May 2019 The Strategic Programme for Primary Care Sue Morgan National Director and Strategic Programme Lead for Primary and Community Care

The Primary Care Model for Wales Setting the Direction (2010) Primary Care Plan for Wales (2015 -2018) A Healthier Wales (June 2018) Strategic Programme for Primary Care (Nov 2018) Cluster Working “A cluster brings together all local services involved in health and care across a geographical area, typically serving a population between 25,000 and 100,000. Working as a cluster ensures care is better co-ordinated to promote the wellbeing of individuals and communities”

Key Messages Get better at measuring what really matters to people Greater emphasis on wellbeing Health and Social Care will work together…... joined up and scaled up Work as a single system, everyone working together Invest in new technologies Shift services out of hospitals into the community Implement the Primary Care Model for Wales

Primary Care Model for Wales Pacesetter Programme (2015-18) – 24 projects on ‘once for Wales’ basis Multidisciplinary teams working at cluster level are the way forward Safe & effective systems to direct people to the right person / team at the point of contact Integrated teams ensure a holistic approach to care - physical, mental and social well-being Services must work well across in- and out-of-hours to ensure seamless care Success also depends on an informed public who have access to a range of community services

The Transformation Required The most cost effective way of improving health and well-being to the practice population is no longer the traditional GP model Role of ‘high street’ needs to grow – change from business to service Wider community infrastructure – health and social care Place based care

ALL WALES WHOLE SYSTEM APPROACH Empowered Citizens Motivated professionals Informed Public Stable Primary Care Promotion of Healthy Living Integrated, Whole Systems Approach Increased citizen wellbeing Improved access to quality care Sustainable Community Resources Sustainable Models of Care New Cluster Models Accessible Resources Complex & Specialised Care in Community Support for Self Care Increased Community Resilience Reduced preventable & avoidable ED/hospital admissions Wide Range of Community Resources

Components of the Primary Care Model for Wales Informed Public Empowered Citizens Support for Well-being, Disease Prevention and Self Care Community Services Cluster Working - Cluster planning, Integration, Sustainability, Cluster Development, Evaluation, MDT Working Call-handling, Signposting, Clinical Triage / Telephone First Systems Urgent Care - 111 and Out of hours & In hours Shifting Resource Complex Care in the Community Infrastructure to support Transformation

Strategic Programme for Primary Care ‘Primary Care response to A Healthier Wales’ 1. Six Key Work Streams (…and business as usual) Prevention and wellbeing 24/7 Model Data & Digital Technology Workforce & Organisational Development Communication, Engagement Transformation Programme and the Vision for Clusters 2. Seamless Working 3. Primary Care Contract Reform

Action to date & delivery mechanism Socialising the programme: Soft launch of the Strategic Programme National Primary Care Conference November 2018 30+ meetings / workshop presentations across Wales (Oct ‘18 - April ‘19) Leadership: DPCC Lead and ‘expert’ Co-Lead assigned to every work stream Programme Support: Programme Manager appointed (March 19) Initial scoping meetings

Strategic Programme for Primary Care Reporting Lines National Primary Care Board (via Strategic Programme Arrangements) Work Stream 1. Prevention & Well-being 2. 24 / 7 Model Areas in Scope Information to citizens Social Prescribing Compassionate Communities of equivalent Prevention in clinical and non clinical settings Population segmentation and risk reduction Maximising opportunities to support national programmes Telephone first / Sign-posting / Triage Urgent Care Escalation Processes Self-Care and Wider Primary Care Contractor Professions Services in the Community OOH (Peer Review) 111 Roll out Management of Rising Risk

Strategic Programme for Primary Care Reporting Lines National Primary Care Board (via Strategic Programme Arrangements) Work Stream 3. Digital & Data 4. Workforce & Organisational Development 5. Communications & Engagement Areas in Scope Systems – current & new Information – data availability & data sharing Technology – enabling an agile workforce, assistive technology MDT review Workforce planning & modelling A good place to work Role development Education, training and skills Sharing best practice Phase 1 – general awareness inc user friendly articulation of model & raising public awareness Phase 2 –behavioural / culture change Engagement at local level

Work with Regional Partnership Boards and sub-committees Work Stream 6. Learning from Transformation Programme & Vision for Clusters Areas in Scope: Identify barriers for clusters to develop at pace Work with external stakeholders to identify areas of alignment Alignment with national programmes (eg Transformation Programme, Clinical Plan, Value Based Healthcare) Seamless Working Welsh Government internal working group established spanning departments Work with Regional Partnership Boards and sub-committees Health Board or Executive Team development sessions III. Contract Reform Lead – Welsh Government & ‘buddy’ DPCC HD HB: Jill Paterson

Awaiting endorsement at the National Primary Care Board – 9 May 2019. On the basis that the deliverables are approved, the full Programme Management Office approach will launch. What does this mean for the RPB…. - how is the national programme reflected in local actions? - how will local actions influence national programme?