1. New models of care in primary care – ‘at-scale general practice’
Tower Hamlets
New models of care in primary care – ‘at-scale general practice’

2. Networks Tower Hamlets before networks
8 Networks1 were formed in the borough during 2009 23 23 5 5 20
Pop: 33,186 6 6 3 5 1 4 19 22 5 2 21 26
Pop: 29,801 20 27 6 6 24 3 19 7 1 2 22 26 4 21 27 8 10 24 9 14 25
Pop: 35,720 7 12 13 11 30 32 8 10
Pop: 28,995 15 16 29 31 28 9 14 25 12 13
Pop: 18,027 30 32 17 11 18 15 16 29 31 28
Pop: 27,839 17
Pop: 29,892
8 LAPs
36 practices
Total population of ~245,000
Practice list sizes of 3,000 to 11,000 33 36 18 35
Pop: 31,975 34 33 36 35 34
Why networks?
Focus on population health across a geography
Collaborative relationships with wide range of partners (e.g. Borough, schools, charities)
Sufficient scale for specialisation of staff, ability to access rare skills and ensure access, resources (e.g. equipment)
Integration with estates plan

3. Case for Networks
Wide variation in clinical practice and outcomes for diabetes patients
Economies of scale
Poor uptake of diabetes education and retinal screening
Need to do things differently
The right people to do the right tasks at the right time
Specialist support
Transparency of data
Putting the patient at the centre of their care

4. GP Care Group Journey April 2009
Development of 8 Primary Care networks
November 2013
Formation of the GP Care Group
September 2014
GPCG registered as a CIC
November 2014
CEPN & Open Doors transferred to the GPCG
March 2015
THT awarded Vanguard status/GPCG awarded PMCF
April 2016
Preferred bidder for CHS contract
Commencement of Health Visiting services
April 2017
Commencement of CHS

5. GP Care Group Community Interest Company limited by shares
Membership organisation
36 general practices
1 homeless access centre
Board comprises:
8 elected GPs representing each network
2 elected Network Managers; 1 elected Practice Manager and 1 elected Practice Nurse
Purpose
to be the voice of primary care working at scale
to ensure sustainability of primary care

6. Primary Care at Scale Current Portfolio Pipeline Surgical aftercare
Pathology transport
Websites
CEPN
Open Doors
Extended access hubs
Social prescribing pilots
Health visiting
System leadership – MCP Vanguard
Network incentive scheme
Out of Hours/Urgent Care
Single Point of Access
Health advocacy and interpreting
CHS alliance manager/system leadership
Medical indemnity
Business Intelligence
QI/ Primary Care resilience
Sexual Health

7. Tower Hamlets Together
MCP Vanguard
GPCG, Barts Health, ELFT, CCG, LBTH, CVS
Now = alliance via MOU
Imminent = alliance partnership (stage 1 of MCP)
Future = accountable care system
Joint commissioner/provider board
CCG devolves commissioning intentions to THT
Outcomes framework
Health and wellbeing strategy alignment

8. CHS Alliance

9. Alliance Partnership

10. Challenges & Learning
Last year has been more about system than about primary care
CHS procurement – somewhat distracting
The future of partnership model – mixed views
Practice and network sovereignty
Communication and buy-in