www.england.nhs.uk @robertvarnam
The future of
general
practice
Dr Robert Varnam
Head of general practice development
robert.varnam@nhs.net
@robertvarnam
King’s Lynn
9 June 2015
www.england.nhs.uk @robertvarnam
Does general practice have a future?
www.england.nhs.uk @robertvarnam
Does general practice have a future?
www.england.nhs.uk @robertvarnam
bit.ly/c2aGP
bit.ly/nhs5yfv
What are people working on?
How to promote, support and
sustain improvements?
Locally led, nationally enabled.
www.england.nhs.uk @robertvarnam
www.england.nhs.uk @robertvarnam
Why change?
Scottish School of Primary Care
Health & wellbeing-promoting care
‘Right access’ Consistently high quality
Holistic, personalised, proactive, coordinated care
Better joined-up care for a population of registered people
bit.ly/nhs5yfv
‘Wider primary care, at scale’
Phone first.
Community diagnostics.
Practice based paramedics.
Pharmacy first.
Web consultations.
Primary care led urgent care centre.
Minor injury service.
Physio first
Direct specialist advice.
Condition management training.
Shared records.
Care coordination.
Hospital in-reach.
Care home ward rounds.
Virtual ward.
Primary care-employed specialists.
Social prescribing.
Travelling health pods.
Peer-led walking groups
Health coaching.
Befrienders.
Schools outreach.
Community development.
www.england.nhs.uk @robertvarnam
The status quo is unsustainable
There are new opportunities, to fulfil the
promise of general practice
www.england.nhs.uk @robertvarnam
Funding
 Co-commissioning
 Increased funding
 Fairer funding
Care innovations
 Prime Minister’s
Challenge Fund
innovations
Workforce
 Recruitment, retention,
returners
 Nursing, pharmacy
 Wellbeing workforce
 Multispeciality Community Providers (MCPs)
 Primary and Acute Care Systems (PACS)
New organisational forms
Infrastructure
 Premises
 Digital primary care
New deal for primary care
www.england.nhs.uk @robertvarnam
Multispeciality Community Providers
GP
practice
GP
practice
GP
practice
GP
practice
GP
practice
GP
practice
GP
practice
GP
practice
Specialists Pharmacists
Community provider
SC provider
VCS
VCS
VCS
MH Trust
VCS
VCS
VCS
www.england.nhs.uk @robertvarnam
Primary and Acute Care Systems
Community
provider
SC
provider
VCSMH Trust
Acute
provider
GP
practice
GP
practice
GP
practice
GP
practice
GP
practice
GP
practice
GP
practice
GP
practice
www.england.nhs.uk @robertvarnam
www.england.nhs.uk @robertvarnam
1. What kind of care?
• Holistic, comprehensive, cradle-to-grave family care
• Health & wellbeing-promoting care
• ‘Right access’ (time, place, person, care)
• Consistently high quality
• Holistic, personalised, proactive, coordinated care
www.england.nhs.uk @robertvarnam
2. What kind of work?
• Segmented (one size does not fit all)
• Multiprofessional teamworking
• bring new skills
• work to the top of our skills
• Partnership with patients & community
• Longer consultations with fewer patients
• GP not always 1st port of call
• Direct access diagnostics
• ‘Pull-in’ specialist advice
www.england.nhs.uk @robertvarnam
3. What kind of practice?
Big
Personal
Competent
Yours
www.england.nhs.uk @robertvarnam
3. What kind of practice?
Big enough for:
• meaningful accountability
• resilience
• collaboration
• broader workforce
• minor illness nurses, pharmacist, MH practitioner,
welfare rights, OT, physio, LTC nurses, HCA, PA
• pull-in power
• economies of scale
www.england.nhs.uk @robertvarnam
3. What kind of practice?
Competent:
• develop the workforce
• look after the workforce
• continually develop people
• highly skilled business planning & operational
management
• service improvement
• clinical governance
• clinical care
www.england.nhs.uk @robertvarnam
3. What kind of practice?
Personal:
• deliberately designed systems, teamwork & processes
to promote continuity
www.england.nhs.uk @robertvarnam
www.biomedcentral.com/1471-2296/11/61/
www.england.nhs.uk @robertvarnam
3. What kind of practice?
Personal:
• deliberately designed systems, teamwork & processes
to promote continuity
• proactive coordinated care
• connecting patients with non-medical support
• using tech to promote wellbeing, self-care and
management
• known in the community
www.england.nhs.uk @robertvarnam
3. What kind of practice?
Yours:
• well-designed
• well-led
• every GP matters
• systems to ensure you flourish
www.england.nhs.uk @robertvarnam
eg Whitstable medical practice
www.england.nhs.uk @robertvarnam
eg GP Care federation, Bristol
www.england.nhs.uk @robertvarnam
bit.ly/GP4Ps
Purpose
Partnerships
Proactivity
Possibility

The future of general practice, Robert Varnam

Editor's Notes

  • #2 *** RECORDING ***
  • #4 not fulfilling the potential Things HAVE changed recently But…
  • #6 Talk of change – why?
  • #7 BUT: underfunding greater focus on hospital heroics workforce crisis ALSO: OPPORTUNITIES FOR BETTER CARE
  • #8 Not more of the same
  • #9 C2A findings … WHAT KIND OF CARE?
  • #14 WHY CHANGE?
  • #15 Premises £192m 721 bids Not just more of the same
  • #28 34k
  • #29 34k