SYSTEM LEADERSHIP

The NHS in England is encouraging organisations to work in partnership to take on collective responsibility for resources, providing joined-up, better coordinated care to improve health outcomes within defined populations.

There are a number of terms being used to describe how this is being taken forwards, such as Sustainability and Transformation Partnerships (STPs), Integrated Care Systems, Integrated Care Alliances, Primary Care Homes and Primary Care Networks.

Whatever terminology is used, how local health and care leaders work together will ultimately decide how the NHS works in future.

One of the challenges in future will be how we support a system-wide approach to medicines optimisation – putting governance frameworks in place and supporting local pharmacy leaders to help people and the NHS get the most health benefit and the best value from medicines.

The Royal Pharmaceutical Society believes that the expertise and clinical knowledge of pharmacists, as medicines experts, working collaboratively across all levels of the NHS, will facilitate services being integrated around the patient, provide the capacity to address the wider workforce challenges, the competency to relieve the pressures within primary care, and the skills to enable system-wide medicines optimisation.

 

Primary Care Networks

NHS England’s Next Step On The NHS Five year Forward View (2017) included proposals for more GP practices to work together in ‘hubs’ or networks. This builds on the ‘Primary Care Home’ approach championed by the National Association for Primary Care and is based on the premise that a combined patient population of at least 30-50,000 allows practices to share workforce, expand diagnostic facilities, and share responsibility for urgent care and extended access. It notes that they also involve “working more closely with community pharmacists, to make fuller use of the contribution they make”.

NHS England is now working towards expanding ‘Primary Care Networks’ across the country. The Next Steps document noted that there are various routes to achieving this, including GP Federations, Primary Care Homes, and Multispecialty Community Providers.

As local health leaders work together to develop their own approach to Primary Care Networks, the RPS has set out five key considerations to help make the most of the health and care workforce, encourage more joined-up working, and deliver person-centred care.

 

Key considerations for Primary Care Networks

Patient and public involvement Patient and public involvement

  • All care provided must be person-centred. 
  • Engage early with patients, carers and the public to co-design primary care services.
  • Take a community ‘asset’-based approach, to mobilise skills and knowledge to improve health and wellbeing.
  • Increased role for third sector organisations and greater recognition of the role communities can play.

Leadership drawn from all of primary care Leadership drawn from all of primary care

  • Primary care means all of the services that provide a front door to the NHS – whether it is general practices and their staff, pharmacists working in the community, in GP practices, in care homes and in urgent care, or services such as dentists and opticians.
  • Consider the whole of the workforce across primary care when developing systems and services.
  • Primary care leaders should encourage collaboration across and within professions in different care settings.
  • Work with training hubs to enable equity of access for the whole primary care workforce to education and training for current and future roles.

The value of medicines is recognised The value of medicines is recognised

  • Primary care plans should link into the NHS England Medicines Value programme to ensure that every individual patient and the NHS as a whole get the most benefit from medicines.
  • Ensure local system leadership includes medicines optimisation advocates.
  • Primary care plans should include how they will meet the WHO Global Patient Safety Challenge to reduce severe avoidable harm from medicines.
  • Pharmacovigilance should drive quality improvement and patient safety.

Interoperability of data Interoperability of data

  • The interoperability of data is central to progress and there needs to be adequate interoperability to enable information flows between all primary care professionals, and with the wider health and social care systems.
  • Support workforce digital literacy to deliver data-driven care for the benefit of patients.
  • Develop clinical standards to support information transfers.

A greater focus on prevention A greater focus on prevention

  • Support the public’s health and well-being and promote self-care.
  • Primary care plans must include a focus on self-care and supported self-management of long-term conditions.
  • Develop behaviour change and consultation skills of healthcare professionals to ensure person-centred care.

NHS Long-Term Plan

The Government announced additional funding for the NHS and asked NHS England to set out a long-term plan for the future of the NHS by the autumn Budget 2018.

NHS England is now working on a plan setting out its ambitions for improvement over the next decade, and its plans to meet them over a five-year funding settlement.

As part of this process, it asked people to contribute their ideas, experiences and insights by 30 September 2018. You can find out more here.

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