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Primary care networks - why and how (leaders' tips)

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Robert Varnam Coaching
Robert Varnam Coaching

Keynote talk at Best Practice 2018. Observations about the critical success factors for leaders wishing to unpack the potential of primary care networks to benefits patients and GP practices.

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@robertvarnam@robertvarnam • Dr Robert Varnam Clinical lead for primary care transformation • Sustainable Improvement Team @robertvarnam Primary Care Networks bit.ly/20181018birmingham Why? How?
@robertvarnam@robertvarnam Primary Care Networks bit.ly/20181018birmingham Why? How? Benefits for practices Benefits for patients Avoiding common pitfalls
@robertvarnam@robertvarnam Primary Care Networks bit.ly/20181018birmingham Why? How? Benefits for practices Benefits for patients Avoiding common pitfalls
@robertvarnam Continuity Accessible personal care built on a relationship from cradle to grave Community focussed Responsible for a registered population, improving wellbeing Holistic Dealing with the patient as a person not a disease or part of the body Comprehensive Handling wide range of problems, managing clinical uncertainty STRENGTHS OF PRIMARY CARE Central Coordinating and connecting other teams, referring where appropriate
@robertvarnam Continuity Community focussed Holistic Comprehensive STRENGTHS OF PRIMARY CARE Central Constraints on delivering the full potential: Demand >> workforce + funding Practices are set up to provide mostly medical care (reactive, individual > proactive, population focused) Hard to coordinate other inputs and ‘pull in’ specialist support Too small and isolated to have significant impact on population or system Primary care doesn’t need reinventing, but liberating to deliver its potential
@robertvarnam Specialists Community services 1948 CARE
@robertvarnam Self Care Broader skillmix Self management / social prescribing Emergency care Collaboration with specialists At scale FUTURE CARE
@robertvarnam@robertvarnam Primary Care Networks bit.ly/20181018birmingham Why? How? Benefits for practices Benefits for patients Avoiding common pitfalls
@robertvarnam@robertvarnam Primary Care Networks bit.ly/20181018birmingham Why? How? Benefits for practices Benefits for patients Avoiding common pitfalls
@robertvarnam Primary care networks: Opportunities for practices
@robertvarnam Primary care networks: Opportunities for practices
@robertvarnam  Staff pooling • nurses, reception & clerical staff, sessional GPs … internal ‘bank’  Overflow support • phone consultations • access hub (phone +/- face-to-face) • home visiting Primary care networks: Opportunities for practices
@robertvarnam  Purchasing • Indemnity bulk purchasing • Supplies & utilities  Shared functions • CQC registration • Accounting • Policies & procedures • Procurement • Correspondence management • IM&T (eg support & maintenance, intranet, web, social media)  Specialist functions • HR • Finance • Clinical governance • Business intelligence Primary care networks: Opportunities for practices
@robertvarnam  Planning • Workforce • Infrastructure development • Service reconfiguration • Public health  Provision • Acute care • Community pharmacy • Dentistry • Optometry • Social care • Housing • Welfare • Voluntary sector Primary care networks: Opportunities for practices
@robertvarnam  Traditional healthcare roles • Pharmacists • Specialist nurses • Physiotherapists • MH therapists • Paramedics  Wellbeing workers • Social workers • Care navigators • Health trainers & coaches • Welfare advisors Primary care networks: Opportunities for practices
@robertvarnam  Sharing ideas  Testing new ideas  QI expertise  Patient engagement  Analytics • Population health analytics • Priority setting • Benchmarking • Realtime measurement  Project management  Research participation Primary care networks: Opportunities for practices
@robertvarnam  Recruitment  HR  CPD  Career development • New options • In-house portfolio career • eg • Teaching • Leadership • Mentoring • Service improvement • Research Primary care networks: Opportunities for practices
@robertvarnam Benefits are not automatic Some mergers achieve little Some ‘alliances’ achieve much Primary care networks: Opportunities for practices
@robertvarnam@robertvarnam Primary Care Networks bit.ly/20181018birmingham Why? How? Benefits for practices Benefits for patients Avoiding common pitfalls
@robertvarnam@robertvarnam Primary Care Networks bit.ly/20181018birmingham Why? How? Benefits for practices Benefits for patients Avoiding common pitfalls
@robertvarnam What size should we be?  Personal focus  Clarity  Commitment  Agility  Population focus  Alignment  Priorities  Partnerships 20 100 Don’t accept either / or solutions
@robertvarnam System: 0.5-3m System partnerships for large scale change Workforce & infrastructure planning Major partnerships & shifts in priority Place: 100-900k Strategic partnerships Organisational development infrastructure Corporate support Career development Population wellbeing Neighbourhood: 30-60k Acute care Shared MDT Population management Business functions Team: 4-30k Place of belonging Doing the right thing at the right scale Microteam: 2-500 Personal continuity of care
@robertvarnam Building a successful primary care network… Purpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > form
@robertvarnam Building a successful primary care network… > ++ Purpose > function > form Connecting with values and focusing on a better future trumps money and fear
@robertvarnam Building a successful primary care network… Purpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > form Connecting with values and focusing on a better future trumps money and fear Build the culture through practical collaboration
@robertvarnam Building a successful primary care network… Build capabilities – clinical, improvement, business Purpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > form Connecting with values and focusing on a better future trumps money and fear Build the culture through practical collaboration bit.ly/20181018birmingham

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Primary care networks - why and how (leaders' tips)

