Upload
others
View
3
Download
0
Embed Size (px)
Citation preview
1
Place in an Integrated Care System
and
PCN Workforce
Health Professionals In Primary Care Conference
30th January 2020
Helen Goodey
Director - Localities and Primary Care – Glos. CCG
Director – Gloucestershire Health and Community Trust
#GlosPCTH
What is Place based care?
Individual Individual support to manage their own care through:
Self-care
Care navigation
Improving patient activation
Neighbourhood
~30-50k
Primary Care Networks that bring together local health and care
professionals around natural local neighbourhoods of care to:
Improving integrated ways of working
More joined-up pathways
Embedding population health approaches
Place
~250-500k
Integrated Locality Partnerships (ILPs) that are groups of local PCNs that
work alongside partners in secondary care, mental health and with CCGs
and LAs to:
Integrate health and care services
Work preventatively to stop people becoming acutely unwell
Care models to redesign care
System
~1m
One Gloucestershire includes providers & commissioners collaborating to:
Hold a system control total
Implement strategic change
Take on responsibility for operational and financial performance
Population health management
Place Summary
• Place-based working enables the NHS, councils and other organisations to collectively take responsibility for local resources and population health.
• We are working together with partners to plan and provide joined up, better coordinated care for Gloucestershire people.
• Strategic Place meetings, ILP meetings and ILP Plans are the enablers to develop place-based care within Gloucestershire.
Place: Gloucester City
Gloucester City ILP
Overarching aims
Best start to life and reducing health inequalities
Partners in Health PRIORITIES
• Respiratory education & link to housing
• High intensity users • Connecting up our services • Children & Young Peoples’
mental wellbeing
Inner City
PCN 5 practices
RHQ PCN
3 practices
Aspen PCN
1 practice
North & South Gloucester (NSG)
PCN
5 practices Public Health
VCS Alliance
Gloucestershire’s 14 PCNs
What is a Primary Care Network (PCN)?
• Groups of primary and community staff working
together to deliver preventative, out of hospital care
in their neighbourhood.
• Services and staff based around the GPs registered
list with PCNs upwards of 30,000 registered patients.
• Long Term Plan aim - Expectation to work closely
with all providers on the patch – healthcare, statutory
and VCS
• From April 2020, every PCN will receive new
national Network Dashboard to measure impact;
• A new national Network Investment and Impact
fund, linked to performance against metrics in the
Network Dashboard from 2020.
NHS England Strategic Goals
NHS England has five aspirations for Primary Care:
1. Stabilise the GP partnership model;
2. Create 20,000 new staff working in general practice
through an ‘Additional Roles Reimbursement’ scheme;
3. Create a wider platform for investment;
4. Dissolve the historic divide between primary and
community care;
5. A clear, quantified, positive impact for the NHS
system and our patients, with fewer patients
being seen in hospital and more being seen
and treated in our communities.
8
New roles to Support the Seven new service specifications being introduced to deliver NHS Long Term Plan primary care goals in a phased way
• Services starting by April 2020:
– Structured Medications Review and Optimisation (increasing in scope and scale each year)
– Enhanced Health in Care Homes
– Anticipatory Care requirements for high need patients typically experiencing several long-term conditions
– Personalised Care
– Supporting Early Cancer Diagnosis
• Services starting by 2021:
– CVD Prevention and Diagnosis
– Tackling Neighbourhood Inequalities
System based collaboration
priorities
9
NHSE Recurrent Funding
“Additional Roles Reimbursement”
Additional staff in five groups by 2024
• Social prescribing link workers (up to B5) 100% funding from 2019/20
• Clinical pharmacists (B7/8a) approx. 70% from 2019/20
• First contact physiotherapist (B7-8a) approx. 70% from 2020/21
• Physician associates (B7) approx. 70% from 2020/21
• First contact community paramedics (B6) approx. 70% from 2021/22
• Maximum re-imbursable amount available for each role - Practices in PCN’s
need to fund remainder of salary through their own income streams.
• Different opportunities/challenges with each of the professional groups
Workforce Development – New Roles
10
National Investment into Primary Care
Projected aspiration for PCN’s
could look like….
5 Clinical Pharmacists
3 Social Prescribers
3 Physiotherapist First
Contact Practitioners
2 Physician’s Associates
1 Specialist Paramedic
• £891 million nationally – next 5
years
• Network Contract Directed
Enhanced Service - Additional
Roles Reimbursement Scheme
Guidance
PCN Size Patients weighted
2019/20 9 months
2020/21 2021/22 2022/23 2023/24
30,000 53,942.25 129,300 208,800 319,000 448,300
150,000 161,827 646,600 1,044,100 1,595,100 2,241,700
• 14 Primary Care Networks in
Gloucestershire PCNs ranging
from 30,000 to 63,000 patients.
11
ICS wide considerations
• Development of Career pathways
• Integrated Roles – in key providers and Primary Care
Stakeholder engagement to include:
• Professional Leads
• Education Leads
• Primary Care Representation
• CCG Commissioning Leads – Specialist leads and Primary
Care
• Higher Education Establishments
• HR arrangements
Advanced Roles in Primary Care – ICS
Integration and Alignment
Clinical Pharmacists Physiotherapists Paramedics Physician’s Associates Social Prescribers
12
Any Questions?