Dr Chris Jones, Programme Director, West Wakefield Heath & Wellbeing

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

West Wakefield

• 6 Practices• 63,910

Patients

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

Primary Care 2.0

The Multi-Speciality Community Provider Model (MCP)

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:Video Consultation

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: Service Directory

Digital Access: Service Directory

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

Questions