1. Friday 4 th February 2011 Aberdeen Clinical Leadership / Primary care Re-Design Aberdeen City CHP Dr Malcolm J Valentine GP Project Manager

2. Clinical Leadership / Primary Care Re-Design – City CHP Friday 4 th February 2011, Aberdeen My brief CV: 1986GP Principal Brimmond Medical Group (Aberdeen) 1988Small Group Leader - Aberdeen VTS 1990Associate Adviser (CME) 1994GP Trainer 1997Associate Adviser (VTS) 2000GMC Revalidation Group 2001MD 2001Assistant Director Postgraduate GP Education 2003 Non-Executive Director NHS Education for Scotland 2008 GP and Independent Resource / CHP Project Manager Introduction

3. Clinical Leadership / Primary Care Re-Design – City CHP Friday 4 th February 2011, Aberdeen General Practice: Engagement Communication Consultation CHP Service development Partnership with independent contractors Responding to the evolving agenda Service Demography Partnerships eg Soc Work Service redesign Introduction – the issues

4. Clinical Leadership / Primary Care Re-Design – City CHP Friday 4 th February 2011, Aberdeen Demography Population – 2021 and all that GP workforce – 75% trained output now female; in 5 years likely 90% female The existing practice models will have to change to embrace risk Premises No systematic support for GP strategic development – but integrity of health service delivery already depends on it; need to INVEST Clinical – and high quality general leadership Introduction – the absolute imperatives

5. Clinical Leadership / Primary Care Re-Design – City CHP Friday 4 th February 2011, Aberdeen No locality clinical leadership to date Moderate effect of core clinical leadership Limited interest (to date) from Board and Executive leadership in facilitating GP strategic development Evidence of creative collaboration in past eg GP fundholding (but incentive then clear and immediate) So: 4 ‘cluster’ model (?Enthoven) Clinical leadership in each cluster Core CHP clinical leadership redefined Introduction – the City

6. Clinical Leadership / Primary Care Re-Design – City CHP Friday 4 th February 2011, Aberdeen Gary Newbigging role in re-design project Core Re-Design group City wide Re-Design meetings Programme of activity now underway Broad range of partnerships eg ACC Soc Work, Programme Managers Broad range of clinical links eg Psychogeriatrics, Elderly Medicine, Public Health etc resulting in joint activities eg workshops, task groups etc ‘Higher level’ effect on creating identity and engagement Introduction – the City (2)

7. Clinical Leadership / Primary Care Re-Design – City CHP Friday 4th February 2011, Aberdeen – Cluster Model North 7 Pract / 63 Docs / 66 300pt Cluster GP Lead Management support Central South 7 Pract / 45 Docs / 51 700pt Cluster GP Lead Management support Central North 8 Pract / 64 Docs / 65 200 pt Cluster GP Lead Management support South 8 Pract / 65 Docs / 60 200 pt Cluster GP Lead Management support Core CHP eg Pharmacy eg Public Health SW links Innovations lead Pathway development leadSystem development lead Shifting locus of care lead

8. Clinical Leadership / Primary Care Re-Design – City CHP Friday 4 th February 2011, Aberdeen Cluster model allows for horizontal integration and partnerships Core CHP role key critical for vertical and strategic integration and strong leadership Must re-specify the Core CHP leadership role. This must assume high quality, energetic GP leadership as a substantial component part. Aspirational Role. NHSG MUST invest in Leadership training / development and extend this deep into GP. Future service delivery depends on getting all of this right