Dr Chris Jones, Programme Director, West Wakefield Heath & Wellbeing
Post on 28-Jul-2015
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Creating the Future ofPrimary Care
The West Wakefield Prime Ministers Challenge for General Practice
Dr Chris JonesGP, Chair West Wakefield Commissioning NetworkProject Director, West Wakefield’s Prime Minister’s Challenge
@drchrisjones1
@westwakefield
uk.linkedin.com/in/drcjones
The Challenge
• October 2013 - £50 Million fund
– Extend Access– Improve Integration– Better use of digital technology
• 9 pilots initially, became 20
• 12 month scheme
Background
• Low morale
• Falling GP pay, PMS review, MPIG, LES & DES tenders
• Recruitment crisis
• Early retirements
• Increasing burden of long term conditions including
Dementia
• Increasing volume of lower acuity presentations
• Reducing bed base locally
Vision of a New Model
• Accepts and plans for the demographic time bomb
• Delivers flexible access
• Embraces new technology
• Promotes self-care and self-reliance
• Avoids duplication and waste
• Proper integration
• A sustainable system
• Rewarding to work in
Extended Hours
• 6.30pm – 8.00pm Weekdays, 8am – 8pm Weekends
• Routine & Urgent appointments
• Routine booked during normal hours
• Urgent from 111 as ITK message into SystmOne
• Staffed by internal personnel
• Run from dedicated premises inside high quality new build
Health Village
• Augmented by the 24/7 digital access solutions
Extended Primary Care Team
• Physiotherapy
• Pharmacy
• Social Worker
• Mental Health worker
• Community nursing
• Heath & Wellbeing Worker
• Community Consultants
• GP led not GP first
HealthPod
• Out reach• Hard to reach• Menu of services
– CAB– Housing– Carers Wakefield– Age UK– Youth groups– Mental health worker– Sexual health outreach– and more…
• Own Twitter account
Digital Access:Unified Communications
• Presence and availability
• Federation with acute
Trust, Local Authority, MH
Trust
• Video Conferencing
• GP to GP
• GP & Patient to Consultant
• Virtual meetings
• Ad-hoc meetings
• Virtual Teams
• Environmentally friendly
• Better use of time
Digital Access:Email Consultation
• Wrapper existing SystmOnline capability, also…
• Appointment booking
• Test results
• Prescriptions
• On-line record access
Digital Access:Self-Service
• Care Navigation App & web site
• Kiosks in Reception
• Part of WW web site
• Service Directory
• Real-time signposting to resources
• App Library
Digital Access:App Library
• NHS and approved local apps
• Long term condition management
• Health and wellbeing
• Easy for clinicians to find, recommend and use with patients
• Potential to save face-to-face appointments
• Give ownership back to the patient and increase shared care
• Big White Wall
• Personal Care Record
Care Navigation
• New ‘front door’
• Training package designed
• Contact in person, on-line chat, by phone
• Different levels to maximise practice engagement
• Supported by Primary Care Health Champions
• Using on-line directory and printed materials
Social Prescribing
• Case finding by PHCT
• Delivered by Health and Wellbeing worker
• Carry out assessment
• Refer into MDT meeting
• Design package of measures including clinical review if necessary
• Focus on Dementia and Depression
• Link in to third sector services
Key Learning Points
• Patient Engagement
• Support of local stakeholders
• Clinical leadership
• Project Resources
• Expect the Unexpected
Learning Points From Useof Technology
• IT Solutions are complex and time consuming
• Importance of patient engagement
• Hands on training helps build confidence
• Delays in procurement due to NHS financial regulations re:
capital/revenue
• Need simple way of stream lining care navigator inter-action
– redesign of SystmOne templates
Learning From the Physical Access Pilot
• Significant effort required to set up mini out-of-hours
organisation
• Policies and procedures – agreement on use of practice
policies and work to develop a single policy where required
• Record sharing – formal agreement required to ensure
information governance compliance
• Clarity on CQC registration requirements
• NHS branding of HealthPod
Patient Engagement:Video Consultations
• Evening test session
• Doctors and Patients
• Case Study filmed by Microsoft
• Excellent feedback
Patient Engagement:Video Consultations
http://youtu.be/DO43WRTq2Go
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