david colin-thom é
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David Colin-Thom é. National Clinical Director for Primary Care GP, Castlefields, Runcorn Visiting Honorary Professor, M.C.H.M, Manchester University. Primary Care. GPs and their staff Dentists Pharmacists Optometrists Community Nurses. General Practice. Traditional Personal Care - PowerPoint PPT PresentationTRANSCRIPT
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PRIMIS Third National Conference Tuesday 1 April 2003
Birmingham
David Colin-Thomé
National Clinical Director for Primary Care
GP, Castlefields, RuncornVisiting Honorary Professor,
M.C.H.M, Manchester University
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PRIMIS Third National Conference Tuesday 1 April 2003
Birmingham
Primary Care
• GPs and their staff• Dentists• Pharmacists• Optometrists• Community Nurses
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PRIMIS Third National Conference Tuesday 1 April 2003
Birmingham
General Practice
Traditional• Personal Care• Co-ordination of Care• Continuity of Care• Longitudinal care• “Gate Keeper”
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PRIMIS Third National Conference Tuesday 1 April 2003
Birmingham
The P.M.’s Principlesfor the NHS
• National Framework of Standards and Accountability
• Devolution to the Local Level• Improved Rewards and Conditions of
Employment (Flexibility, Incentives, Rewarding Success, Shedding Bureaucracy)
• More Choice, More Contestability
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PRIMIS Third National Conference Tuesday 1 April 2003
Birmingham
NSFs
• Clinical Priorities for the NHS• Tackles areas of under performance• Evidence based clinical recommendations• Addresses all aspects of Anticipatory care• Quality framework for the whole care
system• All apply to Primary Care
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PRIMIS Third National Conference Tuesday 1 April 2003
Birmingham
PCT
Manager of the local NHS
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PRIMIS Third National Conference Tuesday 1 April 2003
Birmingham
FOR PATIENTS
• Choice
• Voice
• Control of their Care
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PRIMIS Third National Conference Tuesday 1 April 2003
Birmingham
“Diversity and Plurality are
Government Policy”
Secretary of State for Health
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PRIMIS Third National Conference Tuesday 1 April 2003
Birmingham
Primary Care Development
• PCTs supported by NatPaCT
• New GP Contract (GMS)
• PMS (PDS, LPS) • Other contracts • Appraisal• GPwSIs
• Medicines Management Collaborative
• Primary Care Collaborative
• N&AHPSI• OOH• R&R
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PRIMIS Third National Conference Tuesday 1 April 2003
Birmingham
A New Primary Care
• Access • Self Care• Modern Clinical Professionals• Modern General Practice• Integrated Care• Intermediate Care / Ambulatory Care• The Public’s Health• A New Public Management
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PRIMIS Third National Conference Tuesday 1 April 2003
Birmingham
Rapid Access
• NHS Direct
• Community Pharmacy
• GP Surgeries
• Community Premises
• Walk-in Centres
• Hospital
• Other Providers
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PRIMIS Third National Conference Tuesday 1 April 2003
Birmingham
Self-Care – the informed patient
• NHS Direct Online
• Other Interactive software
• Digital TV
• The expert patient
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PRIMIS Third National Conference Tuesday 1 April 2003
Birmingham
New GMS
• Practice based• Services – Essential, Additional and
Enhanced (National,Direct or Local)• 4 Domains of Quality (Clinical,
Organisational, Additional Services and Patient experience)
• Infrastructure, Aspiration and Rewards• Can opt out of OOH
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PRIMIS Third National Conference Tuesday 1 April 2003
Birmingham
Primary Care Nursing
• First Contact• Care of chronic conditions• Improving the health of the public• Prescribing• Referring• NwSI
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PRIMIS Third National Conference Tuesday 1 April 2003
Birmingham
Modern Pharmacy
• Information Resource• Walk in Services• Medicines Management• Anticipatory Care including CDM• New Primary Care Provision
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PRIMIS Third National Conference Tuesday 1 April 2003
Birmingham
What is “Intermediate Care”?
• Those services that do not require the resources of a general hospital, but are beyond the scope of the traditional primary care team. These services can include ‘substantial care’ for people with complex needs.
• This can also be described as Ambulatory Care
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PRIMIS Third National Conference Tuesday 1 April 2003
Birmingham
New PMS
• Where is PMS plus?• New Organisations (LPS, other PC
contractors)• Extended Contracts into the Hospital• The Broader Public Health• Local Accountability• Models for future iterations of GMS
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PRIMIS Third National Conference Tuesday 1 April 2003
Birmingham
What is “Integrated Care”?
• Integrated care and disease management are often used interchangeably, as the aim is to provide a systematic, multi-agency approach. IC applies to all health care interventions but DM principally applies to chronic illness.
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PRIMIS Third National Conference Tuesday 1 April 2003
Birmingham
Clinical Resource Management
• Case Management• Assertive outreach• Secondary to Ambulatory shift• Clinical Appropriateness• Expert Patient
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PRIMIS Third National Conference Tuesday 1 April 2003
Birmingham
“Medical costs rise to equal the sum of all private
insurance and Government subsidy”
Aaron Wildavsky’sLaw of Medical Money
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PRIMIS Third National Conference Tuesday 1 April 2003
Birmingham
Hospital Re-Design
• Out-Patients• Day Case Surgery• Orthopaedic scoping• DTCs• REC• Configuring Small Hospitals• Private Sector
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PRIMIS Third National Conference Tuesday 1 April 2003
Birmingham
Health Care in Context
• Social Gradient
• Stress
• Early Life
• Social Exclusion
• Work
• Unemployment
• Social Support
• Addiction
• Food
• Transport