1 / 18

NEW Service

NEW Service. Central Cheshire PCT Dr Bill Forsyth. A Bit of History…. Once upon a time in a galaxy far, far away…… Historical Accident of GP OOH Cover On Call as it used to be……… Change of Landscape Shared Rotas Co-operatives New GP contract. Consistent Themes. Fear of Change

roy
Télécharger la présentation

NEW Service

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. NEW Service Central Cheshire PCT Dr Bill Forsyth

  2. A Bit of History…... • Once upon a time in a galaxy far, far away…… • Historical Accident of GP OOH Cover • On Call as it used to be……… • Change of Landscape • Shared Rotas • Co-operatives • New GP contract

  3. Consistent Themes • Fear of Change • ‘What if you get busy?’ • ‘I don’t want him looking after my patients’ • ‘It’ll never work’ • ‘Our system can’t be improved on’ • Rapid normalisation/acceptance of new systems • Demarcation disputes - esp A&E • Lack of whole system approach

  4. Current Position in Central Cheshire • Population 250,000; 30 practices • 5 different sets of arrangements across PCT • 3 different Co-ops within PCT • 3 practices on boundaries with other PCT Co-ops • Concerns around Deputising Service used by 2 Co-ops

  5. Blocks in Old System • Insular, GP-dominated • ‘Can’t be improved on’ • Lack of strategy/development • Poor IT use • Reluctance to work with A&E, other agencies • Lack of equity across PCT

  6. Initial Survey Results • Indicated 100% GP opt-out • Indicated number of GPs willing to do some OOH work • Some times less popular than others • No surprises!

  7. Options • Status Quo - not viable • Existing Co-ops flexing to cover whole PCT - unwillingness to do so; high costs for same service covering same areas • Use of Deputising Service - quality concerns/cost • PCT run service

  8. PCT Approach • One element of GMS Implementation Plan • Linked to Emergency Care Network • Collation of Data on activity • Finance - available resources and costs • Group to oversee - appropriate Membership • Underpinning work-streams • Outline proposals for comment/revision • Process of continuing refinement of plans

  9. Outline Plan • NOT ‘more of the same’ • NOT just a GP service • April 2004 start • Single PCT run service • Central Triage - robust, good quality • 2 main PCCs - VIN and Leighton Hospitals • Co-location/Integration with MIUs

  10. Outline Plan • Service tailored to match demand • Service worked up in partnership with MCHT, MRAS, PT, SS • Involving other disciplines - paramedics, SS, NPs, DNs, etc. - skillmix • Evolving service - initially heavily GP-led • Gradual ‘growing’ of other staff • Close monitoring of demand, problems, etc. with appropriate adjustment to service

  11. Critical Planning Elements • Rotas • Recruitment - practices, GPs, salaried GPs, NPs, other staff • Finance • Not enough money in the system • ‘In generous baseline’ as usual • No option but to fund gap

  12. Other Key Elements • Will and Commitment • Communication, communication, communication • Public Consultation • Clinical expertise and input • Recruitment • Management and Organisational support • Pharmacy Minor Illness and Rep Rx Schemes • Shared working with neighbouring PCTs

  13. Shared PCT Working • Other Cheshire PCTs • Adastra/Technical Links Programme • Sharing best practice • Cross-boundary issues

  14. The Future? • Evolving Service • Management Board to oversee service delivery/quality, shape and develop service • Appropriate membership critical • PCT commitment • Strategy/Innovation • Integration with A&E/MIU • Staff Training and Development

  15. Opportunities in PCT Run Service • Ability to cope with Financial Risks • HR/Finance/Management Support • Removal of vested interest/demarcation disputes • Leverage to broker whole system change • Shared working • Easier to realise A&E/Minor Injuries, Ambulance Service benefits • Other organisations

  16. ‘Mutual’ organisations • Some of ideas seductive • Should NHS be more like this? • Disparaging of PCT ability to provide service • Distrust/fear of PCTs • Could be described as ‘more of the same’ or attempt to preserve status quo • ‘Independence’ - good or bad thing?

  17. From PCT Perspective • Complicated/complex • Introduces another organisation • PCT remains responsible anyhow • Alternative is simplicity and control • Will this deliver integrated, whole-system working? • Lack PCT resources - ?long-term viability • Balancing risks and benefits

  18. Way Forward? • Understand wide variations in Co-op and PCT maturity/skills/attitudes • Need to build relationships/trust • Many similar strands to proposals • Objectives should be the same • Likely to be variety of solutions • Does it matter as long as deliver?

More Related