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The primary care strategy 2012/17 Improving the quality of care Appendix 1 Aim • 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 payers. Scope • 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 boroughs • 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% 1 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 services The Index of Multiple Deprivation (IMD) 2007 Variation in primary care services • Access – wide variation in patient experience, services offered and opening times • Clinical quality – variation in screening and prescribing; under-reporting in CHD and COPD registers • 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 2010-2011 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 solutions • 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- management 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 Recommendations • To have a clear focus on overall quality improvement and the transformation of health outcomes • To establish integrated care networks to improve patient experience • 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 providers • To maximize information technology to improve quality and value for money Thank you Any questions?
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