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7 day working and the Prime Minister’s Challenge Fund

7 day working and the Prime Minister’s Challenge Fund. Aim : To consider the localisation of the 7 day national directive, but in the context of a workable, sustainable solution for Gloucestershire that takes consideration of the pressures felt in Primary Care Format : Overview presentation

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7 day working and the Prime Minister’s Challenge Fund

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  1. 7 day working and the Prime Minister’s Challenge Fund Aim : To consider the localisation of the 7 day national directive, but in the context of a workable, sustainable solution for Gloucestershire that takes consideration of the pressures felt in Primary Care Format : Overview presentation Discussion on key areas Feedback and summarise

  2. Pressures on Primary Care

  3. Pressures on Primary Care • Primary Care funding c.£9.3bn in 2013/14, c.8.4% of total NHS budget • Trend of reducing general practice funding since 2004/05, which is currently forecast to continue (Deloitte 04/2014) • Constrained funding growth

  4. Pressures on Primary Care • Workforce growth from 1995 to 2011 (Centre for Workforce Intelligence (CfWI), 2013) demonstrates challenge : • Consultants : c.100% growth • GPs : c.29% growth • 22% of WTE Gloucestershire GPs are over 55 • We have a further 21% between 50-54 (17% nationally) with 8% under 35 (13% nationally) • Workforce pressures

  5. Pressures on Primary Care Increase in consultation rates by age demonstrates increasing consultations for elderly patients: • Rising Patient Consultations

  6. Pressures on Primary Care • Rising prevalence of chronic disease • Rising Patient Consultations • Longer average consultations, more consultations and more complexity than decade ago (CfWI, 2013) • Number of people with multiple morbidity estimated to grow from c.1.9m in 2008 to c.2.9m by 2018 (Salisbury et al. 2011) • 20% of Gloucestershire’s registered population are aged 65 and over, compared to 17% nationally

  7. Pressures on Primary Care • History of Estates and IT under-development • We want to ensure patients receivecare in safe, accessible, suitable premises • Investment in primary care estatelagged behind secondarycarecapitalspend(NHSE, 03/2014) • General practice often still in inadequate buildings, offering limited facilities, with little (if any) ability to expand to offer more services

  8. Summary of the Challenges • Reduced funding year-on-year • Workforce challenges, specifically relating to our GP workforce age ranges • Increased demand from an ageing population • with increased multiple morbidities • Premises and IT issues • Current structures inhibit effective change

  9. Prime Minister’s Challenge Fund • Aim of Fund : • test new models of care • deliver 7 day services • 20 pilots selected nationally • Opportunity to use £300k for 14/15 • Potential for significant investment next year • GCCG view : change shouldn’t be for change’s sake – must be sustainable and workable

  10. Key Themes of Successful Bids By commonality between schemes: • All successful bids included 7 day working, predominantly via federation • Online functionality (booking, appointments) • More patient services within federations • Single telephone line to Primary Care • Care Navigators / co-ordinators

  11. Discussion • Seven day Primary Care - what model(s) could work in Gloucestershire? • Models for discussion (5 minutes each): • Federated (5/6 practices collaborating to deliver) • Flexibly using extended hours DES • Locality delivery model • Urgent Care Centres (combining MIU; MIIU; GHAC); exploring ‘hot’ and ‘cold’ • Any other ideas >

  12. Feedback • Key points identified • Next steps will be communicated to localities • Any questions to raise with panel at 15.55? • Thank-you for your contribution

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