Hurley Group Past, Present and Future Dr Arvind Madan CEO
The Past - Hurley Clinic in 2007 Helping 1050 QOF 1 Practice single Points handers Substance 6 Partners PCG Misuse Education 2 salaried Homeless Programme
An NHS GP Partnership, that just got bigger… PMS Reduced NHS Rising Patient Reviews Funding CQC Demand Reforms Practice Increasing S Values Revalidation Failures Regulation Cuts NHSE Demands Low Morale PCT Recruitment meltdown Issues Contract KPIs Reviews Publ IT Heal
2% 3% 1% 3% 60% 4% 1% 11 33% % % of borough 2% registered 11% 4% with Hurley 45% 25% % of borough’s 5% urgent care
The Present - Hurley Clinic in 2014 Largest 18 4 Partners London Practices Provider 30 Lead 8 Urgent Policy Clinicians Care sites Influence 20 Senior Social Use of Managers Enterprises Technology
The Future - Hurley Group 1. Hurley Group and the business model 2. Hurley Group and Technology 1. Hurley Group and Federations
Hurley Group and Business Model Partners Directors HQ Staff Lead Medical Managers Support Staff Directors Nurses Deputy Salaried Regional Medical Bank Nurses Directors Service Salaried GPs HCAs Teachers Development Practice IT Managers
Hurley Group and Technology The Iron Triangle Theory One cannot improve one without compromising another. Breaking the Triangle? How do you improve access, Access quality and reduce costs? Offer patients who plan to attend to: The Iron transact online (appointment book) • Triangle • stratify themselves (symptom check) manage themselves (self-help) • • use other services (sign post) Quality Cost take phone advice (nurse callback) • e-consult (structured history analysis) •
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Link to our online offer skinned to match their own practice’s identity - Patient selects condition Patient visits their own practice website 9% use Nurse or 7% self-manage Patient always called back Pharmacy call back to verify identity and close communication loop 22% of patients dealt 20% called back by GP to close case with more efficiently 80% called back by admin team to collect prescription (44%) or book appointment (36%) 6% submit E-Consult to own GP from the website
Results 60% closed remotely 820 E-consults 80% closed 75 calls a month for Remotely advice from Nurse Ensures right 1,000 uses of service first time symptom checkers 6,000 users of self-help 18% of users planned and sign posting to book an appointment information and then don’t Over 23,000 visits to website averaging Popular with Patients about 1,000 per week (83% FFT “extremely likely”)
Cystitis (female) Asthma Depression Sore throat Contraception Rectal bleeding Knee pain Shoulder pain Earache Coughs TOP 10 CONDITIONS
Advantages: Better Access • Better patient experience Reaches the working population • • Enhanced patient’s earning potential Better Health Outcomes • Earlier presentation and intervention Permits embarrassing presentations • Better Practice Efficiency Siphons off self-help and sign-posting • • Time-efficient consults for practices Robust Clinical Governance • Medicolegally safe and approved •
Hurley Group and Federations Hurley Group Suffolk Federation Command and control Democratic Depth of alignment Limited alignment Non-geographical Geographical Service range limited Service range extensive Competition heavy Competition lite? Limited co-design Ability to co-design? Questionable scalability Unlimited scalability
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