1. GP Federations – Personal Observations 21st January 2016

2. STW Provider Services Ltd
Dr Russell Muirhead GP 1989 Chairman ‘Shropdoc’ 2001 Director Your Practice Plus Federation Non-Exec STW Provider Federation 2013
Not an Expert
YP+
STW Provider Services Ltd

3. Why Federate?
SCALE!

4. Has the scale now been determined?
Why Federate? SCALE
Scale to design
Scale to deliver
Scale to influence
Scale to negotiate
Scale to build relationships
Scale to save
Scale to support
Scale to risk share
Has the scale now been determined?

5. STW Provider Services Ltd
YP+
STW Provider Services Ltd
‘The Engine Room’
YP+

6. Shropshire Doctors Cooperative;
Formed 1996 – 290 GP members – 250 staff - £12m turnover
No longer an OOH Co-op – now 24/7 urgent care and beyond
STW Provider Federation
61 Practices – 500,000 population – turnover <£20,000
Lifestyle services contract – PMCF partner – CEPN lead
YPP Federation
12 out of 29 practices across 2 CCGs
We didn’t get it right -> Dissolved!

7. The RCGP Principles Clear communication. Overall leader.
Getting together
Which Practices?
Demonstrate credibility.
Clear communication.
Leadership
Overall leader.
Board of Directors.
Building a common purpose
Clear vision.
Commitment to that vision.
Getting external support
Identify and engage key stakeholders.
Key stakeholders understand the vision.
Developing the organisation
Agree an organisational model.
Develop a governance model.
Develop a financial model.
Internal governance
Documented approach.
Agreed decision making process.
Formal agreement in place.
Conflicts of interest
Documented approach to how conflicts of interest will be addressed.
Developing our staff
Who do we have?
What do we need?
Legal Indemnity & Providing services
Register with CQC
Be an Any Qualified Provider NEW MODELS OF CARE

9. Workforce Development
Recruitment, training and employment of;
Post MRCGP registrars – 1/2 year contracts with additional education in Urgent +/- Elder care
ST 0&4 doctors with educational component via University/HEE
Advanced Nurse Practitioners/Physician Associate/Advanced Paramedics
Primary Care Physiotherapists – direct and GP referral
Advanced Pharmacist training
Additional roles & training for existing GPs and clinical staff

10. Opportunities? Specialist services; room rental income, very few GPwSI
Shared care pathways – unsuccessful
AQP contracts – limited
CCG support – variable
Joint Ventures – caution!
Back office support – not happened yet
Virtual reception – growing

11. Opportunities? Primary Care
“Its our bread and butter and we do it well”
Play to your strengths - Stop chasing services which give a small return
BUT do it at scale
‘New Models of Care’
‘Primary Care Home’
Requires culture change – how/who provides services

12. Achievements to date? Primary Care
Lifestyle Services contract – activity not outcome payment
Buying Consortium – now nationwide >2,000 practices et al
Telephone network -> Virtual Reception
Community Education Provider Network £50,000 pa
PMCF £4.2m; Workforce development
IT and information systems
Services – AVS, Extended Access, Direct Physio
DEMENTIA & FRAILTY

13. Health Education West Midlands
West Midlands Deanery/General Practice
Stafford & Surrounds CCG, Telford & Wrekin CCG, Shropshire County CCG
Badger Group (Urgent Care Cooperative)
Universities of Keele, Birmingham, Wolverhampton & Worcester
EMIS & Endeavour Health Charitable Trust
LETC
British Geriatric Society
St Giles Hospice
Palliative Care Solutions

14. Closing thoughts You need resources – and not just money
Get your Vision right -> buy-in and cohesion -> ownership
Sell the Vision – internally and externally
Chase the big honey pots;
New Models of Care – Primary Care Home (National Contract?)
Education & Training
PH/Local Authority

16. Contact details
Mob: