The NHS Long Term Plan, GP Contract Framework and Primary Care Networks - A collaborative event between Barnet CCG, LMC and Barnet GP Federation
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The NHS Long Term Plan, GP Contract Framework and Primary Care Networks A collaborative event between Barnet CCG, LMC and Barnet GP Federation Barnet GP Forum Wednesday 10 April 2019
AGENDA
PAN BARNET EVENT
10 April 2019
12:30pm – 5:00pm
The 100 Club, Allianz Park, London, NW4 1RL
Item Presenter Timings
REGISTRATION, LUNCH AND NETWORKING 12:30 - 1:00
Welcome and Introductions CCG, Fed, LMC 1:00 - 1:10
NHS Long Term Plan and GP Contract framework Colette Wood, CCG 1:10 - 1:20
Primary Care Networks (PCN) Greg Cairns, LMC 1:20 – 1:40
Dr Charlotte Benjamin, CCG
The Local Barnet Context and Timelines 1:40 - 2:10
Colette Wood, CCG
Barnet Federation Barnet Federated GPs 2:10 – 2:30
Slido Q&As CCG, Federation, LMC 2:40 – 3:00
BREAK 3:00 - 3:20
Table Discussion Table discussion 3:20 - 4:00
Plenary – Table Feedback (1 - 2 points) Dr Charlotte Benjamin, CCG 4:00 - 4:15
Thanks and close Dr Charlotte Benjamin, CCG 4:15 - 4:20
Welcome, Aims and
Objectives
• To understand Primary Care Networks in the context of wider GP
Contract reforms and the NHS Long Term Plan: headlines and
timelines
• Present and discuss guiding principles and options, challenges and
opportunities related to the formation of Primary Care Networks in
Barnet
• Understand what you need to do –now and in the future
• Identify available support and know how to access it
Background and
Context
The NHS Long Term Plan and Investment and Evolution – a five-year
framework for GP contract outline a coherent national policy and strategic
direction for developing primary care, and making it sustainable.
• In June the Government announced there would be an
additional £20bn a year investment in the NHS by
2023/24
• The Long Term Plan (LTP) was issued 07 January setting ✓ Preparing primary care to play a role in
out a ten-year strategy and direction of travel for NHS, designing and driving a future ICS
focus on prevention, improvement and efficiency and ✓ More integration of community
better integrating primary and community care services with primary care –
operational model and roadmap must
• National clinical priorities: children and young people, be clear and agreed. Requires
cancer, cardiovascular disease, stroke, diabetes, significant transformation
respiratory disease and mental health. Primary care has ✓ More coherent and aligned
key role in making progress in relevant outcomes areas arrangements for workforce
development, education and training
• All of England covered by Integrated Care Systems (ICS) needed
by April 2021, based on foundations built by PCNs –
groups of GP practices covering 30–50,000 people ✓ Focus on digital; covers patient self-
service, access, consultation methods
approx.
and better use of data.
Background and
Context
The NHS Long Term Plan and Investment and Evolution – a five-year framework
for GP contract outline a coherent national policy and strategic direction for
developing primary care, and making it sustainable. Contd..
What we know:
• The new GP contractual framework was announced 31 January; first step towards
operationalising the Long Term Plan. Framework covers eight areas:
4. Network
1. Workforce 2. Indemnity 3. QOF
contract DES
6. New 8. Research and
5. Digital and
networked 7. Investment future contract
access
services changes
• Large funding injection for primary care; much of the funding contingent in participation in
Primary Care Networks (PCNs) via a DES
• PCNs are groups of general practices working closely together, with other primary and community
care staff and health and care organisations, providing integrated services to their local
populations.
• PCNs to deliver defined services
• DES service specification released 29th March 2019
Guiding Principles for table discussion
Different forms/ levels of integration and service provision will be required
at different levels
Integrated care system alliance of commissioners and
providers across health and social care; population
based and outcomes focused within a shared budget
At-scale primary care provider delivering efficiencies
of scale and leadership support; providing a voice for
integration across boundaries of care
The primary care network geographically contiguous
teams of practices caring for 30,000-50,000 people;
delivery of data-driven integrated multidisciplinary
team based services.
The practice continues to provide core services, which
are resilient and sustainable; coordination and
planning of holistic, personalised, accessible care
The person supported by families and local
communities; enabled and empowered to access care
in a way which works for them, based on ‘what
matters’ to them
6
Primary Care Networks: Guiding
Principles
Guiding principles include:
- Place has primacy –practices within PCNs should be geographically contiguous
- Size of networks suggested at 30,000-50,000 population; balancing critical mass and
making professional relationships work
- There should be 100% coverage; CCGs have a role in confirming the full PCN
configuration
- All practices eligible to participate in the PCN DES; weighted Network Participation
Payment of £1.76, (alongside Global Sum)
- Viability of PCN delivery model is key. Current national guidance: could be through lead
practice, GP federation, NHS provider or social care enterprise
- Each network must appoint a Clinical Director
- Level of responsibility involved: e.g. service delivery, workforce, financial management
and governance
- PCNs will want to consider: decision-making, accountability, data sharing, dispute
resolution, HR, finances etc
7
Any questions so far?
Slido Questions:
https://www.sli.do/
Code: #8680
GP Contract Agreement 2019/2020
Primary Care Networks
www.lmc.org.uk
Primary Care Networks
Contract specification:
• Is a DES (Network Contract DES), spec applies to year one
• Accessed by Primary Care contract holder – GMS, PMS,
APMS
• Begins 1 April, requirements apply from 1 July 2019
• Part of larger package re Long Term Plan
• Funding to form and develop PCNs, additional workforce
• PCNs to deliver defined services
• DES specification published 29 March 2019
• CCGs may add contracts for enhanced services to the
Network Contracts DES, in discussion with LMCs and
practices
www.lmc.org.ukWhat this means “The Network Contract DES specification must not be varied locally and commissioners are not able to increase or reduce the basic requirements nor reduce the national funding pursuant to this Network Contract DES specification.” “Commissioners and LMCs will need to work closely and in partnership…This will include ensuring any patients with a GP practice not participating are covered, e.g. through a Local Incentive Scheme” www.lmc.org.uk
Structure and Coverage
Key messages:
• Cover @30-50,000 patients.
• Should be ‘geographically contiguous.
• Can overlap, but must ensure full
population coverage.
• Based on collaboration, relationships
within PCN, with other providers.
www.lmc.org.ukPCN Governance (i)
• Practices are core members.
• Based on collaborative working, underpinned by
Network Agreement.
• Legal and contractual status.
• Will have a Clinical Director, decided by PCN
(funding based on size).
• PCN decides how funding/workforce deployed,
and who it flows funding to (e.g. sub-contracting)
• Consider VAT/Liabilities issues (BMA PCN
Handbook)
www.lmc.org.ukPCN Governance (ii)
• CCG confirms PCN configuration.
• CCG confirms network population coverage.
• CCG approves variation to GP contract
(GMS/PMS/APMS).
• PCN to provide services via DES; delivery based
on Network Agreement.
• PCN makes decisions & determines decision
making processes.
• Collaborative working with other organisations by
invitation (e.g. Community Providers).
www.lmc.org.ukPCN Establishment
• 29 March – PCN DES Spec, DES guidance, DES registration form,
Network Agreement 19/20 and network contract VAT information
note issued.
• 15 May 2019 – initial registration submission (names, list size,
geography, draft Network Agreement, funding arrangements via
named lead provider*, named Clinical Director). NB funding via
Nominated Payee; must hold primary care contract
• Full signed Network Agreement by 30 June
• 1 July 2019 – Network Contract live.
• 2019 – amended SFE, Regulations in place.
www.lmc.org.ukPCN Registration
• Initial submission: By 15th May 2019
• Names of proposed member GP Practices
• Practice ODS Codes
• PCN/Practice list size @ 1 January 2019
• Map of geographical area
• Initial Network Agreement
• Single practice/provider to receive funding on
behalf of PCN – Nominated Payee
• 31 May, CCGs confirm PCNs, coverage
www.lmc.org.ukPCN Network Agreement ‘Mandatory’ Network Agreement will set out: • How practices will work together. • Which practice(s) will deliver what. • How funding will be allocated. • How new workforce will be shared. • Patient involvement. • Any other agreements e.g. pooling of practice funding. • Data sharing arrangements. • Conflicts of interest. • Decision-making, meetings. • Joining/leaving arrangements. www.lmc.org.uk
Clinical Director
• Named, accountable CD
• Pay scale nationally negotiated, GP pay scales
• Responsible to PCN members
• Practicing clinician from PCN members
• Collaborate with other PCN CDs
• Strategic/clinical leadership
• Workforce development
• Support service changes and pathways
• Develop relationships
• Shape, challenge wider ICS development
• Selection process as determined by the PCN; i.e.
selection, election
www.lmc.org.ukPCN Workforce
• New workforce over 5 years; +20,000
• Investment £110m in 2019 to £891M in 2023
• Part-funded @70% recurrently inclusive of ON
costs and as per AFC pay scales; 30% from PCN.
