developing a great ccg general practice forward view plan

@robertvarnam #GPforwardview@robertvarnam #GPforwardview

Dr Robert VarnamHead of General Practice Development

CCG Forward View plansPitfalls and suggestions

bit.ly/170302commissioninglive

@robertvarnam #GPforwardview

What do you need to achieve?

Improve access

New models of LTCs

New organisational models

Stabilise practices

Stabilise hospitals

Shift upstream

Multiple competing priorities?

OR Multiple synergistic opportunities?


Local workstreams

£3/head transformational

support£6/head

improving access

Vulnerable practices

Practice resilience

Clinical pharmacists

Online consultations

fund

↑18% GPIT

Staff training fund

10 High Impact Actions

Time for Care programme

Capability building

Integrated urgent care

Bewildering number of competing choices?

OR Multiple synergistic opportunities?(only partially understood by practices)


Improving access to general practicePlan for improving access• Deliver the national mandate commitment to “to ensure

everyone has easier and more convenient access to GP services, including appointments at evening and weekends”

• We have outlined the trajectory and requirements for improving access in the NHS Planning Guidance.

In delivering this we will want to secure: transformation in general practice, including a step change in our use of digital technologies to support for urgent care and changes in general practice services that lay the foundations for general practice providers to move to a model of more integrated services such as MCPs or PACs.

CCGs will:• receive funding per head of population

(weighted) • need to commission services that meet

national requirements• spend £3 per head non recurrent on

practice transformational support (commencing 17/18 and can take place over two years, £3 in 17/18 or 18/19 or split over the two years)

• be required to secure services following appropriate procurement processes.

In addition:• In 2017/18 we will invest £138M and in

2018/19 this investment will rise to £258M as recurrent funding

• We will require trajectories for aspects of GPFV including access as part of CCGs’ GPFV plans by 23 December

• This will enable us to confirm the more detailed access trajectory by February 2016


The GP Access Fund

• Programme to test innovative ways of improving access.

• Commenced April 2014• £175m national funding over

two years• 2 cohorts, of 57 schemes

covering >18 million population, >2,500 practices

• Independently evaluated

@robertvarnam #GPforwardview#GPforwardview

What is good access?


Collaborative working Whole system approach Self-care Broader workforce Tech


Local workstreams


support£6/head

improving access


Practice resilience



fund

↑18% GPIT

Staff training fund



Capability building





So why are people talking about change? It’s partly about the pressure we’re under right now, and partly about the huge opportunity to do something better. And, for once, the same changes that would help with one are also necessary for the other. Pressure Opportunity

@robertvarnam #GPforwardviewwww.nhsalliance.org/making-time-in-general-practice/

bit.ly/time4caretool1


74%

7%

6%

4%

3%

3%2%

2%

Potentiallyavoidable GPappointments

(audit by GPs)

Other in practice

Self care/Pharmacy

Outpatients

Sick notes / appeals

Care navigationContinuity/preparation

Other

Data from 5,128 consultations


GPs judged 26%of their consultations

to be potentially avoidable


74%

7%

6%

4%

3%

3%2%

2%

Other in practice

Self care/Pharmacy

Outpatients



Other





… 18% are about how the practice

manages its workload


(audit by GPs)


165m

15m

12m

8m

6m

6m4m

4m

Other in practice

Self care/Pharmacy

Outpatients



Other







Nationally


(audit by GPs)


20,861

1,889

1,550

1,015

818

789564

564

Other in practice

Self care/Pharmacy

Outpatients



Other







Average practice (6,700 patients)


(audit by GPs)


20,861

1,889

1,550

1,015

818

789564

564

Other in practice

Self care/Pharmacy

Outpatients



Other







Average practice (6,700 patients)


(audit by GPs)

Measure your opportunity…



Innovations from around England that release time for GPs to do more of what only they can do.

bit.ly/gpcapacityforum



Innovations from practices throughout around England that release time and improve care.



Local workstreams


support£6/head

improving access


Practice resilience



fund

↑18% GPIT

Staff training fund



Capability building





Local workstreams


support£6/head

improving access


Practice resilience



fund

↑18% GPIT

Staff training fund



Capability building


Comprehensive, coherent development plan Achieving clearly described goals Attractive to practices

@robertvarnam #GPforwardviewwww.england.nhs.uk/gpdp


PreparationAligning plans, federation

development, local champions

Online consultation fund (from 2017)

Reception & clerical staff training fund (from 2016)

Lear

n &

plan

Cha

nges

Lear

n &

plan

Cha

nges

Lear

n &

plan

Cha

nges

Lear

n &

plan

Cha

nges

Launch event

Development Advisor Support

Learn from innovators

General Practice Improvement Leaders Programme

£3 + Access + GPIT + VP + PRP, etc

Your Time for Care programme

Showcase event

Productive General Practice


General Practice Improvement Leaders programme

Build capabilities and confidence to support colleagues in implementing change in practices

To ensure every locality has a local improvement facilitator who can access both local and national resources in the future

Fundamentals of change and improvement (2-day session)

Human Dimensions of change (2 x 1-day sessions)

Facilitation skills (2 x 1-day sessions)

Primary care improvement community

Your own change project


PreparationAligning plans, federation

development, local champions

Online consultation fund (from 2017)

Reception & clerical staff training fund (from 2016)

Lear

n &

plan

Cha

nges

Lear

n &

plan

Cha

nges

Lear

n &

plan

Cha

nges

Lear

n &

plan

Cha

nges

Launch event

Development Advisor Support

Learn from innovators

General Practice Improvement Leaders Programme

£3 + Access + GPIT + VP + PRP, etc

Your Time for Care programme

Showcase event

Productive General Practice

www.england.nhs.uk/gpdp

@robertvarnam #GPforwardview@robertvarnam #GPforwardview

www.england.nhs.uk/gpdp

[email protected]

CCG Forward View plansPitfalls and suggestions

bit.ly/170302commissioninglive

developing a great ccg general practice forward view plan

Health & Medicine