  • 1. @robertvarnam@robertvarnam • Dr Robert Varnam Clinical lead for primary care transformation • Sustainable Improvement Team @robertvarnam Primary Care Networks bit.ly/20181018birmingham Why? How?
  • 2. @robertvarnam@robertvarnam Primary Care Networks bit.ly/20181018birmingham Why? How? Benefits for practices Benefits for patients Avoiding common pitfalls
  • 3. @robertvarnam@robertvarnam Primary Care Networks bit.ly/20181018birmingham Why? How? Benefits for practices Benefits for patients Avoiding common pitfalls
  • 4. @robertvarnam Continuity Accessible personal care built on a relationship from cradle to grave Community focussed Responsible for a registered population, improving wellbeing Holistic Dealing with the patient as a person not a disease or part of the body Comprehensive Handling wide range of problems, managing clinical uncertainty STRENGTHS OF PRIMARY CARE Central Coordinating and connecting other teams, referring where appropriate
  • 5. @robertvarnam Continuity Community focussed Holistic Comprehensive STRENGTHS OF PRIMARY CARE Central Constraints on delivering the full potential: Demand >> workforce + funding Practices are set up to provide mostly medical care (reactive, individual > proactive, population focused) Hard to coordinate other inputs and ‘pull in’ specialist support Too small and isolated to have significant impact on population or system Primary care doesn’t need reinventing, but liberating to deliver its potential
  • 8. @robertvarnam@robertvarnam Primary Care Networks bit.ly/20181018birmingham Why? How? Benefits for practices Benefits for patients Avoiding common pitfalls
  • 9. @robertvarnam@robertvarnam Primary Care Networks bit.ly/20181018birmingham Why? How? Benefits for practices Benefits for patients Avoiding common pitfalls
  • 10. @robertvarnam Primary care networks: Opportunities for practices
  • 11. @robertvarnam Primary care networks: Opportunities for practices
  • 12. @robertvarnam  Staff pooling • nurses, reception & clerical staff, sessional GPs … internal ‘bank’  Overflow support • phone consultations • access hub (phone +/- face-to-face) • home visiting Primary care networks: Opportunities for practices
  • 13. @robertvarnam  Purchasing • Indemnity bulk purchasing • Supplies & utilities  Shared functions • CQC registration • Accounting • Policies & procedures • Procurement • Correspondence management • IM&T (eg support & maintenance, intranet, web, social media)  Specialist functions • HR • Finance • Clinical governance • Business intelligence Primary care networks: Opportunities for practices
  • 14. @robertvarnam  Planning • Workforce • Infrastructure development • Service reconfiguration • Public health  Provision • Acute care • Community pharmacy • Dentistry • Optometry • Social care • Housing • Welfare • Voluntary sector Primary care networks: Opportunities for practices
  • 15. @robertvarnam  Traditional healthcare roles • Pharmacists • Specialist nurses • Physiotherapists • MH therapists • Paramedics  Wellbeing workers • Social workers • Care navigators • Health trainers & coaches • Welfare advisors Primary care networks: Opportunities for practices
  • 16. @robertvarnam  Sharing ideas  Testing new ideas  QI expertise  Patient engagement  Analytics • Population health analytics • Priority setting • Benchmarking • Realtime measurement  Project management  Research participation Primary care networks: Opportunities for practices
  • 17. @robertvarnam  Recruitment  HR  CPD  Career development • New options • In-house portfolio career • eg • Teaching • Leadership • Mentoring • Service improvement • Research Primary care networks: Opportunities for practices
  • 18. @robertvarnam Benefits are not automatic Some mergers achieve little Some ‘alliances’ achieve much Primary care networks: Opportunities for practices
  • 19. @robertvarnam@robertvarnam Primary Care Networks bit.ly/20181018birmingham Why? How? Benefits for practices Benefits for patients Avoiding common pitfalls
  • 20. @robertvarnam@robertvarnam Primary Care Networks bit.ly/20181018birmingham Why? How? Benefits for practices Benefits for patients Avoiding common pitfalls
  • 21. @robertvarnam What size should we be?  Personal focus  Clarity  Commitment  Agility  Population focus  Alignment  Priorities  Partnerships 20 100 Don’t accept either / or solutions
  • 22. @robertvarnam System: 0.5-3m System partnerships for large scale change Workforce & infrastructure planning Major partnerships & shifts in priority Place: 100-900k Strategic partnerships Organisational development infrastructure Corporate support Career development Population wellbeing Neighbourhood: 30-60k Acute care Shared MDT Population management Business functions Team: 4-30k Place of belonging Doing the right thing at the right scale Microteam: 2-500 Personal continuity of care
  • 23. @robertvarnam Building a successful primary care network… Purpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > form
  • 24. @robertvarnam Building a successful primary care network… > ++ Purpose > function > form Connecting with values and focusing on a better future trumps money and fear
  • 25. @robertvarnam Building a successful primary care network… Purpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > form Connecting with values and focusing on a better future trumps money and fear Build the culture through practical collaboration
  • 26. @robertvarnam Building a successful primary care network… Build capabilities – clinical, improvement, business Purpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > formPurpose > function > form Connecting with values and focusing on a better future trumps money and fear Build the culture through practical collaboration bit.ly/20181018birmingham

Hinweis der Redaktion

  1. Resilience Economies of scale System partnerships Skillmix Innovation and improvement Staff development
  2. Resilience Economies of scale System partnerships Skillmix Innovation and improvement Staff development
  3. Resilience Economies of scale System partnerships Skillmix Innovation and improvement Staff development
  4. False polarities