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Health and Social Care Reform in Greater Manchester Developing a commissioning strategy for Primary Care Rob Bellingham — Director of Commissioning (Greater Manchester) August 2013

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3. Primary Care Case for Change
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Primary Care Case for Change
Need to reduce unwarranted variation in outcomes and care pathways
Extending access to primary care
Ensure focus on self-management, wellness and prevention
Need to ensure integration with other services and organisations
Significant workforce issues; capacity of current workforce, training now and future, work life balance
Potential for increased efficiency

4. Key themes from a patient’s perspective:
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Key themes from a patient’s perspective:

5. Long Term Condition Management
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Long Term Condition Management
Early detection leading to improved outcomes via systematic approach to prevention strategies
Effective use of practice list based registers with development and implementation of transparent benchmarking of best care indicators
Development of clear care pathways and protocols for promoting self management and empowerment
Work alongside Integrated Care Teams to facilitate and promote continuity of care and care co-ordination, including crisis planning for those with multi morbidity and complex needs

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Involvement in care
Facilitate patient access to their health and social care records to encourage health literacy and shared decision making
Support a culture which fosters social responsibility and encourages patients to take responsibility for their health and well being
Support the development of skills and capacity in primary care to support patient choice in end of life care

7. Specialist Primary Care Services
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Specialist Primary Care Services
Develop specialist skills and services within community settings by;
Encourage sharing of skills between practices and collaborative working
Encourage the delivery of traditional hospital specialist services within community settings by integrated working with primary care teams
Ensuring appropriate diagnostic support to enable care closer to home

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Access
Develop an extended model of primary care which improves patient access with aligned levers/incentives to ensure delivery
Encourage development of innovative approaches to access ; Skype/ etc with development of the non medical workforce to support this
Ensure improved access balanced with continuity, particularly in relation to patients with complex needs
GP as co-ordinator of care

9. Enablers – NHS England AT GM
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Enablers – NHS England AT GM
Coherent workforce plan within defined financial envelope to address any skills and capacity shortage
Commission appropriate development and training packages to meet the workforce plan
Estates strategy and implementation plan
I.T.; work with existing clinically led I.T strategy and operational groups to resource and deliver required infrastructure improvements
Financial levers and incentives aligned across the system

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Next Steps
Demonstrator community process – 18 bids received. 6 moving forward in initial phase.
Primary Care Commissioning Strategy in advanced stage of development
Programme of stakeholder and public engagement
Continued development of implementation plans – in conjunction with Integrated Care & Healthier Together programmes
Task & Finish groups (for implementation)
Formal launch of strategy via 2nd Primary Care Summit Weds 25th September 2013

11. Opportunity for Discussion
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Opportunity for Discussion