1. General Practice Forward View & the STP
The CCGs’ Views,
General Practice Forward View & the STP
Simon Trickett
Lynda Dando
&
Interim Chief Officer Redditch & Bromsgrove CCG
Director of
Primary Care

2. The STP & the CCG perspective

3. The STP – Sustainability and Transformation Plan

4. What does it say? Implement acute reconfiguration
Develop new model of community/primary care/social care – the MCP model
Cross county collaboration on some other acute services which are fragile, eg stroke, cancer etc

5. The STP – the money £1.168 billion in 16/17 £1.327 billion in 2021
Allocative approach working through spend on programme areas
5 year journey
Resource shift requires move away from PbR contracts to “allocated” population based capitated budgets
Plan for use of ‘STF’ money - £50 million in 2021, £20 million for transformation

6. Putting that into practice 2017/18
Use emerging Alliance Board structures
Develop notional/devolved budget – CCG level initially, some ideas:
WHCT community services, some WHCT mental health, some non-GMS primary care, prescribing, premises, some social care
Link to contracting round with Worcs Acute – activity plan outpatients, admissions and diagnostics
Align CCG and WHCT management resources and capacity
Voluntary participation

7. 4 priorities for Alliance Boards
Improving access to care – new ways of dealing with same day demand that release GP capacity
Integrating primary care, social care and community teams – focus on most vulnerable patients
Integrate specialist support – reduce steps in the pathway and time taken to access specialist support
Promote prevention and self management

8. Implementing the General Practice Forward View: Local Delivery Plan

9. The GPFV published on 21 April 2016 sets out investment and commitments to strengthen general practice in the short term & support sustainable transformation of primary care for the future. Many of the actions in the GPFV are for NHS England, HEE & CQC to take forward. What Annex 6 of focusses upon are the actions CCGs need to implement more local aspects. Shared annex 6 with practices via Weekly Briefing

10. Local Delivery Plan By 23 December:
How access to general practice will be improved
How funds for Practice Transformational Support (as per GPFV) will be created and deployed
How ring-fenced funding to support training of care navigators & medical assistants & stimulate online consultations will be deployed
Implementation of Time for Care\10 High Impact Changes
Primary Care Commissioning Committee sign off : 7 December 2016
Minim
Support to strengthen and redesign general practice, including delivering extended access in primary care
one off Sustainability and Transformation package of non-recurrent investments
Supporting the increased use of technology backed by both increases in recurrent funding for GP IT, and investment to support the take up of online consultation systems in every practice
Training for Care Navigators & Medical Assistants
um requirements

11. Improving Access to general practice
Additional recurrent funding
17/18
South Worcestershire £6 per head (weighted) % coverage
18/19
Redditch & Bromsgrove & Wyre Forest £3.34 per head
19/20
All CCG’s £6 per head
everyone has access to GP services, including sufficient routine and same day appointments at evenings and weekends to meet locally determined demand, alongside effective access to other primary care and general practice services such as urgent care services.
Need to test the market MCP framework talks about clinical contact centres – integration OOH & 111
Learn from the work in south worcestershire

12. Online general practice consultation software systems
3 year funding starting 17\18 (17p per patient)
National specification awaited
Primary Care IT Operational Group
17/18
18/19
Redditch & Bromsgrove
£45,320
£60,251
South Worcestershire
£78,286
£104,087
Wyre Forest
£29,546
£39,189

13. Training Care Navigators & Medical Assistants
5 year ring-fenced funding (9p per patient)
16\17:
Local Programme in South Worcestershire
“I am writing to let you know that we have had a fantastic response following the Care Navigator event I was present at in Droitwich.
Several Care Navigators have been in touch with my team and are visiting our Dementia Cafes. This really is a brilliant step forward for GP Surgeries to be so engaged in the services we have to offer people living with dementia so many thanks”
“currently looking after a pt who is a carer, not coping at home. Have 2 appts to discuss next steps and uptake offer of support through Worcestershire Association of Carers”
Wakefield on-line programme November
Redditch & Bromsgrove
£15,152
South Worcestershire
£26,173
Wyre Forest
£9,902

14. Transformation Support

15. Transformation Support 2017\18 & 18\19 via CCG allocations (core services)
Funding can take place over 1 or 2 years
£3 per head as one off non-recurrent investment to commence in 2017\18 for practice transformational support as described in the GPFV:
Stimulate development of at scale providers for extended access delivery
Stimulate implementation of the 10 high impact changes in order to free up gp time to care
Secure sustainability of general practice to improve in-hours access
CCGs who have already been involved in provider development are finding that three things are most effective: creating space for practices to meet and plan together, through funding backfill; providing expert facilitation to make rapid progress on reviewing options and creating improvement plans; and focusing development on improving care and ways of working before addressing questions of organisational form. CCGs are encouraged
Redditch & Bromsgrove CCG
£525,000
South Worcestershire CCG
£909,000
Wyre Forest CCG
£336,000

16. Principles
Different starting points across the County but same end point:
Sustainable general practice – a strengthened version
Practice readiness for extended hours additional funding 18\19
Readiness – MCP contract
Principal purpose of Transformation Fund is to pump-prime new ways of working\care models & innovation – not emergency support
Investment to be targeted where it can have most impact
Build on local and wider learning

18. Deployment of Transformation Funding
Devolve to:
Practice clusters\neighbourhoods
Federations
Alliance Boards
‘Making Time’ analysis to shape and inform deployment
Options include:
Pump-prime locality hubs, clinical contact centre
Primary Care Academy
Build capability in general practice teams:
Clinical leadership & development
Change management & lean techniques
Practice Manager & nurse mentorship scheme
IT standardisation & template building
Technology solutions
Making mergers easier

19. 10 High Impact Areas Implementation
Primary care, Transformation & Locality team aligned to practices
Development of a cadre of system leaders- practice managers, clinical leads, IT super users

20. Actions Practices complete the Make Time Audit CCGs find the money
Establish county-wide GP Forward View implementation group
Transformational support agreed
December
Submit plan - intent
January – March
Detail
April onwards
Implementation

21. Questions & Answers