Northumberland, Tyne and Wear Strategic Health Authority

Dr Ian SpencerDirector of Clinical Governance

The new GMS Contract: The local challenge

The Area We Cover

Population of 1.5 million

Berwick, down to Houghton- le-Spring, across to border with Cumbria

Coterminous withone county council, six district councils, two city councils and three borough councils

The NHS in Northumberland, Tyne & Wear 5 hospital trusts 5 primary care trusts 1 care trust 2 mental health trusts 1 disability trust 1 ambulance trust 236 GP practices308 pharmacies238 dental practices148 opticians’ practices

Health policy

• Helping people to live longer and healthier lives

• Providing fast, convenient services meeting universally high standards

• Giving the staff who work in the NHS the support, buildings, training and equipment they need to provide a modernised service

Modernisation challenges

• Partnership

• Performance

• Professions

• Patient care– Speed of access– Empowerment

• Prevention

The National Plan

• The New NHS: the need for change– faster and more convenient care– high standards everywhere– tackle the causes of ill-health

• need a service that reflects and meets the needs and expectations of modern society

The NHS Plan

• a greater range of primary care services• improving working lives• flexible multidisciplinary working• the practice will remain the basic unit• improved standards• wider range of more accessible services• greater freedoms and incentives

The vision for primary care• universal, fast and convenient access• by informed patients• to an extended range of high quality

services• delivered in modern primary care settings• by suitably trained and qualified primary

care professionals

Shifting the paradigm

NHS LIFTNHS LIFT

PMSPMS LDSLPSLPS

New GMSNew GMS

Investing in premises and equipment• investment of £1bn to:

– refurbish 3,000 GP premises– build 500 one stop centres

• investment in IT– access to NHSnet universal by 2002– to assist diagnosis, prescribing and referral– on-line booking of hospital appointments by

2005

Shiremoor

Investing in primary care: people• at least an extra 2,000 GPs by 2004 with

450 more than now in training

• a review of the primary care workforce– professional mix; more practice nurses

• new initiatives– 500 community mental health workers

– 1,000 new primary care mental health workers

Enhanced career opportunities for GPs• up to 1,000 specialist GPs by 2004

• better training and development

• measures to tackle violence, discrimination and harassment

• better working practices

• an occupational health service for GPs and their staff

Building quality into the GP contract• reform of contract

– greater flexibility to reward for quality

• PMS to remain voluntary– 30% by 2002– core contract– local flexibility for innovation

• address isolation of single-handed GPs

nGMS – Roles

• DoH is responsible for policy

• PCTs are responsible for implementation

• SHAs are responsible for ‘bridging the gap’: leadership and performance management

nGMS – Role of the SHA

• SHA role includes:– ensuring swift 3-way communication (up, down

and across)– understanding and informing policy developments– supporting performance improvement, through

performance management– ensuring PCTs use funds to deliver nGMS aims– initial resolution of problems and appeals

nGMS:Performance management• SHA role to ensure PCTs have:

– a clear understanding of the task, including:• the essential (e.g. OOH provision, payment systems)• the potential (e.g. enhances quality, new ways of

working)• the implications (e.g. patients choice, staffing)

– the required management capacity and capability– developed a robust local action plan– effective project management– identified the risks, which may vary locally

(e.g. OOH, IM&T)– opportunity to share good practice

nGMS / PMS: Two vehicles for delivery of Primary CarePMS uptake at 1 October 2003

% doctors %patients

• Northumberland CT 92% 89%• Newcastle PCT 40% 38%• North Tyneside PCT 45% 43%• Gateshead PCT 34% 31%• South Tyneside PCT 72% 70%• Sunderland TPCT 76% 76%

Opportunities for innovation

Structures to deliver nGMS

• history of PCOs working together• TPCT workstreams• from July 2003, SHA-wide monthly meeting • Chair: PCO Chief Executive• links to national implementation group• scoping exercise by individual PCOs to

identify issues for joint working

Key challenges

• “six months and ticking”

• emerging guidance

• building capacity

• managing resources

• managing expectation

• communication

Today’s nGMS Workshops

• opportunity to influence local and national agenda

• feedback to SHA-wide nGMS Implementation Group

• Help us to help you!

Principles for improving NHS

• increasing choice

• increasing equity

• increasing access

• increasing capacity

John Reid 17 September 2003

Northumberland, Tyne and Wear Franchise Plan 2002

The future

..“for the NHS Plan to be successful, develop a whole new model for primary care delivery”…