David Colin-Thomé National Clinical Director for Primary Care GP, Castlefields, Runcorn Honorary Visiting Professor, CPPM, Manchester University Honorary Visiting Professor, School of Health, University of Durham

Benefits of a first contact in primary care. (Starfield) Higher patient satisfaction with health services Lower overall HS expenditure Better population health indicators Fewer drugs prescribed per head of population The higher the number of family physicians the lower the hospitalisation rate.

Responsive Based on needs of informed patients Quality based care in least invasive ways Multi-disciplinary teams Operating across organisational boundaries Vision for Primary Care Fast, convenient access Extended range of services Consistently high quality services Delivered locally Modernised premises Appropriately trained and motivated staff Integrated IT

Commissioning Primary Care nGMS nPMS QOF ‘Liberating the talents’ Agenda for Change nCommunity Pharmacy (LPS, PDS) Community Dentistry ‘Options for Change’ Secondary to Primary care-PwSI, PBR LTC- NSFs, QOF, EPP, Community Matrons...and Practice based commissioning

PSA Targets I.Access to treatment II.Improving the patient experience III.Long term conditions management IV.Health of the population

Infrastructure Health and social system environment Decision support tools and clinical information system (NPfIT) Community Resources Delivery System Disease Management Case Management Better outcomes Prepared and proactive health and social care teams Empowered and informed patients Supported Self care Promoting Better Health Supporting Creating The NHS and Social Care Long Term Conditions Model

Vehicles for System Improvement LTCM Unscheduled Care (OOH, medical emergencies,A&E waits)…. Clinically led commissioning

General Practice First Contact Where Patient Chooses Continuity of Care for Episodic Illness Chronic Disease Management Final Repository (“Their Doctor”)