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Blueprint delivery plan year one

The Primary Care Blueprint Delivery Plan – Year 1 describes the key practical actions to be taken in year one (2024/25) across all chapters of the Greater Manchester Primary Care Blueprint.

A PDF version of the plan is available to download and a full copy is available to read below. You can navigate to each of the headings in the delivery plan by clicking on the relevant link in the content table to the right of this page. To return to the top of the page click on the blue arrow on the bottom right hand side of the page.

Please note, for accessibility purposes the table under the ‘Summary of chapter structures in the delivery plan’ heading in the PDF version of the plan is set out on this page as a list instead of a table (see the ‘Summary of chapter structures‘ heading for more information). You can navigate to the deliverables for each chapter by clicking on the relevant point under each chapter heading in the content table to the right.

Feedback

We welcome feedback, as well as examples of innovative practice that can be shared across the primary care system. To offer feedback, or ask any questions, please contact england.primarycaretransformation@nhs.net 

Primary Care Blueprint Delivery Plan – Year 1

Executive summary

The delivery plan describes the approach to agreeing the actions to be taken in order to meet the ambitions outlined in the GM Primary Care Blueprint, and a summary of key practical actions to be taken across all Blueprint chapters in year one (2024/25).

It also describes the approach to the rolling review of the plan and references the role of the Blueprint Delivery Unit in the coordination, reporting, and risk and assurance processes which will support the effective system-wide engagement with and delivery of the actions.

Introduction

The Greater Manchester (GM) Primary Care Blueprint is a five-year plan for primary care across Greater Manchester. It describes how we plan to address the risks to the stability and sustainability of primary care as highlighted in the Fuller Stocktake (2022) and sets out our prescription for change.

Developed in a truly collaborative way across our primary care family in Greater Manchester, each of the nine chapters of the Blueprint has been widely engaged across sectors and localities and written by a triumvirate partnership of chapter leads representing different parts of the system.

The blueprint is fully inclusive of community pharmacy, dentistry, general practice, and optometry, and it has been developed through extensive consultation with the Voluntary, Community and Social Enterprise (VCSE) sector, the Alternative Provider Collaborative, and the public; therefore, referencing the key areas of primary care in Greater Manchester. The Blueprint was formally signed off by the GM system at the GM Integrated Partnership Board on 29th September 2023, and the final version can be found here.

Purpose

Where the blueprint sets out the agreed ambitions of Greater Manchester’s primary care system, the delivery plan describes the underpinning actions which will be taken in order to meet these ambitions. Given the iterative and evolving nature of the blueprint, it has been proposed that a yearly delivery plan is developed as opposed to a five-year view of the totality of the period of 2024 – 2029. This will enable teams to continually review their progress toward agreed deliverables with the opportunity to flex the approach in response to changes and challenges in the system.

This delivery plan was developed following extensive review of documentation from the blueprint work-up in summer 2023 and engagement with the triumvirate chapter leads and broader colleagues across the GM primary care system throughout late 2023.

The Blueprint is intended to act as an accessible summary of the wealth of information gathered during this scoping exercise regarding the key actions that support the delivery of the blueprint ambitions. It is also helpful to recognise that whilst this delivery plan references the key transformational aspects of work both planned and underway, there remains a wealth of work being undertaken as business as usual across the entire system. Summaries of the key actions per deliverable over the first year of the plan are featured as the main body of the document. Also featured is a high-level view of accountable boards, planning groups and areas of the delivery of actions. For further information on resourcing and risks, please contact england.primarycaretransformation@nhs.net

Progress is being made to identify the output and outcome measures to be expected from the completion of these pieces of work in the interest of consistently evaluating the extent of success and process taken to achieve the blueprint ambitions.

