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thePCH1October 28 2015

The National Association of Primary Care has proposed a new model of care programme to support the strengthening of primary care.

The format, which will build on the NAPC’s Primary Care Home (PCH) initiative, will be in line with the new care models outlined in the NHS Five Year View Forward. It has been designed to meet the health and social needs of populations of up to 50,000 to address health, wellbeing and care, says the NAPC.

Key features will include:

  • provision of care to a defined, registered population of between 30,000 and 50,000;
  • aligned clinical financial drivers through a unified, capitated budget with appropriate shared risks and rewards;
  • an integrated workforce, with a strong focus on partnerships spanning primary, secondary and social care; and
  • a combined focus on personalisation of care with improvements in population health outcomes.

The programme was endorsed by NHS England Chief Executive Simon Stevens, who said: “This programme offers an innovative approach to strengthening and redesigning primary care, centred around the needs of local communities, and tapping into the expertise of a wide array of health professionals.”

In its briefing document, the NAPC says that the PCH model will enable primary care, community health and social care professionals to work in partnership with hospital-based specialists. “A detailed understanding of the needs of the registered population (and therefore the expected volume and type of workload) will enable the creation of the right team at the outset who can then strengthen their efforts on maximising efficiency in the deployment of care resources and specifically in the ‘make or buy’ decisions with their patients.”

GPs and specialists could be equity ‘shareholders’, with the population size and needs shaping the model of clinical partnership. However, it also suggests a ‘medical chambers’ type arrangement with shared equity but retaining existing contractual arrangements may be possible. Other models could be the formation of a company in which the clinicians are directors, such as in a community interest company or not-for-profit company.

In terms of measuring outcomes, the NAPC suggests quality outcome metrics should be based on:

  • improving patient activation
  • improving the capacity to self care
  • improving wellness scores
  • achieving individual health and wellbeing goals.

Dr Nav Chana, NAPC Chair, said: “In essence, what we are describing is the ‘home’ of care for a population with a tailored workforce with access to the data, tools and resources to provide high quality comprehensive care. Working at this scale ensures a functional team where everyone knows each other and there is a true sense of belonging for patients, the population and the workforce.”

Dr James Kingsland, NAPC President, added: “We want to have a strong evidence base behind us, rather than just individual or collective opinion. The Primary Care Home is about building from the registered list, which has served the NHS so well and recognises patients access the NHS through general practice. This new model of care will be more ambitious in the delivery of first contact.”

Now that the implementation programme has been published, NAPC is looking to prepare and develop potential PCH test sites over the winter, with the test sites going live from April 2016.

Links:

NAPC announcement

NACP ‘The Primary Care Home’

NACP ‘The Primary Care Home’ FAQ

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