Primary care in 2015 Primary care provides 90% of NHS contacts with only 9% of the budget Consultations in general practice increased by 75% between 1995 and 2009 There has been an increased clinical workload in general practice of over 40% since with evidence of; – Increasing disease prevalence and diagnosis – Patients living longer with disease Increasing patient expectations Increasing demand for GP appointments Increasing workforce pressures, such as ageing workforce, insufficient trainees to meet future need and demands on GP time

NHS England View of General Practice: 1.Proactive co-ordination of care, particularly for people with long term conditions and more complex health and care problems. 2.Holistic care: addressing people’s physical health needs, mental health needs and social care needs in the round. 3.Ensuring fast, responsive access to care and preventing avoidable emergency admissions and A&E attendances. 4.Promoting health and wellbeing, reducing inequalities and preventing ill- health and illness progression at individual and community level. 5.Personalising care by involving and supporting patients and carers more fully in managing their own health and care. 6.Ensuring consistently high quality and value of care: effectiveness, safety and patient experience.

National picture GP workload AGE LIFESTYLE COMPLEX CONDITIONS ADMINISTRATIVE PRESSURES

Practice size Practice SizeNational Cheshire, Warrington and Wirral Local Area Warrington Up to 20, ,000-30, ,000-60, , , ,

Our map to the future - overview (Visual representation of vision – not to scale – there will be 8 Primary Care Homes) Paediatric Acute Response Team(PART) Primary Care Home Delivery Team ‘Primary Care Home’ (Multi disciplinary team including community nursing/mental health/care coordinator/GP for nursing homes etc.) Clusters of Practices work collaboratively; other provider services refocused around the registered list Non bed-based acute services Intermediate Care Facility (bed bases) Hospital Services GP Practice (With Care Coordination)

Please note that the Town Centre Neighbourhood boundary is not shown on this map

Ten priorities Complex care including long term conditions and cancer rehab Medicines management & prescribing Workforce Whole System/Right Care – the role of primary care in effective utilisation of the whole system resource Access, demand and capacity Promoting prevention and self care Nursing and residential homes Mental health Public engagement and communications Primary care quality – the Warrington offer

Health Plus… Your usual GP Practice PLUS… -more focus on keeping healthy and taking care of yourself and your family -more care closer to home -health and well being services being more joined up -more coordinated care -improved access to services by GP Practices working together

Work in progress… More access Cluster working Integrated teams around local GP clusters New processes for care coordination New services for care homes New technologies