Primary care has been the foundation for healthcare since the inception of the NHS in 1948. We know that high-quality primary and community services are key to preventative, proactive management of people’s health, reducing the need for acute and bed-based care and addressing health inequalities.
However, the increasing number of patients with multiple and complex health needs, coupled with uncertainty around the future workforce, means we need to radically rethink the model of General Practice if we are to make it sustainable beyond the current decade.
In the GP Forward View in April, Dr Arvind Madan stated that the transformation of local care systems “will be built around patients, around the wider workforce, around the redesign of our workload and organisation of care and creating satisfying and rewarding careers for everyone working in general practice”.
We believe that the solution lies in three inter-related areas:
• Ensuring general practice remains resilient and sustainable
• Reconsidering our organisational forms: how we do things and at what scale
• Implementing new integrated ways of working across the health economy.
We have been working in partnership with health systems – from individual practices through to evolving new models of care – to identify challenges and opportunities and implement solutions based around the three ideas above.
Organisational Design covers all aspects of an organisation from what the organisation looks like, to what it does and how it does it.
SCW has a dedicated primary care team located within our Transformation and Consultancy directorate. The focus of their work is supporting transformation of Primary and Integrated Care through strategy development and operationalisation at a CCG level and supporting General Practices to ensure their resilience. The team also supports NHS England with national work programmes, as well as several transactional services for NHS England sub-regional teams.
Our primary care team has recently supported groups of practices to form ‘at scale’ provider organisations, develop and implement resilience plans and explore cluster configurations.
SCW is a market leader in using clinical grouping and risk stratification algorithms. We have datasets and case-finding tools to support commissioning decisions, along with the expertise to offer a wider transformational perspective, incorporating consultancy and insight into what information is needed and how best to use it to shape STP plans and new organisational forms.
Workforce planning, population segmentation, training, recruitment and HR services all support our customers to implement new ways of working.
Intelligence is data put into context. There is a huge amount of data available around healthcare and patients; however it is the ability to put the data into context that makes it valuable intelligence.
We are supporting NHS England and Health Education England (HEE) to evaluate the impact of new models of care and integrated working at a national and regional level.
SCW’s population analytics solution applies our analytics capability to the outputs from risk stratification systems to review integrated datasets across health and social care sectors. This provides customers with an holistic view of healthcare utilisation.
Our team of primary care experts are currently working with practices across the south to explore the challenges facing the practices and identifying opportunities for increased resilience. Our approach is based on challenging discussions about intelligence gathered about the practice, leading to the production of practice-prioritised options. These options cover the core elements in the GPFV: investment, infrastructure, workload, workforce and care design.
Pathway Redesign includes the requirement to consider improvements in process pathways as well as care pathways.
We deliver clinical intelligence and work with customers to set-up and manage integrated projects to deliver the best outcomes for their populations within their cost constraints. We can do this through approaches such as the segmentation of the population and understanding the needs of these different groups, automated data extraction, and the development of data sharing agreements.
As the prevention agenda grows, the need to include data from self-care will increase. With a market-leading capability in population analysis and the ability to integrate data from a variety of sources and technologies, including wearable technologies and apps, SCW is able to deploy resources to support the increase in capability that will be needed.
As practices merge, federate, or start to work more collaboratively, the need to review administrative and process pathways presents real opportunities to increase patient satisfaction and release GP capacity. With a background in practice management, we are able to work with teams to identify system faults and develop streamlined solutions, including the engagement of new ways of working such as improved clinical coding processes, signposting and first point of contact Allied Health Professionals (AHPs).
System Transformation Plans across the country indicate a desire to move appropriate activity from an acute to an out-of-hospital setting. This shift of activity requires changes in contracting mechanisms. We have expertise in contract management at all levels and currently manage 21 enhanced service contracts across around 200 practices.
To find out more about our Primary Care solutions, contact Alison Westmacott, Director leading our work primary and integrated care.