Caring for Darlington Beyond Tomorrow

Prime Ministers Challenge Fund Darlington Provider Collaborative

Who we are

• 10 GP practices covering 94k patient population

• All on the same IT system• We have a Foundation Trust based in the town• Close links with Darlington Borough Council• We are currently progressing discussions

around formal collaboration and federation.

BCF

PMCF

New GP Contrac

t

How it all fits together

• We see the PMCF as a key lever for the change needed in Primary Care to help deliver improvements in many areas of patient care.

• It will enable Darlington Primary Care to work with the other big providers to improve patient care.

What it doesn’t do:

• Is enable GP practices to be open all hours – we believe locally that this will be detrimental and un-sustainable for our local health economy.

What we hope to achieve

4 Key areas• Give flexibility for patients to access health care in

Darlington• To utilise inter-practice clinical experience thus improving

access and reducing variation• To focus on proactive management of our Frail and Elderly

population with the implementation of an MDT framework

• To look at the feasibility and appropriateness of 8-8 working and Saturday/Sunday services for the local population

What else do we want to do• Understand some of the barriers some clinicians have with

new ways of working but who are also the same people struggling with the volume and complexity of work.

• Work with our colleagues across other primary care services especially pharmacy

• Work with the LAT to see how we can best use the public investment in Primary Care services by reducing unnecessary duplication of work without destabilising businesses.

• Begin to map out how an integrated health care system may look and work.

Whole System Collaboration and Integration

=

Where are we up to• We now have sign up from all 11 GP practices in Darlington covering

100k patient population • We have a steering group progressing the collaborative/federation

work.• We have design teams in place who are working up the logistics of our

MDT across 4 organisations – primary care, CDDFT, TEWV & DBC • We are part of a working group with CDDFT looking at use of ED and

UCC during out of hours to analyse and evaluate how a change to primary care access may help alleviate pressure.

• We have an understanding from the Health and Scrutiny committee at DBC that there needs to be population support about these changes and they need to themselves look at how they access and use primary health services.

So…..

8

Better Care Fund

Challenge Fund

AT Support“Collaborat

ion”

Improved Patient

Experience

Better Working Conditions for Primary Care

Elderly in Acute

Hospital bed

Rapid Assessment Base (request diagnostics) 8-8 x 7 days

MDT Community

Rapid Response &

case management

Top 5%

GP practice

s

Nursing

HomesLong Term Condition

Case management/Care Planning/EOL

Self Management and patient education

Crises patient Ambulance 999

Life threatening

Diagnostic rapid access

pull

pull

By-pass A&E

Purple-;

Where PMCF will help support Primary Care to provide this integrated care

What challenges do we have already

• Patient demand is ever increasing• Need more clinical input, how to backfill with

limited resource• Change management – typically takes 18

months…….!!!• Timelines of contractual obligations (ES) of

practices against different timelines of PMCF/BCF• Indemnity and other issues of patients being seen

at other practices – guidance• Data sharing between organisations• Media

What do we need…….

• Assurance that there is support locally, regionally and nationally for changes that we will be proposing

• Assistance with the media & public relations• Help with evaluation of the work-streams• Links with other areas of best practice – we are keen

to learn and try. • Clarity as to the expectations of us as a pilot site –

our plans were an expression of interest not a declaration of what we would be doing.

THANK YOUAny Questions?