1. Developing Primary Care
Adopt
Improve
Solutions

2. 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.

3. 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

4. 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

5. Building Resilient Primary Care & Supporting Practices to Thrive

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

7. 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%

8. 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
£ ,000
Estimated cost of GPs currently
£ ,422,453
Additonal cost of funding GPs to cover these appointments
£ ,453
Extra appointments for a 10,000 patient practice
Extra appointments for a 10,000 patient practice per week
19.23
Extra number of doctors
0.22
Extra cost per practice
£ ,889
Additional appointments for a 10,000 patient practice for frail elderly or similar (weekly)

9. 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