Primary care slide pack presentation final vs2 by qLu36Hx


									   The primary care
   strategy 2012/17
Improving the quality of care

      Appendix 1
• The purpose of the strategy to make sure we
  can provide primary care services in outer north
  east London that are high quality and fair;
  provided from buildings that are fit for purpose;
  and which deliver value for money for tax

• The strategy covers the role of general practice
  within the future health system, but will closely
  link to other existing and emerging strategies
  e.g. pharmacy and urgent care
Context and overview
• Changing healthcare system and environment
• Healthcare for NHS outer north east London and
  cluster arrangements
• Role of clinical commissioning groups and role
  of GPs as commissioners
• Role of primary care contracting
• Building on examples of success in four
• Transition to NHS Commissioning Board
Case for change
• Rapidly changing population
• High health and wellbeing needs
• Significant variation in primary care services:
  –   Access
  –   Clinical quality
  –   Patient health outcomes
  –   Value for money
• Significant variations in estate from which
  primary care is delivered
• New models of care require changing
  workforce with enhanced skills
Rapidly changing population
• 5.5% increase in population since 2001,
  projected increase of 18% (165,500) by 2031
• Higher proportion of people aged 65 and over
  compared with London, lower proportion of
  younger adults (aged 25-39)
• Havering has a higher proportion of people aged
  over 45. Barking and Dagenham has a higher
  proportion of people aged under 19
• Birth rate is increasing overall. Barking and
  Dagenham has the second highest fertility
  rate in London
Population projections
Current and projected
increase – BAME population
Health and wellbeing needs
• Wide variation in health inequalities and
  deprivation across the four boroughs
• 24% of the ONEL population lives in the 20%
  most deprived areas in England
     – Almost 50% of Barking and Dagenham’s population
     – 5% of Havering’s population

1. The Index of Multiple Deprivation (IMD) 2007
Overview of primary care

     The Index of Multiple Deprivation (IMD) 2007
Variation in primary care
• Access – wide variation in patient experience,
  services offered and opening times
• Clinical quality – variation in screening and
  prescribing; under-reporting in CHD and COPD
• Patient health outcomes – deaths from
  diabetes, cancer and smoking varies
• Value for money – variation in referral rates,
  A&E attendances and urgent admissions;
  we spend more per patient in some PCTs
  than others
Patient experience survey

              62.1%                69.2%   70.2%   73.1%

  Overall total percentage score
Primary care estate
• Number of GP premises which are not compliant
  with new standards, or require major works
• Five year estates plan to deliver a better
  environment for patients and staff
• Address the standards of some of our estate by
  encouraging practices to work together to form
• Some GP practices will move from sub-
  standard premises into fewer and better
  buildings that will provide community health
  hubs for patients
Workforce planning
• Workforce strategy required for future health
  needs across outer north east London
• Population based service delivery model to
  deliver equity of access and quality
Comparative GP workforce
Clinical leads feedback
• Good practice: peer performance reviews; patient
  service redesign; prescribing efficiencies
• Federated or network of practices supported with
  optimum lists sizes (c.50-80,000)
• Out of hospital services with one access point
• Need for workforce modernisation
• High quality premises critical but constrained
  financial environment; CQC registration an
  important lever
• IT to share information and enable self-
Delivering the strategy

Borough clinical and partner engagement
Sept/Oct 2011

   12 week consultation
   Nov 2011 - Feb 2012

       Collation and analysis of consultation
       responses – Feb 2012

           Refine strategy - March 2012

               Boards formally receive strategy -
               March 2012
• To have a clear focus on overall quality improvement and
  the transformation of health outcomes
• To establish integrated care networks to improve patient
• To have an effective estates strategy
• To have a unified operating model for primary care
• To have workforce plan to integrate allied health
  professional, primary care and community health service
• To maximize information technology to improve quality
  and value for money
  Thank you

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