JanBea'ePrimaryCareDivision,Sco'shGovernment

October2016

@JanAHPO

ChiefHealthProfessionsOfficer

•  ArtsTherapists(Art;Drama;Music)

•  DieKKans•  OccupaKonalTherapists•  OrthopKsts•  OrthoKsts•  Paramedics•  Physiotherapists

•  Podiatrists•  ProstheKsts•  Radiographer–DiagnosKc

•  Radiographer–TherapeuKc

•  Speech&LanguageTherapists

•  HealthCareScienKsts

TheImportanceofPrimaryCareThefoundaKonoftheNHS:

Over90%ofinteracKonswithhealthcarestartandfinishinprimarycare.

Keytoaddressing:

§  InequaliKesinhealthandcare;§ Accesstohealth(ando\ensocial)care.

PrimaryCareStrategyThelongertermvisionforprimarycareisthatby2030primaryandcommunitycarewillbeattheheartofthehealthcaresystem,withhighlyskilledmul5-disciplinaryteamsdeliveringprimarycarewithinlocalityclusters,GPsinvolvedinstrategicplanning,andpaKentsbeingmoreinformedandempoweredthanever,abletodirectlyaccesstherightprofessionalcareattheright5me,andremainingatornearhomewhereverpossible

Whyweneedtochange•  theworldischanging

•  Demographics•  HealthandSocialCareintegraKon–thenewworld

•  keepingpeopleinthecommunityisrightthingtodo•  Stayingathomeorhomelyse'ngiswhatpeoplewant•  InvestmentinprimarycareiscosteffecKve

•  thestatusquoisnotsustainable•  Thesystemisundergrowingpressure•  AllprofessionsarekeentooperatetothetopoftheirprofessionalcapabiliKes•  HealthinequaliKesdemandcreaKveresponses•  OutofHoursreviewhasdemonstratedaclearwayforward

It’stheRightThingToDo

CreaKngtheCondiKons

§  ReliesonparKcipantsoperaKngtothetopoftheirlicence

§  ClearlydefinedrolesandexpectaKons;§  EnKretyofsystemworkingtocommonpurposethroughintegraKon

§  Removalofimpedimentstoteamworking§  Appropriateinfrastructure;premises,IT,educaKon

§  NodetrimenttopaKentsorprovidersofcare.

Everyoneseespartofamorecomplex

realityandtendstoassumethatwhattheyseeisthewholepicture.

TheGPastheExpertGeneralist

•  Complexcare;reacKveandproacKve•  ReacKve;supportforotherprofessionalsworkingtothe‘topoftheirlicence’

•  Pro-acKve;supportedtoidenKfyandtoworkwithotherstoaddresstheneedsofacohortof‘highgain’individuals

ExpectedBenefits

•  PaKents;moreKmeforcomplexneeds;quickeraccesstorightprofessional

•  AllpracKKoners;focusonqualityofcareforhighneedpaKents,greaterjobsaKsfacKon

•  Widersystem;bestuseofexpensiveresource;secondarybenefitsofhighqualityACPs,acutereferralandadmissionrates

PrimaryCareKeyAcKons•  GPcontracttoreduceavoidableworkload,promotecollabora/onandimprovecommunitybasedclinicalleadership;

•  NewmodelsofcareincludingmentalhealthandarenewedfocusonprevenKon;

•  Reviewofprimarycareoutofhoursandurgentcareservices,includingtheroleofNHS24andSAS

•  Developmentofaprimarycareworkforceplan•  Developinginfrastructure

Themanifestocommitments!

•  BuildaCommunityHealthService.MulK-disciplinaryCommunityHubs

•  NewGPcontract.MoreGPs,moretrainingplaces•  Morenurses.Enhancedpharmacists•  ExtendedGPopeninghours•  OOHNaKonalDeliveryPlan•  1,000extraparamedics•  Freeeyetests•  Biggershareofthemoneyeveryyear

Our children have the best start in life and are ready to

succeed

We live longer, healthier

lives

Our people are able to maintain their

independence as they get older

Our public services are high quality, continually improving, efficient and

responsive

NATIONALOUTCOMES

Our vision is of primary and community care at the heart of the healthcare system. People who need care will be more informed and empowered,

will access the right professional at the right time and will remain at or near home wherever possible. Multidisciplinary teams will deliver care in communities and be involved in the strategic planning of our services.