Given the current financial challenges being faced by the system, the actions featured in this delivery plan focus mostly on what may be achievable in year one, though there remain references to longer term ambitions where appropriate. The scope of a number of year one actions have been changed in the event where little or partial resource is available. This is to prioritise scoping and baselining how the system currently operates to better understand the gap between where we are now and where we would like to be. It also ensures that work can still be carried out actively with existing resource and teams at this early stage. Links between Year one action outputs and overall ambitions of the blueprint will be identified throughout the operation of this delivery plan.

There is an appreciation of the current flux and sustained pressure in the system, and the delivery plan has been developed in a way which will enable individual programmes to flag where they need to change so that work can be delivered according to need whilst ensuring stability and sustainability for providers.

Delivery of actions

As with the drafting of the GM Primary Care Blueprint, the success and delivery of the actions in the delivery plan includes all who are involved in the planning, commissioning and delivery of primary care services in Greater Manchester. This collective involvement is referenced as the Blueprint Delivery Unit.

Coordination, reporting, assurance, risk management and monitoring interdependencies and cross cutting programmes will be supported by a central Blueprint Delivery Unit Programme Management Office (PMO). This is a small team who will be supporting the programme teams in delivering on the blueprint actions, as well as providing a link into GM primary care governance in support of driving implementation, decision making, engagement, supporting alleviation of challenges and management of risks. The Delivery Unit PMO will regularly liaise with the teams carrying out the actions, as well as making connections between the work and drawing in support from senior strategic leaders, subject matter experts and locality leaders where appropriate.

A key function of this PMO is to provide a central method by which we can continue to tell the story and demonstrate the benefit of our unified primary care system – recognising and speaking up about areas of good practice, as well as supporting the adoption, adaptation and spread of things that work well.

The Blueprint Delivery Unit PMO will report into the Blueprint Implementation Group (formerly known as the Primary Care System Board Operational, attended by providers and commissioners) which shall be accountable to the Primary Care Commissioning Committee (PCCC) and therefore, the Board of NHS GM. The Blueprint Delivery Unit will also undertake ongoing engagement regularly with Greater Manchester Primary Care Provider Board (GMPCB) and NHS GM commissioning colleagues.

Commissioning and delivery of nationally directed and statutory work shall be accountable to the GM Primary Care Commissioning Committee (GM PCCC). Development and implementation of local services shall be governed through, locality Primary Care Commissioning committees who are accountable and report into the GM PCCC.  However, where progress on this type of work impacts blueprint delivery (see deliverable 5.1), it shall be reported through to the Blueprint Implementation Group. The work of the Blueprint Delivery Unit is supported by a Blueprint Leadership Group comprised of a small number of senior colleagues in the system and will establish time-limited task and finish groups to provide specialist advice and support to pieces of work where required (see Figure 1).

Assurance, reporting and risk

The Blueprint Delivery Unit PMO will capture and monitor key risks against each chapter and supporting programme teams to implement mitigations and escalate issues to leaders in the ICB governance where appropriate. Programmes should be recording action-level risks within existing programme and project infrastructure, escalating key issues to the Blueprint Delivery Unit PMO where necessary.

Teams will be requested to submit a narrative in the form of a simple highlight report every three months. A draft reporting template and reporting timeline can be found in Appendices 1 and 2.

The highlight report will request updates on each action in the delivery plan and their sustained links to the overall deliverables featured, and any divergence from this. It will also request feedback on any high-level risks or issues, and feedback regarding good news and best practice from teams where work is underway to encourage adoption and spread where appropriate. The highlight report also features a section for chapter leads to flag areas requiring support from the Delivery Unit where appropriate.

In the spirit of the blueprint as an iterative strategy, reporting will be used to review programmes on a rolling basis and to understand if the courses of particular actions are required to shift in the event of receipt of additional resource or changes in scope in order to appropriately meet the deliverables.

It is understood that teams are currently being asked to operate and transform in the midst of sustained operational pressures. The Delivery Unit will therefore take steps to make the reporting aspect of this work ‘soft-touch’ where possible – e.g., utilising existing meeting notes / documents for highlight report updates, or utilising existing meetings with project teams.

