The document discusses the creation of a "Super Partnership" which would integrate primary and secondary care services within one organization. Key features include a patient list size over 100k served across multiple sites, long term business planning, and integrated specialist services delivered through a central hub. The partnership has grown to include 38k patients currently and aims to expand to 50k by November and 70k by December 2012. Specialist services like rheumatology and dermatology are already being provided. Both opportunities and tensions around further integrating specialist community services through this model are discussed.

1. Super Partnerships
Creating a GP led Integrated Care
Organisation
Helen Parker, Director, Practice Partners
Dr Naresh Rati, Executive Partner, Vitality
Partnership

2. A new model for general practice
Key features of the Super Partnership:
• Built on local general practice with local GPs
• Integration of primary and secondary care services, patient processes and
planning within one organisation: managed care model
• Creating a list size of 100k + patients
• Multi-site operation
• Detailed 5 year business and investment plan
• More corporate internal structure for GPs
• Long term business partners for diverse skill set

3. Managed Care Infrastructure
• Provision of high quality
PMS/GMS services over 5
strategic ‘outlets’
• Integrated with wide range of
specialist services delivered from
a service ‘hub’ (Level 2)
• Consultant partnerships
• Social care and patient
partnerships
• Integrated IT system
• Vitality Education Centre

5. Progress to date
• List size 38k … 50k by November 11, 70k by Dec
2012
• 4 sites in operation (plus a university site)
• Specialist services provided:
– Rheumatology
– Dermatology
– Gynaecology
– Digital x-ray
• Purchase of Level 2 facility
• Demand, activity planning and investment modelling

6. Integrating specialist services:
Commissioning enablers
• Supporting (competitive) integrated models of care
• Agreeing longer term contracts to incentivise
provider investments
• Incentives through funding mechanisms e.g.
capitated budget or pathway tariffs
• Shifting from hospital outreach to community in-
reach models of care

7. Integrating specialist services:
Commissioning tensions
• Short termism rules: need to invest to save
• Reluctance to decommission hospital services
resulting in (higher cost) parallel provision
• Consultant co-operation and enthusiasm hampered
by Foundation Trust reluctance to relinquish activity
• Consultant tensions in bidding process – where do
loyalties lie?