Dr Paul Driscoll Chair and Medical Director Suffolk GP Federation Presentation for Kings Fund 18th October 2016

Different Models Ref: Naresh Rati, Executive Partner, Vitality Partnership

As an example… Suffolk GP Federation Aims Scale / Collaboration Support Primary Care Deliver Services So how have we done? Formed 2007 Coastal Locality (30 Practices) 2014 - Ipswich practices joined (44 Practices) 2015 - West Suffolk practices joined (59 Practices) Population covered 560,000

Scale / Collaboration Care Homes Nursing Community Diabetes – North East Essex NEEDS £5 per patient Negotiated Medical Defence Cover “Represented” Primary Care

Support Primary Care Clinical Services PMCF Extended Hours GP Service (GP +) 7 day working Walton Surgery Support Practice Development Suffolk Primary Care - Single Partnership Leadership Training – GP’s - Leading the Way/ Future Leaders Practice Managers Training Represent Practices (STP,ICO,IACO) Collaborative Working GP On the Day / Domiciliary Care Team Employ other health professionals (pharmacist's)

Deliver Services Lymphoedema Cardiology Diabetes ENT Community Ultrasound service Community Pain Service

What else have we done? Collaborative working GP+ Emergency Department 111 Ambulance Service Pathways ACO STP / Community Alliance Diabetes Colchester Hospital / ACE Podiatry / Diabetes UK Cardiology – The Ipswich Hospital Primary Care change (e.g. Suffolk Primary Care “Super Partnership”)

Patient Benefits Support to Practices Extended GP Access Care Closer to Home Quality Services (e.g. PMCF Feedback + Diabetes UK Report)

What haven’t we done? Address Variation Change in Practices (work patterns / new models) Primary Care at scale / genuine collaboration Practices not any more resilient ….. But that is changing - Leadership Course (GP+ SPC) Vulnerable Practice Fund Single Voice? LMC / CCG / Federation

Why haven’t we done it? Change takes time

Spot the Difference

Independent Contractor Status

NHS England CCG Federation

Provider Organisation

What needs to happen? Commission at scale Support for change Consistent message (NHSE/CCG/LMC) Realistic time scales

So what are they good for? Can facilitate collaboration Single Voice Starting Collaboration Training support practice staff Provide structure / management support Employ staff across practices Perform LES across practices MCP BUT – Federations are not the end game

Any questions?