Recognising and acting on the interdependent nature of each blueprint chapter will be paramount to the achievement of the deliverables. Highlight reporting will request teams to demonstrate how they have been engaging with the enabling and interdependent chapters where this is indicated in the delivery plan.

Communications and engagement

A Blueprint Leadership Group will be established to monitor progress, raise issues, and share learning, and will act as a regular touchpoint for engagement. This regular and action-focused meeting will be supported by the Blueprint Delivery Unit PMO.

The outputs of these meetings will be supported with regular communications to the system regarding progress of the blueprint delivery – including good practice and learning around what is working. This will be supported via GM governance where appropriate – e.g. The Blueprint Implementation Group supporting the spread and adoption of good practice where it is recognised through regular reporting. Communications feature heavily as a key enabling factor to the blueprint, and communications team input will be sought in the blueprint delivery unit to ensure these links are maintained. Communications and sharing of good practice will also be supported via the Primary Care Provider Board and ICB website to encourage spread and adoption of ways of working. Further, a member of the GM Communications team will be embedded in the broader Blueprint Implementation Group to ensure that key messages are shared with the system.

Next steps

Following support to this document from the GM Primary Care Commissioning Committee, the Blueprint Delivery Plan was released to the system in May 2024.

The Blueprint Delivery Unit PMO will conduct a ‘quarter zero’ reporting round to introduce and refine the highlight reporting process to programme teams and begin to report on and support progress where this is possible. The team will also continue development of the approach to communications, engagement and evaluation strategies, ensuring broad recognition and understanding of the work currently underway in our unified system.

Toward the end of calendar year 2024, work will commence on development of the year two delivery plan, which will be advised by information from the year one reporting.

Appendices

Summary of chapter structures

The chapters describe the agreed year one actions to meet the ambitions outlined in the blueprint. Year two actions are mentioned where appropriate. Information regarding the nature of resources available to deliver on the actions, such as funding sources and teams and system level groups assigned to the work, is held by the Blueprint Delivery Unit PMO.

Throughout the workup of this plan it was recognised that in many cases, implementing new programmes and transforming services can lead to double running, which has an impact on the bandwidth of staff and teams to deliver. This pressure is recognised as a key risk to the delivery of the blueprint as a whole. The Blueprint Delivery Unit PMO will work with teams to identify where this becomes an issue and flag to system leaders in the governance to support where possible to do so.

Details are also given as to the relative levels of accountability, planning, and delivery of the actions. Actions relating to specific provider disciplines and groups are colour coded in the PDF version of the plan to enable colleagues to see relevant discipline and provider-level actions at a glance.

In the chapter headings below, deliverables are numbered under each of the chapter headings, for example 1.1, 1.2, year one actions for 2024/5 are listed in bold text under each of the deliverables and the relevant accountable board, planning and delivery responsibility is set out using the codes below:

Acountable Board

Planned by

Delivered by

Blueprint delivery plan

Chapter 1: Demand, access and capacity

1.1 Promote and expand access to NHS Dentistry

1st Year launch June 2023 Review of initial implementation March 2024, with planning for 24/25 budget commitment and continuation

GM Primary Care Commissioning Committee

GM Dental Provider Board, NHS GM Dental Team, Local Dental Network

Dental practices

1.2 Improve children’s dental health services

Increase the number of Child Friendly Dental Practices (CFDP) to reduce the number of children being referred to dental extraction under General Anaesthetic

Complete the Oral Health Needs Assessment to determine re-investment of resources as a result of contract hand backs

Maintain the pathway for looked after children being referred into Dental Practices and ensure that they have a dental home

Increase the number of children accessing NHS dental practices who receive fluoride varnish application

