Developing Primary Care Adopt Improve Solutions

CCG Results Practice Results Q. How Important Is It For The CCG To Set Out Its Aspirations & Strategy For Primary Care? CCG Results Practice Results Scored: Very Important Needs to be an inclusive document & each practice needs to understand what the priorities are. There needs to be clear goals and set outcomes that practices can believe in and follow. As a membership organisation where the members are practices a clear strategic direction will enable practices to understand the direction of travel and contribute to developments. Scored: Very Important Clarity of aspiration & strategy is important so that constituent GP practices will be aware of their key contribution to CCG to ensure. patients have consistent high quality services Sadly it will be driven by targets that need to met but logically it should be around parity of care for all patients. If Primary Care is not aware of the goals and aspirations the delivery of primary may change irrevocably. My fear if practices are not engaged that the services offered to patients will no longer be based on the current holistic primary care approach – but a “pick and mix” where no one knows the whole person.

Practice Development Plan Primary Care Development Strategy – Summary on a page Our (draft) Vision and Aims “Primary care across South Worcestershire will be accessible, innovative, responsive and cost effective. Our Practices will provide consistent high quality care by working together to improve health outcomes for our patients.” Aims- To support the CCG’s strategic aims by… To make Primary Care the Place of Choice Priorities for Developing Primary Care Continuous quality improvement Improving Access and managing workload Managing the shift from Secondary to Primary Care Primary Care role in delivering the Urgent Care Strategy Building Resilient Primary Care and supporting practices to thrive Reducing unwarranted variation & Rewarding Excellence Education, Development and Learning Locality Development Locality Development Local Clinical priorities for Primary care Frail Elderly Long Term Conditions Capacity - Capability- Efficiency- Linkage Practice Development Plan

Improving Quality & Supporting Practices Quality Improvement + Support Team - Core Other Acute Consultants   Practice Nurses GPs Practice Managers CCG Team Pharmacists Practice Peer Review Data Start of discussions   Packages of support Development needs Expert advice, mentoring, coaching, facilitation Feedback on plans, pathways, guidelines Sharing of good practice Locum bank? Other interventions – e.g Productive General Practice Quarterly visit Protected time Single Operating Framework Patient Experience Patient Safety Clinical Effectiveness Organisation Effectiveness   Cluster of Practices Peer Review Ethos Encouraging Supportive Enabling Challenging     Improved Care + Health Outcomes Reduced Unwarranted Variation Greater cash efficiency – recycled into Quality Premium and support    Published  

Building Resilient Primary Care & Supporting Practices to Thrive

Improving Access & Managing Workload-Top 10% But….

Access Peer range (ONS group) Indicator Unit Value Top 10% Top 25% Top 50% Bottom 25% Bottom 10% • Overall experience of making an appointment Percent 81.6 85.1 83.7 81.4 79.0 74.1 • Ease of getting through on the phone 79.7 88.6 86.6 82.6 78.7 73.7 • Frequency of seeing preferred GP 69.1 73.4 70.8 68.3 65.3 61.0 • Able to get an appointment to see or speak to someone 92.4 93.8 93.3 91.2 89.6 • Satisfaction with opening hours 85.6 87.7 86.2 84.9 82.1 Experience • Overall experience of GP surgery 91.8 91.5 90.0 88.5 86.8 • Overall rating of GP soft skills 90.1 90.2 88.7 84.5 • Confidence and trust in GP 97.1 97.7 97.3 96.8 95.8 95.0 • Overall rating of nurse soft skills 92.9 92.5 90.9 90.3 • Confidence and trust in nurse 98.4 98.5 98.2 97.8 97.4 • Support from local services or organisations to help manage long-term health condition 89.9 90.4 89.0 87.5 85.9 84.7 • Impression of waiting time at surgery 68.0 73.0 68.7 66.1 63.8   Top 10-25% Top 25-50% Bottom 10-50%

Patients in South Worcestershire (Q1 2013/14 practice list sizes) 295,241 Recommended number of consultations per patient per year 4.2 Additional appointments needed 29,524 Additional full time GPs needed to cover appointment increases 7 Average cost per full time GP £ 85,000 Estimated cost of GPs currently £ 23,422,453 Additonal cost of funding GPs to cover these appointments £ 557,453 Extra appointments for a 10,000 patient practice 1000.00 Extra appointments for a 10,000 patient practice per week 19.23 Extra number of doctors 0.22 Extra cost per practice £ 18,889 Additional appointments for a 10,000 patient practice for frail elderly or similar (weekly)

Knowledge Skills Attitude Education and Learning – Membership Development Knowledge Skills Attitude Geriatric medicine LTC – what? Phased? Mentoring The first five years Struggling practices Re-invigorating careers – (50+) Role development - Urgent care fellows “Specialism” – Key clinical areas Leadership