The Primary Care Home: A solutions focused new care model provider
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The document discusses the challenges and opportunities in large-scale general practice, highlighting the 'primary care home' model aimed at transforming primary care delivery and improving efficiency through community involvement. It emphasizes the importance of evolving commissioning practices within the NHS, moving away from outdated systems and focusing on accountable care. Key barriers to reform include cultural resistance, inconsistent values, and insufficient tools for effective decision-making.
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The Primary Care Home: A solutions focused new care model provider
- 1. Large scale general practice: can we rise to the challenge? #largescalegp The Primary Care Home – A solutions focussed new care model provider Dr James Kingsland, President, National Association of Primary Care @JamesPKingsland Chair: Dr Brian Fisher, Vice Chair, New NHS Alliance @fisher0606
- 2. Dr James P Kingsland OBE Senior Partner in General Practice President, The National Association of Primary Care Chair, Jhoots Pharmacy Group Non-Executive Director, Clatterbridge Cancer Centre (CCC NHS FT) Director, Waring Health Ltd
- 3. Retention, return to practice, re-energising and meeting patient need “If you land this - I am deferring my retirement” General Practitioner - Newcastle “If we are able to do this, I am returning to practice” General Practitioner - Nottingham “You know…I read this and it made me feel young again” Practice Manager - Liverpool “I’ve lived in the same house for 50 years. Being able to access one of these would make me move” National Patient Representative Body “It’ the first time in a long time that I’ve really felt valued” - District nurse in RTS
- 4. New Care Model Style Primary Care Programme • The Primary Care Home • A complete clinical community • Size really does matter • Learning from success – budgetary control
- 5. The Primary Care Home What it is • An opportunity to really transform first contact care • A shift to focus on primary care provision • An attempt to involve a ‘complete community’ in the make or buy decisions in daily practice • A drive to improve efficiency in the deployment of NHS resource usage through accountable care • One system, one budget to provide care to a defined population
- 6. What it is not • A return to any previous reform of the internal market, especially fund holding • An NHS management reorganisation or requirement for new legislation or regulations • A focus on general practice profitability or new income streams • A sub-set of the CCG • Locality commissioning • A new idea
- 7. Why reforms fail • Cultural persistence Difficulties in creating the right environment in which reform can flourish Behavioural malalignment Inconsistent sets of values Culture inherently focused at status quo and centralised control • Leadership remains positional Distributed leadership articulated but not implemented Delegation becomes too difficult Disenchanted and disenfranchised majority who do the work • Tools to do the job withheld from the front line Data analytics to inform decision making Meaningful metrics Develoved budgetary responsibility (if not full accountability)
- 8. The Future of Commissioning in the NHS • Evolve and devolve • Demand and Divvy – ‘is over’ - No more block contracts - Pay for actual activity - Referrer defines the service requirement through referrals • Current model is unsustainable • Uncontrolled / unchallenged activity must cease • Release resource tied up with other providers • Without referrer responsibility the risk is greater, engagement is the key – smash organisational boundaries • This is over 10 years old