GM Primary Care Commissioning Committee

GM Dental Provider Board, NHS GM Dental Team, Local Dental Network

Dental practices

1.3 Increase number of healthy living dental practices

Around 80 practices were signed up to deliver the scheme in 2023/24

Gold standard practices to share the learning so far

Continuation is a part of commissioning intentions and planning for 24/25

GM Primary Care Commissioning Committee

GM Dental Provider Board, NHS GM Dental Team, Local Dental Network

Dental practices

1.4 Expand community pharmacy services across GM

Expand Urgent and Emergency Care (UEC) Pharmacy First by as an additional referral route with a Community Pharmacist for a minor illness or urgent meds supply

GM Primary Care Commissioning Committee

Community Pharmacy Provider Board via Community Pharmacy Services Working Group

Community Pharmacy Providers and Urgent Care Providers

Increase provision of Pharmacy contraception service (1st December Tier 2)

Increase provision of Blood Pressure Check services

Deliver Pharmacy First (Clinical Pathways) service from 31st Jan 2024, offering self-care advice, minor illness support and supply of NHS medicines for 7 conditions under PGD

GM Primary Care Commissioning Committee

Community Pharmacy Provider Board via Community Pharmacy Services Working Group

Community Pharmacy Providers with support from General Practice

Continuing and embedding the Discharge Medicines Service – supporting optimisation of medication and reducing hospital readmission post discharge

GM Primary Care Commissioning Committee

Community Pharmacy Provider Board via Community Pharmacy Services Working Group

Community Pharmacy providers and secondary care providers when discharging patients

Continuing implementation of other nationally commissioned services such as New Medicines Service and Smoking Cessation Service

GM Primary Care Commissioning Committee

Community Pharmacy Provider Board via Community Pharmacy Services Working Group

Community Pharmacy providers, Trusts

1.5 Increase the number of patients accessing community urgent eye care service


NHS 111 redirection pilot to happen over winter 23/24 – continued into Q1 2024-25


Ongoing work to expand the Independent Prescribers in Optometry work – LEHN working with the confederation of GMLMCs. (Links with CP, Workforce) – work to continue year on year to expand and develop – ensuring funding pots are aligned/grouped appropriately

GM Primary Care Commissioning Committee

Local Eye Health Network, working with Confederation of GM LMCs

GM PC Workforce team, Optometry providers

24/25 piece of work with general practice to maximise consistency in messaging across comms channels for the CUES service. Care navigation, websites etc to be explored (important as deflection from GP is a key output)

GM Primary Care Commissioning Committee

NHS GM optometry Provider Board and general practice teams

Optometry providers and General Practice providers

1.6 Expand access to the Glaucoma Enhanced Referral Service

Ensuring workforce are in place, trained and resilient in order to meet demand via the SPOA referrals. Further geographical spread is required in future to maximise the impact of the service. Continuation of work with provider to understand where the work is happening, supporting and promoting practices to increase numbers of practitioners trained and providing the service

Refreshed mapping work to develop a baseline from which to measure increase in coverage

GM Primary Care Commissioning Committee

GM Optometry Provider Board, NHS GM optometry team, Local Eye Health Network

Optometry providers and GERS Single Point of Access

Facilitating access routes to ensure that practices can refer people into the service more easily

GM Primary Care Commissioning Committee

NHS GM optometry team

Optometry providers, optometry Single Point of Access, general practice providers

1.7 Ensure same day urgent access to General Practice where clinically warranted

Launch in line with national Primary Care Access Recovery Programme requirements

GM Primary Care Commissioning Committee

GM Capacity and Access Plans Group

General Practices supported by locality teams

1.8 Ensure all non-urgent patients are seen by general practices within 2 weeks

Launch in line with national Primary Care Access Recovery Programme requirements

GM Primary Care Commissioning Committee

GM Capacity and Access Plans Group

General Practices supported by locality teams

1.9 Fully implement cloud-based telephony across General Practice

Launch in line with national Primary Care Access Recovery Programme requirements

GM Primary Care Commissioning Committee

GM Capacity and Access Plans Group

General Practices, with support from GM Information Management & Technology, Digital and Organisational Development teams

