Simon Brownleader & Ashraf Ullah: GP Networks

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Simon Brownleader & Ashraf Ullah: GP Networks

  1. 1. Tower Hamlets NetworksSimon BrownleaderAshraf Ullah
  2. 2.  Population 262,000 Diverse mix – large Bengali community Major health inequalities Primary care under-resourced Variability in service quality - LTCBackground
  3. 3.  Increased investment Creation of 8 networks Geographically aligned 4-5 practices per network Funding for management infrastructure2008/9
  4. 4. 536 Practices in 8 networks65*123456891071112151316141718192421222023252627282930313233343536Pop: 28,956Pop: 23,868Pop: 38,529Pop: 33,948Pop: 25,549
  5. 5.  Blithehale Health Centre Albion Health Centre The Spitalfields Practice Health E1 Homeless Medical Centre XXP SurgeryEast End Health Network
  6. 6. 36 Tower Hamlets practices8 geographical networksNetwork staff £1.2mCare packages £3.5mLES £3mTotal £8m
  7. 7. Improved our ITNetwork admin staffEducational budgetChanged LES to Network care Packages (NIS)EEHN LTDMonthly MDT meetings with specialistsOrganisational change
  8. 8.  Similar to LES but stricter targets Payment is made to the network 70% in advance 30% on network achievementFunding
  9. 9.  CVD (Health check, hypertension & 2nd prevention) Diabetes COPD ImmunisationCare packages
  10. 10. Did we make a difference?
  11. 11. MMR Immunisation 2006-10
  12. 12. Diabetes Hba1c by practice networkNW1 NW2 NW3 NW4 NW5 NW6 NW7 NW8 BoroughApr-11 7.63 7.97 7.91 7.56 7.44 7.70 7.80 7.65 7.71May-11 7.67 7.95 7.93 7.56 7.45 7.68 7.78 7.63 7.71Jun-11 7.67 7.96 7.92 7.56 7.45 7.66 7.77 7.62 7.70Jul-11 7.70 7.94 7.95 7.63 7.50 7.71 7.78 7.66 7.73Aug-11 7.74 7.92 7.97 7.62 7.54 7.74 7.80 7.63 7.75Sep-11 7.72 7.91 8.00 7.59 7.52 7.74 7.78 7.60 7.75Oct-11 7.71 7.89 8.00 7.56 7.50 7.72 7.75 7.60 7.73Nov-11 7.69 7.85 7.97 7.52 7.51 7.76 7.75 7.59 7.727.107.207.307.407.507.607.707.807.908.008.10AveragebynetworkNetwork Average HbA1cGP Network average forHbA1c forpatients on register(excludingdiagnosed within last 6 months)
  13. 13. 0501001502002503002009 2010 2011COPD admissions/100,000 population* ineast London, 2009-11Tower HamletsNewhamCity and Hackney
  14. 14.  Shared values Trust Size Organisation Data Peer comparison/support Incentives Education AutonomyWhy does it work?
  15. 15.  Improving quality of care plans Frail complex and co-morbidities Innovation & integration into the community Networks + Delivery of other community services (CHS) Risks around funding – uncertainty/complexityFuture Focus

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