1. Northumberland is working to better integrate primary and secondary care through leadership collaboration and various enabling initiatives. 2. Key enablers include shared leadership across the clinical commissioning group, local authority, and healthcare trust, as well as initiatives to improve access to care, information technology, and workforce development. 3. Additional enablers focus on strengthening primary care through practice mergers, federations, and developing a culture of shared learning across the healthcare system to plan and deliver sustainable, patient-centered care through a new accountable care organization model.

1. Primary & Secondary Care
Collaboration in
Northumberland

2. Dr Robin Hudson FRCGP
Joint Clinical Director
Northumberland PACS Vanguard
Primary Care Quality Lead
NHS Northumberland CCG

3. Primary & Secondary Collaboration
• Our integration journey (Vanguard)
• Leadership
• Enablers
• Culture

5. A clear story?

6. Enabler 1: System Leadership
• CEO Local Authority also Accountable Officer CCG
• Deputy CEO Local Authority also Senior board position
NHCFT and leadership role in CCG
• Director Adult Social Care also Chief Operating Officer
CCG
• Accountable Officer CCG is the chair of the CCG and
will be the new chair of the ACO

7. Enabler 1: System Leadership
• Leadership development programmes open to GPs
• GP leaders within Northumbria Healthcare NHS Foundation
Trust (medical director, assoc MDs)
• Vanguard Clinical directors & leads
• Chief Clinical Information Officers
• CCG & Local Authority
• Clinical leaders Forum & Clinical Strategy Group
• Enhanced Care Steering Group
• Primary Care Leadership Group & LMC

8. Enabler 1: System Leadership
• Meeting together regularly
• Joint goals and purposes
• Building trust
• Not just about structure
• Accelerated culture of development

9. Enabler 2: Access to healthcare
• Northumbria Specialist Emergency Care Hospital
• GPs in urgent care centres
• Building capacity in General Practice
• Improving access in General Practice

11. Specialist
Emergency
Hospital
Outpatients
Diagnostics
Day cases
Elective
Surgery
Sub acute in-
patients
A&E
Emergency
Admissions
Acute in-
patients
Minor injuries
Acute in-
patients
A&E
Emergency
admissions
“hot” diagnostics
Outpatients
Diagnostics
Day cases
Elective
Surgery
Sub acute in-
patients
A&E
Emergency
Admissions
Acute in-
patients
Minor injuries
STAGE ONE
1st purpose built
specialist emergency care
hospital
in England
Outpatients
Diagnostics
Day cases
Elective
Surgery
Sub acute in-
patients
A&E
Emergency
Admissions
Acute in-
patients
Minor injuries

12. Urgent and emergency care when you need it, in
the right place
Acute visiting service
-triage of same day
requests to GP,
community nurse or
pharmacist
7 day emergency
care – The
Northumbria
-reduced
admissions
-reduced length of
stay
Local urgent care
-Capacity and demand
exercise: increased GP
urgent access
-Extended GP access
Quick access
-to specialist
telephone advice/
assessment
-single point of
access

14. Primary care access – latest data shows that the average percentage helped has increased
to just over 8% from 7.5% - equating to an additional 3,226 contacts per week – 170,000
potentially per year (across 30 practices) – 43 practices will have data for the next quarter

15. Enabler 3: IM&T
• Medical interoperability Gateway (MIG)
• System One (S1)
– Community nursing, palliative care, diabetes teams
– 33/44 practices on S1 “Summer” 2017
• Openness to change within NHCFT
• Ambulatory Care/ ED/ UCC?
• North East Ambulance NHS Foundation Trust?
• S1 Care Homes?

16. Enabler 4: Workforce
• Accelerated nurse training programme
• Clinical Pharmacists
• Community education provider network

17. Enabler 5: Primary medical care
• Engagement
• Building capacity
• Integration vs Independence
• Provider focus locally
• Single voice in the county
• New organisational forms

18. Today…
Choluteca River Bridge, HondurasIntegration Independence

19. Courtesy 20th Century Fox

20. Enabler 5: Primary medical care
• Engagement
• Building capacity
• Integration vs Independence
• Provider focus locally
• Single voice in the county
• New organisational forms

21. Enabler 5: Primary medical care
• New organisational forms
– Practice mergers
– Northumbria Primary Care
– Countywide federation +

22. Culture
• Not just structural
• Accelerated culture of learning and transformation
• No more silo thinking
• Sharing improvement methodology
• Challenging the medical model when needed
• Enhancing communication
• Sharing risk across the entire system
• Truly empowering patients

23. A capitated budget for
the population
Mutual responsibility
for the system
Sustainable services
for the future
A new model of planning and delivering care
ACCOUNTABLE
CARE
ORGANISATION

24. Primary & Secondary Care
Collaboration in
Northumberland