Hugh Reeve: Transforming Primary Care in Cumbria

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Hugh Reeve: Transforming Primary Care in Cumbria

  1. 1. Health Policy Summit Tital Transforming Primary Care in Cumbria Twitter: #ntsummit
  2. 2. 82 Practices List sizes: 750 –20,000
  3. 3. The task of primary care:• Population based care - improving the health of the local population• Unplanned care – for acute illness and crises in people with ongoing problems• Planned care – ‘one off’ or ‘on and off’ issues• Ongoing care - for people with LTCs (physical and psychological), cancer, multi-system problems• End of life care
  4. 4. “Every system is perfectly designed to deliver the results it gets”
  5. 5. Dual Challenge:Transformation of general practice• Internal systems and processes – Access, paper and electronic communications, medicines management, LTC management systems, etc• Clinical capacity – Workforce mix and clinical skills capabilitiesIntegration with other health and social care teams• Information flows - Chinese walls• Different business models – Independent contractors, FTs, Social Enterprises, Social Care, private and third sector providers• Commissioning responsibilities and funding flows
  6. 6. Independent, super heroes
  7. 7. Teams, delivering joined up care
  8. 8. A new paradigm• Moving from the current reactive approach to planned, proactive anticipatory care• Health giving relationships and supporting self management – allowing people to take control, co- production of their health with ‘professionals’• Access to the right clinician - face to face IF you need to see a clinician, otherwise by phone or on-line ‘Call, click or come-in’• Learning from the best from elsewhere in the “service sector” – patient not organisation centred care
  9. 9. Cumbria’s “Common Platform”InfrastructureAppropriate buildings; Integrated electronic record; Common templates Directory of services (statutory and non- statutory);Performance feedback; .
  10. 10. Integrated Information: Pharmacyglue that holds it all together H os pi Radiology Minor Injury Unit ta Radiology lI nf EMIS Web o Report Hospital Portal EHR Radiology EHR Report EHR Patient Info EHR Lab EMIS EHR LabPatient Results EHR Info Data Rx Referral Patient Results ReportsALERT EHR ALERT Info Rx Repository Path Lab Patient Guide Specialist Clinics Info linesData EMIS Web Patient Portal ALERT Info ReferralALERT Data Streaming ReportsGP and Community Teams between local Guide lines Central Support Team centres and
  11. 11. Cumbria’s “Common Platform”Infrastructure WorkforceAppropriate buildings; Workforce planning; Integrated electronic Training and education; record; Multidisciplinary Teams with Common templates appropriate skills and Directory of services competencies; (statutory and non- Mobilised Community assets . statutory);Performance feedback; .
  12. 12. Cumbria’s “Common Platform”Infrastructure Workforce OutcomesAppropriate buildings; Workforce planning; Supported self Integrated electronic Training and education; management; record; Multidisciplinary Teams with Reduced mortality; Common templates appropriate skills and Reduced morbidity; Directory of services competencies; Improved quality of life; (statutory and non- Mobilised Community assets . Improved experience for statutory); patients, carers and staff;Performance feedback. Improved cost efficiency.
  13. 13. Cumbria’s “Common Platform”Infrastructure Workforce OutcomesAppropriate buildings; Workforce planning; Supported self Integrated electronic Training and education; management; record; Multidisciplinary Teams with Reduced mortality; Common templates appropriate skills and Reduced morbidity; Directory of services competencies; Improved quality of life; (statutory and non- Mobilised Community assets . Improved experience for statutory); patients, carers and staff;Performance feedback. Improved cost efficiency. Cumbria Learning and Improvement Collaborative Providing the capacity for delivering change across Cumbria Joint ownership – CCG, Provider Trusts and Local Authority
  14. 14. Built around GP populations 15,000 – 50,000 GP Non-traditional Practice Social Care Providers ProvidersSpecialist Specialist Individuals and Families Teams Teams Community Assets NHS Community Pharmacy Providers Dentist Optometry GP Practice
  15. 15. Built around GP populations 15,000 – 50,000 GP Non-traditional Practice Social Care Providers ProvidersSpecialist Individuals and Families Specialist Teams Teams Community Assets NHS Community Pharmacy Providers Dentist GP Optometry Practice Cumbria’s “Common Platform” Infrastructure Outcomes Risk stratification system; Supported self management; Care planning process; Integrated electronic record; Workforce Reduced mortality; Workforce planning; Reduced morbidity; Directory of services Training and education; Improved quality of life; (statutory and non-statutory); Multidisciplinary Teams with Improved experience for Performance feedback; appropriate skills and competencies; patients, carers and staff; Appropriate buildings. Mobilised Community assets . Improved cost efficiency. Cumbria Learning and Improvement Collaborative
  16. 16. A central Commissioner with a network ofPrimary Care Provider Groups Carlisle Allerdale Eden Copeland CCG “INSURER” Furness South Lakeland Primary Care Communities
  17. 17. Some Key Issues• A new Business Model - moving from the corner shop to larger groups – SPAR Local or Tesco Local• Partnership between CCG, LAT and local providers to facilitate this• Contractual mechanisms – GMS v APMS v ?? – Alternative Quality contract, Lead Provider, Alliance• Conflict for CCG in increasing investment into primary care – air cover from H&WBB + LAT/NCB

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