general practice development framework (emerging)
TRANSCRIPT
www.england.nhs.uk
General practice development framework
Dr Robert VarnamHead of General Practice Development
@robertvarnam
Work in progress
Version dated 29/07/15
Health & wellbeing-promoting care
‘Right access’ Consistently high qualityHolistic, personalised, proactive, coordinated care
Comprehensive, joined-up care for a registered population,shaped around them in the community
bit.ly/c2aGP
‘Wider primary care, at scale’
bit.ly/nhs5yfv
Phone first.
Community diagnostics.
Practice based paramedics.
Pharmacy first.
Web consultations.
Primary care led urgent care centre.
Minor injury service.
Physio first
Direct specialist advice.
Condition management training.
Shared records.
Care coordination.
Hospital in-reach.
Care home ward rounds.
Virtual ward.
Primary care-employed specialists.
Social prescribing.
Travelling health pods.
Peer-led walking groups
Health coaching.
Befrienders.
Schools outreach.
Community development.
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Work areas
Quality• safety• effectiveness• experience
Access
Proactive
Self care
Coordinated
Secondary / specialist care
Care & support
Community services
Pharmacy
Diagnostics
CCG AT LA
Improvement
Care models
Larger scale
Participationin wider system
Collaboration
Collaboration
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Leadership
Creating shared purpose
Strategic planning & partnerships
Leading through change
Being a leader
Improvement
Patients as partners
Processes and systems
Using data for improvement
Rapid cycle change
Business
Governance
Operations management
HR
Business intelligence
Capabilities
EnablersInnovation spread
Policies & permissions
Contracts & incentives
InfrastructureProductive federation
Transparent measurement
General practice development framework
eg releasing capacity
PMCF 1+2
Access programme
Workforce
Releasing capacity
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Capability building
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Good ideas and intentions are not sufficient. It will be necessary to build capabilities for transformation, improvement and innovation in primary care.
• Some communities already have primary care leaders skilled in facilitating innovation and improvement. However, they are in the minority. We therefore wish to support the creation of a wide range of high quality, relevant development offers. Our goal is that, in time, every local network of practices has in-house expertise in service redesign, improvement and change leadership.
Need for capability-building
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• Gaps in every enabler & capability• Historic underinvestment• Ad hoc culture• Unconscious incompetence• Independence• Anti-academic• Lack of capacity• Superhero innovation
Development challenges
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• Capabilities > consulting• Learn while doing• Build around a patient-facing purpose
• Purpose > function > form• Use ‘pull’ for capability-building
• Something for everyone• Reach every ‘level’ & ‘corner’• Multi channel• Options: educational functional
• Awaken, train, mentor, coach [not necessarily in that order]
• Recognise the gap• Ensure transformational learning
• Use existing networks• …and develop them
Capability building principles
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The supplier market
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Selection of good offers for some needs But v limited capacity for some
Many one dimensional suppliers Easy to omit some needs
Consultancy >> capability-building More problematic in some areas than others
No ‘case manager’ Where to start? How to pull it all together?
The supplier market