The future of general practice, Robert Varnam

www.england.nhs.uk @robertvarnam

The future of general practice

Dr Robert VarnamHead of general practice development

[email protected]

@robertvarnam

King’s Lynn 9 June 2015


Does general practice have a future?


bit.ly/c2aGP

bit.ly/nhs5yfv

What are people working on?

How to promote, support and sustain improvements?

Locally led, nationally enabled.


Why change?

Scottish School of Primary Care

Health & wellbeing-promoting care

‘Right access’ Consistently high qualityHolistic, personalised, proactive, coordinated care

Better joined-up care for a population of registered people

bit.ly/nhs5yfv

‘Wider primary care, at scale’

Phone first.

Community diagnostics.

Practice based paramedics.

Pharmacy first.

Web consultations.

Primary care led urgent care centre.

Minor injury service.

Physio first

Direct specialist advice.

Condition management training.

Shared records.

Care coordination.

Hospital in-reach.

Care home ward rounds.

Virtual ward.

Primary care-employed specialists.

Social prescribing.

Travelling health pods.

Peer-led walking groups

Health coaching.

Befrienders.

Schools outreach.

Community development.


The status quo is unsustainable

There are new opportunities, to fulfil the promise of general practice


Funding Co-commissioning Increased funding Fairer funding

Care innovations Prime Minister’s

Challenge Fund innovations

Workforce Recruitment, retention,

returners Nursing, pharmacy Wellbeing workforce

Multispeciality Community Providers (MCPs) Primary and Acute Care Systems (PACS)

New organisational forms

Infrastructure Premises Digital primary care

New deal for primary care


Multispeciality Community Providers

GP practice

GP practice

GP practice

GP practice

GP practice

GP practice

GP practice

GP practice

Specialists Pharmacists

Community provider

SC providerVCS

VCS

VCS

MH TrustVCS

VCS

VCS


Primary and Acute Care Systems

Community provider

SC provider

VCSMH Trust

Acuteprovider

GP practice

GP practice

GP practice

GP practice

GP practice

GP practice

GP practice

GP practice


1. What kind of care?

• Holistic, comprehensive, cradle-to-grave family care• Health & wellbeing-promoting care• ‘Right access’ (time, place, person, care)

• Consistently high quality• Holistic, personalised, proactive, coordinated care


2. What kind of work?

• Segmented (one size does not fit all)

• Multiprofessional teamworking• bring new skills• work to the top of our skills

• Partnership with patients & community• Longer consultations with fewer patients• GP not always 1st port of call• Direct access diagnostics• ‘Pull-in’ specialist advice


3. What kind of practice?

Big

Personal

Competent

Yours



Big enough for:• meaningful accountability• resilience• collaboration • broader workforce

• minor illness nurses, pharmacist, MH practitioner, welfare rights, OT, physio, LTC nurses, HCA, PA

• pull-in power• economies of scale



Competent:• develop the workforce• look after the workforce• continually develop people• highly skilled business planning & operational

management• service improvement• clinical governance

• clinical care



Personal:• deliberately designed systems, teamwork & processes

to promote continuity


www.biomedcentral.com/1471-2296/11/61/



Personal:• deliberately designed systems, teamwork & processes

to promote continuity• proactive coordinated care• connecting patients with non-medical support• using tech to promote wellbeing, self-care and

management• known in the community



Yours:• well-designed• well-led• every GP matters• systems to ensure you flourish


eg Whitstable medical practice


eg GP Care federation, Bristol


bit.ly/GP4Ps

PurposePartnerships

ProactivityPossibility

The future of general practice, Robert Varnam

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