Transcript The evolution and revolution of Primary Medical Care

Welcome and updates
Angela Bright, Chief Operating Officer
The evolution and revolution
of Primary Medical Care
The essence of general practice
• General Practice has been around since the dawn
of the NHS
• Individual business units – “corner shop”
• Based on a patient registered list- av,7,000
• Practice teams - GPs ,practice managers, practice
nurses, admin staff
• National core contract – 16/17 =£76.44 per head
Locally
North West Leicestershire
1 Castle Medical Group
2 Hugglescote Surgery
3 Broom Leys Surgery
4 Manor House Surgery
5 Whitwick Health Centre
(Dr Hepplewhite & Dr Virmani)
6 The Surgery, Coalville
7 Whitwick Health Centre
(Dr A M Lewis & Dr M Patel)
8 Castle Donington Surgery
9 Long Lane Surgery
10 The Surgery,
Ashby de la Zouch
11 Ibstock House Surgery
12 Markfield Medical Centre
13 Measham Medical Unit
North Charnwood
14 Forest House Surgery
15 Woodbrook Medical Centre
16 Field Street Surgery
17 The Surgery, Charnwood
Medical Group
18 Bridge Street Medical
Practice
19 Park View Surgery
20 Pinford Gate Medical
Practice
21 Dishley Grange Medical
Practice
22 Medical Centre,
Loughborough University
North West
Leicestershire:
99,611
Hinckley and
Bosworth: 121,783
Hinckley and Bosworth
36 Maples Family Medical
Practice
37 The Centre Surgery
38 Newbold Verdon Medical
Practice
39 Groby Surgery
40 Barwell & Hollycroft Medical
Centre
41 The Orchard Medical
Practice
42 Heath Lane Surgery
43 The Burbage Surgery
44 Desford Medical Centre
45 Ratby Surgery
46 The Old School Surgery
47 Station View Health Centre
48 Castle Mead Medical
Centre
South Charnwood:
South Charnwood
75,792
23 Greengate Medical Centre
North Charnwood:
76,991
24 Quorn Medical Centre
25 Banks Surgery
26 Cottage Surgery
27 Charnwood Surgery
28 Highgate Medical Centre
29 Anstey Surgery
30 Alpine House Surgery
31 Mahavir Medical Centre
32 Silverdale Medical Centre
33 Birstall Medical Centre
34 Barrow Health Centre
35 The Leicester Medical
Group, Thurmaston Health
Centre
Locally
• 48 practices covering a population of 370,000
• Average funding
• Deliver high quality care – local and national
benchmarks
• Urban and rural population
What patients, carers and staff told us matters
most to them based on their experiences
Very good surgery
nurses… any problems
I can ring the nurse
and have a chat
GP – regular blood tests
– listens when I have a
problem and this is
sometimes all I need
My GP – I get all the
treatment and advice I
need. GP has phoned
me at home to see
how things are –
excellent service
Better access
to GPs; easier
to get an
appointment
Nurse and GP
supported (me)
with medications.
I have mental
health problems
GP – don’t go very
often; when I do go
they are always very
helpful and reassuring
GP surgery – even
when you go in for
appointment for one
thing they help with
other things – they
helped me to reduce
weight.
Constant GP
moving therefore
I need a stable
GP and they
understand me.’
‘See the same
doctor every time
Better contact to the surgery. Takes several
phone calls. I get anxious if it’s for my wife
But …..General Practice is under pressure
Ageing Population
The population is projected to grow by 10% over the next eight years
Care homes
Changes to characteristics of care home residents, with many older
people making the decision – or having it made for them – to move
into care homes later in life, frequently with more complex health
needs
Housing developments
An estimated 3,500-4,500 new homes per annum for 2006-2031
Increasing demand
The CCG has lower than typical admissions and prescribing rates, but
is nonetheless facing pressures of rising demand and increasing cost.
Long term conditions
High numbers of smokers, alcohol related and obesity contribute to
our higher rates of cancer
Financial situation
Faces a 21% funding gap between income and expenditure by
2018/19
Practice Workforce
Of a total practice workforce of 970, 250 (26%) are aged 55 or over
Premises
.
More than two thirds believe their premises limit the GP services and
community services they can provide.
What we want to achieve in the future
Increase the proportion of care provided in local communities
and people’s own homes, reduce the care currently provided
in an acute hospital
Reduce inequalities in care both physical and mental
Increase the number of people reporting a positive experience
of care
Optimise the opportunities for integrating services
Achieve financial sustainability
Develop our workforce and develop new capacity and
capabilities
STP
Better Care Together
LLR 5 Year Strategic Plan
Primary
Medical
Care
Plan
Better
Care
Fund
Plan
Community
Services
Plan
Operational Plan
CCG Operation & Management
Our model
Self-care
Core
Primary
Care
Enhanced
Primary
Care
Integrated
primary and
community
specialised
care
Emergency
and/or
specialised
Patient
Practice
Locality
Multispecialty
Community Provider
Acute
The revolution has started
• Our ambition- that our emerging federations provide the
opportunity for general practice to be delivered at
population scale providing many of the tests,
investigations, minor injuries and minor surgery currently
only provided within the hospital setting.
• North Charnwood GP Community Network Ltd
 Dr Anu Rao
• Hinckley and Bosworth Medical Alliance
 Dr Will Priestman
• North West Leicestershire GP Ltd
 Dr Kirk Moore & Dr Nick Rushman
• South Charnwood GP Network Ltd
 Dr Trishal Darji
Priorities in 16/17
Federation:
Priorities:
• North Charnwood GP Community Network Ltd
Integrated Urgent Care
• Hinckley and Bosworth Medical Alliance
Services for frail older people
• North West Leicestershire GP Ltd
Integrated refferals
• South Charnwood GP Network Ltd
Medicines optimisation
Questions
Thank you
How the patient and carer engagement
structure is already responding to changes
in primary medical care
Sue Venables
Communications, Engagement and Involvement Manager
How PPG have developed
Platform created for PPG members to work in
collaboration with other PPG’s and CCG
Influencing provision of wider health services
and influencing reviews and new services
Campaign work including
PPG Awareness Week
Membership recruitment drives
Health information events
Formal structures established
Joint working with practice influencing
the work of the practice
Work that is happening at PPG level
Help at Flu clinics – utilising community venues
Raising awareness of the PPG and recruiting
members – PPG awareness week
Input in the development of federations
Support patients by having events to educate
about health issues
Joint working opportunities
•
Supporting Campaigns – Autumn
campaign/ Healthy you, Happy
you.
•
Distributing leaflets in local area
•
Working in partnership with PPGs
Public Health, HealthWatch, VAL
and Leicestershire County Council
The emerging picture
Locality PPG groups
CCG and federated
localities
PPGs
PPG Network
Future opportunities
• Joint opportunities with CCG’s
• Federations – joint events, campaigns collection of patient
experiences
Advantages
• Get clinical and patient voice
• Better targeting
• Alignment of aims
• Reduce duplication and fill gaps
• Overall campaign improve knowledge of self care and prevention
• Better understanding of patient and carers through collection of
insights and experiences.
Group Discussion: In working groups discuss:
1. How can patient, carer and practice staff engagement at
individual PPG, locality/federation and CCG levels help
to transform services?
2. What should patient, carer and practice staff
engagement comprise at PPG, locality/federation and
CCG levels to avoid duplication, avoid gaps and
encourage partnership working?
3. How can people be better supported to self care and
improve their health and wellbeing and what should be
done at PPG, locality/federation and CCG levels to avoid
duplication, avoid gaps and encourage partnership
working?
Thank you