1. DCHS in Primary Care A Case Study Dr. Bola Owolabi, Clinical Director Kate Davis, Contract Manager

2. Creswell & Langwith Ex-Mining, high deprivation, relatively elderly population A legacy of 8 different providers over a 10 year period. Practice list size decline from c.10,000 to just over 5,000 ( over 10 year period). Poor patient satisfaction and low staff morale Lack of clear workforce structures/lines of accountability Crisis point January 2015 - contract collapsed

3. The Challenge DCHS took on Caretaker role with 1 working day notice (No previous history of General Practice Provision) Adapting DCHS Corporate culture to General Practice Difficult practice reputation exacerbating GP recruitment crisis (with attendant high locum costs within finite financial envelope). Seamless transition with little or no adverse impact on patient care.

4. The Opportunity Introduction of an innovative, multi-specialist workforce comprising GPs, ANPs, ECP, Practice Pharmacist, MSK Practitioner. Streamlined services: One-stop shop LTC clinics. “Back-office”/Business Support functions provided by DCHS existing structures. Opportunity for DCHS to develop Primary Care Expertise. More collaborative working with the PPG, CCG and neighbouring GP Practices. Introduction of portfolio career opportunities to Clinicians.

5. Enablers Strong positive DCHS reputation with very well established relationship with local GPs and CCGs. Early and ongoing engagement with the LMC and PPG. Utilisation of Trust governance framework in quality improvement. Pro-active staff engagement Presence of experienced GPs within DCHS Exec and Senior Team

6. Development Areas Currently engaged in tendering process to secure contract. Continue GP Recruitment drive. Establish/facilitate integrated working between Primary Care and Community Teams. Building relationships with CCGs to overcome mixed reactions. Delivery of innovative services within constrained financial envelope. Investment in standardised consultation template.

7. Next Steps Continuing to support Primary Care in moving integrated care forward e.g Erewash CCG Vanguard. The Offer of support/partnership working with General Practice, e.g. Imminent partnership with highly successful, training practice. Discussions ongoing with other well run, stable practices wishing to explore the opportunities of the MCP model of care delivery with DCHS.

8. Creswell and Langwith practice team Dr.Bola Owolabi - bola.owolabi@nhs.netbola.owolabi@nhs.net Kate Davis – kate.davis@nhs.netkate.davis@nhs.net www.dchs.nhs.uk