Ben was CEO of Nene CCG for 8 yrs. He was a Director of an acute trust and has run national improvement programmes. He is a founding director and Principal Consultant of Ockham Healthcare, which he describes as ‘a platform for change’.
Reports in the HSJ that Southern Health Foundation Trust is to set up a joint venture with a GP practice and employ practice staff have created consternation in some sections of general practice.
Practices are concerned that the Southern Health initiative might mark a further degradation of the model of independent general practice, and that the local FT is being ‘predatory’ in the face of the difficulties general practice is currently experiencing.
I recently spoke to Chris Ash, the Lead Director for the MCP at Southern Health, and what I found was something completely different. It was clear to me that Chris and Southern Health fully understand the importance of general practice (‘it does 90% of the work for 10% of the resources’), the critical role it plays in the local health economy (‘if general practice falls over, the rest of the system falls over’), and the interdependence that exists between them (‘we can’t do this without general practice and general practice can’t do this without us’).
It was also clear that Southern Health are committed to supporting general practice to succeed and in Chris’s words, ‘truly doing it as a partnership’. The FT is putting money directly into general practice, for example funding GP leadership time. He recognises that there is always a risk that big organisations will revert to type because of the financial and operational pressures. The biggest challenge as he sees it is not between commissioners and providers, but between providers because of the lack of support for collaboration over competition in the NHS in the recent past.
The plans, nonetheless, are radical. They include creating primary care access centres for populations around 70,000, that will have 7 day 8-8 access, where all the on the day demand for local practices will be treated by a wider inter-disciplinary team including a range of professions such as extended scope physiotherapists. In addition practices are being encouraged to sub-specialise; a single physical and mental health team is being brought together with the primary care team; and population health data is to be used as the basis for hospital and community based specialists to work with general practice to improve outcomes.
What I found most striking about the conversation with Chris was the fact that other providers in the system were taking responsibility for the development of general practice. In many places general practice is left to get on with it itself. In others CCGs have worked hard to provide support where they can. But rarely have I come across such a clear articulation of the responsibility of providers such as the community and acute trusts to play their part in the development of general practice, and such a willingness to take this on.
My conclusion is not that Southern Health is a threat to general practice; rather it is leading the way in showing the role that providers in the system need to take in supporting general practice to extricate itself from the precarious position it finds itself in today, in order that the system as a whole can be successful.
You can listen to my conversation with Chris Ash from Southern Health in full HERE
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