Health and Social Care Reform in Greater Manchester

Developing a commissioning strategy for Primary Care

Rob Bellingham — Director of Commissioning

(Greater Manchester)

August 2013

Primary Care Case for Change• Need to reduce unwarranted variation in outcomes and

care pathways• Extending access to primary care • Ensure focus on self-management, wellness and

prevention• Need to ensure integration with other services and

organisations• Significant workforce issues; capacity of current

workforce, training now and future, work life balance • Potential for increased efficiency

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Key themes from a patient’s perspective:

Long Term Condition Management• Early detection leading to improved outcomes via

systematic approach to prevention strategies• Effective use of practice list based registers with

development and implementation of transparent benchmarking of best care indicators

• Development of clear care pathways and protocols for promoting self management and empowerment

• Work alongside Integrated Care Teams to facilitate and promote continuity of care and care co-ordination, including crisis planning for those with multi morbidity and complex needs

Involvement in care• Facilitate patient access to their health and social care

records to encourage health literacy and shared decision making

• Support a culture which fosters social responsibility and encourages patients to take responsibility for their health and well being

• Support the development of skills and capacity in primary care to support patient choice in end of life care

Specialist Primary Care Services• Develop specialist skills and services within community

settings by; – Encourage sharing of skills between practices and

collaborative working– Encourage the delivery of traditional hospital specialist

services within community settings by integrated working with primary care teams

– Ensuring appropriate diagnostic support to enable care closer to home

Access• Develop an extended model of primary care which

improves patient access with aligned levers/incentives to ensure delivery

• Encourage development of innovative approaches to access ; Skype/Email etc with development of the non medical workforce to support this

• Ensure improved access balanced with continuity, particularly in relation to patients with complex needs

• GP as co-ordinator of care

Enablers – NHS England AT GM• Coherent workforce plan within defined financial

envelope to address any skills and capacity shortage• Commission appropriate development and training

packages to meet the workforce plan• Estates strategy and implementation plan • I.T.; work with existing clinically led I.T strategy and

operational groups to resource and deliver required infrastructure improvements

• Financial levers and incentives aligned across the system

Next Steps• Demonstrator community process – 18 bids received. 6 moving

forward in initial phase.• Primary Care Commissioning Strategy in advanced stage of

development• Programme of stakeholder and public engagement• Continued development of implementation plans – in conjunction

with Integrated Care & Healthier Together programmes• Task & Finish groups (for implementation)• Formal launch of strategy via 2nd Primary Care Summit Weds 25th

September 2013

Opportunity for Discussion