securing the future of general practice harrow lmc dr michelle drage, ceo 29 january 2014
TRANSCRIPT
Securing the Future of General Practice
Harrow LMCDr Michelle Drage, CEO
29 January 2014
1. The registered list - individuals and practice population
2. Expert generalist care of the whole patient
3. The consultation as the irreducible essence of delivery
4. Take into account socio-economic and psychological determinants of disease and the inverse care law
5. The therapeutic relationship6. Deliver safe, effective long term and
preventative care, balanced with timely episodic care by promoting access to relationship continuity
7. Advocacy and confidentiality
1. Sufficient consultation time2. Sufficient numbers of GPs, nurses
and practice staff per 1000 weighted patients
3. Right premises4. Right technology 5. Right extended Primary Health Care
Teams centred around the practice or networks of practices
6. Right connections and communications across services
7. Flexibility to innovate locally
1. Improve access to GPs and their Primary Health Care Teams by reducing bureaucracy, freeing up consultation time and adding
more clinical staff2. Improve support for GP and practice Primary Health Care Team
delivery through integrated care centred around practices3. Support more training and practices for General Practice Nurses
4. Use contractual mechanisms to support all of the above plus networks of practices and collaboration
5. Re-route funding from secondary care to support all the above by stopping A&E seeing and admitting non-emergencies
6. Get back to basics of service delivery: move away from models that are aimed at developing an alternative provider market.
Commissioning for General
Practice and Primary Care in
London
Core Values of General Practice
Basic Building Blocks of Excellent General Practice
www.lmc.org.uk
Core Values of General Practice
1. The registered list - individuals and practice population
2. Expert generalist care of the whole patient
3. The consultation as the irreducible essence of delivery
4. Take into account socio-economic and psychological determinants of disease and the inverse care law
5. The therapeutic relationship
6. Deliver safe, effective long term and preventative care, balanced with timely episodic care by promoting access to relationship continuity
7. Advocacy and confidentiality
www.lmc.org.uk
1. Sufficient consultation time
2. Sufficient numbers of GPs, nurses and practice staff per 1000 weighted patients
3. Right premises
4. Right technology
5. Right extended Primary Health Care Teams centred around the practice or networks of practices
6. Right connections and communications across services
7. Flexibility to innovate locally
Basic Building Blocks of Excellent General Practice
www.lmc.org.uk
1. Improve access to GPs and their Primary Health Care Teams by reducing bureaucracy, freeing up consultation time and adding more clinical staff
2. Improve support for GP and practice Primary Health Care Team delivery through integrated care centred around practices
3. Support more training and practices for General Practice Nurses
4. Use contractual mechanisms to support all of the above plus networks of practices and collaboration
5. Re-route funding from secondary care to support all the above by stopping A&E seeing and admitting non-emergencies
6. Get back to basics of service delivery: move away from models that are aimed at developing an alternative provider market.
Commissioning for
General Practice and
Primary Care in London
www.lmc.org.uk
Commissioning for
General Practice and
Primary Care in London
Core Values of General Practice
Basic Building Blocks of Excellent General Practice
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What shall we integrate this week?
www.lmc.org.uk
Turn the whole process on its head
Commission FOR general practice & primary care
www.lmc.org.uk
• Better outcomes for patients• Reduced A&E / Hospital attendances• Enhanced integrated care across health, social
and mental health care settings• Improved quality of patient services• Maintenance of high quality generalist
healthcare service with relationship continuity at its heart
• Cost effective care
… to deliver
www.lmc.org.uk
Invest in general practice, primary, community & social care…….
www.lmc.org.uk
……free up hospitals to do what they should do
www.lmc.org.uk
Londonwide LMCs support
• Campaign• Engagement with NHSE to shape agenda• Surveys • Brokering relationships beyond the CCG• Policy & Influence• Securing the future of general practice in
London
Londonwide LMCs Support • Investment fund for general practice to operate more
effectively but more importantly the support services that help general practice function eg community services, social care, mental health and pharmacy
• Keep the existing structure as it is proven that it works well and is admired internationally
• Review primary care development that includes the development of collaborative working and allows the whole system to operate more efficiently
www.lmc.org.uk
Case for change
• Health and Social Care Act• Procurement• Choice and Competition, AQP • Transformation; system changes with LAs,
H&WBs &PH, • “Shaping a Healthier Future”• Lack of investment/disinvestment• General Practice is being challenged as the
provider of choice
Key Issues
• Legal
• Governance
• Financial
• HR
• Services
• Conflicts of interest
• Patients
GPs as Providers
• Maximise opportunities• Why collaborate – shared vision• What do we want to achieve through
collaboration• Cost; benefits• What level of collaboration
Management, shared costs/functions Primary Medical Services – quality/coverage Service providers; procurement/AQP
Organisation
• What does this mean for you? - Existing collaborative modelsNetworks; FederationsSuper PartnershipsCICSocial EnterpriseLLPCLS/CLGCooperatives
Development Programme
• Collaborative programme for GPs • Working with CCGs to meet their needs• Practical tools for practices to meet
commissioning/provider priorities• Legal input• Locally focussed - practical tools -
How? What? Why? When?• Local outcomes – Collaborative working is a solution not a problem
Practical ToolkitGuidance for set up and sustainability that includes:
•Core contract protection
•Legal framework
•Network setup
•Company Formation
•Engagement with stakeholders
•Workforce
•Premises
•Service Contracts/Procurement
•Technical guidance and examples of process infrastructure
•Individual practical support
GP Providers Working Together
www.lmc.org.uk