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Securing the Future of General Practice Harrow LMC Dr Michelle Drage, CEO 29 January 2014

Securing the Future of General Practice Harrow LMC

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Securing the Future of General Practice Harrow LMC. Dr Michelle Drage, CEO 29 January 2014. Core Values of General Practice. Basic Building Blocks of Excellent General Practice. The registered list - individuals and practice population Expert generalist care of the whole patient - PowerPoint PPT Presentation

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Page 1: Securing the Future of General Practice Harrow LMC

Securing the Future of General Practice

Harrow LMCDr Michelle Drage, CEO

29 January 2014

Page 2: Securing the Future of General Practice Harrow LMC
Page 3: Securing the Future of General Practice Harrow LMC

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

Page 4: Securing the Future of General Practice Harrow LMC

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

Page 5: Securing the Future of General Practice Harrow LMC

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

Page 6: Securing the Future of General Practice Harrow LMC

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

Page 7: Securing the Future of General Practice Harrow LMC

Commissioning for

General Practice and

Primary Care in London

Core Values of General Practice

Basic Building Blocks of Excellent General Practice

Exte

nded

PHC

T

MDT

Socia

l Ser

vice

sHo

spita

l Car

ewww.lmc.org.uk

Page 8: Securing the Future of General Practice Harrow LMC

What shall we integrate this week?

www.lmc.org.uk

Page 9: Securing the Future of General Practice Harrow LMC

Turn the whole process on its head

Commission FOR general practice & primary care

www.lmc.org.uk

Page 10: Securing the Future of General Practice Harrow LMC

• 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

Page 11: Securing the Future of General Practice Harrow LMC

Invest in general practice, primary, community & social care…….

www.lmc.org.uk

Page 12: Securing the Future of General Practice Harrow LMC

……free up hospitals to do what they should do

www.lmc.org.uk

Page 13: Securing the Future of General Practice Harrow LMC

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

Page 14: Securing the Future of General Practice Harrow LMC

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

Page 15: Securing the Future of General Practice Harrow LMC

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

Page 16: Securing the Future of General Practice Harrow LMC

Key Issues

• Legal

• Governance

• Financial

• HR

• Services

• Conflicts of interest

• Patients

Page 17: Securing the Future of General Practice Harrow LMC

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

Page 18: Securing the Future of General Practice Harrow LMC

Organisation

• What does this mean for you? - Existing collaborative modelsNetworks; FederationsSuper PartnershipsCICSocial EnterpriseLLPCLS/CLGCooperatives

Page 19: Securing the Future of General Practice Harrow LMC

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

Page 20: Securing the Future of General Practice Harrow LMC

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

Page 21: Securing the Future of General Practice Harrow LMC

GP Providers Working Together

www.lmc.org.uk