Primary care service design

North East Lincs Care Trust Plus

• Open Door has twice been profiled in Society Guardian
• Winner 2009 Health & Social Care awards for tackling health inequalities
• Over 800 “hard to reach” people registered with a GP
• Designed a successful social enterprise, co-produced by its membership

In 2007 I was asked by the trust to pay attention to the primary care needs of all of the groups in Grimsby who would not normally go to see a GP. I spent a month sitting with and talking to people in homeless shelters, drug clinics, pubs and clubs, working out why they wouldn’t bother with a GP but what they might engage with. I then spent a further month working with the trust and clinicians to develop a service that would meet their needs and those of the “hard to reach”.

The service design that we developed opened in 2007; since then visitor numbers have doubled each year and crime in the local area has fallen by a quarter. Most of the people registered with Open Door would not have been registered with a GP in a normal practice, they would be too demanding, but each year almost 100 people are returned to mainstream services.

There is very little about the building and facilities that is unusual. The service design I developed is successful mainly because of the people who work there, but also because I was able to develop with them a clear ethos or brand and embed that in every aspect of the service; everything they do expresses what they believe.