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Primary Care FIT FOR 20:20 GP Contract – what next? Primary Care Division Scottish Government

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Page 1: Primary Care FIT FOR 20:20 GP Contract – what next? Primary Care Division Scottish Government

Primary Care FIT FOR 20:20

GP Contract – what next?

Primary Care Division

Scottish Government

Page 2: Primary Care FIT FOR 20:20 GP Contract – what next? Primary Care Division Scottish Government

Primary Care FIT FOR 20:20

What the workshop will cover:

•Strategic Context of the 2020 Vision

•GMS Contract Arrangements 2014/2017

•What next – looking forward to 2020 for GP Contract in Scotland

•How can you help shape the future

Page 3: Primary Care FIT FOR 20:20 GP Contract – what next? Primary Care Division Scottish Government

“2020 Vision” Our vision is that by 2020 everyone is

able to live longer healthier lives at home, or in a homely setting.

Integrated health and social care; A focus on prevention, anticipation and

supported self management; Where hospital necessary, day treatment the

norm and focus on getting people back into their home as soon as appropriate, with minimal risk of re-admission.

Page 4: Primary Care FIT FOR 20:20 GP Contract – what next? Primary Care Division Scottish Government

The Healthcare Quality Strategy for Scotland

Person-Centred - Mutually beneficial partnerships between patients, their families, and those delivering healthcare services which respect individual needs and values, and which demonstrate compassion, continuity, clear communication, and shared decision making.

Effective - The most appropriate treatments, interventions, support, and services will be provided at the right time to everyone who will benefit, and wasteful or harmful variation will be eradicated.

Safe - There will be no avoidable injury or harm to patients from healthcare they receive, and an appropriate clean and safe environment will be provided for the delivery of healthcare services at all times.

Page 5: Primary Care FIT FOR 20:20 GP Contract – what next? Primary Care Division Scottish Government

12 Priority Areas for Action

ROUTE MAP TO THE 20:20 VISIONROUTE MAP TO THE 20:20 VISION

Page 6: Primary Care FIT FOR 20:20 GP Contract – what next? Primary Care Division Scottish Government

The Importance of Primary Care

The foundation of the NHS:

Over 90% of interactions with healthcare start and finish in primary care.

Key to addressing:Inequalities in health and care;Access to health (and often social) care.

Page 7: Primary Care FIT FOR 20:20 GP Contract – what next? Primary Care Division Scottish Government

The Challenges Demographic shift to an ageing population Ageing brings a more multi-morbid population (two or more

long term conditions) Worsening health inequalities

This matters because: Living with multiple conditions is the norm rather than the

exception for many people. It is associated with poorer quality of life, more hospital admissions and higher mortality, and significantly worsens the impact of deprivation.

But: We still tend to design healthcare along single disease

pathways

Page 8: Primary Care FIT FOR 20:20 GP Contract – what next? Primary Care Division Scottish Government

– The majority of over-65s have 2 or more conditions, and the majority of over-75s have 3 or more conditions

– More people have 2 or more conditions than only have 1

Multimorbidity is common in Scotland

Page 9: Primary Care FIT FOR 20:20 GP Contract – what next? Primary Care Division Scottish Government

There are more people in Scotland with multimorbidity below 65 years than

above

Particularly true in more deprived areas

There are very few generalist hospital services for the under-65s

Page 10: Primary Care FIT FOR 20:20 GP Contract – what next? Primary Care Division Scottish Government

People living in more deprived areas in Scotland develop multimorbidity 10 years

before those living in the most affluent areas

Page 11: Primary Care FIT FOR 20:20 GP Contract – what next? Primary Care Division Scottish Government

Primary Care FIT FOR 20:20

Scottish GMS Contract Arrangements 2014 -2017Reduction in bureaucracy – 264 QOF points to Core;Emphasis on professionalism, clinical decision making;No planned major changes to QOF – will be kept under review by SG/ SGPC;Work with SGPC to develop a Scottish GMS Contract;Work to support improved recruitment and retention.

Page 12: Primary Care FIT FOR 20:20 GP Contract – what next? Primary Care Division Scottish Government

Primary Care FIT FOR 20:20

Scottish GMS Contract Arrangements 2014 -2017Areas of work going forward affecting the GP Contract

o Financial Framework to support GP Contracto Review of GP workload;o Review of Infrastructure (GP Premises and IT);o Review of Enhanced Services and Immunisations;o Further work to support Recruitment and Retention.

Page 13: Primary Care FIT FOR 20:20 GP Contract – what next? Primary Care Division Scottish Government

Primary Care FIT FOR 20:20

Page 14: Primary Care FIT FOR 20:20 GP Contract – what next? Primary Care Division Scottish Government
Page 15: Primary Care FIT FOR 20:20 GP Contract – what next? Primary Care Division Scottish Government

What do we need and want from General Practice?

Need to manage expectations of system; Generalism: crucial component of healthcare; Management of unscheduled and

undifferentiated illness; Chronic Disease Management; Primary prevention and health promotion; Co-ordination of complex care.

Page 16: Primary Care FIT FOR 20:20 GP Contract – what next? Primary Care Division Scottish Government

Self Management

Page 17: Primary Care FIT FOR 20:20 GP Contract – what next? Primary Care Division Scottish Government

The Conductor

Page 18: Primary Care FIT FOR 20:20 GP Contract – what next? Primary Care Division Scottish Government

Creating the Conditions Relies on participants operating to the top of

their licence; Clearly defined roles and expectations; Entirety of system working to common

purpose; Removal of impediments to teamworking; Appropriate infrastructure; premises, IT,

education; No detriment to patients or providers of care.

Page 19: Primary Care FIT FOR 20:20 GP Contract – what next? Primary Care Division Scottish Government

How should the role of the GP evolve now and over the coming years?

How do we position and define this generalist role within the primary and community care health team and the interface with specialist or hospital care?

What currently works well that we need to do more of? What could work better? How can practices work together to provide services and

reduce workload? Should we consider amalgamation and federation of practices?

How can general practice benefit from integration and what is the role of HSCP’s in helping GP’s manage workload?


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