The future of general practice, Robert Varnam
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Presentation at the RCGP East Anglia faculty annual symposium. Reflections on the current pressures facing general practice, the vision presented in the NHS Five Year Forward View and some of the ways in which practices can lead for the future
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The future of general practice, Robert Varnam
- 1. www.england.nhs.uk @robertvarnam The future of general practice Dr Robert Varnam Head of general practice development robert.varnam@nhs.net @robertvarnam King’s Lynn 9 June 2015
- 2. www.england.nhs.uk @robertvarnam Does general practice have a future?
- 3. www.england.nhs.uk @robertvarnam Does general practice have a future?
- 4. www.england.nhs.uk @robertvarnam bit.ly/c2aGP bit.ly/nhs5yfv What are people working on? How to promote, support and sustain improvements? Locally led, nationally enabled.
- 6. www.england.nhs.uk @robertvarnam Why change? Scottish School of Primary Care
- 8. Health & wellbeing-promoting care ‘Right access’ Consistently high quality Holistic, personalised, proactive, coordinated care Better joined-up care for a population of registered people bit.ly/nhs5yfv ‘Wider primary care, at scale’
- 10. Phone first. Community diagnostics. Practice based paramedics. Pharmacy first. Web consultations. Primary care led urgent care centre. Minor injury service. Physio first
- 11. Direct specialist advice. Condition management training. Shared records. Care coordination. Hospital in-reach. Care home ward rounds. Virtual ward. Primary care-employed specialists.
- 12. Social prescribing. Travelling health pods. Peer-led walking groups Health coaching. Befrienders. Schools outreach. Community development.
- 13. www.england.nhs.uk @robertvarnam The status quo is unsustainable There are new opportunities, to fulfil the promise of general practice
- 14. www.england.nhs.uk @robertvarnam Funding Co-commissioning Increased funding Fairer funding Care innovations Prime Minister’s Challenge Fund innovations Workforce Recruitment, retention, returners Nursing, pharmacy Wellbeing workforce Multispeciality Community Providers (MCPs) Primary and Acute Care Systems (PACS) New organisational forms Infrastructure Premises Digital primary care New deal for primary care
- 15. www.england.nhs.uk @robertvarnam Multispeciality Community Providers GP practice GP practice GP practice GP practice GP practice GP practice GP practice GP practice Specialists Pharmacists Community provider SC provider VCS VCS VCS MH Trust VCS VCS VCS
- 16. www.england.nhs.uk @robertvarnam Primary and Acute Care Systems Community provider SC provider VCSMH Trust Acute provider GP practice GP practice GP practice GP practice GP practice GP practice GP practice GP practice
- 18. www.england.nhs.uk @robertvarnam 1. What kind of care? • Holistic, comprehensive, cradle-to-grave family care • Health & wellbeing-promoting care • ‘Right access’ (time, place, person, care) • Consistently high quality • Holistic, personalised, proactive, coordinated care
- 19. www.england.nhs.uk @robertvarnam 2. What kind of work? • Segmented (one size does not fit all) • Multiprofessional teamworking • bring new skills • work to the top of our skills • Partnership with patients & community • Longer consultations with fewer patients • GP not always 1st port of call • Direct access diagnostics • ‘Pull-in’ specialist advice
- 20. www.england.nhs.uk @robertvarnam 3. What kind of practice? Big Personal Competent Yours
- 21. www.england.nhs.uk @robertvarnam 3. What kind of practice? Big enough for: • meaningful accountability • resilience • collaboration • broader workforce • minor illness nurses, pharmacist, MH practitioner, welfare rights, OT, physio, LTC nurses, HCA, PA • pull-in power • economies of scale
- 22. www.england.nhs.uk @robertvarnam 3. What kind of practice? Competent: • develop the workforce • look after the workforce • continually develop people • highly skilled business planning & operational management • service improvement • clinical governance • clinical care
- 23. www.england.nhs.uk @robertvarnam 3. What kind of practice? Personal: • deliberately designed systems, teamwork & processes to promote continuity
- 25. www.england.nhs.uk @robertvarnam 3. What kind of practice? Personal: • deliberately designed systems, teamwork & processes to promote continuity • proactive coordinated care • connecting patients with non-medical support • using tech to promote wellbeing, self-care and management • known in the community
- 26. www.england.nhs.uk @robertvarnam 3. What kind of practice? Yours: • well-designed • well-led • every GP matters • systems to ensure you flourish
- 27. www.england.nhs.uk @robertvarnam eg Whitstable medical practice
- 28. www.england.nhs.uk @robertvarnam eg GP Care federation, Bristol
Editor's Notes
- *** RECORDING ***
- not fulfilling the potential Things HAVE changed recently But…
- Talk of change – why?
- BUT: underfunding greater focus on hospital heroics workforce crisis ALSO: OPPORTUNITIES FOR BETTER CARE
- Not more of the same
- C2A findings … WHAT KIND OF CARE?
- WHY CHANGE?
- Premises £192m 721 bids Not just more of the same
- 34k
- 34k