer them to the Phyllis Tuckwell service.

HCPs can learn more by checking under the Staff and Federation Member's area, Partner Contacts above.

Clinical Pharmacists -

News from the team plus new and updated Clinical Protocols

The latest news on Clinical Pharmacists, what they are now trained to cover and how they can serve GP Practices is available in the newsletter (to read it, hover over the image on the left and click the popout box, top right).

A new protocol has been set up for the clinical pharmacists to deliver COPD reviews. If you need a copy, contact Salus' Senior Pharmacist, Rachel Nilsen.

Further new and updated documents are due shortly covering Asthma, Vitamin D, Hypertension and Lipid protocols.


Aldershot Practices Roll out Mental Health Toolkits

After the award-nominated series of workshops last year, from April Aldershot GPs will have toolkits available for Mental Health patients visiting their GP Surgery.

Receptionists and GPs have been trained and now have a number of ways to make attending a GP appointment easier for patients who struggle with the experience of visiting their GP Surgery.

To see the full report by Stephen Manley of Healthwatch Hampshire click the image on the left.


Vanguard ends: the good work goes on

Vanguard, the programme driving real improvement for patients since 2015, celebrated the outcomes of their projects in North-East Hants and Farnham at a Symposium in Farnborough  last week.

Vanguard funding for these services is ending, but due to the high quality of the results delivered, the services are being renewed. They include Integrated Care Teams, Rapid Home Visiting Service, Yately Integrated Care Centre, the Oasis and Clinical Leadership.

The slides from the Evaluation Symposium can be viewed here.

How Integrated Care teams keep people Healthy, Happy, at Home

The Our Services page for the Integrated Care Teams (ICTs) now holds links to examples of how the team has met its brief of reducing hospital convayances and admissions whilst keeping some of the areas most vulnerable patients safe. Click the image on the left to watch and learn more.


If your health matters - follow a Salus GP Blogger and learn more!

GP Principal Karen Robinson, who is based at Southlea Practice, runs a regular blog on the North East Hants and Farnham CCG web site. You can read Karen's most recent Your Health Matters - Stay Well this Winter blogs via the links below. Why not follow her on Facebook and Twitter too?

A breath of fresh air: helping you manage your respiratory health

'Tis the season to be vaccinated

Self care is for life