Helen parker and naresh rati the vitality partnership
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Transcript of Helen parker and naresh rati the vitality partnership
A Model for Innovative
General Practice ‘Super Partnerships’
Dr Naresh Rati Helen Parker
Concept and Formation
Key Features
• Medically-led Integrated Care Organisation • Large, single entity, GP provider • Integration of GMS/PMS with community and specialist
services • Registered list of 80k plus • Geographically coherent • Multi - site delivery • 5 year Strategic Business Plan • Population Health Planning • Hub for research, training and education
Formation • Motivated local GPs with a vision • Procuring additional capacity and skill set • New partnership agreement and partner status options • Mergers and consolidation • Organisational development +++ - Defined GP leadership and management roles - New governance structures - Centralisation agenda • Clinical and financial decision making absolutely aligned • Brand creation • Evolution, not revolution - but with some pace
Drivers
• Commissioning weak, innovation slow
• GPs history of primary care provider innovation
• Fragmented inner city general practices with quality variation
• Barriers to shifting care into community settings
• Larger scale investments in infrastructure and staff needed
• Patient demand outgrown small practice model
• Financial security
Levers • Motivated and committed GPs
• GP + business development skill dynamic
• In house specialist skills and positive
relationships with local consultants
• Local GP demographics
• Local strategic plan to downsize acute trust
• Strong commissioning influence
Delivering the Business Plan
Vitality: Vital Statistics
List size: 2009 26k 2010 32k 2011 38k 2012 51k
(LCG 125k, CCG, 550k)
• 7 mergers • 14 equity partners (11 wte) + 1 fixed share partner + 2 associate partners • PMS/GMS contracts • 150+ staff • 9 NHS specialist services • 2 private services • 7 primary care sites (plus
university site) • Integrated IT: EMIS Web
across all sites
Service Portfolio Current • Rheumatology • Dermatology • Gynaecology • Orthopaedics • Immunology • X-ray • Substance Misuse • Intermediate Care • Extended Minor Surgery
Pilots • Urology • ENT • Community
Physiotherapy • A&E diversion
Planning • Health and Well Being • Paediatric Assessment • Community Nursing • Pharmacy • Dentistry
2005/6
National SHA Provider Selected PCT Practice Group
Axis Split
2010/11
National SHA Provider Selected PCT Practice Group
Axis Split
Impact on Demand Management: Dermatology
Getting the Foundations Right
• The Super Partnership structure
• New Partnership Agreement
• Corporate governance structure within to operate
• Communication ++
• Lead management roles for partners
• Procuring additional skill set
• Pace of patient and service growth
• Centralisation agenda for efficiencies
Challenges • Impact of CCG development and contracting void
• Degree of influence in CCG and conflicts of interest
• Acute Trust threat
• Local GP politics
• Patient choice
• GP contract changes – maintaining momentum
• IT and informatics to support business planning
Impact • Improvement in quality of primary care and demand
management
• Increased patient satisfaction with practice based services
• Significant local influence
• Less dependence on core contract and increased turnover
• Creating infrastructure for viable alternative to hospital care
• Increased efficiency due to centralisation
• Transforming general practice as a career option– clinical and non-clinical staff
Sustainability
• On a journey from single practice to ICO to…. ACO
• Expand research and education activity
• New models of patient engagement
• Contracting model and shared risk important - Prime contractor, AQP, Programme budgets
• Potential to re-engineer health system accountability and commissioning model
• Future policy framework critical to success
• Impact of new GP contract – potential facilitator
Moving forward….