The increasing number of patients with multiple and complex health needs, coupled with uncertainty around the future workforce requires a radical rethink of the model of General Practice to ensure it remains sustainable beyond the current decade.

The emergence of Integrated Care Systems (ICS) highlights the need for General Practice to take a lead in the establishment of new care systems and to be an integral part of the solution.

SCW's adaptable, expert primary care team provides the skills, knowledge and expertise to support you with the key considerations, explained below, to successfully deliver the outcomes you need:

Creating at scale solutions

The General Practice Forward View led to increasing numbers exploring new ways of working collaboratively across large clusters of 30,000 to 50,000 patients in ‘local care networks’, ‘primary care home’ and ‘GP hubs’ that brought together communities of GPs and other care professionals to deliver a unified health and care system for local neighbourhoods.  These developments have now been formalised with the introduction of Primary Care Networks ( PCN's) as part of the NHS Long Term Plan.

Integrated systems rely on relationships and cultures of collaboration. Success requires early agreement from all partners on:

  • the need for change,
  • the preferred vision for the future, and
  • new ways of working, workload, remuneration, staffing levels, skill mix, decision-making, and services.

We have worked with several groups of practices to support the local delivery of primary care at scale through the development of new organisational forms. We can help you to understand the scale of the challenge and to prioritise appropriate interventions and have developed an approach that aims to encourage practitioners to spend time together thinking about the benefits they hope to achieve, consider the key elements that need to be in place to achieve success and agree the plans that will need to be developed that will contribute to the successful establishment of the agreed way of working.

Primary care resilience and sustainability

General Practice is the foundation of our health service, but it’s changing rapidly, with practices closing and merging and GPs leaving. Therefore, practice sustainability and resilience is becoming ever more crucial. 

Practice leadership teams need to respond to the changing needs of local health and care systems. In doing so you will need to consider your current operating environment, develop a practice-level forward view and define an actionable plan to develop practice resilience. Understanding and planning for upcoming change now will avoid future vulnerability.

SCW's primary care experts can deliver a General Practice Resilience Programme that supports practice and system leaders to respond to the changing needs of local health and care systems helping to deliver value for money and sustainable change initiatives. 

Digital transformation and system integration

To progress towards system integration you will need to analyse, interpret and integrate information from across your system to enable you to map and redesign how services will be delivered. 

Shared care records and interoperability projects, where information is shared across record systems by CCGs, GPs, Acute providers and social care, will be vital to the success of developing new models and integrating care.

We can support you to understand how to make your systems work for you and to create integrated solutions for your populations. Working with General Practice both individually and at a system level we create communities ready to take on the needs for transformational change in the health and care service.

Creating highly effective multi-disciplinary teams

Communities who are making these changes work most effectively when they combine as multi-disciplinary teams where responsibilities and capabilities are shared, ensuring those receiving care access the most appropriate support.

Whether it’s the creation of daily huddles between care professionals in which the day’s activities are orchestrated, or the development of integrated care plans that enable everyone who has contact with individuals to understand their needs and care programme, our SCW team have the experience to help primary care services address the sustainability challenges they face.

Resilient communities

The Five Year Forward view is clear on the need to help people to manage their own health in order to stay well and to manage long term conditions. When people are empowered with information and tools to self-care, they will experience better care, better health and better value services.

Working with health and care organisations and the voluntary sector, we’ve been able to deploy a range of traditional and digital channels aimed at improving patient self-care, building resilient communities and enabling people to interact with healthcare services in a way that best suits their lifestyle and needs.

Operational support

Delivering transformation is challenging – especially when ‘Business As Usual’ functions continue to be required. Through SCWs shared service business model our customers can achieve economies of scale and access the innovation and best practice solutions we bring to improve services for the NHS. Our approach extends beyond delivering economies of scale but also embraces operational excellence and business efficiency in support of our customers' own agenda in delivering better patient care.

Case studies