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Centric Health
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The Centric Health Model
1st National Primary Care Conference –
Examples of Innovation in General Practice
Dr Ray Power
17th November 2011
Centric Health – Business Structure
Ireland
Australia
Medical RecruitmentPrimary Care Diagnostic Imaging
UK
Ireland
• 1988 - Qualified University College Dublin• 1993 – Australian General Practice• 1994 – Established Mediventure GP recruitment service• 1999 – Returned to Ireland to establish Locumotion• 2003 - The Well opened in the Beacon medical campus
Dr Maurice Cox• 1993 - Qualified Trinity College, Dublin• 1994 -M.Phil Cambridge• 1994 -1998 Orthopedic residency, FRCSI• 1998-2004 - McKinsey and Co (Associate Principal)• 2004 - Joined Centric Health full time as CEO
Dr Ray PowerDr Paul Carroll
• 1992 - Qualified University of Western Australia• 2000 – FRACGP Australian GP qualification• 2001 – Worked as locum GP with Locumotion• 2003-2005 – The Well and Locumotion• 2002 & 2005-2006 – GP in Australia• 2006 – Returned to Ireland to head up GP Division of Centric Health• 2006 - MICGP
The Centric Health GP Team
What sums up Centric’s approach
1. Infrastructure or ‘Practice Hardware’ is critical but only one part of the story
Looks great but now …but nearly broke our hearts!
Ranelagh Medical
PJ Monaghan, Managing DirectorQuantity Surveyor by profession, B.Sc. Surveying (Hons)2003 - to date; Managing Director of Leading Edge Project Directors2001 – 2003; Financial Director and Shareholder, Walsh Maguire & Co Ltd1995 – 2000; QS in Walsh Maguire & O’Shea Construction company
Conor Reilly, DirectorQuantity Surveyor by profession, B.Sc. Surveying (Hons), Dip. Proj. Management2004 - to date; Project Director of Leading Edge Project Directors2000 - 2004; Senior Quantity Surveyor with Walsh Maguire & Co.1999 - 2000; Quantity Surveyor, Austin Reddy & Co
Fergus GordanB. Eng (Hons)Post Grad. Project Management (Distinction)Health & Safety Management
Time for the professionals…
CLARINGTON PROPERTIES LTDCLARINGTON PROPERTIES LTD
First project under new structure - Newbridge
Newbridge Medical - Jan 2013
Getting a balanced funding structure has been key
Senior Debt – Bank of Ireland 80% Loan to cost No more than 10x rent Centric Health doctor continuity has provided comfort re opt out in
HSE lease
Pension Funding 10% of Costs Pension fund annual paid coupon 12% Refinanced at year 5
Risk Equity – Centric Health
What sums up Centric’s approach
1. Infrastructure or ‘Practice Hardware’ is critical but only one part of the story
2. Pushing the definition of community care services
The Continuum of Primary Care
Reactive and Proactive Reactive Proactive
GP Practices
Doctor Surgery Doctor
Surgery
Hospital A&E Hospital A&E
15-20% presentations could be seen in a GP
practice
3-4% require referral onto secondary care
75-80% presentations are exactly consistent with the
proposition
- Clear Patient Proposition
12
Community Diagnostics
Community-referred X-ray and Ultrasound service in Arklow Primary Care Centre, Co Wicklow, on behalf of the HSE
Direct access for 30 GP’s
Over 6,000 X-rays and 2,500 Ultrasounds performed per annum
Average reporting turnaround time is 120 minutes (non-urgent)
VhiSwiftCare Clinics
Ennis General Hospital
Health Risk Assessments
BLISSFULLY IGNORANT
TIME BOMBS
WANNABESCHAMPS
1 2 3 4 5 6 7
1
2
3
4
5
Increasing risk (No. Of risk factors)
In
cre
as
ing
wil
lin
gn
es
s t
o c
ha
ng
e
HRA
Patient Coaching
Chronic Disease Management
What sums up Centric’s approach
1. Infrastructure or ‘Practice Hardware’ is critical but only one part of the story
2. Need to push the definition of community care services
3. Embedding quality from the outset
Our Quality Agenda
1. Clinical Governance structures
2. Accreditation (CHKS UK & ISO9001)
3. CME including Audit
4. Meducation
What sums up Centric’s approach
1. Infrastructure or ‘Practice Hardware’ is critical but only one part of the story
2. Pushing the definition of community care services
3. Embedding quality from the outset
4. Nurturing our talent or ‘Practice Software’
These guide our day to day behaviours & underpin our company culture
Pride in what we do – humility in how we do it Patient Centric
Power of the team
Courage to fulfil our potential
Relationships based on trust
Our values….
Clinical & AdminSkills
Patient Relationship
Practice Building
Team leadership and communication
People development – The emerging GP job description
Associate Salaried +/- performance bonus
may be sessional
Junior Partner Salary + small profit share
shows commitment to practice
Partner Salary + 1/x profit share (x = no of partners)
owner of the business
Senior Partner Salary + overall profit share
The Professional Partnership Journey
The future of Centric Health – The 1st Fellowship programme graduates
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