s152 - day 2 - 1045 - transforming primary care in greater manchester
DESCRIPTION
Health and Care Innovation Expo 2014, Pop-up University. S152 - Day 2 - 1045 - transforming primary care in Greater Manchester Dr Anne Talbot, Ivan Benett and Rob Bellingham #Expo14NHSTRANSCRIPT
Transforming Primary Care in Greater Manchester
Dr Anne Talbot, Associate Medical Director, Greater Manchester Area Team, NHS EnglandGP Clinical Director, Bolton Community Practice CIC
Aims of the session• Provide context around primary care work in Greater Manchester• Introduce the Primary Care Strategy and Community Based Care
Standards• Hear from two demonstrator sites:
– Middleton GP Practices – Organisations in Partnership– Central Manchester CCG: Making a difference for our whole community
The Case for Change
1,055,959 1,075,025
1,105,464
1,149,174
1,000,000
1,020,000
1,040,000
1,060,000
1,080,000
1,100,000
1,120,000
1,140,000
1,160,000
2009/10 2010/11 2011/12 2012/13
A&E
atten
danc
esGM A&E Attendances
Primary Care Progress• Primary Care Strategy for GM was approved by NHS England in Feb 2014, with wide engagement from GPs,
LMCs and CCGs
• A suite of Community Based Care standards has also been approved and work is taking place to ensure these are agreed, owned and embedded into local CCG visions
• A GM Primary Care Transformation Steering Group has been formed to steer delivery of enabling work streams - including organisational development and workforce led by Health Education England
• Six primary care demonstrator sites have been approved across GM covering a population of 377,000 with a total budget of £2million
• 18 bids submitted to the Prime Ministers Challenge Fund
• Emergence of new provider models in Primary Care and consideration of innovative contracting models (eg Alliance Contracts)
Primary Care Strategy
Multidisciplinary CareIdentification of Long Term Conditions
Best Care PathwaysMedicines OptimisationIntegrated Care Teams
GP as co-ordinator of Care
Involvement in CareAccess to care recordsPromotion of self-care
Primary preventionPatients die in place of their choosing
Access and ResponsivenessDigital Technology; range of access
mediumsContinuity of Care
Increased access to primary care services
Increased Out of Hospital ServicesLocally based enhanced servicesSmooth primary/secondary care
interfaceInter-practice referrals
Quality & Safety
Community Based Care Standards - Rationale
Align Primary care and Integrated care into a coherent offer for out of hospital services that people can understand.
To provide a mechanism for reducing variation across Primary Care and measuring quality
Set future aspirations upon which activity assumptions can be based.
Providing a set of metrics for activity upon which the money flows can be determined
Aim to develop high level standards , outcomes and metrics which reflect those emerging from local plans
To provide a consistent approach across Greater Manchester the quality and commitment to OOH which can be implemented locally
Community Based Care StandardsACCESS AND RESPONSIVENESS
People will have access to professional health and social care advice and triage (assessment) provided 24 hours a day, seven days a week and be directed to the most appropriate service to meet their health or social care needs
Everyone will have access to primary (e.g. GP services) and community care within 2 hours in case of an urgent health need, or within 6 hours if considered needing same day consultation
Everyone with an urgent social care need will have access to social care within 2 hours, those with a less urgent need will be contacted on the same day THE STANDARD WILL DELIVER THE FOLLOWING OUTCOMES WHAT THIS WILL MEAN FOR YOU
People will be able to use primary care as their first port of call when accessing health services People with an urgent health or social care need will have rapid access to primary, community and
social care services Increased satisfaction with access to health and social care services Reduced use of the ambulance service, attendances at A&E and emergency admissions to hospital People will have improved access to NHS Dental and NHS sight test services Carers will feel more supported to continue in their role
Accessing primary care is simpler
and easier than going to A&E You know who to contact and
when, even in a crisis When you need urgent care, you
have rapid access to an appropriate health or social care professional
You have access to health and social care advice 24 hours a day, 7 days a week
You have support to help you access the most appropriate health or social care service to meet your needs
THE STANDARD MAY BE MEASURED IN A NUMBER OF WAYS
Fewer A&E attendances for minor conditions Fewer emergency admissions for conditions that should not usually require hospital admission Better responses to the annual GP Out Of Hours Survey Fewer A&E attendances and admissions to hospital related to long term conditions More people needing social care who receive an initial assessment and advice the same day More people who need social care whose needs are resolved through online services Fewer ambulance journeys to A&E as a proportion of the overall total More carers assessed In development: Measures for the responsiveness of primary care within 2 hours and 6 hours
