1. Working with GPs Chris Drinkwater Chair, Ways to Wellness

2. Re-balancing the bio-medical & the social: Looking in both directions Hospital CCGs Individuals & Communities DTCs Polyclinics Wellbeing Services Medical model (QoF/health checks)Social model Evidence Individual responsibility & behaviour change Patient centeredness £££ Unsustainable Demand Physical Capital Social DTC – Diagnostic & Treatment Centre

3. Long term Conditions Compared to social class I, people in social class V have 60 percent higher prevalence of LTCs and 60 percent higher severity of conditions LTCs account for much of the gap in healthy life expectancy between the best and the worst LTCs 70% of NHS costs, 55% of GP appointments.

4. Determinants of Health and Their Contribution to Premature Death. Adapted from McGinnis et al. NEJM 2007

5. Pathways between medical and social models of health https://www.diabetes.org.uk/upload/Professionals/Year%20of%20Care/thanks-for-the-petunias.pdf

6. NHS Vanguards Integrated primary and acute care systems(9) Multi-speciality community providers(14) Enhanced health in care homes(6) Urgent and emergency care(8) Acute care collaborations(13) Stop press. 2016/17 cuts to funding, only acute care will receive increased investment and double it’s funding!!

7. Pressures on general practice Kings Fund & NHSE 2016 2010/11 to 2014/15 Consultations increased by 15% Workforce grew by 4.75% Funding for primary care as a share of NHS budget fell from 8.3% to 7.9% General practice forward view – “social prescribing one of ten high impact actions to release capacity” https://www.england.nhs.uk/wp-content/uploads/2016/04/gpfv.pdf

8. New models of care GP as commissioner or provider. Move to large super practices eg. Whitstable 16 practices 170,000, Modality Birmingham 100,000. Primary care home model – integrated health, social care and voluntary sector. Personalised approach covering population of 30, 000 to 50,00.

10. Engaging GPs Take a community development approach Who/what is most likely to influence GPs - peers - patients - stories - feedback loops