hugh reeve: transforming primary care in cumbria
Post on 21-May-2015
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Health Policy Summit
Twitter: #ntsummit
Tiiii
Transforming Primary Care in Cumbria
82 Practices
List sizes:
750 – 20,000
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
“Every system is perfectly designed to deliver the results it gets”
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
Independent, super heroes
Teams, delivering joined up care
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
Cumbria’s “Common Platform”
Infrastructure Appropriate buildings; Integrated electronic
record; Common templates Directory of services (statutory and non-
statutory); Performance feedback;
.
EHR
GP and Community Teams
EMIS Data Repository Path Lab
Radiology Minor Injury Unit Hospital
Central Support Team
Specialist Clinics
EMIS Web Portal
EMIS Web Portal
PatientInfo Data
PatientInfo
EHREHR
EHREHREHR
EHR
RxRx
Hospital Info
Reports
Guidelines
PatientInfo
PatientInfo
Reports
Guidelines
PatientInfo
LabResults
RadiologyReport
RadiologyReport
LabResults
Integrated Information: glue that holds it all together
Pharmacy
Referral
ALERT
ReferralALERTALERT ALERT
ALERTData Streaming between local
centres and
Workforce Workforce planning;
Training and education; Multidisciplinary Teams with
appropriate skills and competencies;
Mobilised Community assets .
Infrastructure Appropriate buildings; Integrated electronic
record; Common templates Directory of services (statutory and non-
statutory); Performance feedback;
.
Cumbria’s “Common Platform”
Workforce Workforce planning;
Training and education; Multidisciplinary Teams with
appropriate skills and competencies;
Mobilised Community assets .
Outcomes Supported self management;
Reduced mortality; Reduced morbidity;
Improved quality of life; Improved experience for patients, carers and staff; Improved cost efficiency.
Infrastructure Appropriate buildings; Integrated electronic
record; Common templates Directory of services (statutory and non-
statutory); Performance feedback.
Cumbria’s “Common Platform”
Workforce Workforce planning;
Training and education; Multidisciplinary Teams with
appropriate skills and competencies;
Mobilised Community assets .
Outcomes Supported self management;
Reduced mortality; Reduced morbidity;
Improved quality of life; Improved experience for patients, carers and staff; Improved cost efficiency.
Infrastructure Appropriate buildings; Integrated electronic
record; Common templates Directory of services (statutory and non-
statutory); Performance feedback.
Cumbria Learning and Improvement Collaborative Providing the capacity for delivering change across Cumbria Joint ownership – CCG, Provider Trusts and Local Authority
Cumbria’s “Common Platform”
Individuals and Families
Community Assets
Built around GP populations 15,000 – 50,000
NHS Community Providers
Pharmacy Dentist
Optometry
Specialist Teams
Specialist Teams
Social Care Providers
Non-traditional Providers
GP Practice
GP Practice
Workforce Workforce planning;
Training and education; Multidisciplinary Teams with
appropriate skills and competencies; Mobilised Community assets .
Outcomes Supported self management;
Reduced mortality; Reduced morbidity;
Improved quality of life; Improved experience for patients, carers and staff; Improved cost efficiency.
Infrastructure Risk stratification system; Care planning process;
Integrated electronic record; Directory of services
(statutory and non-statutory); Performance feedback; Appropriate buildings.
Cumbria’s “Common Platform”
Individuals and Families
Community Assets
Built around GP populations 15,000 – 50,000
NHS Community Providers
Pharmacy Dentist
Optometry
Specialist Teams
Specialist Teams
Social Care Providers
Non-traditional Providers
GP Practice
GP Practice
Cumbria Learning and Improvement Collaborative
CCG “INSURER”
Carlisle
Eden
Furness South Lakeland
Allerdale
Copeland
A central Commissioner with a network of Primary Care Provider Groups
Primary Care Communities
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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