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. “Every system is perfectly designed to deliver the results it gets”
5.
6.
7.
8. 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 capabilities
Integration 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
11. 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
14. Integrated Information:
Pharmacy
glue 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 Reports
GP and Community Teams between local Guide
lines
Central Support Team
centres and
15. Cumbria’s “Common Platform”
Infrastructure Workforce
Appropriate 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;
.
16. Cumbria’s “Common Platform”
Infrastructure Workforce Outcomes
Appropriate 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.
17. Cumbria’s “Common Platform”
Infrastructure Workforce Outcomes
Appropriate 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
18. Built around GP populations
15,000 – 50,000
GP
Non-traditional Practice Social Care
Providers Providers
Specialist Specialist
Individuals and Families
Teams Teams
Community Assets
NHS Community Pharmacy
Providers Dentist
Optometry
GP
Practice
19. Built around GP populations
15,000 – 50,000
GP
Non-traditional Practice Social Care
Providers Providers
Specialist 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
20. A central Commissioner with a network of
Primary Care Provider Groups
Carlisle
Allerdale
Eden
Copeland CCG
“INSURER”
Furness South
Lakeland
Primary Care Communities
21. 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
