Healthcare delivery through to implementation and evaluation.
4. Access to community resources – where approaches connect people to community resources, practical help, group activities and volunteering opportunities to meet health needs and increase social participation.
These actions have arisen from research into the fact that people are living longer with complex health needs but are often struggling to access primary care, social care and community-based services to help them to meet these needs. Into the bargain, many people who have these needs have no access, due to poverty, to internet services, which would help them to become informed of the required services. This disenfranchisement, not only of the elderly, but also those in poverty, is contributing to many of the inequalities that they are experiencing. This may mean that their health deteriorates
which indicates they may need hospital care instead of being managed in the community. It is also more expensive for the taxpayer. There are many people living with two or more long- term conditions such as diabetes, dementia or mental health illness. They need a great deal of ongoing support, which is often best provided by primary care rather than one-off crisis episodes of hospital treatment. What people need is to access primary care, so that they can be diagnosed, monitored, supported and receive treatment when they need it. Early interventions and ongoing primary care support may prevent future urgent hospital care.
Primary care collaboratives The existing primary care networks (PCNs) will in future in some areas of the country become one of the components of the proposed and nascent primary care collaboratives. A PCN is a group of GP practices working closely together, aligned to other health and social care staff and
organisations, providing integrated services to their local population. A PCN covers a patient population, of 30,000-50,000 patients, although by approval of the commissioner, this may be lower in rural and remote areas, and higher where it is appropriate.3 Most GP Practices have membership of a
PCN now, and PCNs look as though they will become part of a larger group, as part of the Integrated Care Board. An ICS brings together NHS providers, commissioners, local authorities, and voluntary community sector (VCS) partners together to collaboratively plan and organise how health and care services are delivered in their local area. They serve populations of around 1-3 million people, with the health and social care partners from different sectors in that geographical area coming together to set strategic direction and to develop economies of scale for cost efficiencies. This appears to the author, to be the shape and size of the described primary care collaboratives, although there may be invisible differences.
We will have to wait to understand what the
new government wants to do about access to primary care and whether this ‘collaborative’ is a new title for organisational change. There is enormous talent and energy within general practice, and it will be interesting to see how this is harnessed for the benefit of patients going forward. Primary care, as we know, includes general practice, community pharmacy, optometry, dental services and audiology. Integrated Care Boards are working using a
set of different models. Provider collaboratives already existed in some areas, particularly in mental health and there is research going back to the early 2000s in this area. Collaboratives are also not uncommon in the acute sector. Some ICBs have taken a multi-sector approach to achieve collaborative relationships and others have multiple collaboratives representing different provider types.4 Collaboratives are incredibly varied in the
scope of what they deliver. Some are focused on influencing upwards and ensuring there is a primary care voice. Others have taken that a step further and are actively involved in shaping services and ensuring that primary care is part of the discussion on key services such as frailty services. The NHS Confederation has recently published an in-depth report looking at primary care providers.5
Leaders they spoke to
described several opportunities for collaborative colleagues, such as: l Flexible pooling of resources to support practices to deliver services at scale either locally or as a delegated function, such as back office, contract management, HR and workforce employment and provision, administration of services.
l Development of innovative solutions with 16
www.clinicalservicesjournal.com I October 2024
Andrey Popov -
stock.adobe.com
Prostock-studio -
stock.adobe.com
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