• 1 Social Prescriber 100% NHSE funded.
• 1 Clinical Pharmacist 70% NHSE funded
• Community workforce should be aligned.
• Clinical Director (0.25 WTE per 50K list)
• Funding when in post, actual costs reimbursed
• Also from 2020, PAs, First contact Physio, 2021
First contact Community Paramedics
www.lmc.org.ukPCN Funding
• £1.50 pp recurrent to PCNs via the NFE (Network Financial
Entitlement).
• Based on yearly population @1 January.
• £1.45 pp for Extended Hours, 30M in Global sum (£1.90 for
extended hrs DES paid in full).
• Network ‘investment & Impact Fund’, £75M in 2020 rising to
£300M by 2024.
• £6 pp from 2021 for Improving Access to go to PCNs or
earlier, where contracts ending before then.
• Existing CCG LCS funding, pending local negotiations and
agreement.
NB £1.761 pp Network Participation directly paid to
practices via the SFE practice entitlement, not PCN funding!
www.lmc.org.ukNetwork Funding Flows
• CQRS sign-up 30 June
• Single bank account
• CD payments monthly from July
• £1.50 paid by end July, backdated to 1
April, monthly afterwards
• Workforce payments monthly in arrears
• Extended Hours paid monthly from July
(1.099 pp from £1.45 for 2019/20)
www.lmc.org.ukPCN Funding - Overview www.lmc.org.uk
PCN Service Delivery
National Requirements
2019/20;
• Extended Hours DES for whole population, July 2019
2020;
• Structured medication review
• Enhanced health in care homes
• Anticipatory Care
• Personalised care
• Supporting early cancer diagnosis
2021;
• Cardiovascular disease prevention & diagnosis, case finding
• Action to tackle neighbourhood inequalities
Subject to yearly negotiations with NHSE
www.lmc.org.ukPCNs – Key Questions?
• How do we work together; what are our aims?
• Who do we work with?
• What area do we cover?
• What about existing groupings,
Networks/Localities/Neighbourhoods?
• How can our Federations support the PCN?
• Who makes/how are decisions made?
• What happens to existing support for
localities/networks?
• How do we appoint our Clinical Director?
www.lmc.org.ukNot forgetting….
• Primary Care Networks are one part of a
wider GP Contract package
• Access review: 111/Urgent Care
developments
• Existing STP/CCG plans re shifting care.
• Existing workforce, workload pressures.
www.lmc.org.ukWider GP Contract Offer
• IT & Digital
• Digital-First Providers
• QOF
➢Personalisation
➢Quality Improvement
• Indemnity
• Practice funding & pay
• Other agreements for 19/20
• Reviews to come: Access, V&I, Premises
www.lmc.org.ukThe Contract package on a page
• What general practice gains What general practice delivers
• Indemnity state backed scheme • PCN creation (2019)
• Pay & expenses uplift each year • LTP ambitions (2020 onward) through
• Additional workforce & linked funding additional funding and additional workforce
• QOF amendments • Greater digital access (built up)
• Resources for IT and digital
Stability
• What it means
• Five year deal, built upon each year
• Workforce expansion
• 2019: build foundations, expand workforce
• Workload reduction
• Funding increase, pay uplift • 2020 onward: expand workforce further,
reconfigure services
• Autonomy retained
• Leadership role for rebuilt community
team
Overall funding in excess of £2.8bn over 5 years, through practices and networks
2
www.lmc.org.uk 7The Local Barnet Context
and timelines
28What have we achieved in
the past 12 months in
Barnet?
• We have successfully achieved the formation of 7 Care and Health Integrated Networks (CHINs),
providing 99% patient population coverage. This was achieved through the launch of the
Infrastructure LCS in October 2018
• The CCG has invested in the programme through the Infrastructure LCS, Plan, Do, Study, Act
(PDSA) cycles and embedding the CCG primary care transformation team into the formation and the
development of the networks.
