Parity of EsteemA primary care and CCG perspective

Dr Guy Pilkington

Holism

• Natural perspective for primary care– Generalists– Common primary care presentations– Bio psychosocial components

• Definition of health– WHO definition (1948)– Or The ability to adapt and self manage

• M Huber et al– BMJ 2011;343:d4163

A new commissioning landscape?• Payment by results (PBR) vs Block contracts

Hospital Based Care

Mental Health

Services

Community NHS Ser-vices e.g. District

Nursing etc.

Other Community

Services

Continuing Healthcare

GP Prescrib-ing Drugs

Costs

Primary Care Ser-vices e.g.

GP's, Den-tists,

Pharma-cists etc.

Public Health

NHS Fund-ing to

support Social Ser-

vices

£-

£50,000

£100,000

£150,000

£200,000

£250,000

Year on year comparison of NHS commissioning expenditure in Newcastle

2008/092009/102010/112011/122012/13

Category of Spend

Annu

al E

xpen

ditu

re (£

000)

Chronic disease model

• How do we apply models used in physical LTCs to LTCs of largely mental health dimensions?– Prevention– Case finding– Early detection / Early intervention– Supported self management– Self determination– Compassion and care at the end of life