Our plans for

co-commissioning primary care in South WorcestershireWednesday 21 January 2015

Agenda• Welcome and introductions• Housekeeping • Setting the scene: challenges and opportunities• Background to primary care commissioning• How could primary care look in the future?• Getting involved and next steps• Q&As

Housekeeping

Challenges

1. Increasing number of people2. Increasing number of over 75s3. Increasing number of people with multiple long term

conditions4. Patient expectations5. Static funding6. Work force planning and recruitment7. Fragmented care8. Fragmented commissioning

Setting the scene

Opportunities

1. Awareness of the challenges!2. Greater integration – commissioning of primary

care3. Greater integration – providing4. New models of primary care5. Five Year Forward View

Setting the scene

Commissioning primary care

• GP services previously commissioned by NHS Worcestershire• Long history of collaborative and innovation in Worcestershire• 2012 – NHS Reorganisation - NHS England manages GP

contracts• CCGs joint statutory responsibility to improve quality of

primary care• Proposed options

o Greater involvemento Joint commissioningo Co-commissioning and delegation

• South Worcestershire CCG proposal

Co-commissioningAim:

‘‘To harness the energy of CCGs and clinical commissioners to create a joined up, clinically-led commissioning system which delivers seamless, integrated out-of-hospital services based around the needs of local populations.’’

Why do we want to do this?

• Deliver the best outcomes for people in South Worcestershire through integrated commissioning

• Sustainable primary care – at scale• Promote innovation• Alignment of contracts and incentives• Better decisions about how primary care resources are deployed

• Greater consistency between outcome measures and incentives used in primary care services and wider out-of-hospital services

• A more collaborative approach to designing local solutions for workforce, premises and IM&T challenges

Conflicts of interest• Need for transparency in decision making• Primary Care Committee will not have local GP

members and chaired by Lay Representative • Involvement of HealthWatch, Health & Wellbeing Board • Will meet quarterly in public • Maintain register of interests• Public register of procurement decisions

and actual conflicts of interest• Registers included within CCG annual report• Publication of GP earnings

So how might this look?

• Nuffield Trust: ‘Is General Practice in Crisis?’• Different types of appointments• Rapid access to appointments• Use of Skype and other forms of

communication• Continuity of care for people with long term

conditions (LTCs)• Co-production – ‘we are patient advocates’

Involvement & co-production

• Communication and engagement plan developed to:o communicate changes to wider public o seek feedback from patients on what improvements

they would like to see made to primary care• Public events being held to communicate these changes• Workshops over coming months to look at detail• Creation of Co-commissioning Patient and Stakeholder

Group to co-produce service specification• To register your involvement please contact Helen Perry-

Smith at helen.perry-smith@worcestershire.nhs.uk

Next steps• Application for co-commissioning

submitted on 5 January• Expecting to learn whether application

successful in February/March 2015• Consider feedback and use this to

shape commissioning plans for 2015/16 and 2016/17

Any questions?

Do we need to change primary care?

What do you think of proposals?

Do you want to help shape this?

Do you understand our proposals?