Benefits of using NHS Choices in conjunction with GP consultations
GP premises, networks and new models of care · GP Premises •The players: –NHS England –NHS...
Transcript of GP premises, networks and new models of care · GP Premises •The players: –NHS England –NHS...
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GP premises, networks and new models of care
Dr Brian Balmer, GPC Executive Team, GPC Lead on Practice Finance
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GP Premises, Networks and New Models of Care
Dr Brian Balmer
GPC Executive Team
Chief Executive, Essex LMCs
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GP Premises
• The players:
– NHS England
– NHS Property Services
– Community Health Partnerships
– Department of Health
– GPC/BMA Law
– Royal Institute of Chartered Surveyors (RICS)
– Lawyers, surveyors, GPs, Trusts, managers, etc
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Current issues with GP Premises
• Do not hold your breath!
• Negotiations with NHS Property Services on a template lease
• Negotiations with NHS England on Premises Cost Directions
• Discussions with Community Health Partnerships re fair charges etc
• Primary Care Infrastructure Fund (£1 Billion?)
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The Billion Pound note!
• Announced in early 2015, £250 million capital each year for 4 years.
• Wonderful, perhaps not, as we initially dont need capital
• Could this capital be used to create a recurrent income stream. Yes, but no.
• Underspend this year ??
• Use of the fund for other schemes
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The good news
• There is an acceptance that we need to reach agreement
• There is investment in skills and people
• CCGs will have premises plans by December
• Practices have been able to plan ahead
• What future there is for GP ownership will depend on the GP workforce
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GPs working at scale
• There are 106 GP networks on the BMA Communities database.
• “Network” is a generic term for Practice owned companies, Federations, and “super-partnerships”
• The future for small practices which are not linked to colleagues as providers looks very uncertain
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Why form networks?
• Give GPs a stronger provider voice
• Protect income
• Acquire new work
• Mutual support
• Manage practices?
• Control workload?
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Challenges
• Competition or collaboration• Service provision within locality and/or outside• Domination by one group over another• Accountable Care Organisations• Merged budgets• Single provider or lead provider with sub-contracts• Time limited contracts• Impact of efficiency savings• Independent advocate or management control
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New Models of Care
• Vanguards
• Prime Minister’s Challenge Fund
• Transformation
• Transition
This is the NHS, not a disaster relief Fund.
• ACOs, ICO, etc etc
Merging several failures does not generally produce a success.
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New Models (2)
• Designed to improve financial efficiency
• Usually depend on moving services out of hospital
• Some look quite interesting
• These schemes have the ear of ministers etc and so attract a lot of talent
• Combining social and health care is an immense risk
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New Models (3)
• MCP or PACS?
New Organisation
GP
GPGP
GPGP
CCG
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Full integration
CCG
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The future, assuming there is one, will not be dull
Questions are welcome