• The Primary Care Transformation team have worked with the networks, alongside the GP
Federation, supporting the development of a number of clinically led PDSA projects across Barnet.
• The London Borough of Barnet, who jointly lead this programme with the CCG, have developed the
LBB CHIN offer, a document describing council services and pathways, which was shared initially
with the Burnt Oak CHIN and then more widely through the CCG Clinical bulletin. The aim is to begin
wrapping these services around the primary care networks to provide an integrated health and care
offer.
• We have developed Business Intelligence capability through the North East London Information
Exchange (NELIE) which provides Network Insights across a number of areas where can be
benchmarked and compared on a borough, network and practice level.
You can also drill down to see activity and costs at a practice and individual patient
level. 29We are in a good position in
Barnet to implement this
national change
Key Practice List size Care & Health
(Feb 19) Integrated Network
1 Deans Lane Medical Centre 4257 CHIN One
2 Parkview Surgery 6556 CHIN One
3 Oak Lodge Medical Centre 18472 CHIN One
4 Watling Medical Centre 16207 CHIN One
5 The Everglade Medical Practice 8267 CHIN One
6 Dr Lamba (Colindeep Lane) 8835 CHIN One
7 Wakeman’s Hill Surgery 4675 CHIN One
8 Jai Medical Centre 8303 CHIN One
9 Hendon Way Surgery 8493 CHIN One
10 The Village Surgery 5201 CHIN Two
11 East Barnet HC (Dr Weston & Dr Helbtitz) 3609 CHIN Two
12 East Barnet HC (Dr Peskin/Syed/Hussain) 4507 CHIN Two
13 East Barnet HC (Monkman) 3074 CHIN Two
14 St Andrews Medical Practice 10885 CHIN Two
15 Brunswick Park Medical Practice 8548 CHIN Two
16 The Clinic (Oakleigh Rd North) 8934 CHIN Two
17 Friern Barnet Medical Centre 9046 CHIN Two
18 Doctors Lane - Colney Hatch Lane 5425 CHIN Two
19 Longrove Surgery 11327 CHIN Three (a)
20 The Old Courthouse Surgery 8323 CHIN Three (a)
21 Addington Medical Centre 9061 CHIN Three (a)
22 Vale Drive Medical Practice 5555 CHIN Three (a)
23 Gloucester Road Surgery 1802 CHIN Three (a)
24 Derwent Medical Centre 5581 CHIN Three (b)
25 Torrington Park Group Practice 12569 CHIN Three (b)
26 The Speedwell Practice 11440 CHIN Three (b)
27 Wentworth Medical Practice (Ballard Lane11404
MergingCHIN
with
Three
Wentworth
(b) on
28 Cornwall House Surgery 6411 CHIN Three (b)
29 Squires Lane Medical Practice 5796 CHIN Three (b)
30 Lichfield Grove Surgery 6235 CHIN Three (b)
31 Rosemary Surgery 5286 CHIN Three (b)
32 Woodlands Medical Practice 4395 CHIN Three (b)
33 East Finchley Medical Practice 7806 CHIN Three (b)
34 Penshurst Gardens 6639 CHIN Four
35 Millway Medical Practice 18483 CHIN Four
36 Lane End Medical Group 13136 CHIN Four
37 Mulberry Medical Practice 9946 CHIN Four
38 Langstone Way Surgery 7997 CHIN Four
39 St George’s Medical Centre 11116 CHIN Five
40 Hillview Surgery 1876 CHIN Five
41 The Phoenix Practice (Boyne Ave (E83656) has
9987 now
CHIN
merged
Five with this pra
42 Dr Azim & Partners 9147 CHIN Five
43 Ravenscroft Medical Centre 7378 CHIN Five
44 Pennine Drive Surgery 8991 CHIN Five
45 Greenfield Medical Centre 6857 CHIN Five
46 Supreme Medical Centre 4357 CHIN Six
47 Mountfield Surgery 5006 CHIN Six
48 Heathfielde 8135 CHIN SIX
49 PHGH Doctors 10941 CHIN Six
50 Temple Fortune Health Centre 7264 CHIN Six
51 The Practice @ 188 7588 CHIN Six
52 Adler & Rosenberg (682 Finchley Road) 5846 CHIN Six
53 Hodford Road Surgery 3663 CHIN Six
54 Cricklewood Health Centre(Barndoc Healthcare
8493 Ltd)
Unallocated
Barnet GP Practices and 99%
Primary Care Network configuration coverage
(April 2019)
30Potential Primary Care
Network structures to
support the Network DES
There are currently 5 proposed models for the delivery of the Network DES specification and networks may start with one
structure but change structures as relationships mature. 2019/20 is the developmental year for the networks across the country.
