Barnet Primary Care Strategy Implementation Plan

Introduction

NHS North Central London (NCL) has developed a primary care strategy, which describes how we intend to improve primary care – that’s the care you receive at your GP, dentist, pharmacist and optician. The improvements are set to be put in place over the next three years and are backed up with investment funds to be spent on primary care, in particular general practice, over this period.  The goal of the investment is to improve primary care standards, results and experience for patients and to rely less on hospitals for care, providing more care in a local setting instead.

The primary care strategy will support the Barnet,Enfieldand Haringey Clinical Strategy, which also provides for more care being provided away from a hospital setting. Here we describe the first steps we are taking to develop primary care in Barnet up until March 2015.

Leadership for implementation

From April 2013, a new organisation named the National Commissioning Board will be responsible for managing the contracts of all primary care contractors - that includes GPs, Community Pharmacies, Dentist, and Optometrists. Also from April 2013, Barnet Clinical Commissioning Group (CCG) will be responsible for ensuring that the population of Barnet get all the health services that they need, though this will exclude directly managing primary care contractors.  With this in mind, Barnet CCG wants to help primary care practitioners to expand the range of services they offer.

Barnet CCG will be in charge of implementing all aspects of the strategy apart from contractual arrangements with primary care contractors. They will also look at what extra services could be better provided in a local primary care setting – that could mean at their local GP surgery, at a local clinic or community hospital.  

The Barnet Primary Care Strategy Implementation Group has been put in place to lead implementation. The group includes CCG Board members, and representatives from the Local Involvement Network, the Barnet Practice Managers Group, the Local Medical Committee, community pharmacy, the London Borough of Barnet and the NHS North Central London (NCL) Barnet borough team.

Investment in primary care

We are investing £2.9 million in primary care and community services in Barnet for 2012-13. Over the three years 2012-2015 we will be investing £11.7m. We are spending this money with the goal of giving patients better quality health care, and of rebalancing the local health system towards primary care and away from hospital care.

Our approach to implementing

The development of integrated care networks is one of the most important changes we are making in primary care. Integrated care networks are groups of GPs working together with community health and social care services with close links to hospital specialists. Helping practices to set up these networks will help us to provide more health services in a local setting. This will make it easier for local people to get the health care that they need.

This is a large change for primary care, so part of the funding will be used to give GPs advice and training to help them to make the changes. But the main focus will be on developing services for patients. We’re starting with care for the frail elderly, people with poor mental health, and people that need urgent access to primary care. These are areas where there is clear local need, that GPs have told us are important, and where a range of different changes are likely to be needed. GPs have said that they want to work together with patients, finding ways to help patients to be more involved in their health care, and this will be an important theme in all our changes.

What’s happened so far?

Since the implementation plan was approved in June 2012, we have:

  • Held three large events with GPs and practice staff from across Barnet, to focus on the priorities noted above. This allowed us to draw together a picture of the changes that GPs themselves would like to make;
  • Met with the Local Authority to see which projects we could work on together, to provide a more joined-up approach to health and social care;
  • Offered practices the opportunity to take part in a programme designed by the NHS Institute for Innovation and Improvement to improve the way the practice runs day to day, so that there is more time for patient care. Local practices are currently finding out more about the programme and deciding whether they want to take part;
  • Offered practices the opportunity to use text messaging to communicate with patients, for example sending reminders about appointments or ‘flu immunisations;
  • Been working with practices to install web-based information systems which will make it easier, with permission from patients, to share information between different health and social care services.

What happens next?

  • We are currently working with primary care practitioners to look at how urgent access to primary care can be improved. We are planning a joint event with the Local Involvement Network to hear the views of the public on this;
  • We are also working with primary care practitioners to look at how care for the frail elderly, and people with poor mental health, can be improved;
  • We are developing a service whereby patients who do not pay for their prescriptions will be able to get over-the-counter medicines directly from their community pharmacy;
  • We are working with one practice in Barnet and with the Local Authority to develop an information and advice centre based in a practice, to support people with long term conditions;
  • We are encouraging practices to see where they can work together with other practices, or with other primary care services – for example community pharmacies, to improve care for patients.

What does this mean for patients in Barnet?

We want delivery of this implementation plan to result in practical improvements in primary care that patients will notice themselves:

  • Patients with long term conditions will receive more of their care in primary care, and an improved quality of care. This may include lifestyle sessions;
  • Frail elderly patients will receive more integrated care to help them to maintain independence;
  • Patients who no longer need secondary mental health care will be supported in primary care by their GP and mental health professionals working together;
  • Patients who do not pay for their prescriptions will be able to go direct to the pharmacy for particular medicines;
  • Patients will be helped to access health information in different ways;
  • Patients will receive text message reminders of their doctors’ appointments if they wish;
  • Depending on the results of a previous pilot, patients will be able to access advice from a doctor in different ways;
  • Practices will make some appointments available for booking on line for patients who have access to the internet.