primary care workshops - nhs oxfordshire ccg€¦ · what further support? • don’t panic •...
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Lunch and Registration 13:00 Welcome 13:30 Primary Care Networks • What are they? • What needs to be done.
13:30
Federations how can they support? 14:10 Primary Care and Community Services Integration 14:20 Panel Q&A 14:30 Tea and coffee 15:00 Primary Care Networks space 15:00 Next Steps 16:30 Close 17:00
Agenda
Aims for today 1.Background 2.Practical next steps 3.Questions 4.Time with your proposed PCN 5.More questions and discussion 6.Any issues? What further support?
Context • The NHS Long Term Plan • The GP contract reform • Primary Care Networks
(PCNs) are a key part
Wider
Working with other Health, Care and 3rd
Sectors
Working with other practices
Practice
What is a primary care network? Local Community of 30,000-50,000
McGovern L, Miller G, Hughes-Cromwick P. Health Policy Brief: The relative
contribution of multiple determinants to health outcomes. Health Affairs. 21 August 2014. Available from: http://healthaffairs.org/healthpolicybriefs/brief_pdfs/healthpolicybrief_123.pdf
The bigger vision
What are PCNs designed to do? 1. Use data to design services around the needs of
the population 2. Proactive, coordinated care Prevention Health inequalities 3. Connect patients to other services (e.g. health, care or third sector) 4. Support the whole system
Why should we sign up?
• PCNs shown to be successful elsewhere
• Funding increasingly channelled into PCNs
• Lose out on funding if opt out • Greater influence
Potential challenges • New way of working Doing a lot for the first time • Relationships and possible disputes • Clinical Director responsibilities • Management and admin capacity • Data • Workforce - recruiting, supervising, liabilities, costs • Legal and tax advice
How are we going to get there? • ‘Ground-up’ approach
• CCG and LMC to support practices
• Network Contract DES - vehicle
for general practice taking a leading role in every PCN
1) Additional roles
• Additionality rule • New roles added from 20/21 • From 20/21 reimbursable rate calculated based on
weighted population
2) Funding Practice Support Practice participation (£1.76/weighted pt/year direct
to practices) Network Support • Core PCN funding (£1.50/head for 19/20)
• Clinical Director (£0.51/head for 19/20 then £0.69/head)
Access • Extended hours DES (£1.099/head for 19/20 then £1.45/head)
• Improved access (GPAF) (~£6/head) from 2021 Investment and Impact Fund
• Further details awaited
And in return… 7 national specifications: 2019 2020 2021
2019 2020 2021 • Extended Hours access
integrated into networks – 100% of network population
• Structured medication review
• Enhanced health in care homes
• Anticipatory care (with community services)
• Personalised care • Supporting early cancer
diagnosis
• Cardiovascular disease prevention and diagnosis, through case finding
• Action to tackle inequalities
Plus… • Support the system • Making best use of resources • Engagement with patients – including
‘seldom heard’ • Additional services based on local need
Tuesday 2 April 2019
Wednesday 3 April 2019
Thursday 4 April 2019
Dr Raman Nijjar Dr Matt Mayer Dr Richard Wood
Chair Oxfordshire LMC
Chief Executive Officer Oxfordshire LMC
Chief Executive Officer Oxfordshire LMC
Clinical Director & Governance • Clinical Director
– Who • Clinician working within your PCN. • COIs
– How • Governing Body
– How are practices represented? – How do you make decisions? – Other concerns
“We’d like one of our practices to lead on this”
Pensions CQC Easier for most Incentive for the keen
! Liability ! VAT
“We’ll ask our federation to do this”
Liability Managerial Easier for most
! ? VAT ! ? Pensions ! ? CQC
“We’ll team up with our local community trust who can help us
deliver this”
Pensions CQC Easier for most Liabilities Diverse staff
! VAT ! ?GP Autonomy
4.
Network Agreement • Clauses – sign by 15th May • Schedules – sign by 30th June
– Schedule 1: Network specifics and meetings – Schedule 2: Additional Terms – Schedule 3: Activities (e.g. KPIs) – Schedule 4: Financial Arrangements – Schedule 5: Workforce – Schedule 6: Insolvency – Schedule 7: Arrangements with organisations outside network
• You need to keep this up-to-date!
Timetable for DES introduction
https://www.england.nhs.uk/wp-content/uploads/2019/01/gp-contract-2019.pdf
Developing support • CCG Locality meetings: discussions at the
January and February meetings • CCG and the LMC: discussions on the significance
of the contractual developments • CCG, GP Federations and Oxford Health:
discussions as potential delivery partners in the PCNs
Ongoing support to PCNs • PCN workshops • 3 sessions per practice (£900) • 1 session per week per PCN (for 10 weeks)
– Early indication of PCNs – Engagement in June integration workshop
• Integration workshops – June tbc • Integrated multidisciplinary working workshops • Development of support programme locally and by NHSE • CCG locality meetings to advance, support and share learning • FAQs
Tuesday 2 April 2019
Wednesday 3 April 2019
Thursday 4 April 2019
Dr John Harrison Andrew Elphick Helen Shute
Chairman PML
Chief Executive Officer PML
Chief Executive Officer OxFed
Tuesday 2 April 2019
Wednesday 3 April 2019
Thursday 4 April 2019
Pete McGrane Tehmeena Ajmal
Clinical Director, Community
Oxford Health NHS Foundation Trust
Lead for Primary & Community Integration Oxford Health NHS Foundation Trust
Breakout questions • Who will be chosen as accountable clinical director? Will
the job be shared? • How will the process take place? By appointment or by
election? How would voting work? • Who will receive funding on behalf of the PCN? • How will you decide what goes into your network agreement
(decision-making processes, employment model, accountability)?
• Any issues that need to be resolved before 15th May?
By 15 May • The Names and the ODS codes of the Member
Practices. • The Network list size, as of 1 January 2019 • A map clearly marking the agreed network area • The initial Network Agreement • The single practice or provider that will
receive funding on behalf of the PCN • The named accountable Clinical Director
Do you need further support? • Reading to help you:
– GP Contract – BMA Handbook – FAQs
• Contact the LMC ceo@bbolmc.co.uk • Contact the CCG occg.pcn@nhs.net
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