1. “The Brave New World” May 2011 By Paul Zollinger- Read

2. The King’s Fund 10 High Impact Changes 1.Self-management 2.Primary prevention 3.Secondary prevention 4.Managing ambulatory conditions 5.Integrating mental & physical health care

3. The King’s Fund 10 High Impact Changes 6.Care coordination & integration 7.End-of-life care 8.Medicines management 9.Managing elective activity 10.Managing emergency activity

4. Enablers Post Industrial Primary Care Integrated Care Systematic and proactive management of Long Term Conditions Empowerment of patients Population management

5. Primary Care Coordination and signposting Become the navigator to steer patients No longer act as the sole reactive care giver New deal with patients Measure performance, improving care standards, and transparent reporting

6. Integrated Care Organisations Cross organisational Capitated budget Governance models Across Care Pathways

7. The Bigger Picture Be clear on decision making process Risk management Strategic oversight Learn and build on clinical networks Power of relationships

8. ZRs First Law SP = (C * I ) CR SP = Sustained Performance C = Capabilities I = Incentives

9. Healthy Organisations Strong correlation between “healthy organisations” and performance –Set clear medium term health aspirations –Strive for a baseline of good health –Involve a broad leadership coalition, develop followership

10. The Challenge for Consortia Relationships between practices must be build on shared values and vision, trust, respect and collaboration. As well as requiring leadership from the consortium, this will require member practices to have time, patience and commitment. Kings Fund Report on Primary Care Quality 2010

11. Carpe Diem 10 + 5