One Halton and General Practice Strategy

PresenterNHS Halton CCG

27/03/15

ONE HALTON

Key strategic issues• Five Year Forward View

– New models of care– A new deal for primary care

• Dalton review• Care Act 2015• JSNA/BCF• Co-Commissioning

– Full delegation

• Collaborative commissioning• 2015/16 tariff & PMS review• A Call to Action• Prime Ministers Challenge Fund 2015

General Practice Strategy for Halton

• Population of 128,500• 17 practices (8 in Runcorn, 9 in Widnes)• 74 GPs (headcount)• 52 nurses• Registered list sizes at practices range from over

14,000 to 2,000

• A blueprint for co-commissioning general practice services from April 2015.

Progress updateCase for Change

Engagement

Public

Providers/ Partners

General Practice

High quality care for all Care continuity Reducing unwarranted variation

Clinical leadership and decision making

Services at scale, delivered locally

Co-production and co-design

Outcomes focus Services working in community

Improving access

Focus on prevention Supporting aspirations of parity of esteem and the crisis care concordat

General Practice in current guise not sustainable

PrinciplesPriority areas

Mental illnessCancer and CVDUnplanned/urgent care HypertensionGastrointestinal including liver disease

Respiratory diseaseAccidents

Emerging Care Model – Multi-Specialty Community Provision Key features

• Driving concept is to strengthen services in the community, wrapping them around local people, ensuring needs are met through integrated health and social care services

• Practices working together

• A focus on areas/conditions where we can have a greater impact

• Innovative solutions and alternative funding approaches

• Embracing the role, skills and insight of the local Voluntary/Community sector

• Creation of Community Hubs – co-location of services

• Multispecialty Community Provider (MCP) model

• Prime Minister Challenge Fund 2015

Partners and providers (not exhaustive)Community nursing Voluntary groups District nursing

Community midwives Community groups Social care services

Mental health teams Urgent care centres Elective pathways

Well being services Children’s services Health improvement teams

Family nursing Out of Hours provider Promotion, prevention and screening

Community pharmacy Outpatient services Diagnostic services

School nursing Health visiting Sexual health services

Proposed engagement approachPhase Approach Timescale

One Insight work – understanding behaviours, thoughts and views On-going *

Two Informing/warming up – mass publicity of work and engagement events

8 weeks(April – May)

Three Engaging and co-producing – designing care pathways with public/patients, General Practice and providers/partners

16 weeks(June – Sept)

Four Consultation – formally consulting on changes 12 weeks(Oct - Dec)

Five Implementation Business As Usual (Jan 16…)

‘* Run in parallel with phases two and three

• Clear objectives for each phase• Element of flexibility

So what’s next?

Well it could mean……..• Right person, right service, right time, right

place with best possible outcomes and experience?

• Tell your story once, get seen quicker, stay well longer?

• One assessment, One set of tests and One treatment plan?

• Plan together, Care together?

ONE HALTON

What we don’t want is….

• Rigid old ways of working• No more “like it or lump it” • One Size fits all• We don’t want centralised conformity, we want

what is right for our population. • Numerous hand offs and no diagnosis• Long Waits to get better (treatment)• Top down approach – we want to harness a

collective energy.

What we want is….

• A health and social care service to be proud of• Services fit for the populations needs• A multi speciality community model• Everyone working together• Improved care delivery• Better outcomes• Reduced inequalities• Joint planning

What we want is Ideas

We could see….. • GP surgeries set up in hospitals/Urgent Care Centres• Out patient clinics & diagnostics (x ray/blood tests)

in the community• Community services in different buildings (settings)• Different services in the same buildings• Specialist doctors and nurses in the community• Non clinical models supporting services and people• New creative (alternative) ideas

RehabilitationEnd of LifeChildren

Self CarePlanned CareUrgent Care

Prevention

Gen

eral

Pra

ctice

Soci

al c

are

Com

mun

ity

Men

tal H

ealth

Acut

e

Volu

ntar

y se

ctor

Publ

ic h

ealth

One Halton

Wel

l bei

ng

Phar

mac

y

Lear

ning

Dis

abili

ty

Trust

Communication

Culture

Commitment

Resource

Integration

Enablers – Resources, IM&T, Workforce, Estates, Communications & Engagement

Co production

Next steps• One Halton – direction of travel – have we got it right?• General Practice Strategy - Co produced – co

commissioned – Working Together• Engagement and communication- clinical and beyond• Commitment to deliver (this is what Halton does well) • Alignment of work plans and priorities• Multi agency / disciplinary teams• BUT HOW?