A Primary Care Hub supporting eight GP practices covering around 38,000 patients in Liverpool and Sefton is reducing avoidable hospital admissions, improving efficiency and optimising access across the care continuum. Primary Care 24 (PC24) is a social enterprise delivering NHS services across Merseyside and operates the service in partnership with NHS commissioners, using NHS England’s Modern General Practice framework. The hub supports general practice teams through digitally enabled triage, clinical overflow support, and care navigation, with an integrated telephony system and multidisciplinary team co-location. The challenge The service addresses the mismatch between rising patient demand and limited general practice capacity. Traditional delivery models struggled to meet appointment targets, such as 70 appointments per 1,000 patients per week, as face-to-face consultations grew longer post-COVID and telephony demand surged. Inadequate call handling led to high abandonment rates, delayed care, and patient dissatisfaction. Practices were also unable to absorb telephone consultation overflow, resulting in unmet needs particularly in deprived clusters such as Netherley and North Park. Service design and development Service development followed extensive modelling using NHS England’s Digital Triage Demand and Supply Calculator and local demographic adjustments. The model factored in 7.3% weekly demand, split into online, telephone, and face-to-face contacts, with time allocations of 3, 10, and 15 minutes respectively. After consultation, a revised model was adopted, rotating GPs and ANPs between practices and the hub to preserve continuity of care and aligning staffing to population need. Option 1 was funded, introducing 47.5 additional clinical hours and embedding staff across practices and the hub. The model is contracted through NHS commissioners with short-term funding secured for the initial implementation phase. Innovation PC24’s key innovation lies in its ‘Hub-first’ care navigation system and integration of real-time operational control. The hub answers 1,400 calls daily, 45% within three minutes, reducing average wait times and abandoned call rates. By co-locating admin and clinical teams, it enables a fluid response across the care continuum, optimising access, reducing duplication, and providing resilience akin to acute settings. Impact Notable metrics include a 13% increase in call connection rate (from 60% to 73%), and telephone appointment backlogs being mitigated by reallocating 70 hours of ANP time weekly to manage overflow demand. This allowed all practices to meet face-to-face demand targets while addressing commissioner requirements for appointment volumes per capita. Alignment with government and NHS priorities The hub’s impact aligns strongly with government priorities around improved access, digital transformation, and integrated care systems. It supports sustainable economic growth through local job creation, over 300 associates and 300 employees, and improved workforce efficiency. It also reduces avoidable hospital admissions, as evidenced by its full-time specialist heart failure nurse in Sefton, the region with historically the worst outcomes in this area. Scale To scale this innovation, national policy should offer flexible funding models that recognise the capital and training investment needed for integrated hubs. Policy should also incentivise digital triage adoption and inter-practice collaboration. “The hub has significantly improved patient access and allowed our clinicians to focus more time on complex care. It feels like a safety net rather than a compromise.” A PCN partner. Policymakers: PC24’s model exemplifies how social enterprises can deliver scalable, patient-centred innovations in public healthcare, bridging gaps that traditional models cannot reach. What next? • More case studies of social enterprise innovation
A Primary Care Hub supporting eight GP practices covering around 38,000 patients in Liverpool and Sefton is reducing avoidable hospital admissions, improving efficiency and optimising access across the care continuum. Primary Care 24 (PC24) is a social enterprise delivering NHS services across Merseyside and operates the service in partnership with NHS commissioners, using NHS England’s Modern General Practice framework. The hub supports general practice teams through digitally enabled triage, clinical overflow support, and care navigation, with an integrated telephony system and multidisciplinary team co-location. The challenge The service addresses the mismatch between rising patient demand and limited general practice capacity. Traditional delivery models struggled to meet appointment targets, such as 70 appointments per 1,000 patients per week, as face-to-face consultations grew longer post-COVID and telephony demand surged. Inadequate call handling led to high abandonment rates, delayed care, and patient dissatisfaction. Practices were also unable to absorb telephone consultation overflow, resulting in unmet needs particularly in deprived clusters such as Netherley and North Park. Service design and development Service development followed extensive modelling using NHS England’s Digital Triage Demand and Supply Calculator and local demographic adjustments. The model factored in 7.3% weekly demand, split into online, telephone, and face-to-face contacts, with time allocations of 3, 10, and 15 minutes respectively. After consultation, a revised model was adopted, rotating GPs and ANPs between practices and the hub to preserve continuity of care and aligning staffing to population need. Option 1 was funded, introducing 47.5 additional clinical hours and embedding staff across practices and the hub. The model is contracted through NHS commissioners with short-term funding secured for the initial implementation phase. Innovation PC24’s key innovation lies in its ‘Hub-first’ care navigation system and integration of real-time operational control. The hub answers 1,400 calls daily, 45% within three minutes, reducing average wait times and abandoned call rates. By co-locating admin and clinical teams, it enables a fluid response across the care continuum, optimising access, reducing duplication, and providing resilience akin to acute settings. Impact Notable metrics include a 13% increase in call connection rate (from 60% to 73%), and telephone appointment backlogs being mitigated by reallocating 70 hours of ANP time weekly to manage overflow demand. This allowed all practices to meet face-to-face demand targets while addressing commissioner requirements for appointment volumes per capita. Alignment with government and NHS priorities The hub’s impact aligns strongly with government priorities around improved access, digital transformation, and integrated care systems. It supports sustainable economic growth through local job creation, over 300 associates and 300 employees, and improved workforce efficiency. It also reduces avoidable hospital admissions, as evidenced by its full-time specialist heart failure nurse in Sefton, the region with historically the worst outcomes in this area. Scale To scale this innovation, national policy should offer flexible funding models that recognise the capital and training investment needed for integrated hubs. Policy should also incentivise digital triage adoption and inter-practice collaboration. “The hub has significantly improved patient access and allowed our clinicians to focus more time on complex care. It feels like a safety net rather than a compromise.” A PCN partner. Policymakers: PC24’s model exemplifies how social enterprises can deliver scalable, patient-centred innovations in public healthcare, bridging gaps that traditional models cannot reach. What next? • More case studies of social enterprise innovation