Presentation to the Empowered Committee, Prime Minister’s ...
7 day working and the Prime Minister’s Challenge Fund
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Transcript of 7 day working and the Prime Minister’s Challenge Fund
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7 day working and the Prime Minister’s Challenge Fund
• Aim : To consider the localisation of the 7 day national directive, but in the context of a workable, sustainable solution for Gloucestershire that takes consideration of the pressures felt in Primary Care
• Format : • Overview presentation • Discussion on key areas• Feedback and summarise
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Pressures on Primary Care
Primary Care
Constrained funding growth
Workforce pressures
Rising Patient Consultations
Rising prevalence of
chronic disease
History of Estates and IT
under-development
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• Primary Care funding c.£9.3bn in 2013/14, c.8.4% of total NHS budget
• Trend of reducing general practice funding since 2004/05, which is currently forecast to continue (Deloitte 04/2014)
Pressures on Primary CareConstrained
funding growth
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• Workforce growth from 1995 to 2011 (Centre for Workforce Intelligence (CfWI), 2013) demonstrates challenge :
• Consultants : c.100% growth• GPs : c.29% growth
• 22% of WTE Gloucestershire GPs are over 55
• We have a further 21% between 50-54 (17% nationally) with 8% under 35 (13% nationally)
Pressures on Primary Care
Workforce pressures
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Increase in consultation rates by age demonstrates increasing consultations for elderly patients:
Pressures on Primary Care
Rising Patient Consultations
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• Longer average consultations, more consultations and more complexity than decade ago (CfWI, 2013)
• Number of people with multiple morbidity estimated to grow from c.1.9m in 2008 to c.2.9m by 2018 (Salisbury et al. 2011)
• 20% of Gloucestershire’s registered population are aged 65 and over, compared to 17% nationally
Pressures on Primary CareRising Patient
Consultations
Rising prevalence of chronic disease
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• We want to ensure patients receive care in safe, accessible, suitable premises
• Investment in primary care estate lagged behind secondary care capital spend (NHSE, 03/2014)
• General practice often still in inadequate buildings, offering limited facilities, with little (if any) ability to expand to offer more services
Pressures on Primary CareHistory of
Estates and IT under-
development
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• Reduced funding year-on-year
• Workforce challenges, specifically relating to our GP workforce age ranges
• Increased demand from an ageing population
with increased multiple morbidities
• Premises and IT issues
• Current structures inhibit effective change
Summary of the Challenges
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• Aim of Fund :– test new models of care – deliver 7 day services
• 20 pilots selected nationally• Opportunity to use £300k for 14/15• Potential for significant investment next year
Prime Minister’s Challenge Fund
GCCG view : change shouldn’t be for change’s sake – must be sustainable
and workable
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By commonality between schemes:• All successful bids included 7 day working,
predominantly via federation
• Online functionality (booking, appointments)
• More patient services within federations
• Single telephone line to Primary Care
• Care Navigators / co-ordinators
Key Themes of Successful Bids
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• Seven day Primary Care - what model(s) could work in Gloucestershire?
• Models for discussion (5 minutes each):– Federated (5/6 practices collaborating to deliver)– Flexibly using extended hours DES– Locality delivery model– Urgent Care Centres (combining MIU; MIIU;
GHAC); exploring ‘hot’ and ‘cold’– Any other ideas
Discussion
>
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• Key points identified
• Next steps will be communicated to localities
• Any questions to raise with panel at 15.55?
Feedback
Thank-you for your contribution