Primary Care Strategy

An Emerging Transformation Agenda

Why Transform? - The challenges ahead:

• an ageing population –increase in consultations - 95% growth in consultation rate for people aged 85-89 in ten years up to 2008/09.

• growing co-morbidities - The number of people with multiple long term conditions set to grow from 1.9 to 2.9 million from 2008 to 2018

• increasing patient expectations• financial resource constraints • push for more to be done in out of hospital settings• inequalities in access and quality of primary care• recruitment and retention • new inspection regimes

Dedicated MDT managing the top 3-5

% of health & care users

Advanced Care Coordination team (Extensivist)

Incentivised to stop people deteriorating to higher levels of care

Incentivised to keep people healthy

GP Triage/telephone

consultation and

signposting

GP specialists undertaking

work on behalf of multiple/all

practices

Co-ordinated support to

Residential and nursing care

Complex Chronic

disease mgt through MDTs

7 day access to GP services planned and

urgent

Access to specialist clinics e.g.

dermatology

GP and wider team

AppointmentsPrescribing

GP specialist referral pathways

for some conditions

Stable Chronic disease

mgt

Incentivised to reduce / stop

unplanned admissions to

hospital

General Practice at Scale

General Practice Health and

wellbeing

Local commissioner expectations – direction of travel

• Continuation and stabilisation of elements of PMS (notably hospital diversion)

• Support to other providers e.g. care homes• Services spanning multiple practices e.g. 7 day

access • Services across all practices/whole population e.g.

minor surgery• Working with other providers

– Advanced community care (extensivist) – Joint hospital & primary care MDTs e.g. complex long

term disease management • Health & wellbeing management

Using Resources better, together• “Burning platform” – cant just keep doing more of the

same• Joint commissioning between NHSE, the CCG and LA• PMS review – NHSE pulling money out of the contracts

held by GPs locally but that can then be reinvested to deliver revised requirements

• LINCS GP federation is in place to support practices to change and work with the CCG

• Practice efficiencies – doing things once for many • Better estate utilisation• Workforce recruitment