1.10 Ensure full use of the NHS App across all general practices

Launch in line with national Primary Care Access Recovery Programme requirements, including the use of the NHS Ap for repeat prescriptions, booking and access to notes

GM Primary Care Commissioning Committee

Patient Led Ordering Group

General practice and Community Pharmacy providers

Chapter 2: Integrated working in neighbourhoods

2.1 Each PCN to address health inequalities

Following success and evaluation of phase 1 in 2023/24, phase 2 of the Proactive Care Support Package for a second cohort of 20 PCNs, concentrating on CVD and diabetes in line with GM Population Health strategic priorities, the Local Enhanced Services and links with the BeCCoR review

GM Primary Care Commissioning Committee

Primary Care Provider Board, Proactive Care Group

PCNs

2.2 Ensure neighbourhood-based outreach activities are in place

Scoping exercise via GM PC Board to understand the current extent and magnitude of neighbourhood based and outreach activities taking place in the localities. This measure will outline delivery in year 2

Cohort 1 of the Advanced System Leadership Programme for PCN Clinical Directors and Clinical Managers (2023/24) will enter phase 2

Cohort 2 (new intake) of the Advanced System Leadership for PCN Clinical Directors and PCN Managers

Development of a Greater Manchester Primary Care Leadership Community. Initial focus on general practice (Year 1).

PCNs to receive the leadership programme

PCN Development days will continue throughout year 1 of the Blueprint. Covering workforce, inequalities, integrated neighbourhood working as examples

GM Primary Care Commissioning Committee

Primary Care Provider Board

Primary Care Provider Board Delivery Team

2.3 Work collaboratively across all primary care providers

Localities to ensure they have parity of primary care representation locally

Seek to identify and promote opportunities for collaborative working and share examples of where this is working well

GM Primary Care Commissioning Committee

NHS GM Commissioning colleagues at locality level, and Primary Care Provider Board

Discipline specific provider boards and locality primary care boards

Chapter 3: Health Inequalities

3.1 Targeted business support to Primary Care partnerships

Identify a network of GM Communities of Practice on integrated neighbourhood working to engage with primary care providers, VCSE and wider neighbourhood public sector partners and agree business support requirements

Year 2: Scoping exercise to understand the areas of the system where this is already working, how it works and to develop an understanding of the resource needed to develop a Community of Practice

Year 2: Develop a tangible offer for primary care partnership support and delivery routes

GM Primary Care Commissioning Committee, GM Population Health Committee

Integrated Neighbourhood Working Community Of Practice,  GM Primary Care Provider Board

Locality Boards and Primary Care Networks

3.2 Co-design a Population Health Management (PHM) approach

Enable primary care providers and partnerships to understand needs and assets of different communities of interest, identity and geography and the impact on access, experience and outcomes of care

Co-design of intelligence, performance, finance, workforce development and governance tools and policies that build capacity/capability for PHM at all spatial levels and across all partners

GM Population Health Committee

GM Population Health Delivery Programme Groups

All levels: System, Locality, PCN, Providers to be able to use the developed tools

3.3 Establish funding and governance processes that enable a PHM approach

Develop GM good practice advice for Inclusion health and agree sustainable funding options (commissioning for Inclusion) and investment in prevention (for all adult and children CORE20PLUS5 pathways) that builds on the learning from the CORE20PLUS5 community connector and the PCN-VCSE test and learn programmes

Undertake an options appraisal of alternative funding models aimed at shifting funding towards prevention and early intervention, reducing inequalities, and offer enhanced and tailored support to those living in the most deprived communities

Agree role requirements and workforce development plan for named Health Inequalities lead in all organisations to facilitate community engagement, integrated neighbourhood working and develop shared Health Inequality priorities

