Empowering Wellbeing Through Healthy Communities Claire Oatway, Chief Operating Officer @beaconmedgroup

Formed in 2014 - merger of three practices Serving 33,000 patients across rural, small town and suburban areas Reputation for positive disruption and delivery Focus on population health - operating as part of an ecosystem A sustainable practice that thrives on innovation

The right commissioning conditions “I want a healthcare service that doesn’t stop at the boundaries” What does exceptional look like for us? We have bigger ambition still; we need to make it real for those who experience services-structures are not enough; we are aiming for non-reversible change; we want one head and one body…… The challenge is still huge but the will and determination strong!

Great strides at a city level Created ONE system: Integrated governance arrangements Four Strategies Commissioning of an integrated health and social care provider for the city Creating ONE budget: Section 75 between NEW Devon CCG and PCC Integrated funds £638 million gross (£462 million) Risk share and financial framework

But still disjointed for providers Beacon Medical Group Voluntary Sector Community Pharmacy Community Health Patients & Community Hospital Care Homes Mental Health Devon County Council Plymouth City Council NHS England NEW Devon CCG

Those gaps are artificial Our patients are our patients We're all struggling with workforce, budgets, increasing demands We agree the system works well when the patients get the right care from the right person at the right time We agree that we have hidden assets in our communities, in our partners, in our patients And yet, the contracts and workload get in the way of trust and joint working Which creates its own bough wave of demand

Phase 1: redesign normal Dermatology / MSK Services PMCF: COPD outreach, in-hours visiting service, mixed clinical team Minor injuries service Urgent Care Team: 'No Waiting Room' Co-ordinated flu campaign

Phase 2: redesign “together” Joint workforce developments: nudging each other, learning together, examining new roles Enhancing access to wider clinical support Co-ordinated and targeted care incorporating social intervention New roles to empower patients to take care of their own health and wellbeing

Every community needs something different now Safe but could do better Needs investment to shift behaviours Makes sense but needs co-ordination We haven’t got time to play it safe Better co-ordination and proactive care for most vulnerable patients Targeted support for high demand patients Health promotion, especially self care

We can no longer afford to tinker and think that that is transformative Help patients to take care of their own physical and mental health through self-care tools, patient education, more person-centred long term conditions management and use of health coaches Help communities to take care of themselves through health fayres, social prescribing, peer to peer support, innovative volunteering Energise multi-disciplinary teams by creating community hubs, joint workforce development, opportunities for co-ordinated care such as virtual ward