3. Key Features
• Medically-led Integrated Care Organisation
• Large, single entity, GP provider
• Integration of GMS/PMS with community and specialist
services
• Registered list of 80k plus
• Geographically coherent
• Multi - site delivery
• 5 year Strategic Business Plan
• Population Health Planning
• Hub for research, training and education
4.
5. Formation
• Motivated local GPs with a vision
• Procuring additional capacity and skill set
• New partnership agreement and partner status options
• Mergers and consolidation
• Organisational development +++
- Defined GP leadership and management roles
- New governance structures
- Centralisation agenda
• Clinical and financial decision making absolutely aligned
• Brand creation
• Evolution, not revolution - but with some pace
6. Drivers
• Commissioning weak, innovation slow
• GPs history of primary care provider innovation
• Fragmented inner city general practices with
quality variation
• Barriers to shifting care into community settings
• Larger scale investments in infrastructure and
staff needed
• Patient demand outgrown small practice model
• Financial security
7. Levers
• Motivated and committed GPs
• GP + business development skill dynamic
• In house specialist skills and positive
relationships with local consultants
• Local GP demographics
• Local strategic plan to downsize acute trust
• Strong commissioning influence
11. Service Portfolio
Current Pilots
• Rheumatology • Urology
• Dermatology • ENT
• Gynaecology • Community
• Orthopaedics Physiotherapy
• Immunology • A&E diversion
• X-ray Planning
• Substance Misuse • Health and Well Being
• Intermediate Care • Paediatric Assessment
• Extended Minor Surgery • Community Nursing
• Pharmacy
• Dentistry
12. 2005/6
Impact on Demand
Management:
Dermatology
National SHA Provider Selected
PCT Practice Group Axis Split
2010/11
National SHA Provider Selected
PCT Practice Group Axis Split
13. Getting the Foundations Right
• The Super Partnership structure
• New Partnership Agreement
• Corporate governance structure within to operate
• Communication ++
• Lead management roles for partners
• Procuring additional skill set
• Pace of patient and service growth
• Centralisation agenda for efficiencies
14. Challenges
• Impact of CCG development and contracting void
• Degree of influence in CCG and conflicts of interest
• Acute Trust threat
• Local GP politics
• Patient choice
• GP contract changes – maintaining momentum
• IT and informatics to support business planning
15. Impact
• Improvement in quality of primary care and demand
management
• Increased patient satisfaction with practice based services
• Significant local influence
• Less dependence on core contract and increased turnover
• Creating infrastructure for viable alternative to hospital care
• Increased efficiency due to centralisation
• Transforming general practice as a career option– clinical and
non-clinical staff
17. Moving forward….
• On a journey from single practice to ICO to…. ACO
• Expand research and education activity
• New models of patient engagement
• Contracting model and shared risk important
- Prime contractor, AQP, Programme budgets
• Potential to re-engineer health system accountability and
commissioning model
• Future policy framework critical to success
• Impact of new GP contract – potential facilitator
