draft primary care commissioning strategy · towards ‘primary care at scale ... patient-centred...
TRANSCRIPT
DRAFT PRIMARY CARE
COMMISSIONING STRATEGY
Primary Care Commissioning Committee
1st November 2017
Contents
• National guidance on the development of
primary care and general practice
• Sutton approach to date
• Timescale and process for finalising the
Sutton CCG Primary Care Strategy
2
Primary care now
– surviving?
3
Primary care future
– thriving
4
National Policy
GP Forward View
– Care Redesign• Extended access
• Online consultations
– Workload• 10 High impact actions
• Practice Resilience
– Workforce• Clinical pharmacists
• Care navigators and Medical assistants
– Practice Infrastructure• Improved estates
• Improved use of digital technologies
5
10 High impact actions
6
10 point action plan for
General Practice Nursing
7
London Strategy
• 17 Primary Care Specifications:
– Proactive Care
– Accessible Care
– Coordinated Care
8
Sutton’s Draft
Primary Care Strategy
Sutton CCG’s Primary Care Strategy identified 4
priorities for primary care:
• Sustainability
• Healthy Communities
• New Ways of Working
• Improved Access and Experience
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Sustainability
• Policy drivers and long term trends point
towards ‘primary care at scale’
• Central capacity should be
complementary to existing model of
general practice
• At a borough level this could mean
triage, referrals, roving GP, telephone
and online consultations, etc.
• Larger primary care health centres as
focal point for locality based services
• Development of more specialised
support for most complex patients
(Sutton Health and Care)
H E A L T H C E N T R E
GP GP GP
Enabling This:
• Subcontracting between practices,
federation & health centres
• Sharing of patient records
• Shared employment models
• Consolidation and collaboration of
administrative functions
Locality Collaboration
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Other Community Services
Healthy Communities
• Significant untapped potential of
community assets for generating health
• Approximately 20% of demand in primary
care driven by social rather than health
needs (local & national evidence)
• Primary care referrals into Sutton
council’s advice and liaison service for
assessment via Social Prescribing
• Better use of volunteer capacity
(championed by Patient Participation
Groups and Sutton Volunteer Centre) for
signposting and to lead social
interventions
• Better use of community pharmacies to
signpost (health champions) and to
deliver some interventions
Enabling this:
• New approach to commissioning
third sector organisations
• Ongoing training of workforce for
social prescribing
• Better data to understand local
variation in wider determinants of
health11
New Ways of Working
Enabling This:
• Increase training via multi-
professional training hubs
• Commissioning levers to be
identified
• Recruitment drive reinforcing the
benefits to living and working in
Sutton
GP
Practice Nurse
Healthcare Assistant
Core Team
Extended Team
Integrated MDT
• Core practice team as fundamental
building block
• Diversify the primary care team to
utilise a higher proportion of skilled
nurses, healthcare assistants,
pharmacists to free up GPs for more
complex care
• Divert some activity to extended teams
(with a locality footprint)
• Integrated multi-disciplinary team-
working to improve cross-organisational
patient-centred care
• Embed multidisciplinary training &
development (e.g. trainers groups) and
move to a model where trainees deliver
capacity12
Improved Access &
Experience
• Reinforce continuity via core practice
teams
• Offer ‘one stop’ type clinics
• Help navigate complex health
management via care navigators
• Primary care referrals into Sutton
Council’s advice and liaison service
• Move towards a single point of access
for primary care for booking
appointments, viewing records, and
telephone/online consultations
• Continue to promote digital access
• Support self-care and self-
management
Telephone & Web Based
Support
Healthy Living Apps
Health Coaching &
Peer Support
Group Consultations
& Clinics
Assistive Home Based
Support
SpecialisedLocalityClinics
UrgentCare Hubs
Single Point of Access
Enabling This:
• Implementing care coordinator role
• Training for staff in influencing
health behaviours
• Commissioning levers for
centralised clinics 13
What is being delivered in 2017/18?
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New primary care model signposting patients to reduce unnecessary usage of primary and secondary services
New primary care model greatly increases numbers of patients that can be seen for minor ailments; reduced A&E attendances, 111/Out Of Hours
New contract models increasing access to services in primary care, reducing secondary care elective activity
Comprehensive model of multi-disciplinary team-working supporting complex patients to avoid emergency admission and facilitate discharges
Transformation
workstreams 2017 - 2019
• Extended Access
• Social Prescribing
• MDT Locality Model
– “Sutton Health and Care”
• Patient Education
• Help Yourself to Health
• National Diabetes Prevention
Programme (NDPP)
• Releasing Time for Care
Programme
• Pharmacists in General Practice
• Health Champions
• Development of Care Navigators
and Medical Assistants
• iPlato
• GP TeamNet
• Skype for Business
• Mobile working
• Wifi for GP Practices
• E-consultations
• Sutton Integrated Digital Care Record (IDCR)
• Kinesis
• Docman Upgrade
• Patient Online
• Premises Developments
• Community Education Provider Network (CEPN)
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What will be different?
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Integrated Teams
Collaborative working and proactive case management of
the most complex patients
Primary Care Team
GP as expert generalist within a multi-disciplinary team
Access
Shorter waiting times
Easier to see GP when needed
Experience
Patients feel better supported to manage their health and
know how to access help when they need it
Sustainability
Stable workforce, increased staff satisfaction, digital
innovations
Next steps
• Engage with stakeholders on the current draft strategy
– Carshalton Locality October 2017
– Sutton and Cheam Locality November 2017
– Wallington Locality November 2017
– LBS Scrutiny Committee October 2017
– Patient Reference Group January 2018
• Primary Care Commissioning Committee - November 2017
• Governing Body approval - January 2018
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