The National Primary Care Research and Development Centre Primary Care Trusts: modernising the NHS? Diane Jones Research Fellow

The National Primary Care Research and Development Centre Overview  PCGs and PCTs in the new NHS  National Tracker Survey of PCGs & PCTs  Research findings  Conclusions

The National Primary Care Research and Development Centre Primary Care Groups and Trusts in the New NHS  One of the most radical reforms since 1948  Modernisation agenda reliant on PCTs  IfH reliant on PCTs

The National Primary Care Research and Development Centre Health Service Reforms Core Functions of PCG/Ts:  Improve health of the local population  Commission hospital & community based health services  Develop primary & community health services

The National Primary Care Research and Development Centre Primary Care Trusts approx. 200,000 population Primary Care Community Services Health Services Strategic Health Authorities approx. 1.5 million population Hospitals Funding

The National Primary Care Research and Development Centre Primary Care Trusts approx. 200,000 population Primary Care Community Services Health Services Strategic Health Authorities approx. 1.5 million population Hospitals Information Flows

The National Primary Care Research and Development Centre The National Tracker Survey of PCGs and PCTs in England  Longitudinal survey - 72 PCGs  Oct-Dec 1999, Oct-Dec 2000 Jan-Mar 2002  Describe/evaluate achievements and obstacles  Interviews - CEO, Chair, HA Lead  Postal questionnaires

The National Primary Care Research and Development Centre Modernising Primary Care  Improving access  Extending the range of services  Increasing the workforce capacity  Integrating primary and community services  Improving quality  Information and IT systems

The National Primary Care Research and Development Centre Initiatives to improve access

The National Primary Care Research and Development Centre Extending the range of services through sharing

The National Primary Care Research and Development Centre Enhancing workforce capacity

The National Primary Care Research and Development Centre Primary Care Electronic Patient Record Mental Health Services Electronic Patient Record Hospital based Electronic Patient Record Community Services Electronic Patient Record Social Care Records The Vision

The National Primary Care Research and Development Centre Modernising Information Systems  Are information systems meeting the needs of PCG/Ts?  Will the targets set out in Information for Health and NHS Plan be met?  Development of IM&T in general practice

The National Primary Care Research and Development Centre GP systems - current position  High level of computerisation  Accredited GP systems  Erratic development  Data quality questionable

The National Primary Care Research and Development Centre Research Questions  What are the information needs of PCGs and PCTs?  Do current information systems meet needs?  How can information systems be improved?

The National Primary Care Research and Development Centre IM&T in PCGs and PCTs  Postal questionnaire - IM&T Lead  Response rates Year 1 53 % (n=38) Year 2 72% (n=51)  Case Studies  Selected Findings

The National Primary Care Research and Development Centre % of PCG/Ts where information systems meet needs well or very well

The National Primary Care Research and Development Centre PCG/T Information Systems  Poor/ very poor data from: Community Health systems (84%) GP systems (63%) Hospital based systems(63%)  Most had e-links to NHS Net & Internet  Few with e-links to practices & hospitals

The National Primary Care Research and Development Centre % of PCG/Ts reporting more than half of practices using selected links

The National Primary Care Research and Development Centre % of PCG/Ts reporting more than half of practices using information management tools

The National Primary Care Research and Development Centre Education and Training  24% had an E & T policy for IM&T  46% aimed to by April 01  23% of PCG/Ts signed up to PRIMIS  26% had plans to sign up to PRIMIS

The National Primary Care Research and Development Centre % of PCG/Ts confident of meeting national targets

The National Primary Care Research and Development Centre Obstacles to progress on IM&T targets  Inadequate levels of IM&T staff (71%)  Poor budget information  LIS does not reflect PCG/T needs  Funding diverted

The National Primary Care Research and Development Centre Obstacles to Progress - general (PCG/T Chief Officers)

The National Primary Care Research and Development Centre Conclusions PCG/Ts are:  taking action to improve access to primary care  extending the range of services by sharing resources between practices  working to increase capacity through extended professional roles

The National Primary Care Research and Development Centre Conclusions  Development of primary and community services - high priority for PCG/Ts  PCG/Ts are making an important contribution to NHS modernisation  Inadequate management capacity and resources are seen as major obstacles to further progress  Continuing tension between central control and local autonomy

The National Primary Care Research and Development Centre Conclusions  Information to support core functions is inadequate  Ability to meet national targets is doubtful  Practice systems - key source of data  GP systems advanced but data quality inadequate  Use of information tools in general practice very low  Essential to improve data quality  Substantial investment required

The National Primary Care Research and Development Centre The Third Tracker Survey  Third survey underway  Findings published in Autumn 2002 