The practices in the network would jointly sign up to the network agreement, which would record
Flat Practice Network the fact that contracts relating to the functions and workforce of the PCN are jointly entered into
by all practices and that the liability arising from it are jointly split between them.
The practices in the network would jointly sign up to the network agreement, which would record
Lead Provider the fact that contracts relating to the functions and workforce of the PCN are entered into by a
specific lead practice (different lead practices could be identified to lead on differing thing
The member practices would continue to employ their normal staff and provide their core GMS
GP Provider/Limited services, but the provider entity would be subcontracted to deliver services required by the DES,
Liability Vehicle and employ the range of staff necessary to do so. These services would be funded by the monies
received via the DES
As a single entity the super-practice would need to create an internal ‘network’ amongst its
Super Practice constituent sites, with each ‘neighbourhood’ of practices operating as a mini network in
themselves. The super-practice would be the nominated payee and would then supply support and
resources to its constituent neighbourhoods
Practices may wish to ally themselves with another local healthcare provider from the start, such
Non-GP Providers as a community trust, which through signing up to the network agreement alongside the GP
practices can provide network-level services on behalf of the PCN.
These proposed models have been taken from the British Medical Association (BMA) Primary 31
Care Network Handbook.How much per head
investment is going into the
Barnet Primary Care
Networks?
If our current CHIN configurations were to be the Primary Care Networks, the indicative
investment would be as follows:
Example RAW List Size Network Network Extended Hours Extended Total Funding
Primary Care Engagement Payment Funding Access Funding
Networks Funding (£1.50/h) (£1.45/h) (£6/h from Apr
(£1.76/h) 2020)
Network 1 84,065 £147,954 £126,098 £121,894 £504,390 £900,336
Network 2 59,229 £104,243 £88,844 £85,882 £355,374 £634,343
Network 3(a) 36,068 £63,480 £54,102 £52,299 £216,408 £386,288
Network 3(b) 76,941 £135,416 £115,412 £111,564 £461,646 £824,038
Network 4 56,201 £98,914 £84,302 £81,491 £337,206 £601,913
Network 5 55,352 £97,420 £83,028 £80,260 £332,112 £592,820
Network 6 52,800 £92,928 £79,200 £76,560 £316,800 £565,488
Totals 420,656 £740,355 £630,984 £609,951 £2,523,936 £4,505,226
Indicative Primary Care Network Funding
Extended Access Funding (£6/h from Apr £1,000,000
2020) £800,000
£600,000
Extended Hours Funding (£1.45/h)
£400,000
£200,000
Network Payment (£1.50/h)
£0
Network Engagement Funding (£1.76/h)
Network 1Network 2 Network Network Network 4Network 5Network 6 32
3(a) 3(b)How much workforce
investment is going into the
Barnet Primary Care
Networks?
If our current CHIN configurations were to be the Primary Care Networks, the indicative
investment would be as follows:
Example Primary RAW List Size Network Clinical Clinical Social Prescriber Total Funding
Care Networks Administration Director Pharmacist (100% funded)
(70% funded)
Network 1 84,065 £105,000 £48,131 £37,810 £34,113 £225,054
Network 2 59,229 £75,000 £34,279 £37,810 £34,113 £181,202
Network 3(a) 36,068 £45,000 £20,267 £37,810 £34,113 £137,190
Network 3(b) 76,941 £105,000 £48,131 £37,810 £34,113 £225,054
Network 4 56,201 £75,000 £34,279 £37,810 £34,113 £181,202
Network 5 55,352 £75,000 £34,279 £37,810 £34,113 £181,202
Network 6 52,800 £75,000 £34,279 £37,810 £34,113 £181,202
420,656 £555,000 £253,645 £264,670 £238,791 £1,312,106
Primary Care Networks - Workforce Investment
£300,000
£200,000
£100,000
£0
Network 1 Network 2 Network 3(a) Network 3(b) Network 4 Network 5 Network 6
Network Administration Clinical Director Clinical Pharmacist (70% funded) Social Prescriber (100% funded) 33What are the key dates for
the Primary Care Networks
and the new Network DES?
