David Colin-Thomé

• National Clinical Director for Primary Care • GP, Castlefields, Runcorn • Honorary Visiting Professor, CPPM, Manchester University • Honorary Visiting Professor, School of Health, University of Durham

Benefits of a first contact in primary care.

(Starfield)

• Higher patient satisfaction with health services • Lower overall HS expenditure • Better population health indicators • Fewer drugs prescribed per head of population • The higher the number of family physicians the lower the hospitalisation rate.

Vision for Primary Care

Responsive Based on needs of informed patients Quality based care in least invasive ways Multi-disciplinary teams Operating across organisational boundaries Fast, convenient access Extended range of services Consistently high quality services Delivered locally Modernised premises Appropriately trained and motivated staff Integrated IT

Commissioning Primary Care

• nGMS • nPMS • QOF • ‘Liberating the talents’ • Agenda for Change • nCommunity Pharmacy • (LPS, PDS) • Community Dentistry ‘Options for Change’ • Secondary to Primary care-PwSI, PBR • LTC- NSFs, QOF, EPP, Community Matrons • ...and Practice based commissioning

PSA Targets

• I. Access to treatment • II. Improving the patient experience • III. Long term conditions management • IV. Health of the population

To improve health outcomes for people with long term conditions by offering a personalised care plan for vulnerable people most at risk; and to reduce emergency bed days by 5% by 2008, through improved care in primary care and community settings for people with long term conditions.

The NHS and Social Care Long Term Conditions Model Infrastructure

Community Resources

Delivery System

Case Management Decision support tools and clinical information system (NPfIT) Health and social system environment Disease Management Supported Self care Promoting Better Health

Better outcomes

Empowered and informed patients Prepared and proactive health and social care teams

Vehicles for System Improvement

• LTCM • Unscheduled Care (OOH, medical emergencies,A&E waits)….

• Clinically led commissioning

General Practice

• First Contact Where Patient Chooses • Continuity of Care for Episodic Illness • Chronic Disease Management • Final Repository (“Their Doctor”)