Primary Care Home Mr. Nick Sutton Programme Manager Wakefield Integrated Care Partnership & Primary Care Home
Summary • Explain the language… • What is the Wakefield Way? • Relevance to population health • Vehicle for partnership working
Practice Networks A group of GP practices that have decided to work together to jointly commission and provide services.
Primary Care Networks • General practice networks working together with community, mental health, social care, pharmacy, hospital and third sector • Enable proactive, personalised and integrated care • Responsible for population health management • Small enough to provide the personalised care, but large enough to deliver economies of scale • Defined population of between 30 – 50k Primary Care networks animation: https://www.youtube.com/watch?v=W19DtEsc8Ys
Primary Care Home Primary Care Home is a specific form of Primary Care Network. Developed by the National Association of Primary Care with key characteristics: 1. Defined set of priorities focusing on population health 2. Higher level of integration on service delivery 3. Greater collaboration across health and social care 4. Common outcome framework
The Wakefield Way • Practices have been divided into 7 Primary Care Homes • All registered with the National Association of Primary Care • Network contracts have been agreed • Leadership teams have been appointed • Provisional priorities have been identified • Partners and patients actively engaging • Social prescribing service established
Impact on Population Health • Shift from condition management to prevention • Emerging priorities focus on population health • Broad range of partners delivering common set of outcomes • PCH is a vehicle for delivery of population health outcomes • Leadership development programme includes population health management
Emerging Priorities • Obesity WHA North • COPD WHA Central • Improving mental health WHA South • Improving mental health Brigantes • Support for people pre-diabetes Five Towns • Smoking Trinity Health • Self care West Wakefield
Public Health Themes Education • Partnerships between schools and care homes • Corporate parenting initiatives • Raising awareness of public health issues in schools Housing • Assisted living schemes • Mental health support for vulnerable tenants • Local homeless initiatives Family, Friends and Communities • Mapping community assets • Community organisation around public health • Community integration / social isolation
Joint Working Partnerships • Joint working across practice and community nursing • Aligning Connecting Care Hubs with PCHs • Aligning Early Health Hubs with PCHs Social prescribing • Addressing social isolation • Better access to voluntary and community services • Enabling GPs to focus on people with medical needs Care Homes • Coordinated approach to supporting care home residents • Reducing avoidable hospital admissions • Better Advanced Care planning
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