New Primary Care Networks in Greenwich

1. New Primary Care Networks in Greenwich Irene Grayson Associate Director Primary Care

2. Primary Care Networks – Why? • There is a commitment in the NHS Long Term Plan (published January 2019) to invest in Primary Care as part of a new service model for 21stcentury recognising that the NHS needs to change the way it works to improve patient experience. • One of the key areas in the Long Term Plan is to boost ‘out-of-hospital’ care and get all NHS services working much more closely together, breaking down barriers between services.

3. Primary Care Networks – Why? • In Primary Care this is being achieved through: • Setting up Primary Care Networks serving populations between 30,000 – 50,000 patients • Additional investment by introducing new clinical staff roles into primary care and increasing technology such as on-line services • Moving to GPs and practice nurses working with a wider range of clinicians in a much more joined up way

4. Primary Care Networks – Why? • Historically general practices have worked in ‘silos’, but over the last few years, many practices have formed partnerships or networks and have found benefits for both the practice and the patients through: • Sharing workforce and reconfiguring services to improve access; increasing skills in general practice by introducing new roles such as clinical pharmacists, paramedics and physiotherapists; developing partnerships with other community and secondary care services. • Evidence from these initiatives have led to the new Primary Care Network Agreement.

5. Primary Care Networks in Greenwich • Nationally all CCGs have been working in line with the guidance and have submitted applications on 15 May 2019 for their Primary Care Networks (PCN). • In Greenwich we have endorsed 6 Primary Care Networks covering the whole GP registered population – these networks are made up of our 35 GP practices who have come together and signed an agreement which will bind how they will work together for the future. • Each PCN has appointed a local GP Clinical Director who will be responsible for the development of the Network and ensuring the network engages and works closely with other local services serving its population.

6. Greenwich PCNs Population: 299,805 Riverview Health Blackheath & Charlton Greenwich West Eltham Health Note: site numbers not listed are borough-based branch sites

7. Greenwich Primary Care Networks • Over the next 9 months, the main concentration will be PCN internal organisational development – by 30 June each PCN will have agreed their Primary Care Network Agreement which includes a number of schedules which will explicitly set out their governance, financial, organisational and engagement arrangements. • From July 2019, the PCNs will be funded to recruit two new additional staff roles into their PCNs – Clinical Pharmacists and Social Prescribers. These staff roles are currently already in existence in some practices across Greenwich– this will give equity of access for patients to these roles

8. Additional Roles in PCNs • Social Prescribers – Live Well Greenwich is a well established social support offer for Greenwich residents and Live Well Coaches are operating across primary care – we are keen to ensure that there is no fragmentation of this service with the additional roles scheme. • From April 2020 onwards PCNs will be funded to recruit Physiotherapists, Physician Associates and Paramedics – these roles will support multi-disciplinary working arrangements, ensuring patients will have access to more services in primary care.

9. Network Service Specifications • A key component of the Network Contract DES will be the development and implementation of seven national service specifications which will evolve over time to support specific delivery goals in the Long Term Plan.

10. What happens now? • We do not expect patients will see any changes in the way they receive care in general practice in the short term while PCNs are working up their arrangements for working together. • Live Well Coaches (Social Prescribers) are increasing sessions across practices and this year patients will have access to a social prescriber in every PCN. • Clinical pharmacists will also be working across all PCNs who can carry out face to face appointments and do medication reviews • These roles were only available in certain practices but now all patients will have access.

11. What happens now? • Going forward the PCNs will be responsible for delivering the outcomes of the new service specifications • PCNs will link more closely with community services to help improve patient experience • Patients from one practice in a PCN could access services in another practice in the PCN where specialist services are being provided for the registered list of the PCN.

12. What happens now? • These new arrangements do not affect your patient registration. • Your GP will still be providing the core services of general practice and the services under the new PCN contract are additional services. • PCNs are set up to support practices within their network, thus putting more resilience into general practice.