Providing sustainable resilient primary care at Saltash Health Centre July 2018

Currently… 13.000 patients but growing Aging population Complex medical needs Long term conditions Offloading from hospital to the community It is almost impossible these days to open a newspaper without reading that our health service is under immense strain. The continued funding squeeze, rising demand and the need to safeguard quality are combining to exert huge pressure across the entire system. These challenges are not limited to England but are faced by health systems across the world. None of the pressures is likely to abate. An ageing population, changing patterns of disease and rising patient expectations will all add to the demands on the NHS. There is now wide consensus that health care needs to change dramatically to meet these demands.

Recruitment Crisis Fewer doctors training to become GPs Increase in numbers of GPs retiring Practices merging or closing Primary care is well established as the first port of call for most people when they need medical help. For many, the GP surgery is a constant thread in their lives. As such, primary care has the potential to offer a much wider range of support. By going beyond medical care as we know it, primary care teams have the chance to influence the wider social determinants of people’s health – and to help them make lifestyle and behavioural changes. General practice, with its registered list and everyone having access to a family doctor, is one of the great strengths of the NHS, but it is under severe strain. Even as demand is rising, the number of people choosing to become a GP is not keeping pace with the growth in funded training posts - in part because primary care services have been under-resourced compared to hospitals.

for Saltash Health Centre? What does this mean for Saltash Health Centre? Innovative practice Integrated team Multidisciplinary health professionals Alongside traditional GPs

Our vision Primary care is well established as the first port of call for most people when they need medical help. For many, the GP surgery is a constant thread in their lives. As such, primary care has the potential to offer a much wider range of support. By going beyond medical care as we know it, primary care teams have the chance to influence the wider social determinants of people’s health – and to help them make lifestyle and behavioural changes. General practice, with its registered list and everyone having access to a family doctor, is one of the great strengths of the NHS, but it is under severe strain. Even as demand is rising, the number of people choosing to become a GP is not keeping pace with the growth in funded training posts - in part because primary care services have been under-resourced compared to hospitals.

What will the future look like? Signposting Three key elements Minor ailment scheme at the Pharmacy Self care Over the counter medication Build the public’s understanding that pharmacies and on-line resources can help them deal with coughs, colds and other minor ailments without the need for a GP appointment or A&E visit

Acute Assessment Clinic 3 Paramedics already 2 more Paramedics to start in September Home Visits

Musculoskeletal Specialist Twice a week Rapid assessment Early advice on self help Prompt onward referral if indicated

Mental Health Practitioner Twice a week Prompt assessment Onward referral if indicated Continuity in management

Pharmacist Safe prescribing Adjusting medication after hospital stays or appointments Answering questions in a timely manner Optimization of medicines

Nursing Team Minor Illness Clinic Chronic disease management Training of HCA in management of hypertension and asthma

Patient Care Co-ordinator Ongoing evolvement of their role to support clinical staff and co-ordinate patient’s care Signposting to more appropriate pathways Key element to the patient’s journey

By Sept 2018 Sign-posting Supported by GPs Minor ailments Direct access to a range of health professionals Nurse / HCA Paramedic Musculoskeletal Physiotherapist Mental Health Practitioner Pharmacist E consult Acute Assessment Clinic

Saltash Health Centre: Our vision Signposting Receptionist Phlebotomy Health Care Assistant Nurse Pharmacist GP Paramedic Mental Health Practitioner Musculoskeletal Initial assessment Education Investigations Prevention Quality Outcome Framework Treatment Safeguarding Medicine optimization

Professional, competent and caring staff More co-ordinated care New Care Model: while change is challenging in itself, we are hoping to achieve positive impact on individual patients Opportunities Professional, competent and caring staff More co-ordinated care Patients will receive the right care by the right clinician “The workload constantly gets bigger and bigger. And we can adapt to that, if we keep up with innovative ideas.”

Thank you Questions