Membership Event 7 December 1-3pm
Welcome
Aims for today To hear the outcome of the recent vote on the future structure of the company; To feedback on the proposed articles of association (i.e. company constitution); To discuss the proposed business plan for 2018/19; To learn more about the shared resource project and the Barnet research network
Our board Anuj Patel Leora Harverd • Chair • Director Leena Mistry Thiv Thiruudaian • Director • Director Caroline Peters Sanjiv Ahluwalia • Director • Strategic Advisor
Chair’s update Current Services • Finance 8-8 (OOHs & A&E) • Business Plan NoClor D-QIST (CHINs) • Chief Operating Officer recruitment • Company structure & articles of Pipeline association Pharmacists (CEPN) • CQC & Governance (Quality MSK/Urology/Gynae improvement committee) Under 5s in A&E Shared resources • Engagement - Website, PPG, Collaborative working Provider Partnership
Website update http://212.48.93.25/~ryantestingco/dev/bfg/
Website update
Website update
Website update
Website update
Service update 8-8 service • 47 practices now directly booking into the service • 111 direct booking improved • New call centre now up and running Diabetes Quality Improvement Service (DQIST) • Funding now secured • Service being developed for CHIN 1 • Future wider roll out
Outcome of membership vote on our company structure 12
How many practices participated? 51% of our practices participated in the vote 13
What was the preferred company structure? 61% of participating practices voted for a community interest company limited by shares 14
What are the next steps? 19 December 2017: Formal board vote to confirm the voting outcome January 2018: Articles of association drafted (this is the company constitution) February 2018: Draft articles of association sent out to members for comment March 2018: Articles of association adopted in time for 2018/19 financial year 15
Any questions?
2018/19 Business plan 17
What you told us Our key challenges & What services the federation opportunities should consider • Demand management – waiting times, • One stop shop of elderly service – care complexity, patient self-care home, frail pathways • Lack of service integration – • In-hours home visiting services primary/secondary care, IT, pathways • In-practice clinical pharmacist • Practice resilience – finance, workload, • Shared resources – staff bank, document retaining control, recruitment, management, standardized letters • Working together – sharing good practice, • Integrated community services – MSK, self supporting each other referrals, pathway reviews Our financial sustainability • Transparency • More detail and clarity on what investment cost from practices needs to be • Equity for non-contributing practices
Our business plan sets out a strategy for growth in three key areas 1. A provider of services in a primary care setting Market area Out of hospital care Population focus Frail and elderly Delivery mechanism Care Closer to Home Networks Service improvement focus Quality improvement support teams (QISTs) e.g. NOCLOR 19
Our business plan sets out a strategy for growth in three key areas 2. Developing the shared resource model In line with your feedback, we will focus on: Workforce development Clinical pharmacists in GP practices (in partnership with the and the development of the Blue- CEPN): stream academy Providing back office Purchasing services, IT services and functions at scale: CQC support. Supporting vulnerable Support to practices to prevent them practice: becoming vulnerable, and facilitating solutions if they do. e.g. LWP Resource model 20
Our business plan sets out a strategy for growth in three key areas 3. Providing strong leadership for primary care in the wider healthcare system The landscape of the NHS is changing. With the development of accountable care systems (ACSs) fast underway, primary care will need to play a central role in ensuring that these new models of care run effectively for the benefit of the local population. We believe Barnet Federated GPs is the right organisation to provide this leadership. e.g. Provider Partnership 21
Achieving Financial Sustainability 1. Best Case The federation can achieve Price per patient £0.55 financially sustainability through: @ 70% Share* • Increasing income by winning 2. Most Likely new contracts Price per patient £0.65 • @ 70% Share* Minimising federation operating costs achieved by having an 3. Worst Case efficient management structure Price per patient £1.00 • Asking practice members to @ 70% Share* financially contribute *The price per patient has been based on a 70% share of patient list size being covered by practice members signing up to the federation. 22
Any questions?
Barnet Research Network 24
Developing a PAN Barnet Research Network Paula McLaren Clinical Research Lead Barnet Federated GPs
Primary Care Research- why? Wealth of research opportunities in the community and primary care Access to large numbers of patients Primary care traditionally difficult to engage in research
Benefits of Research Practices Research accreditation Financial remuneration Access to education and training Upskilling of staff-Staff retention Put you on the map Kudos Engage in local opportunities
Benefits of Research Patients Access to new information, treatments, technologies and equipment Altruism Individuals Professional development Education CPD Develop special interest Develop collaborative working practices and relationships
Benefits of Research Health Economy Practices develop new ways of working Individual local Pan Barnet Working at scale Building infrastructure Building personality and character as a collaborative
Collaboration North Thames Clinical Research Network/Noclor Primary Care & Mental Health Governance/NIRHR/Ethics Federation Framework and infrastructure to support and engage GPs
Research Network Steering group Model Utilise MCLG geography Clinical Lead-Paula McLaren 9 clusters – attached to MCLGs Cluster clinical leads Senior research coordinator Research administrators
Rollout Recruitment of staff to support engagement Engage practices Federation – contract with Noclor Practices framework agreement Each practice will receive annual one off payment Payment for individual studies
Rollout Federation Provide support and admin Practices Take part in 3 studies per year Designated Clinical Lead/contact for research (GCP training) Engage with cluster leads/research coordinator and administrators
Leaflet for practices See handout Contact Paula McLaren, Clinical Research Lead paulamclaren@nhs.net
Shared resource 36
Sharing Resources Joint Clustering Internal External Shared process & services management Shared Shared policies together structures Service Service Implementation resource LOW HIGH Financial Benefit Impact on Clinical Working Shared Resource model Practice Collaboration
Practice Collaboration Practice B Practice collaboration: Practice Practice C • Federation facilitated - practice run A • Merging of processes • Step wise by pathway Unified • Inclusive model across Barnet • Encourage Collaboration process • Retain practice partnership control • Sharing clinical resource 38
Would you like to see Barnet practices working closer together? Maybe No Yes 0.00% 20.00% 40.00% 60.00% 80.00% 100.00%
Staff sharing - Bank staff/Centralised admin work Single call centre QOF - Help with recalls Premises - List of approved tradeperson/Infection control audits/Risk assessments/PAT testings etc IT - Utilise EMIS to full potential/Sharing EMIS protocols and concepts Finances - Centralised payroll/pension/support with claims Series1 Federation wide PPG Enhanced services - Support practices not signed up to services CQC - Support with policies, systems and protocols/Mock visits Coding - Improve efficiency of paperflow (Snomed, Docman) Bulk purchasing - Medical and non-medical supplies/Stationary/HR support/Insurance Blue Stream Academy - Standardising staff training/Pan Barnet approved policies 0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00% 70.00% 80.00%
Frame mewor ork Overseen by PMs; Implemented by Administrators Physical Resources 1. Bluestream training 2. Policy bank (updated documents) 3. Joint purchasing (list of providers) Resilience CEPN training funding Peer Support Process Change 1. PM Forum 1. Clinical Correspondence 2. PM Learning Groups 2. Signposting (sharing learning) 3. IT processes; EMIS; Docman 3. Practice Support Teams (going into practices) Overseen by Lead by PMs; Programme Managers; Supported by Piloted by PMs Engagement Officers
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