general practice development framework (emerging)
TRANSCRIPT
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www.england.nhs.uk
General practice development framework
Dr Robert VarnamHead of General Practice Development
@robertvarnam
Work in progress
Version dated 29/07/15
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Health & wellbeing-promoting care
‘Right access’ Consistently high qualityHolistic, personalised, proactive, coordinated care
Comprehensive, joined-up care for a registered population,shaped around them in the community
bit.ly/c2aGP
‘Wider primary care, at scale’
bit.ly/nhs5yfv
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Phone first.
Community diagnostics.
Practice based paramedics.
Pharmacy first.
Web consultations.
Primary care led urgent care centre.
Minor injury service.
Physio first
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Direct specialist advice.
Condition management training.
Shared records.
Care coordination.
Hospital in-reach.
Care home ward rounds.
Virtual ward.
Primary care-employed specialists.
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Social prescribing.
Travelling health pods.
Peer-led walking groups
Health coaching.
Befrienders.
Schools outreach.
Community development.
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Work areas
Quality• safety• effectiveness• experience
Access
Proactive
Self care
Coordinated
Secondary / specialist care
Care & support
Community services
Pharmacy
Diagnostics
CCG AT LA
Improvement
Care models
Larger scale
Participationin wider system
Collaboration
Collaboration
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Leadership
Creating shared purpose
Strategic planning & partnerships
Leading through change
Being a leader
Improvement
Patients as partners
Processes and systems
Using data for improvement
Rapid cycle change
Business
Governance
Operations management
HR
Business intelligence
Capabilities
EnablersInnovation spread
Policies & permissions
Contracts & incentives
InfrastructureProductive federation
Transparent measurement
General practice development framework
eg releasing capacity
PMCF 1+2
Access programme
Workforce
Releasing capacity
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Capability building
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Good ideas and intentions are not sufficient. It will be necessary to build capabilities for transformation, improvement and innovation in primary care.
• Some communities already have primary care leaders skilled in facilitating innovation and improvement. However, they are in the minority. We therefore wish to support the creation of a wide range of high quality, relevant development offers. Our goal is that, in time, every local network of practices has in-house expertise in service redesign, improvement and change leadership.
Need for capability-building
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• Gaps in every enabler & capability• Historic underinvestment• Ad hoc culture• Unconscious incompetence• Independence• Anti-academic• Lack of capacity• Superhero innovation
Development challenges
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• Capabilities > consulting• Learn while doing• Build around a patient-facing purpose
• Purpose > function > form• Use ‘pull’ for capability-building
• Something for everyone• Reach every ‘level’ & ‘corner’• Multi channel• Options: educational functional
• Awaken, train, mentor, coach [not necessarily in that order]
• Recognise the gap• Ensure transformational learning
• Use existing networks• …and develop them
Capability building principles
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The supplier market
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Selection of good offers for some needs But v limited capacity for some
Many one dimensional suppliers Easy to omit some needs
Consultancy >> capability-building More problematic in some areas than others
No ‘case manager’ Where to start? How to pull it all together?
The supplier market