GM Primary Care Commissioning Committee, GM Population Health Committee

GM Population Health Delivery Programme Groups

Locality Boards and Primary Care Networks

3.4 Workforce development and leadership to enable Fairer Health for All

Co-design cross-sectoral leadership approach to Fairer Health for All and grow distributed leadership across primary care

20 Fairer Health for All Fellowships

GM Primary Care Provider Board, GM Population Health Committee

Fairer Health For All Oversight Group

System-wide colleagues can participate

Chapter 4: Prevention

4.1 Support primary care to provide person-centred, trauma-responsive and health promoting care

Develop pathways, tools and resources to support primary care to provide care that is person-centred, trauma-responsive, health promoting and integrated with broader welfare, financial, emotional, and social support

GM Population Health Committee, GM Primary Care Commissioning Committee, GMCA

LiveWell Subgroup, Operational support from GM Primary Care Board

PCNs

In line with GM LiveWell ambitions, map the current training offer and associated resources, and identify the training/ approaches that are currently working well, and the potential gaps in provision. Agree what an effective training offer relating to person-centred, trauma-responsive and health promoting care could look like across the Primary Care workforce, and develop a plan to progress this (including resources required)

GM Population Health Committee, GM Primary Care Commissioning Committee

GM Primary Care Board, GM Primary Care workforce team, PCCA team

GM Primary Care Board Delivery Team, GM Primary Care workforce team, PCCA team

Scope out the opportunities for optimising the role played by primary care in tackling poverty

GMCA, GM Population Health Committee, GM Primary Care Commissioning Committee

Tackling Poverty Action Group

Primary Care Providers and localities to support this work as it develops

4.2 Improve the early detection and management of risk factors for ill health

Scope and develop tools, resources, and approaches to increase the uptake, reach, quality, and impact of NHS health checks across GM, with an initial focus on high-risk and inclusion health groups. (Years 1 and 2)

GM Population Health Committee, GM Primary Care Commissioning Committee

NHS Health Checks Steering Group

General Practice providers

Continue to embed the optometry Easy Eye Care Learning Disability Pathway

GM Primary Care Commissioning Committee

GM Optometry Provider Board, GM Optometry Team, GMLOCs

Optometry providers

Increase the proportion of cancers diagnosed at an early stage through optimisation of the early cancer diagnosis DES in line with national target (2030) (Years 1-5)

  • Seven pathways prioritised by GM Cancer Alliance based on: volume of presentation; proportion of early diagnosis; deprivation and inequality gaps; and relative position of GM against other Alliances. Specifically for Primary Care the focus will be upon bowel , lung and breast
  • Embedding of Primary Care and Early Diagnosis Facilitators within PCNs to support early diagnosis
  • Cancer leads identified for all PCNs with financial incentive to support delivery and engagement
  • Circulation and embedding of toolkits and templates to support diagnosis
  • Link with localities and CVS with particular focus on inequalities
  • Commission innovate approaches
  • Identify opportunities with pharmacy and dental and progress pilot schemes of work

GM Cancer Board, Screening and Immunisation Oversight Group

Locality Level with support from NHS GM (national DES), GM Cancer Alliance

Locality implementation of National DES with GP provider and trust delivery

Develop tools and resources to increase the uptake, reach, quality, and impact of LD and SMI health checks (including increasing the use of point of care testing kits and training)

GM Mental Health Programme Board, GM Primary Care Commissioning Committee

PH SMI Working Group, Workforce, Primary Care Provider Board

GP Provider Level, with Point of Care Testing available at PCNs

4.3 Improve the management of long-term health conditions

Develop tools and resources to support evidence-based management of cardiovascular risk factors (lipids, hypertension, AF) across all patient populations (Years 1 and 2)

GM Strategic Clinical Network – Cardiovascular

CVD Prevention Group

Toolkit to be used at all spatial levels

Improve the diagnosis of COPD and asthma by improving access to quality assured spirometry at a neighbourhood level

GM Primary Care Commissioning Committee

Delegated Management Oversight Group (DMOG) (Locally Commissioned services)

