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Unlocking the vision for new primary care premises………

Unlocking the vision for new primary care premises………. George Murdoch Nexus Consulting January 2003. The vision for quality…. Quality of service delivery – and the human resources offering it. Quality of patient experience – and the communications systems supporting it.

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Unlocking the vision for new primary care premises………

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  1. Unlocking the vision for new primary care premises……… George Murdoch Nexus Consulting January 2003

  2. The vision for quality….. • Quality of service delivery – and the human resources offering it. • Quality of patient experience – and the communications systems supporting it. • Quality of working environment – and the physical facilities providing it. • Quality of strategic planning – and the degree of futureproofing behind it.

  3. Service delivery……. • Considering services provided by GPs & other Primary Care Practitioners…. • ensuring services are accessible & local. • reflecting national targets & local needs. • ‘all under one roof’ integrated approach. • seamless ‘patchwork quilt’ effect. • but what is General Practice anyway? • & how is quality being monitored??

  4. Managing the Patient experience. • Retailers manage customer needs, not wants • Economists seek to manage expectations. • Politicians manage the decisions process - (while mismanaging much else besides). • GPs have to manage ‘gatekeeper’ responses to what patients put in front of them. • Needs careful balance of demand & supply. • While maintaining perceived/actual quality.

  5. Expectations Close & accessible Clean & functional Convenient times Clear wayfinding Chain-links in service Choice of provider Comfortable setting Cost-effective service Need to avoid…. Difficult locations Dirty appearance Deterring attendance Dearth of signage Disintegrated org. Disconcerting feel Duplicating resources More on Patient experience

  6. Quality of working environment • Technical specification for primary care – currently changing– eg HBN36. • Managing & maintaining the new asset – for which revenue funding is crucial. • ‘Facilities Management’ process must maintain quality & controls (PFI lessons). • Key human role in good asset management. • Inter-dependencies with service delivery.

  7. Quality of Strategic Planning.. • ‘Fit for purpose’ & functional suitability – the straightforwad bits around logistics. • Flexibility & malleability in space use – giving architects a challenge to respond to. • Be big enough to meet future demand – the goal for PCTs & General Practice. • Needs whole systems approach & service integration – the real challenge for all…….

  8. But how can we afford to be big? • Funding surgery space ‘non cash limited’ for local health economy level for now. • Allocating PCT funding support for additional space requirements. • PCT commissioning & Unified Budgets. • Rooting out current cost inefficiences – while maintaining quality. • Forcing funding to follow the patient??

  9. More on Affordability • Surgery space for GPs may still access Red Book rental funding for both GMS & PMS. • Additional space, in addition to surgery area, needs other rental commitment. • Other operational costs, in addition to Rent & Rates, met by Practices & PCT. • Balance between optimising surgery area for Practice & additional areas for PCT & other healthcare users, including retail.

  10. Sharing space can save money… • Sharing surgery areas among primary care services increases efficiencies. • It also improves deliverability. • Practice service delivery policies should reflect flexible working & substitutability. • Longer opening hours allows user spread. • Building security with tiered access for differential in areas available, out of hours.

  11. Underpinning strategy • Individual scheme should be an output of SSDP or SOC, or at least comply with it. • Business Cases & Feasibility Studies for individual schemes should adopt an integrated whole health-economy approach. • Linkages with secondary care services, transfers from acute, intermediate care & community provision should be developed. • PCT commissioning should support plan.

  12. NatPact/NHS Estates Premises guidance. HBN31 Electronic. Workshop venues. Management support. One-to-one discussion Supporting PCT team Signposting. Process/procurement Framework process for GP-led schemes PFI/PPP for PCT-led schemes (FRS5). Lift & non-Lift Batching & linking. StHA/PCT approvals Optimising Red Book Toolkits for making right choice

  13. Decision Tree Pyramid • GP-led primary care reimburseable areas forms the first layer for surgery projects. • Larger & mixed use schemes maintaining >50% GP-led surgery space is next layer. • PCT-led schemes with subletting to GPs more complex next layer • PFI projects following established hospital route is top layer. • Remember these • can run concurrently,

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