Primary Care Case for Change

1. Health and Social Care Reform in Greater ManchesterDeveloping a commissioning strategy for Primary CareRob Bellingham — Director of Commissioning (Greater Manchester)August 2013

3. Primary Care Case for Change • Need to reduce unwarranted variation in outcomes and care pathways • Extending access to primary care • Ensure focus on self-management, wellness and prevention • Need to ensure integration with other services and organisations • Significant workforce issues; capacity of current workforce, training now and future, work life balance • Potential for increased efficiency

4. Key themes from a patient’s perspective:

5. Long Term Condition Management • Early detection leading to improved outcomes via systematic approach to prevention strategies • Effective use of practice list based registers with development and implementation of transparent benchmarking of best care indicators • Development of clear care pathways and protocols for promoting self management and empowerment • Work alongside Integrated Care Teams to facilitate and promote continuity of care and care co-ordination, including crisis planning for those with multi morbidity and complex needs

6. Involvement in care • Facilitate patient access to their health and social care records to encourage health literacy and shared decision making • Support a culture which fosters social responsibility and encourages patients to take responsibility for their health and well being • Support the development of skills and capacity in primary care to support patient choice in end of life care

7. Specialist Primary Care Services • Develop specialist skills and services within community settings by; • Encourage sharing of skills between practices and collaborative working • Encourage the delivery of traditional hospital specialist services within community settings by integrated working with primary care teams • Ensuring appropriate diagnostic support to enable care closer to home

8. Access • Develop an extended model of primary care which improves patient access with aligned levers/incentives to ensure delivery • Encourage development of innovative approaches to access ; Skype/Email etc with development of the non medical workforce to support this • Ensure improved access balanced with continuity, particularly in relation to patients with complex needs • GP as co-ordinator of care

9. Enablers – NHS England AT GM • Coherent workforce plan within defined financial envelope to address any skills and capacity shortage • Commission appropriate development and training packages to meet the workforce plan • Estates strategy and implementation plan • I.T.; work with existing clinically led I.T strategy and operational groups to resource and deliver required infrastructure improvements • Financial levers and incentives aligned across the system

10. Next Steps • Demonstrator community process – 18 bids received. 6 moving forward in initial phase. • Primary Care Commissioning Strategy in advanced stage of development • Programme of stakeholder and public engagement • Continued development of implementation plans – in conjunction with Integrated Care & Healthier Together programmes • Task & Finish groups (for implementation) • Formal launch of strategy via 2nd Primary Care Summit Weds 25th September 2013

11. Opportunity for Discussion