Improving Access to General Practice

NAPC takes the view that good quality care is the right care at the right time delivered by the right person. Waiting too long is a common cause of complaints from patients and is frequently the start of when care begins to go wrong.

Practices and their PCTs should develop local solutions to access and waiting problems. Nationally superimposed targets and guidance may not work. For example, patients in rural areas are more likely, on balance, to want their surgery open on Saturdays, while patients in urban areas are more likely to want evening opening or both.

In urban areas, patient choice and competition might be a powerful lever for change. In rural areas, different factors will influence change.

An advantage of extended opening hours, which could be provided in collaboration with out of hours services, is that patients are attracted to a practice providing this service - we are now in competitive times - and extended hours enable practices to position themselves for future innovation.

Several of NAPCs executive member’s practices have developed local solutions to extending ‘in hours’ opening. The following is an example of developing a low cost open 8-8 service.

To download the full article click on link below.

NPDT NATIONAL PRACTICE BASED COMMISSIONING PROGRAMME

What is the Programme?
This is a development programme of support for all PCTs and their practices to help with the practicalities of developing Practice Based Commissioning. The programme will help to make a reality of the roll-out of PBC by providing a faster timeframe than if each PCT or individual practice set about it in isolation.

The programme will do this by sharing learning from those who have already done it, by training people in the use of quality improvement tools to take advantage of good practice identified elsewhere and by placing clinicians in the driving seat. The programme capitalises on clinical engagement by ensuring that PBC is viewed as a means to an end and not an end in itself – and that end sought is an improvement in the services provided for patients.

The programme aims to support:

• Engagement with local clinicians in the re-design of services (with a focus on both unscheduled and scheduled care)
• Re-design of commissioning systems to support improved service delivery
• Faster universal roll-out of PBC
•Support the development of PCTs and practices to deliver PBC

Why NPDT?
NPDT’s experience has shown that to achieve major change you need to do more than inform people of ‘what’ to do, you actually need to change peoples’ behaviour. Changing behaviour needs a completely different approach – a methodology of behaviour change that presents the ‘how’ as well as the ‘what’. NPDT has substantial experience and results in this area.

Structure of the Programme
Based on earlier learning from other programmes, including the Primary Care Contracting Collaborative, we have built upon our original collaborative model to offer additional, integrated support for the NHS. There are a number of phases to this programme which include:

• a Preparatory Period to ensure PCTs and practices have their data, informatics and finance structure and functions in place so they are ready to take advantage of the collaborative phase
• an Assessment Point that will determine the PCT and practice readiness to progress
• a Collaborative process to engage local clinicians in the practicalities of Practice Based Commissioning as a means of delivering improved services
• a process of Parallel Learning for other organisations

The timeframe for this Programme is:
• all PCTs engaged in the process within 8 months of the starting point through 3 waves (by December 2006).

Waves
Wave 1 (National wave): The aim is to recruit initially one PCT site per current SHA area, providing each SHA with a PBC exemplar site. These 28 PCTs will form the national wave that will develop the worked examples of PBC. These sites will need to be able to make improvements quickly and will therefore need to be areas that have already done some work on PBC, e.g. indicative/real budgets are in place, practices are keen to get involved etc.

Waves 2 and 3 (Regional waves): Recruitment of the remainder of the PCTs in the country in the spread phase will be carried out by the 11 local NPDT Centres working with all the SHAs. Within 2 waves all PCTs will have been offered an opportunity to take part. These waves will give sites a longer preparatory period to help practices and the PCT to start working effectively together and will be run shortly after the national wave commences.

What is a site?
A site will consist of a PCT and up to 5 practices formally participating on the programme, either individually, as clusters/localities or as representatives of localities, and that are interested in working on the chosen service areas and wish to implement PBC.

For further information please contact Jacquie White, NPDT Programme Director, on 0161 236 1566. Or go to our website on: www.npdt.org

NPDT NATIONAL PRACTICE BASED COMMISSIONING PROGRAMME

What is the Programme?
This is a development programme of support for all PCTs and their practices to help with the practicalities of developing Practice Based Commissioning. The programme will help to make a reality of the roll-out of PBC by providing a faster timeframe than if each PCT or individual practice set about it in isolation.

The programme will do this by sharing learning from those who have already done it, by training people in the use of quality improvement tools to take advantage of good practice identified elsewhere and by placing clinicians in the driving seat. The programme capitalises on clinical engagement by ensuring that PBC is viewed as a means to an end and not an end in itself – and that end sought is an improvement in the services provided for patients.

The programme aims to support:

• Engagement with local clinicians in the re-design of services (with a   focus on both unscheduled and scheduled care)
• Re-design of commissioning systems to support improved service   delivery
• Faster universal roll-out of PBC
•Support the development of PCTs and practices to deliver PBC

Why NPDT?
NPDT’s experience has shown that to achieve major change you need to do more than inform people of ‘what’ to do, you actually need to change peoples’ behaviour. Changing behaviour needs a completely different approach – a methodology of behaviour change that presents the ‘how’ as well as the ‘what’. NPDT has substantial experience and results in this area.

Structure of the Programme
Based on earlier learning from other programmes, including the Primary Care Contracting Collaborative, we have built upon our original collaborative model to offer additional, integrated support for the NHS. There are a number of phases to this programme which include:

• a Preparatory Period to ensure PCTs and practices have their data, informatics and finance structure and functions in place so they are ready to take advantage of the collaborative phase
• an Assessment Point that will determine the PCT and practice readiness to progress
• a Collaborative process to engage local clinicians in the practicalities of Practice Based Commissioning as a means of delivering improved services
• a process of Parallel Learning for other organisations

The timeframe for this Programme is:
• all PCTs engaged in the process within 8 months of the starting point through 3 waves (by December 2006).

Waves
Wave 1 (National wave): The aim is to recruit initially one PCT site per current SHA area, providing each SHA with a PBC exemplar site. These 28 PCTs will form the national wave that will develop the worked examples of PBC. These sites will need to be able to make improvements quickly and will therefore need to be areas that have already done some work on PBC, e.g. indicative/real budgets are in place, practices are keen to get involved etc.

Waves 2 and 3 (Regional waves): Recruitment of the remainder of the PCTs in the country in the spread phase will be carried out by the 11 local NPDT Centres working with all the SHAs. Within 2 waves all PCTs will have been offered an opportunity to take part. These waves will give sites a longer preparatory period to help practices and the PCT to start working effectively together and will be run shortly after the national wave commences.

What is a site?
A site will consist of a PCT and up to 5 practices formally participating on the programme, either individually, as clusters/localities or as representatives of localities, and that are interested in working on the chosen service areas and wish to implement PBC.

For further information please contact Jacquie White, NPDT Programme Director, on 0161 236 1566.    Or go to our website on: www.npdt.org