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Primary Care Opportunities Set In the Context of Reconfiguration

Primary Care Opportunities Set In the Context of Reconfiguration. Dr Paul Twomey Partnership Council Nov 2013. OVERVIEW. New System: Commissioning Development / Sustainability QA / Performance Management HOW DO WE ? Focus GP Practice.

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Primary Care Opportunities Set In the Context of Reconfiguration

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  1. Primary Care Opportunities Set In the Context of Reconfiguration Dr Paul Twomey Partnership Council Nov 2013

  2. OVERVIEW • New System: • Commissioning • Development / Sustainability • QA / Performance Management HOW DO WE ? • Focus GP Practice

  3. GP PRACTICE Challenges / Opportunities / Threats Strategic Reviews: • Shift secondary Community • 7 / 7 and 8 to 8 Working • >Scrutiny (keogh + CQC) • Issues re recruitment + moral

  4. GP PRACTICE Challenges / Opportunities / Threats ‘WE’ NEED: • Consistent quality primary care: • for patients - focus primary care experience • For system to evolve - reconfiguration - effective utilisation + release of resources

  5. GP PRACTICE Challenges / Opportunities / Threats HOWEVER Essential to describe ‘What is Consistent Quality Primary Care’ Headroom to enable and deliver change Super-saturated Sponge

  6. Standard operating policies and procedures for primary care Primary medical services assurance framework

  7. UTILISING A DIFFERENT ENVIRONMENTPrimary Care Focus Area Team CCG Executive GP Practice Primary Care Professional GP Practice as a Provider CQC LMC

  8. PRIMARY CARE STRATEGY • Office GP Practice • Full range of primary care services through the working day • Collaborative approach (federal model/other providers).

  9. RESPONSIBLE OFFICER FUNCTION To make available to their constituent doctors a quality assured Appraisal programme which is Fit for Purpose.  Supported by the Clinical Governance Framework which will provide suitable developmental opportunities

  10. Reflections MEDICAL REVALIDATION First cycle 3 ¼ years ¼ Year 0 = 14 % Residual cohort Year 1 - 20 % Year 2 - 40 % Year 3 - 40% Focus: Fitness for Practise vs Fitness for Purpose

  11. INFORMATION FOR GP PRACTICE QoF PMS (KPIs) Quality Dashboard (varied by PCTS) Ownership / Reflection Inform Commissioning and Development

  12. GP HIGH LEVEL INDICATORS • Secondary Care Activity • QoF • Prevalence LTC • Exception Rate • Prevention / Immunisations • Medicines Management • Patient Experience

  13. OUTCOME STANDARDS 27

  14. CLINICAL GOVERNANCE FRAMEWORK KEY FOCUS Strategic Direction of the organisation consistent with individual and team objectives Formative focus benefiting from peer review and peer support = Partnership / ownership (spine)

  15. CHARACTERISTICS OF QUALITY GENERAL PRACTICE • Holistic and evidence based approach to patient care • Continuity of care • Positive GP practice : patient relationship • Appropriate management of risk • Attention to detail • Good communication with patients and other health care professionals • Appropriate skill mix • Education • Strong leadership • Support from secondary care colleagues • Quality IT support Delivered by culture and system

  16. HOW CAN WE CULTIVATE HIGH QUALITY PRIMARY CARE? • Nurture current resources to build on strengths • Promote new growth • Consider hybrids • Pruning • Commissioning and design

  17. NEXT STEPS ?

  18. SYSTEMS FOR QUALITY GP PRACTICE • The Team • induction (int / ext) • mentoring • integrated training programme • individual team PDP well-being • skill mix • communication • guidance

  19. SYSTEMS FOR QUALITY GP PRACTICE • Service Delivery • 8 am – 6.30 pm Monday Friday • access to whole team as clinically required • focus patient Objectives • supported by MDTs / complex case management • seamless relationship with community services

  20. SYSTEMS FOR QUALITY GP PRACTICE • Collaboration (spectrum) • Focus primary care centre • well-being • service delivery capacity • Bring / share enable • Build on good characteristics • Achieve 3 Rs

  21. ACTION PLAN SUMMARY ACTION PLAN • Focus on what we value GP practice to deliver (call to action) • Health & Wellbeing Boards describe & support • Public Health consistent good GP practice • Bring / share to enable • back office and clerical staff • Medical Leadership • Focus Primary Care Centre

  22. ACTION PLAN SUMMARY COMMISSIONING OF GP PRACTICE • Synergy of : • Core + (Area Team) = 9 clinical sessions • Local enhanced services (HWBB) • Resource identified from reconfiguration

  23. ACTION PLAN SUMMARY GOVERNANCE 3 steps: • Conversation engagement sign off (AT) ownership delivery (CCG led) - local community • Consensus • (AT / CCG / Link / HWBB)

  24. KEY ACTIONS • Consistent quality GP practice NOW Monday- Friday 8.00 am – 6.30 pm Integrated into wider community service transparent patient sees single service SOON 7 / 7 8 am – 8 pm build on characteristics of good GP practice

  25. COMMISSIONING • Minimise safety netting • Utilise ITF (protection of PMS)

  26. SERVICE DELIVERY Timescales re impact • Unplanned admissions Timely Discharge NOW • LTCs 2 – 5 yrs • Well-being 5 – 10 yrs

  27. RECRUITMENT / RETENTION • ACT NOW • change environment / culture well-being • > relationship with Med Students and Drs in training • Year 4 • 5 yr sliding programme (training + Collab) • Last 5 years • Initial focus GPs but then broaden

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