Administering up to 3,700 vaccines per day*, the NHS Vaccination Centre at Askham Bar in York, established and managed by Nimbuscare Ltd—a federation of eleven GP practices, that’s committed to delivering high-quality “local care, for local people”—has been hailed as a national exemplar and all-round success story. Prof Mike Holmes, Chair at Nimbuscare, GP at Haxby Group, and former Vice-Chair at the Royal College of General Practitioners (RCGP), spearheaded this immense, admirable feat.
About Prof Holmes
Growing up near Newcastle, Prof Holmes knew from an early age he wanted to study medicine. By his own lights, his background, in particular his parentage, helped him develop the physical, psychological, and social abilities that the role of a GP requires. He said: “My grandfather was a miner and an uncle on my mother’s side was a doctor; it seemed like a ‘coming together of worlds’ and gave me an understanding of people.”
In 1999, after studying medicine at Leicester University—followed by a brief foray into surgery—he moved to York to train as a GP, and he has been here ever since.
In recent years, Prof Holmes has had to combine his usual role as a GP with increasing leadership responsibilities. But that said, he has not yet stepped back from general practice altogether: he’s at a surgery one day per week and is the go-to doctor in the area for vasectomies (of which he has performed over 4,000 to date, usually on Friday afternoons at the Gale Farm clinic).
Local care, for local people
Nimbuscare is among the largest “at scale” providers of primary care in the north of England, caring for more than 250,000 people; it comprises eleven GP practices, working collaboratively to deliver new, innovative, and sustainable health care services.
Although it was only established in 2015, it was—as Prof Holmes informed us—a whole decade in the making. “General Practice is complex, and sometimes you need a bit of scale; ‘coming together’ to act, in certain situations, is an advantage. There were failures, but I have never been afraid of learning from failure. Nimbuscare finally came together as a group of four practices in 2015. In 2018 this increased to seven. And just prior to the pandemic, we managed to [ … ] create a single provider that covers the whole city [of York] and includes all eleven GP practices and five Primary Care Networks.”
Timing is everything; and timeliness was indeed on Nimbuscare’s side. As a result of the collaboration of York GPs and networks occurring prior to Covid rearing its head, they were set-up in perfect time to run a successful vaccination programme.
Prof Mike Holmes said: “We could see the vaccinations coming and held weekly planning meetings from August 2020 to organise drive-through flu vaccinations, as a precursor to the Covid vaccinations. The Vaccination Centre was clearly in the national interest and was everyone’s number one objective.”
Given its success, the Vaccination Centre in York has attracted national attention. “I’m very proud of the system for responding in York,” said Prof Holmes. “It’s a phenomenal ‘at-scale’ machine: a testament to the huge team of people.”
Alongside the many healthcare professionals, administrators and managers, there are almost 400 volunteers who now help at the centre. Prof Holmes said, “We couldn’t do without them.”
Local businesses have shown also their support; in fact, the centre has been inundated with acts of kindness. An anonymous benefactor delivered pizzas, LNER have donated a catering trolley, and local shops and supermarkets—including Bettys—have delivered food and drink.
Alongside vaccinations, Nimbuscare provides various other services (including contraceptive services and an Anticoagulation Monitoring Service). They also work with asylum seekers in York.
Healthcare for all
Prof Mike Holmes explained that, although the volume of services required by GPs is increasing, the number of GPs is (on the whole) decreasing. To support areas with an especial difficulty recruiting GPs, Haxby Group, under Prof Holmes’s partial leadership, has established practices beyond York’s walls, as it were: in Scarborough and Hull.
Prof Holmes counts this among his proudest moments. He told us: “We went to Hull in 2008, where public health outcomes are much worse than in York. It was doing something; it was having the chance to make a difference. We started from nothing and now have five surgeries and around 30,000 patients [in Hull].
“The government needs to recognise that GPs have so much to offer in terms of getting the country out of the pandemic,” he added.
Looking onwards and upwards, Nimbuscare is looking to increase the efficiency and standard of the current healthcare systems in York. Prof Holmes himself, with the support of all practices in the city, gives the voice of general practice in the York Health and Social Care Alliance—a group that will guide local implementation of new NHS legislation due to go through Parliament later this year. “We want to be part of the system,” he said.
He continued: “Nimbuscare is committed to working with partners such as [York] hospital to tackle long waiting lists and relieve pressure on the system as we recover from the Covid-19 pandemic. The delivery of the Askham Bar Vaccination Centre has given us confidence to go ahead. There is a desire to do something this year.”
Nimbuscare, Prof Holmes said, are also keen to be involved in delivering urgent care in York. “York residents have expressed a desire to have urgent care delivered by their own GPs and we are talking to the hospital and Vocare about how best to deliver this. The hope is that by April 2022 there will be a new service delivering people’s needs.”
Prof Holmes’s afterword
Prof Mike Holmes recognises that there is a warrant for a “new way of doing things”—a novel approach to healthcare—post-pandemic. He said: “We’ve swung, from a service that wasn’t perfect but had been the same for 70 years, to working predominantly remotely. But now we need to swing back to something in-between ‘traditional face-to-face, relationship-based, patient-centred care’ and a ‘remote and transactional service’.”
He would also like encourage anyone to choose a career in healthcare. “It’s extremely rewarding, irrespective of whether you choose to be involved in management, clinical or allied healthcare, or administration. Nimbuscare would like to support people down this route and have offered work experience to students at the Vaccination Centre this spring. It’s been an absolute pleasure to have bright and capable young people working with us. I want the Centre to have a lasting impact.”
Lastly, he’d like to give thanks to the people of York for being so supportive over the last fifteen months and to remind everyone to go and get a vaccine.