Locality and PCN level

4.4 Increase vaccination uptake amongst target populations

Re-establish a GM screening and immunisation oversight group to improve governance and links between localities and the central GM screening and immunisation team to drive improvement at a local level

Work with system partners to implement GM MMR elimination plans

Support PCNs to develop plans to improve uptake of vaccinations among target groups and address inequalities through the provision of detailed data and intelligence

GM Population Health Committee, Directors of Public Health, GM Primary Care Commissioning Committee

GM Screening and Immunisations team

PCNs, General Practice and Community Pharmacy providers

4.5 Equitable access to high quality contraceptive services and zero new transmissions of HIV and hepatitis

Audit against NICE quality standards for HIV testing in general practice in areas of high and extremely high HIV prevalence

Develop quality improvement activities depending on the findings

Continue promotion of Long-Acting Reversible Contraception (LARC) in line with the GM Women’s Health strategy

GM Population Health Committee, GM Primary Care Commissioning Committee

Directors of Public Health, GM Screening and Immunisations team, GM Sexual Health Team

PCNs and General Practice providers

4.6 Optimise primary and secondary prevention programmes to improve oral health

Delivery of an Oral health improvement programme, working with local authorities for 0-5 year olds (Years 1-5)

Potential expansion from initial 4 localities to full GM coverage

Delivery of an Oral Health improvement programme with local authorities for customers of the Working Well (Work and Health) programme for unemployed people with health conditions or disabilities, and those in long-term unemployment (Years 1-2)

GM Primary Care Commissioning Committee

NHS GM Dental Team, Local Dental Network, GMCA Working Well programme

Dental practices

Chapter 5: Sustainability

5.1 Ensure a viable GM primary care system

Influence national contractual review processes and discussions regarding the future of contracting

Secure necessary funding injections

Generate consistent service specifications to ensure that primary care is appropriately resourced to meet business cost and can support its workforce

GM Primary Care Commissioning Committee

GM Primary Care Provider Board

GM Primary Care Provider Board Delivery Team

Delivery of a consistent Minor Ailments Service during the winter surge

GM Primary Care Commissioning Committee

GM Primary Care Provider Board, GM Community Pharmacy Provider Board

Community Pharmacy providers via locality level plans

5.2 Develop new clinical delivery models in order to meet demand

Developing our understanding as a primary care system how to consistently and operationally split outputs of pieces of GM work into localities where they will ultimately be delivered

A project to understand how accountability is played back into GM from the 10 localities

Development of a framework or terms of engagement whereby there is a single GM spec where agreed, with a series of agreed, consistent outcomes and reporting, which can be implemented and actioned as per local need

GM Primary Care Commissioning Committee

GM Primary Care Provider Board, Locality colleagues in GM ICB

Local providers

Progress the work on and engagement with the Primary Care/Secondary care interface following system support of interface principles in 2023 – in four key areas: Onward Referral, Complete Care, Call and Recall, Clear Points of Contact

GM Primary Care Commissioning Committee

Primary and Secondary Care Interface System level

Primary and Secondary Care providers

Implement system recommendations of the General Practice/Community Pharmacy interface principles (initially through separate, new programmes such as patient led ordering)

GM Primary Care Commissioning Committee

GM Primary Care Pressures Group

Community Pharmacy and General Practice Providers

Delivery of Primary Care Winter Surge Plan and learning from this to be used as proof of concept to advise approach to future system level clinical delivery

GM Primary Care Commissioning Committee

GM Primary Care Pressures Group

Community Pharmacy, Optometry and General Practice Providers

Progressing the work started in 2023 to ensure that a timely, effective phlebotomy service is in place in all localities, building on good practice and addressing gaps where they are found to exist

GM Primary Care Commissioning Committee

GM Primary Care Pressures Group, Delegated Management Oversight Group (DMOG), Locality Leads

