1. Hampshire Multi-specialty Community Provider
New Care Models

2. Joint CEOs, Southern Hampshire MCP
Dr Nigel Watson Katrina Percy
Chief Executive, Chief Executive,
Wessex Local Medical Committee Southern Health Foundation Trust
GP New Forest
Chair SW New Forest Vanguard
Joint CEOs, Southern Hampshire MCP

3. Contents. . . What is the problem? What are the solutions?
What are we doing about it?
Why do it? NW

4. Recruitment and Retention Fragmented Care Resources
What is the problem?
Recruitment and Retention
Fragmented Care
Resources NW
Urgent care – current system too complex need to rationalise – look at A/E, GP services, Pharmacists, 111, ambulance and self help
LTC – need to change approach from hospital and general practice to population – 70% of NHS spend

5. Why do we need change? Demand rising faster than funding
Ageing population
Exponential growth in chronic illness
Over dependency on hospital based care
Cut in social care budget
Current model not sustainable
General practice in crisis
Silo working, tribalism, organisational barriers NW

6. Five Year Forward View - 5YFW
Roadmap for future
Remove barriers
New models of care
MCP
PACS
Greater focus on out of hospital care
Re-design Urgent and Emergency Care
Greater focus on self care NW

7. Why did the LMC get involved?NW

8. The Future – An LMC View…
Build on the GP Practice Registered list
Population focus – GP federations or provider companies
Employed status – for those who want it
Greater resources to support practices
Too much focus on hospitals (they are bricks and mortar)
Integration with community services and social care
Workforce – new roles
Make general practice a great place to work – but how? NW

9. The Vanguard Programme. . .
Multi Speciality Community Provider (MCP)
Primary and Acute Care System (PACS)
Care Homes
Acute Providers (latest programme) KP

10. The Hampshire MCP (part of the Vanguard Programme)KP

11. Your Health, In Your Hands, With Our Help.
Creating an MCP. . .
Our New Care Model
Provider Reform
Commissioner Reform
A new care model with better access to care, extended primary care team proactively managing need, and specialist advice and support in the community.
Coming together to deliver the new model of care
that has been
co-designed with local people, is seamless across health and social care services and is cost effective
Pooling the combined resources for the local population and commissioning services using long term outcome and capitation based contracts KP
Your Health, In Your Hands, With Our Help.

12. Building block of the MCP is the Extended Primary Care Team
The Extended Primary Care Team (EPCT) pools the knowledge and care resources of primary care, community and mental health services, social care, pharmacists and voluntary, community and social enterprise sector partners, to manage the population health of their community.
They will operate in a single team under the leadership of local GP’s.
An Extended Primary Care Team may operate at the level of a large practice, or a group of smaller practices.
Some, but not all members of the EPCT will be employed by or funded through the MCP. KP

13. MCP Locality Design
Assumption of localities across Hampshire, based around natural communities.
Each locality led by a GP with a General Manager and Senior Nurse.
Purpose is to lead locality wide resources, e.g. primary care access centre, community hospitals, CMHTs and to harness community and voluntary sector involvement.
In this scenario there will be a choice:
Does the MCP manage the non-General Practice members of the EPCT or do General Practices manage the EPCT through a management contract with clear required outcomes and governance arrangements?
EPCTs where the GPs are directly employed by the MCP
EPCTs where the GPs remain independent practitioners KP
MCP Locality
The MCP manages the GMS contracts with these independent practices

14. Some Examples. . . Primary Care Access Centre MSK Long Term Conditions
Delaying specialist services
Mental Health
New Workforce Model at Forton

15. The Future. . . Scaling the current examples Common Health Record
Premises solutions
New Care Home Models
New Workforce Models, e.g. Pharmacists

16. South West New Forest - Common Health Record -
Read
&
Write
Community Services
GP Practices x 4
Medical Interoperability Gateway
(MIG)
GP Practices x 3
Read
&
Write
Read
&
Write
Minor Injury Unit
The Practice
Ambulatory Care Unit
OPD
Oakhaven
Hospice
Care Home
In-patients
Lymington Hospital

17. Implementing Change. . . Not the 8 day programme
Leadership and Engagement
The MCP Manual
New MCP Contract

18. New “GP Contract” for MCP. . .
Available from 2017
Network of practices covering population 30,000 or more
Working in a multi professional environment
Seven day access within the network would be a requirement
QoF funding moved into core contract NW

19. What will this achieve? Better place to work Improved patient outcomes
Improved patient experience
Sustainability of the NHS

20. Any Questions?