developing a great ccg general practice forward view plan
Post on 06-Apr-2017
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@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?
@robertvarnam #GPforwardview
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)
@robertvarnam #GPforwardview
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)
@robertvarnam #GPforwardview
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
@robertvarnam #GPforwardview
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
Collaborative working Whole system approach Self-care Broader workforce Tech
@robertvarnam #GPforwardview
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)
@robertvarnam #GPforwardview
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
@robertvarnam #GPforwardview
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
bit.ly/time4caretool1
GPs judged 26%of their consultations
to be potentially avoidable
@robertvarnam #GPforwardview
74%
7%
6%
4%
3%
3%2%
2%
Other in practice
Self care/Pharmacy
Outpatients
Sick notes / appeals
Care navigationContinuity/preparation
Other
Data from 5,128 consultations
bit.ly/time4caretool1
GPs judged 26%of their consultations
to be potentially avoidable
… 18% are about how the practice
manages its workload
Potentiallyavoidable GPappointments
(audit by GPs)
@robertvarnam #GPforwardview
165m
15m
12m
8m
6m
6m4m
4m
Other in practice
Self care/Pharmacy
Outpatients
Sick notes / appeals
Care navigationContinuity/preparation
Other
Data from 5,128 consultations
bit.ly/time4caretool1
GPs judged 26%of their consultations
to be potentially avoidable
… 18% are about how the practice
manages its workload
Nationally
Potentiallyavoidable GPappointments
(audit by GPs)
@robertvarnam #GPforwardview
20,861
1,889
1,550
1,015
818
789564
564
Other in practice
Self care/Pharmacy
Outpatients
Sick notes / appeals
Care navigationContinuity/preparation
Other
Data from 5,128 consultations
bit.ly/time4caretool1
GPs judged 26%of their consultations
to be potentially avoidable
… 18% are about how the practice
manages its workload
Average practice (6,700 patients)
Potentiallyavoidable GPappointments
(audit by GPs)
@robertvarnam #GPforwardview
20,861
1,889
1,550
1,015
818
789564
564
Other in practice
Self care/Pharmacy
Outpatients
Sick notes / appeals
Care navigationContinuity/preparation
Other
Data from 5,128 consultations
bit.ly/time4caretool1
GPs judged 26%of their consultations
to be potentially avoidable
… 18% are about how the practice
manages its workload
Average practice (6,700 patients)
Potentiallyavoidable GPappointments
(audit by GPs)
Measure your opportunity…
@robertvarnam #GPforwardview
10 High Impact Actions
Innovations from around England that release time for GPs to do more of what only they can do.
bit.ly/gpcapacityforum
@robertvarnam #GPforwardview
10 High Impact Actions
Innovations from practices throughout around England that release time and improve care.
bit.ly/gpcapacityforum
@robertvarnam #GPforwardview
10 High Impact Actions
Innovations from practices throughout around England that release time and improve care.
bit.ly/gpcapacityforum
bit.ly/gpcapacityforum
@robertvarnam #GPforwardview
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)
@robertvarnam #GPforwardview
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
Comprehensive, coherent development plan Achieving clearly described goals Attractive to practices
@robertvarnam #GPforwardview
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
@robertvarnam #GPforwardview
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
@robertvarnam #GPforwardview
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
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