PRIMARYCAREVISION

Wearemoreinformedand

empoweredwhenusingprimarycare

Ourprimarycareworkforceis

expandedandmoreintegrated

Ourprimarycareservices

beMercontributetoimprovingpopula5onhealth

Ourexperienceaspa5entsin

primarycareisenhanced

Ourprimarycareinfrastructure

–physicalanddigital–isimproved

Primaryandcommunitycare

beMeraddresseshealthinequali5es

PRIMARYCAREOUTCOMES

PeoplecanlookaOerownhealth

LiveathomeorhomelysePng

Posi5veExperienceofServices

Servicesimprovequalityoflife

Servicesmi5gateinequali5es

Carerssupportedtoimprovehealth

Peopleusingservicessafefromharm

EngagedWorkforceImprovingCare

EfficientResourceUse

IJBOUTCOMES

We start well We live well We age well

TRANSFORMINGPRIMARYCARE:HOW?

Workforce Infrastructure

NewModelsofCare Finance

2016–ConKnuingtheChange:PrimaryCareTransformaKonFund

‘aimstobuildtowardsafuturewhereprimarycareandmentalhealthsupportwithinprimarycareisdeliveredthroughmul/-disciplinary

teamswithgeneralprac//oners,otherhealthprofessionalsandsocialcarepartnersworkingacrossclustersofprac/ces,integratedinto

healthandsocialcarepartnerships.’

PrimaryCareTransformaKonFund:KeyPrinciples

•  AvisionforthefutureroleoftheGPwhichwillseethemfocusoncomplexcare;undifferenKatedpresentaKonandqualityandleadership;and

•  AmulK-disciplinaryapproachtopaKentcarewhichwillinvolvetherightmixofexperKseandservicesrequiredtoensurethatpaKentsareprovidedwiththemostappropriatetreatmentinthemostappropriatese'ng,whentheyneedit

Exampleofacluster

HSCPLocality

performan

ce

5menow 20202017

transi5on

“oldworld”

“newworld”

Transformingprimarycare

Fromaprescrip5vecontracttoanenablingcontract

TheAHPJourney

AHPNaKonalDeliveryPlan

ReadyToAct5ambiKons

•  ParKcipaKonandEngagement•  EarlyIntervenKon&PrevenKon•  Partnership&IntegraKon•  Access•  LeadershipforQualityImprovement

Prescribing

•  LegislaKoncameintoeffectinScotlandin2006toallowappropriatelytrainedpharmacistsandnursestoindependentlyprescribeanylicensedmedicine.

•  SimilarlegislaKonforPhysiotherapistsandPodiatristscameintoforcein2014

•  TherapeuKcRadiographerswillbeIndependentprescribersby2017

DirectReferral&PhysiotherapyIndependentPrescribing

Online Falls Information Zone

Living it Up platform

Falls Assistant App

Invigor8 Strength & Balance Classes

Positive Steps Education Sessions Third sector

Active Case Finding

Emergency Department

Fracture Liaison Service

Allied Health Profession Services

Optometry

Social Work Services

Motiv8 Strength & Balance Classes

Community Alarm/ Telecare Response & Referral Pathway

Scottish Ambulance Service Response & Referral Pathway

Integrated Care and Enablement Team (Falls Screeners)

Multifactorial Screening

Specialist Intervention

Integrated Care and Enablement Team (PT/OT/Nursing)

Osteoporosis Service (incl DXA)

Medical Clinics

South Ayrshire H&SCP Integrated Falls and Fragility

Fracture Pathway January 2016

Scottish Fire and Rescue

Local Enablers

Strategic Falls Lead and Community Falls Lead

Reshaping Care for Older People Change Fund

Detailed Local Implementation Plan

Multiagency Falls and Bone Health Steering Group

Learning Sessions, elearning, Care Homes Falls Educator

Data for monitoring and improvement

Technology Enabled Care (incl SmartCare)

What does the Up and About Pathway look like on the ground?

3rdSectorPartners

@JanAHPO