DRAFT PRIMARY CARE COMMISSIONING STRATEGY · towards ‘primary care at scale ... patient-centred...

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DRAFT PRIMARY CARE COMMISSIONING STRATEGY Primary Care Commissioning Committee 1 st November 2017
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Transcript of DRAFT PRIMARY CARE COMMISSIONING STRATEGY · towards ‘primary care at scale ... patient-centred...

  • 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

  • Suttons Draft

    Primary Care Strategy

    Sutton CCGs Primary Care Strategy identified 4

    priorities for primary care:

    Sustainability

    Healthy Communities

    New Ways of Working

    Improved Access and Experience

    Bo

    rou

    gh W

    ide

    Serv

    ice

    s

    9

  • 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

    Bo

    rou

    gh W

    ide

    Serv

    ice

    s

    10

  • 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

    councils 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

    Councils 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?

    14

    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)

    15

  • What will be different?

    16

    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

    17