unlocking the potential - king's fund
TRANSCRIPT
![Page 1: Unlocking the Potential - King's Fund](https://reader034.vdocuments.net/reader034/viewer/2022050500/627168799c02f42e733c7dd9/html5/thumbnails/1.jpg)
Transforming General Practice
Unlocking the Potential
![Page 2: Unlocking the Potential - King's Fund](https://reader034.vdocuments.net/reader034/viewer/2022050500/627168799c02f42e733c7dd9/html5/thumbnails/2.jpg)
Current Market Context • Increased demand for primary care • GP contract – doing more for less • CQC and new QoF - ‘demonstrating quality’ • CCG developments and pressures on commissioners • Shift of focus of care from secondary to primary • Greater cooperation with social care • GP demographics • Think Tank focus on the organisational model of general
practice e.g. Nuffield Trust and Kings Fund reports July 2013
![Page 3: Unlocking the Potential - King's Fund](https://reader034.vdocuments.net/reader034/viewer/2022050500/627168799c02f42e733c7dd9/html5/thumbnails/3.jpg)
Drivers for Change • Need for greater GP involvement in driving better care…
but can’t wait for commissioning led innovation • Fragmented general practice infrastructure a barrier to
reducing hospital activity and service redesign • Poor quality primary care remains largely unchallenged
by commissioners • Current GP model unsustainable: economics,
demographics • Our interest in applying ‘best bits’ of Kaiser, Physician
Groups to English system
![Page 4: Unlocking the Potential - King's Fund](https://reader034.vdocuments.net/reader034/viewer/2022050500/627168799c02f42e733c7dd9/html5/thumbnails/4.jpg)
Traditional Practice Model Federations ‘Super Partnerships’
(Sole trader, multi-partners)
Full Merger/Integration Collaboration Consultation
2k – 15k patients 30k – 500k patients 80k + patients
Emerging Models in General Practice
![Page 5: Unlocking the Potential - King's Fund](https://reader034.vdocuments.net/reader034/viewer/2022050500/627168799c02f42e733c7dd9/html5/thumbnails/5.jpg)
The Vitality Partnership
• Built on local general practice with local GPs • Single partnership • Delivery at scale: 50k + patients • Clinically and quality focused • Commercial structure
![Page 6: Unlocking the Potential - King's Fund](https://reader034.vdocuments.net/reader034/viewer/2022050500/627168799c02f42e733c7dd9/html5/thumbnails/6.jpg)
Key Features of the Partnership
• Integrated planning and delivery of general and specialist services in community based modern facilities
• Single IT system – shared records • Population management to support business
planning • Foundation for large education provider • Shortlisted for National Integrated Care Pioneer
![Page 7: Unlocking the Potential - King's Fund](https://reader034.vdocuments.net/reader034/viewer/2022050500/627168799c02f42e733c7dd9/html5/thumbnails/7.jpg)
Growth and Development
List size: •2009 26k •2010 32k •2011 38k •2013 50k (LCG 125k, CCG, 550k)
• 15 equity partners + 3 fixed share partners • PMS and GMS contracts • £10m+ turnover • 200+ staff • NHS specialist services • Private services • 7 primary care sites (plus
university sites)
![Page 8: Unlocking the Potential - King's Fund](https://reader034.vdocuments.net/reader034/viewer/2022050500/627168799c02f42e733c7dd9/html5/thumbnails/8.jpg)
Strategic footprint
![Page 9: Unlocking the Potential - King's Fund](https://reader034.vdocuments.net/reader034/viewer/2022050500/627168799c02f42e733c7dd9/html5/thumbnails/9.jpg)
![Page 10: Unlocking the Potential - King's Fund](https://reader034.vdocuments.net/reader034/viewer/2022050500/627168799c02f42e733c7dd9/html5/thumbnails/10.jpg)
Vitality Partnership
Innovative Organisational Dynamic
![Page 11: Unlocking the Potential - King's Fund](https://reader034.vdocuments.net/reader034/viewer/2022050500/627168799c02f42e733c7dd9/html5/thumbnails/11.jpg)
Partners
Salaried Partners
Associate GP
Salaried GP
Corporate Overview
![Page 12: Unlocking the Potential - King's Fund](https://reader034.vdocuments.net/reader034/viewer/2022050500/627168799c02f42e733c7dd9/html5/thumbnails/12.jpg)
