Future vision for Primary Care Jonathan Kerry, Senior Assistant of Primary Care
1. To give you an update on the recent changes to urgent primary care services. 2. To tell you about the CCGs ‘vision’ for primary care services. 3. To tell you about the consultation we are planning around primary care. 4. To get some of your thoughts/input.
Urgent Primary Care Services • These are the services open when your own GP practice is closed: - Extended hours hubs - Out of hours - Urgent treatment centre *new* - Walk in centre • Last year you may remember we did some engagement work around primary care streaming in A&E (NHS England mandated service). • We’ve talked about these services at previous Forums and set up a reference group last year. • As a next step NHS England have mandated that all health economies have an Urgent Treatment Centre in place by December 2019. • Within Wigan Borough we are planning to implement our Urgent Treatment Centre before the 31 st March 2019, phase 1 of this is the co-location of the GP Out of Hours Service which moved on the 23 rd January 2019. • NHS England mandated many aspects of the urgent treatment centre.
National, Regional and Local Context • Urgent and Emergency Care is one of the NHS main national service improvement priorities as set out in the Next Steps of the Five Year Forward View document. • One element of this is the implementation and roll out of standardised Urgent Care (Urgent Treatment Centre) by December 2019. • Greater Manchester Health and Social Care Partnership have mandated a model of Urgent Primary Care which requests at least one Urgent Treatment Centre in each location. • Key components include: o Comprehensive front door clinical streaming o Significant revision to NHS111 interface o Standardised Urgent Treatment Centre • The Greater Manchester model will also incorporate o Utilisation of Urgent Treatment Centre to manage same day demand o GP Streaming can refer directly into urgent treatment centre o Principle of GP Practice first 24/7
Our Ambition Locally the health economy in Wigan has set an ambitious target to implement an Urgent Treatment Centre before end of March 2019 (Q4 2018/19) This will build on the success of: o Phase 1:the implementation of Primary Care Streaming o Phase 2 :the relocation of Minor Injuries and therefore; o Phase 3 to have UTC in Wigan by Q4 2018/19.
Why earlier than the national requirement? The rationale to implement the Urgent Treatment Centre earlier than the national requirement is to: • support the health and social care system to respond to winter pressures • achieve the required standard for A&E performance; whilst making access to services clearer for patients.
Urgent Treatment Centre (UTC) The implementation of an Urgent Treatment Centre forms part of a wider transformation programme of work to transform the provision of primary and community care to deliver a GP led 24/7, 365 day service provision.
Location of Service • The Urgent Treatment Centre will be located in the Christopher Home Unit at Royal Albert Edward Infirmary (at Wrightington, Wigan & Leigh NHS Foundation Trust) • Booking and triage will be undertaken within the current walk in area of the A&E department which will be rebranded to the Urgent Treatment Centre (UTC) triage area • The streaming of all walk-in patients would be take place within the triage area. • Patients suitable to see the GP team will be transferred to the Urgent Treatment Centre at Christopher Home. • All patients requiring A&E would be streamed.
Service provision • 24/7 GP led service • Booked Appointments & walk in patients • Access to a range of diagnostics • Links to wider public sector services to deal with the patients presentation and then connect the patient back to the place.
Urgent Treatment Centre (UTC) UTC (Multi-agency (Out of Hours) safeguarding hub)
BENEFITS OF URGENT TREATMENT CENTRE • 24/7 booked face to face appointments by GP in Urgent Treatment Centre • Reduce pressures on A&E • Making better use of NHS resources in an increasingly challenging time. • Access to a range of diagnostics. • Supports Winter Resilience planning for 2019/2020 • Utilising the skills of the wider Primary Care teams rather than unnecessarily going to A&E
Next steps • We still have lots of service duplication and patients tell us it is confusing to know where to go when their own GP practice is closed. • We think we could be making better use of the money we spend on these services. • Urgent Treatment Centre go live – need to learn from implementation and evaluate • Look at opportunities to implement 2 nd Urgent Treatment Centre within the Leigh end of the borough (timescales to be agreed). • Wider redesign of a 24/7 GP led urgent care system. • Agreement of timescales. • We need to look at number of locations the extended hours hubs are delivered from – 8 to 5 potentially • We also want to think about the provision we may need over in Leigh side of Borough.
Extended Hours Hubs • The extended hours hubs were first commissioned in 2016 and now operate from 8 locations: Pemberton Surgery Ashton Medical Centre Pennygate Medical Centre, Hindley Shevington Surgery Bridgewater Medical Centre, Leigh Tyldesley Health Centre Winstanley Health Centre Urgent Treatment Centre at Royal Albert Edwards Infirmary • The service has been trialling different opening times. • Appointments are accessed by calling 01942 482848.
A new model of GP Service Delivery
Borough Vision In January 2014, all partners in the economy signed up to a shared vison via the Wigan Health and Wellbeing Board. This is summarised below: 1. That health and social care services should support people to be well and independent and to take control of their lives 2. That heath and social care services should be provided at home, in the community, or in primary care, unless there is a good reason why this should not be the case. 3. That all services in our borough should be safe and of a high quality and part of an integrated, sustainable system led by primary care
Taking The Vision Forward Wigan Borough has developed its locality plan “Further Faster Towards 2020 ” for the future to deliver a transformed service model for Health and Social Care and other public services. A new model of GP services is the heart of this. Service Delivery Footprints, 30-50,000 population – GP Cluster groups Place based model – Wigan Deal principles: Asset or strengths based approaches Integrated working Proactive approaches and early intervention Effective care co-ordination and support Supporting individuals to be independent and empowered Knowing the place – understanding the needs and assets in community Support from borough wide teams/ resources, including access to specialist skills Take account of a life course approach of Start Well, Live Well and Age Well
Healthier Wigan Partnership The development of an Integrated Care Organisation (ICO) for Wigan is the mechanism by which we secure a transformation in the operation of out of hospital services. The Healthier Wigan Partnership (HWP) the Borough’s Integrated Care Organisation. It is independently chaired and its steering group contains representatives from the main NHS provider and commissioner organisations in the borough (including GP Clusters) as well as the Council.
Our proposed model will… Wrap health and social care services around primary care and be focused on prevention and early intervention. Develop partnerships in natural communities of 30,000- 50,000 population with GP practices working together in clusters; known as Service Delivery Footprints (SDFs). Ensure GP Clusters ‘own’ the patient list and influence the shape of wider public services contributing to improving health and well-being of the population. Engage wider Public Service Partners (e.g. Housing and Leisure) align service offer to service delivery footprints. Deliver place-based multi-agency hubs working closer to GP clusters. Deliver an asset based approach to health and social care building on the strengths of individuals and using community assets. Seek to join up services in the community, such as Integrated Community Services and Start Well
GP Practices have organised themselves into Clusters Cluster business cases implemented and starting to deliver expected outcomes Collaboration through Healthier Wigan Partnership – Alliance Agreement developed for implementation April 2018 Community link workers are engaged fully with practices. Successes GP Clusters working with partners to address the needs of their patient population including Bridgewater Community Trust, Hospital Trust, Wigan Council, Mental Health, Voluntary & Community Providers Integrated Community Services and complex care huddles operating GP Streaming introduced at Christopher Home (WWL) GP Practices continue to deliver against the Primary Care Standards
Recommend
More recommend
