@anyadei @NHSEngland Who can ever clarify what the NHS intends with structural reorganisations? But... a) primary care is the right place to get person centred care right, embedding care planning, linking to other teams/services close to home (pharmacy, social care, community nurses etc)... #1
@anyadei @NHSEngland b) primary care is (or should be) more community rooted, able to work with community provision of emotional & social support, meaningful activities, fitness, volunteer/work opportunities etc (hence social prescribing)... #2
@anyadei @NHSEngland c) primary care leaders tend (though this may have reduced a bit) to stick around with their patient populations, while other NHS leaders churn & disappear.
However... #3
However... #3
@anyadei @NHSEngland If primary care is to have a new mission *not* to just be a referral point to secondary care, but to deliver person centred coordinated care, manage population health and tackle inequalities (as per the new shared view of quality), it's really hard to do from small practices.. #4
@anyadei @NHSEngland So, the idea is to get greater scale into primary care, pulling in more resources to deliver more/differently, and taking responsibility for the health of a significant population (hence the c. 50,000 figure).... #5
@anyadei @NHSEngland I think @nhsengland hopes that by providing a pcn contract, incentives/funding, support to develop, it can help pcns emerge from GP groupings that have developed as 'reform without policy' bit.ly/23AhWB9 #6
@anyadei @NHSEngland The Primary Care Home model/movement is one building block napc.co.uk/primary-care-h…. GP federations such as Taurus are another reform.uk/reformer/prima… #7
@anyadei @NHSEngland Big questions remain, though. Doubtful that just steering a chunk of the new (T May) £s to primary care will be enough. Need a significant switch of resource away from acute & into primary... #8
@anyadei @NHSEngland Not just £ resource, but stuff/services (diagnostics, urgent care beds for community) & people (nurses, specialists) need to come out of 2ndry & into primary care. #9
@anyadei @NHSEngland Much reform needed, not just of funding streams but of the whole payment system - population outcomes, not activity. Good that @CareQualityComm calling for this. #10
@anyadei @NHSEngland @CareQualityComm And from the VCSE sector viewpoint, pcns might just seem like nyet another shifting of goalposts re who is responsible for making good community partnerships, engaging our expertise & support, etc. Should we trust them? Invest our time in them? ... #11 (ends)
