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.

Responsive

Based on needs of informed

patients

Quality based care in least

invasive ways

Multi-disciplinary teams

Operating across organisational

boundaries

Vision for Primary Care

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 outcomesfor people with long termconditions by offering apersonalised care plan forvulnerable people most at risk;and to reduce emergency beddays by 5% by 2008, throughimproved care in primary careand community settings forpeople with long termconditions.

Infrastructure

Health and social system environment

Decision support tools and clinical

information system (NPfIT)

Community Resources

Delivery System

Disease Management

Case Management

Better outcomes

Prepared and proactive health and

social care teams

Empowered and informed patients

SupportedSelf care

Promoting Better Health

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The NHS and Social CareLong Term Conditions Model

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”)