The following outlines key imminent deadlines/milestones:
PCNs to have submitted the initial completed ‘Network Contract Directed Enhanced Service (DES)
1 Registration Form’, by email with the subject header ‘Primary Care Network Registration’, to Barnet
CCG Primary Care Team via barccg.barnetccgprimarycare@nhs.net by 15th May 2019.
Between 16th May 2019 and 31st May 2019, Barnet CCG will confirm and approve all Network Areas
2 in a single process that ensures that all patients in every GP practice are covered by a PCN and that
there is 100% Barnet CCG GP practice registered population coverage.
After Barnet CCG confirmation has been received and prior to 30th June 2019, each GP practice in a
3 PCN will sign-up to the Network Contract DES through the Calculating Quality Reporting Service
(CQRS).
4
By 30th June 2019, PCNs must confirm to Barnet CCG Primary Care Team that the fully completed
Network Agreement has been signed by all PCN member GP practices and that the GP practices
have entered into the appropriate data sharing (and, if relevant data processor arrangements) to
support delivery of extended hours access services from 1st July 2019. This includes submitting
completed ‘Network Contracted Directed Enhanced Service – Network Agreement Schedules’ to
Barnet CCG Primary Care Team via barccg.barnetccgprimarycare@nhs.net.
5 PCNs commence delivery of the Extended Access DES from 1st July 2019.
34Additional Roles
Reimbursement Scheme-
Wider Workforce
• 20,000 plus new workforce over five years; investment £110m in 2019 to £891m in 2023
• Part-funded: 70% recurrently; 30% from PCN.
• One social prescriber (link worker) 100% NHSE funded.
• One clinical pharmacist 70% NHSE funded
• Community workforce should be aligned.
• Clinical Director (0.25 WTE per 50,000 list)
• Also from 2020, Physician Associates, first contact physios, 2021 first contact community paramedics
35There are a number of
documents available for
practices
Resource Resource Link / Document
Network Contract Directed Enhanced Service – Contract https://www.england.nhs.uk/publication/network-
Specification 2019/20 contract-directed-enhanced-service-des-specification-
2019-20/
Network Contract Directed Enhanced Service – Guidance for https://www.england.nhs.uk/publication/network-
2019/20 in England contract-directed-enhanced-service-des-guidance-
2019-20/
Network Contract Directed Enhanced Service (DES) https://www.england.nhs.uk/publication/network-
Registration Form contract-directed-enhanced-service-des-registration-
form/
Network Contract Directed Enhanced Service – Mandatory https://www.england.nhs.uk/wp-
Network Agreement (April 2019) content/uploads/2019/03/mandatory-network-
agreement.pdf
Network Contracted Directed Enhanced Service – Network https://www.england.nhs.uk/wp-
Agreement Schedules content/uploads/2019/03/network-agreement-
schedules.docx
The Network Contract DES and VAT https://www.england.nhs.uk/wp-
content/uploads/2019/03/network-contract-des-and-vat-
information-note.pdf
Primary Care Networks: Frequently Asked Questions https://www.england.nhs.uk/gp/gpfv/redesign/primary-
care-networks/pcn-faqs/
An Introduction to Quality Improvement in General Practice https://www.england.nhs.uk/wp-
content/uploads/2019/03/an-introduction-to-quality-
improvement-in-general-practice.pdf
British Medical Association (BMA) Primary Care Network https://www.bma.org.uk/-
Handbook /media/files/pdfs/collective%20voice/committees/gpc/gpc%
20england/pcn%20handbook.pdf?la=en
36GP Federation
Barnet GP Federation
37THIRD
SECTOR
Barnet
Primary
Care
Networks
DENTIS
T
EMPLOYEE HEALTH AND
WELLBEINGWHAT SUPPORT DOES
Leadership and Governance YOUR PRIMARY CARE
Your Primary Care Network will need to have robust leadership and NETWORK NEED?
governance arrangements in place
Population Health and Care Models SERVICES
Your Primary Care Network will need to understand the health needs of your local population
and develop integrated models of care
Which services?
When?
Your Primary Engaging People and Communities
From whom?
Your Primary Care Network will need to engage and involve teams coming together to provide
Care Network integrated care across your network
Care Teams and Clinical Governance
PEOPLE (CEPN)
30,000-50,000 Your Primary Care Network will involve teams coming together to provide Which people?
