Our Primary Care Transformation
The national Improving General Practice – A Call to Action was issued by NHS England to collate views on how to shape the future of general practice services in England. The drivers for change are:
- An increasingly ageing population with co-morbidities
- Increasing patient expectations
- Pressure on NHS financial resources
- Growing dissatisfaction with access to general practice services
- Inequalities in access and quality of care
- Growing workforce pressures.
The CCG delivered a workshop in February 2014 providing an opportunity for the CCG, together with members and stakeholders, to consider the challenges for general practice as described in the document. Following eight months of engagement with our general practices using the evidence available the CCG and member practices identified the areas requiring improvement and committed £2.1m to funding the trial of new ways of working designed contributing to the wider transformation programme.
Better Futures for All was co-designed locally as a programme to enhance the existing offer of primary care services in Bracknell and Ascot. Stakeholders came together towards the end of 2014 to design a positive future for our patients with a particular focus on patients who currently struggle to access services in general practice during traditional hours and patients who would benefit from more focused input for their more complex conditions. This vision has been the corner stone for the further development of this programme and outlines the following outcomes for our patients:
People are involved in decisions about their care. Care goals are joint decisions in partnerships between people and clinicians support:
- People always feel respected and that they have a choice. We have reached ‘no decision about me, without me’ in reality; not just political spin. The doctor and the person make all decisions together. Everyone feels fully involved in their care.
- People with LTCs have good access to routine care and a real sense of choice; especially around sharing goals.
- People are supported by health professionals who act as much as motivational coaches, setting meaningful targets and goals that are owned by the person for their future health. People feel deeply listened to as a result. People and health professionals feel that ‘we are in this together’.
- People understand their long-term conditions and all information they receive about their conditions, treatment, tests and results. They are confident about managing their condition and this has translated into self-management.
People know their numbers
- People recognise they have a responsibility to look after their own health. “They know their numbers”.
- People understand the system and how to work around it and with it; and where they need to go.
- People understand and respect the cost of care and as a result, they recognise the value of the services they use. This has changed their attitude towards using services and they take more personal responsibility for service use.
A shift in culture towards community support and partnerships
- There has been a shift in culture so that the community is now supporting each other. This connection matters and is available both in the physical and online in the virtual world.
- People no longer feel isolated. They do not feel they have to do things and cope on their own any more.
- Young people and their parents know how to prevent LTCs and how to use services because education starts early and their awareness builds as they grow up. As a result, children educate their parents and grandparents on how to keep well.
- Proactive screening within the community means that we catch LTCs early, giving people a greater chance to take control of their long-term condition earlier – or even preventing the onset of a long term condition altogether.
- The services in Bracknell and Ascot have become one united team. There is joint partnership between health, social care and the voluntary sector. Technology and a change in attitude has driven this change, rather than a change in building or physical location.
- There is distinction between ‘paid-for’ and ‘unpaid’ care; both need to be valued.
- The primary care workforce is happier. They feel they have come off the treadmill and onto the pitch and are now more available to everyone; Bracknell and Ascot United.
Programme Work streams
- Extended Access – extending the hours of access to general practice and complimentary services for routine and planned care
- Enhanced Patient Support – using technology and engagement to support patients in their own care through alternative points of access for primary care services
- Workforce Development – recognising the national workforce challenges for the NHS, the CCG to have a high level of retention of existing staff and professionals, whilst developing existing opportunities to attract work force.
- Co-operative Working – support our practices to explore the benefit for general practice to work closer together as providers and sustain consistent high quality of care
- Co-Commissioning Primary Care – commit with NHS England to enable transformation to support the wider health system through the flexibilities around primary care contracting
Useful documents and links: