Dr Fuller reminds us that our biggest challenge is creating the conditions by which local change can happen and singles out PCN leadership and representation at every level within the system as being crucial to the success of integrated primary care.
“Support, enablement, and respect have been among the most common themes throughout this stocktake…we have to ensure that we lead in an inclusive, compassionate and respectful way: setting the right tone will accelerate and embed the kind of change we all want to see delivered.” Next Steps for Integrating Primary Care: The Fuller Stocktake Report May 2022
One of the take-aways for us is that there are examples of great practice across the country. The golden thread running through the report is that we need to enable the creation of the right environment to enable what is working somewhere to work everywhere.
To do this, the report emphasises, there is a pressing need to create stability in General Practice and the need for system-wide approaches to workforce, data and estates to improve capacity and capability.
The concept of integration is metaphorically bold and underlined throughout the report. With the commitment of all the ICS Chief Executives to the Fuller Report, the role of the systems in supporting the integration of primary care is clear.
We know that what primary care does defines the demand in the system. Primary Care Networks need to be empowered and enabled within the system to be part of the solution. This could be through evolution into integrated teams working collaboratively with colleagues from across the system to address the challenges of urgent / on the day care; or the emergence of teams to wrap care around those most vulnerable within our communities for whom personalised approaches and continuity is key.
These integrated teams have a great opportunity to build on both the knowledge and expertise that exists in primary care and the success of initiatives identified across the country. A good example was in the vaccination approaches that saw services being delivered where people needed them.
The change to integrated care will require a shift from the narrative of ‘us and them’ to one of ‘us and us’ and the creation of teams of teams. There needs to be a spread of examples where working with communities has fundamentally changed, and where people and communities are involved with designing and delivering care that works for them.
SCW has worked with primary care to support the development of leaders and the design and implementation of new approaches to workforce planning (as seen in the Fuller report). Read further below: