I am undertaking a senior career fellowship with Nottingham City GP Alliance (NCGPA) looking at the development of a sustainable general practice model to deliver care for people particularly in deprived and disadvantaged communities.

Drawing on my own extensive experience as an academic GP involved in teaching and training I am endeavouring to synthesise and distil information and evidence from a variety of sources to provide an empirical basis for my conclusions.

The project is particularly relevant and interesting in the context of the challenges and stresses facing general practice today.

Having successfully incorporated several ARS roles into their primary care structure, Rushcliffe PCN were interested in both exploring and supporting the new primary care mental health workers as they began working. Rather than implement an immediate direct referral policy from primary care, the focus has been on clarifying a broader role for the initial worker, soon to be joined by a colleague. In the short term this has led to a greater understanding of the referral process and changes needed to improve the effectiveness of the written referral; going forward work is now needed to ensure the transition from working with patients felt not to be suitable for LMHT involvement to being embedded within the practices is as successful as it can be. Another senior nurse starts in post in September which opens up new dynamics and there are challenges from a change in NHS policy to use a model with Band 4 workers. I have been fortunate to have experience from a past mental health commissioning role as well as being recently retired from local general practice, but would reflect that it has been a great opportunity to advise, and help, a local service evolve to benefit both clinicians and, of course, patients.