JOINT COMMITMENTS
Greater Manchester health and social care commissioners give you the following commitments We will ensure that there is excellent access to primary, community and social care services across all
parts of Greater Manchester Children between 0-5 years will be able to access primary care services appropriate to their need the
same day We will promote the use of different communication methods and technology for accessing services
(e.g. using smart phones)
You give GM the following commitments
People will have access to professional health and social care advice and triage (assessment) provided 24 hours a day, seven days a week and be directed to the most appropriate service to meet their health or social care needs
Everyone will have access to primary (e.g. GP services) and community care within 2 hours in case of an urgent health need, or within 6 hours if considered needing same day consultation
Everyone with an urgent social care need will have access to social care within 2 hours, those with a less urgent need will be contacted on the same day WHAT THIS WILL MEAN FOR YOU
Accessing primary care is simpler
and easier than going to A&E You know who to contact and
when, even in a crisis When you need urgent care, you
have rapid access to an appropriate health or social care professional
You have access to health and social care advice 24 hours a day, 7 days a week
You have support to help you access the most appropriate health or social care service to meet your needs
Primary Care Demonstrator SitesSix demonstrator communities are trialling innovative solutions in Primary Care across GM – commenced in Nov/Dec 2013, covering a population of 377 000 with combined budget of £2million:
- Bolton CCG: Care Homes & GP weblinks- Bury GP Federation: A Healthier Radcliffe- Central Manchester CCG: Making a difference for our whole community- Heywood Federation: Pilot in integrated care- Middleton GP practices: Organisations in Partnership- Stockport CCG: Development of Integrated hub
Commissioning robust formal evaluation of benefits realisation to aid future commissioning and prioritisation
Summary• Delivery and assurance regarding the future responsiveness, capacity and
capability in Primary Care, is critical to the wider health and social care reform programme
• Recognise that improved access needs more than just extending hours face to face …. and should include improved responsiveness with new ways of working embracing digital technology
• Recognition of the importance of continuity of care and balance of improved access and responsiveness
• Our challenge is to develop the current and future Primary Care workforce, IT, estates and new contracting models to meet the needs of a reformed health & social care system…..but also an opportunity?
Middleton GP practices: Organisations in Partnership
Dr Mohammed Jiva, GP
Bid Oversight
Bid
GP AccessA&E DeflectionEarly Hospital
Discharge
GP Access Ext Opening (Evening/weekend)
DISHI Diary
IT IntegrationWebcam (GP, DN, Pharmacy)
GP / MH /DN Clinics
Data Intelligence Software : Health Information diary
DISHI Diary
DISHI Diary
DISHI Diary
DISHI Diary
DISHI Diary
Access to Medical Records
GP Medical Records (40,000)
7*GP Practices
(Edit)
AED (View only)
DN (View only)
Patient Pathway
Attend A&E
Inappropriate
DISHI Diary
Attend A&E
Appropriate
DISHI Tracker
Data Intelligence Software :Health Information Tracker
DISHI Tracker
DISHI Tracker
Virtual Ward25 beds (2000pt/bed)
Patients own home
Proactive GP Care
Summary
Bid
GP Access
A&E Deflection
Early Hospital
Discharge
Thank you
Central Manchester CCG: Making a difference for our whole community
Dr Ivan Benett, GP and Clinical Director,
Central Manchester CCG
Responsive Access• Emergency requests responded to within 20 minutes• Requests for same day appointments clinically triaged
within 60 mins• Urgent GP Care within 2 hrs• Sameday GP Care within 6 hrs
Availability• Increase GP availability - Available in all 4 localities• 8am-8pm weekdays and 3 hours per day on
weekends - 96 appointments per week per locality• Will be able to take appointments from A&E, OOH
and eventually direct from patients• So far more than 700 patients have attended
Primary Care Manchester Ltd• Development of General Practice Provider Organisation • Primary Care Manchester representing 35 practices• Have enabled improved cross practice working and supported
the development of new ways of working.• Will continue to support equity of service provision across CCG
footprint.
Increased Out of Hospital Services• GP led in-reach service has started supporting a
smooth primary/secondary care interface• Consultant advice lines available in 6 specialities
– more in development
Questions