Patients integrated and shared care When?
Managing Resources From whom?
Your Primary Care Network will need to manage resources to make them efficient and effective
SUPPORT
Working Together What support?
Your Primary Care Network will have to collaborate to deliver integrated care to your local population
When?
From whom?Delivery Structures across NCL
ICP – Pan-borough or Hospital Geography
Health & Social Care Partnership
Business Analytics / Contract management
GP Federation – Pan-borough
Management infra-structure / Service management / Population Health
Enhanced access / Specialist workforce /Integration Agreement
Primary Care Networks – Geographical Networks of 30-50,000
patients
Community alignment / Social prescribing
LTC management / MDT Approach
GP Practice – GMS Contract
Health promotion / Diagnosis / Disease managementFederation Roles
Representing at ICP
Supporting GP Practice and Networks
Offering back office PC leadership in ICP
Delivering PC Services at Scale
Providing access
functions and hubs Delivering joined up
support Managing / population health at
Joining up Governing network the most
workforce multidisciplinary appropriate scale
capabilities teams e.g. elderly, Aligning community
Brokering paediatrics, LTC teams, community
collaboration Employing shared facing consultants
conversations staff e.g.
pharmacists, care
home visitingJust some of the successes so far…
GP Federation Infrastructure EAS Hubs Research
• Board Governance Structure – • 48,000 appointments • 48/52 practices signed up – 42 active
clinical/financial governance strong • Stable workforce • 15000 patients screened
• Underpinned BI Dashboards • Nurse appointments (smears) • 6000 patients taking part in research locally
• Pensions, NI and Premises • Low DNA rates • Total number of new studies undertaken in
• IT/BI Capability/Clinical Auditors • Same day/routine appointments Barnet 185
• Service, Operational and Programme Leads • Populate EMIS directly with discharge • LTCs, Cancer and MH key research areas
• Trusted and represent all practices summary and refer on • £36k paid out to practices
• Communications/HR/Contracting (LMC
Law)
Practice Support/Membership Offer Anti-coagulation GP FED/CEPN – Workforce Development
• Blue Stream Academy • Mobilised new service • Workforce Development
• Blue Stream Federation Portal • Estimated value: £300k (plus start up costs) • Workforce Retention
• Dene Healthcare (Buying Consortium) • 133 patients already contacted • I-GPs
mobilised • Clinical staff in place and equipment bought • Clinical Pharmacists
• DPO Service & GDPR • Clinics commenced • Non-Clinical Training – reception booklets
• QOF Prevalence • Clinical Governance in place • DQIST Diabetes Training
• New Telephone system • Productive General Practice
• Expanding further in coming year • BRAD Group
Federation is your organisation – can be developed into what you need for the next stage of
the journey?Primary Care Networks – Planning
for the Future
1st May 2019
What do you want from us and how can we help?
LMC/CEPN/BFG
Membership
CHINs Steering Group
Engagement - 8th May 2019
Dates for the
Diary Submission to NHS E of the Clinical Directors
15th May 2019
NCL Event for Clinical Directors – success,
enablers and what next
29th May 2019Questions from the Room and Slido
Slido Questions: https://www.sli.do/
Code: #8680Discussion – Practice
Perspectives
Other questions?
What conversations have you already had?
Share your thoughts…
Discussion on tables:
• What are our aims?
• How do we work together?
• Who do we work with?
• What area do we cover?
• What about existing groupings, Networks/Localities/Neighbourhoods?
• How can our Federation support the PCN?
• Who makes/how are decisions made?
• What happens to existing support for localities/networks?
• How do we appoint our Clinical Director?
• What support do we need?
46Next Steps and Contacts
PCN DES Agreement published (29 March)
PCN DES Specification published (29 March)
NCL Practice events (until early April)
Further practice communications by 11 April
Practices confirm PCNs (before 15 May)
CCGs confirm PCNs (by 31 May)
PCN DES goes live (1 July 2019)
For more information:
https://www.england.nhs.uk/gp/gpfv/investment/gp-contract/
https://www.england.nhs.uk/wp-content/uploads/2019/01/gp-contract-2019.pdf
Or contact:
barccg.barnetccgprimarycare@nhs.net
HCCH.NCLSTP@nhs.net
Greg.Cairns@lmc.org.uk
47Thank You & Close Dr Charlotte Benjamin, Barnet CCG
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