Not a massiver tweeter but plenty of stuff to share regarding the draft PCN specs having been a vanguard site with plenty of learning to share (have all the scars). #PrimaryCareNetworks @NHSEngland @NikkiKF So here goes 1/9
ambitions of the spec are commendable (the why),however the hows are not thought through properly.
Funding for care home mdts doesn't account for number of patients in care homes in each practice. Massive issue if you're a practice with 10 CH residents vs practice with a 100 2/
Funding for care home mdts doesn't account for number of patients in care homes in each practice. Massive issue if you're a practice with 10 CH residents vs practice with a 100 2/
Aligning to care homes needs significant collaboration with care homes and leverage from the council. Extra support needed eg nursing input into care homes( eg older people , frailty practitioners),podiatry, salt, dieticians etc. GPs may lead the mdt but not the most impactful.3
Technology and data sharing key to all of the proactive/ anticipatory care and working with wider community health care. Considering telecare, NEWS tablets, telemedicine etc.4/9
Anticipatory care, ie patient segmentation and risk stratification has a current weak body of evidence as no one can agree where to invest time and effort, high users? Or the tier below.. ie predictive modelling vs threshold modeling..5/9
This however doesn't help with GP capacity.. you'll be asking gp to invest time now to save for the future..a leap of faith that needs to be widely supported (I'm personally supportive with local evidence). Definitely need pump pruning and the DES funding insufficient. 6/9
Both care home ward rounds and anticipatory care need significant funding to general practice, organisational development across all community and working with LA and supportive enablers. 7/9
A weekly or fortnightly ward round is subject to the number of patients in the care home. Doable but will take at least 2 years to align all patients to a single practice ( easier than PCN due to clinical governance) across the PCN. Domino effect 8/9
could write more but doubt will be read. Information and learning available if nhse interested #PrimaryCareNetworks @NHSEngland 9/9
Happy to elaborate on any points, @NikkiKF #PrimaryCareNetworks @ATBSunderland @SunderlandCCG .. plenty of excellent people leading on various bits and pieces.