Partnership Structure
• Executive Partner • Medical Director • Managing Director
• PPI lead • HR and workforce • Estates • Commissioning
• Director of Primary Care
• Director of Specialist Services
• Outlet Directors • Comms and
marketing • IT and informatics • Teaching/Training
![Page 13: Unlocking the Potential - King's Fund](https://reader034.vdocuments.net/reader034/viewer/2022050500/627168799c02f42e733c7dd9/html5/thumbnails/13.jpg)
Organisational advantages
• Deliver Services at scale • Long term planning and investments • Greater ability to bid for AQP • In house business development • Greater level of local influence • Staff employment protection and development • Multi -sites – patient choice • Standardised policies and procedures
![Page 14: Unlocking the Potential - King's Fund](https://reader034.vdocuments.net/reader034/viewer/2022050500/627168799c02f42e733c7dd9/html5/thumbnails/14.jpg)
Clinical Quality
• Increase in overall quality in merging practices (QOF points increase, access increase, range of services)
• Increased uptake of flu vacs, cytology etc. • Reduction in OPD referrals in merged practices • Integrated care pathways • Single patient record (EMIS web) • Peer review of referrals and prescribing
![Page 15: Unlocking the Potential - King's Fund](https://reader034.vdocuments.net/reader034/viewer/2022050500/627168799c02f42e733c7dd9/html5/thumbnails/15.jpg)
Evaluation to Date CLINICAL •↑ QOF in merged sites •↓ OPD referrals •↑ vac and imm uptake •Single patient record •Standardised policies, protocols •Active referral management •Integrated pathways •↑ influence in CCG service development
ORGANISATIONAL •Broader GP partner structure •Cultural change •Integrated Central Management Team •Phased retirement plans •Centralisation e.g. supplies, contracts, notes summarisation, data reporting •PPI development
![Page 16: Unlocking the Potential - King's Fund](https://reader034.vdocuments.net/reader034/viewer/2022050500/627168799c02f42e733c7dd9/html5/thumbnails/16.jpg)
Patient Engagement
• Greater level of strategic discussions • Increased scope of topic feedback • Changes to practice information – pt led. • Prompt feedback on service change • Innovative surveys
![Page 17: Unlocking the Potential - King's Fund](https://reader034.vdocuments.net/reader034/viewer/2022050500/627168799c02f42e733c7dd9/html5/thumbnails/17.jpg)
Challenges • Clinical time investment into merged practices • Financial investment • Culture change – partners and staff • Communications – vision and decisions • Local GP politics • NHS in transition (PCTs/NCB/CCGs) • Accurate data to enable service planning and
evaluation • Optimum size? How much risk?
![Page 18: Unlocking the Potential - King's Fund](https://reader034.vdocuments.net/reader034/viewer/2022050500/627168799c02f42e733c7dd9/html5/thumbnails/18.jpg)
Challenges (2)
• Lead and manage merger and acquisitions • Strategic business and investment planning • Organisational development • Property and estates support • Legal, accountancy, financial management and
HR support • New business and market opportunities
![Page 19: Unlocking the Potential - King's Fund](https://reader034.vdocuments.net/reader034/viewer/2022050500/627168799c02f42e733c7dd9/html5/thumbnails/19.jpg)
Our Vertical Integration
•Rheumatology •Dermatology •Orthopaedics •Immunology •Substance Misuse •X-ray •Intermediate Care
•ENT •Urology •Paediatrics •Neurology •Pain Management •Gynaecology
![Page 20: Unlocking the Potential - King's Fund](https://reader034.vdocuments.net/reader034/viewer/2022050500/627168799c02f42e733c7dd9/html5/thumbnails/20.jpg)
Our Horizontal Integration
• Community partnerships • Health and wellbeing services • Social Care • Mental health
![Page 21: Unlocking the Potential - King's Fund](https://reader034.vdocuments.net/reader034/viewer/2022050500/627168799c02f42e733c7dd9/html5/thumbnails/21.jpg)
Further reading