Primary Care Networks: Patient Engagement and Infrastructure Plan Update

1. Patient Participation Group (PPG) Network17 May 2019

2. Agenda 10:00 Welcome and Programme for the Morning 10:10 Introduction of Primary Care Networks Bronwyn Barnes - Programme Manager, Primary Care, Localities & Variation, NHS Gloucestershire Clinical Commissioning Group (CCG) 10.40 Primary Care Infrastructure Plan –Update and Forward Look Andrew Hughes - Associate Director, Commissioning, CCG Questions and Answers 11:15 Break – Networking and Market Place Market Place includes: MIND Swindon, Stroke Association, Healthy Lifestyles 11:35 PPG Spotlight 11:50 Gloucestershire’s Long Term Plan, workshop 12:20 Sum up, messages and Close

3. Primary Care Networks Update Countywide PPG Network Friday 17th May 2019

4. General Practice and the Long Term Plan “The biggest reform to GP services in 15 years” HSJ “The most important change to the GP contract since 2004 and a potential game changer” BMJ “These are the most significant changes in 15 years” BMA “The start of a new era for general practice” NHSE

5. Primary Care Networks (PCN) • Increasing patient need, complexity, Long Term Conditions and other factors contribute to rising workloads, making proactive, joined up care more and more important. • PCNs are groups of practices that collaborate locally, in partnership with community services, social care and other providers of health and care services. • They allow practices to continue doing what they do best, while working together to share other services that require additional scale. • PCNs build on the core of current primary care and enable greater provision of proactive, personalised, coordinated and more integrated health and social care. • It is about proactively caring for the people and communities they serve. • 15

6. Primary Care Networks– • PCNs are based on GP registered lists, typically serving natural communities of around 30,000 to 50,000, which experience has shown is the optimal size for integrated locality-based working. • PCN register by 15 May 2019 • Complete Network Agreement documentation by 30th June 2019 • PCNs officially commence and can start receiving national investment from 1 July2019. • EachPCN will appointaClinicalDirectorasitsnamed,accountableleader,responsiblefor delivery. • 15

7. Primary Care Networks– Additional Workforce • National Funding available to PCNs for additional staff in five groups by2024 (linked to training numbers qualifying each year): • Social prescribing link workers (reimbursement from2019/20) • Clinical pharmacists(reimbursement from2019/20) • First contact physiotherapist (reimbursement from2020/21) • Physician associates (reimbursement from2020/21) • First contact community paramedics (reimbursement from2021/22). • 15

8. Primary Care Networks– Digital • A digital NHS ‘front door’ through the NHS App to all practices in 2019 • A number of digital development including: • Online and video consultation by April 2021 • Online access to patient record • At least 25% of appts available for online booking by July 19 • All practices to have up-to-date online presence with key information standardised as metadata for other platforms by April 2020 • All patients have access to online correspondence by April 2020 • 15

9. Primary Care Networks– Gloucestershire PCNs • To be confirmed. PCNs will be formally approved by 31st May • Likely 14 PCNs across the 6 Localities in Gloucestershire, with PCNs comprising between 1 and 11 GP practices • 15

10. Questions/ for consideration • What opportunities do you foresee PCNs will give? • How could you align your PPG to your new PCN? • Any further questions?

11. Primary Care Infrastructure PlanUpdate and Forward Look Countywide PPG Network Friday 17th May 2019

12. Primary Care Infrastructure Plan 2016/2021 2019 refresh and forward look to 2026

13. Why refresh? • Is the plan still aligned with policy and strategy development? • Progress update • Financial implications • Sense check against housing plans • Identify next stage priorities 2021 to 2016 • Review business case processes and governance Primary Care Infrastructure Plan 2016 to 2021

14. Recap on PCIP 2016/ 2021 • Future direction of primary care service provision • Challenge of existing estate • Future population • Flexible- respond to changing strategies • Estimated to be around 713,000 by 2031 • Condition of surgeries • Service strategies- expanded primary care provision, practices employing or hosting larger teams and increasingly working more in networks • Joined up care and wider out of hospital care strategies • General practice operating at larger scale and where appropriate, development of hubs • A more progressive approach by commissioner, reaching out • Recognising financial investment required • A streamlined business case process and patient engagement requirements

15. Policy development - Development of integrated care

16. Supporting individuals to manage their own care through self-care, care navigation and improving patient activation. Individual Primary Care Networks that bring together local health and care professionals around natural local neighbourhoods of care – improving integrated ways of working and more joined-up pathways; and embedding population health approaches. Neighbourhood 30~50k • Groups of local primary care networks that work alongside partners in secondary care, mental health and with CCGs and local authorities, to: • Integrate health and care services • Work preventatively to stop people becoming acutely unwell • Care models to redesign care Place ~250-500k • Providers and commissioners collaborating to: • Hold a system control total • Implement strategic change • Take on responsibility for operational and financial performance • Population health management System 1+m

18. Housing forecast 2019 to 2031 4,887 10,325 9,368 3,318* 5,030 7,295 1,370 * To 2026

19. Housing forecasts and population growth January 2019 to March 31st 2031 registered list size increase from 652,500 to between 700,000 and 720,000 – still in line with original PCIP assumption. Since baseline (July 2014 list size increased from 627,545 to 652,500 at April 2019. An average annual increase of over 5,500 patients. ONS estimates for residents are 686,000 to 2031

20. PCIP 2016/ 2021 Completed and approved schemes Around £40m capital investment with revenue implications funded by CCG

21. Remaining priorities status

22. Forward look to 2021/ 2026 emerging priorities

23. Conclusions, your thoughts and next steps Is there anything you believe we are missing? What are your views on the plan? How do you think patients should be involved? Is there anything we should do differently? How could we improve things even further? PCIP remains aligned with policy development Housing and population growth remain in line with planned assumptions A number of proposals have been delivered and a number remain on track There remain a number of issues that impact on delivery The financial implications are higher than initially estimated The next phase of priorities from 2021 to 2016 see a more steady state

24. QUESTIONS Countywide PPG Network Friday 17th May 2019

26. PPG Spotlight Countywide PPG Network Friday 17th May 2019

27. Gloucestershire’s Long Term Plan Countywide PPG Network Friday 17th May 2019

28. Close Date of next meeting: Friday 19 July 2019