PCNs and General Practice Providers

5.3 Achieve a Net Zero NHS GM Integrated Care Carbon Footprint

Training and workforce

  • Rollout a suitable ‘Climate and Healthcare’ training module for primary and secondary care
  • Ensure training and briefing materials on the health benefits of exercise and social prescribing are available to all PCNs

Culture change

  • Embed carbon reduction considerations into up to five care pathways

Carbon footprint and estates

  • Calculate carbon footprint changes from virtual healthcare delivery encompassing universal access to virtual GP consultations
  • Identify and implement existing decarbonisation initiatives across the primary care estate

Travel and transport

  • Promote low carbon travel options to staff via: a staff / business travel portal, cycle-to-work leads embedded in every trust/primary care network, improved messaging, and a travel buddy system, tied in with the ‘Live the NHS’ values
  • Explore incentivising sustainable alternatives to staff private car use such as shared car use/mobility opportunities, car clubs, shorter journeys, reimbursement for grey fleet activity and public transit use

Medicines

  • Implement Green Inhaler approach to prescribing across GM, ensuring only 25% of non-salbutamol inhalers are MDI’s and reducing the mean life-cycle carbon intensity of salbutamol inhalers to 13.4 kg
  • Support medicines waste reduction projects and projects tackling overprescribing through carbon footprint impact calculation
  • Expand the uptake of green social prescribing referrals by 10% in each locality against 2019/20 baseline, and collate and promote green social prescribing opportunities being delivered across GM

Procurement and commissioning

  • Embed net zero into future procurements / commissioning
  • Undertake spend analytics and benchmarking at pilot sites to identify areas of high-carbon-generating procurements and investigate funding opportunities for widespread uptake

Communications

  • Provide strong and consistent messaging/materials about the risks to health from climate change and air pollution and the need for individual and collective action to address this

GM Net Zero Delivery Board

GM Primary Care Sustainability Group

System development, with locality roll out and individual provider uptake

Chapter 6: Digital

6.1 Build a comprehensive picture of the digital ecosystem in primary care

Completion of Digital First questionnaire regarding online consultations and platform usage, links to PCARP and digital pathways framework

GM Primary Care Commissioning Committee

Operational delivery supported by GM Primary Care Board and GM Primary Care Digital Board

Locality IM&T teams with support from Digital First where appropriate

Plan and begin development of method to understand current functionality, tools, digital maturity across the region. To feature information on all 4 PC Disciplines.

GM Primary Care Commissioning Committee

Operational delivery supported by GM Primary Care Board and GM Primary Care Digital Board

System-level team to be established to deliver this work

6.2 Work in collaboration to tackle digital exclusion

Identify how to evidence collaboration between local authorities and clinical providers in addressing digital exclusion, collating, and building on existing work done across localities and PCNs

GM Primary Care Commissioning Committee

Operational delivery supported by GM Primary Care Board and GM Primary Care Digital Board

Locality teams and local authorities to support providers

Deliver a comms campaign to patients on how and when to access care digitally

GM Primary Care Commissioning Committee

Operational delivery supported by GM Primary Care Board and GM Primary Care Digital Board

GM Communications Team supporting locality communications leads

Ensure that digital inclusion is in a prominent section of equality impact assessments for all programmes of work in primary care

GM Primary Care Commissioning Committee

GM Primary Care Board, GM Primary Care Digital Board

GM Primary Care team and Digital First Programme

6.3 Create a GM Primary Care Digital Centre of Excellence

Establish a GM Primary Care Digital Centre of Excellence to collate and promote best practice and innovation in digital primary care

Incorporate digital skills training into existing skills-based workforce offers

GM Primary Care Commissioning Committee

GM Primary Care Board, GM Primary Care Digital Board

GM Primary Care team and Digital First Programme

6.4 Enhanced digital access to general practice

Actions associated with Year 1 PCARP, including:

  • Rollout of NHS App
  • Enhanced Telephony support
  • Cloud based telephony
  • Development of comms plan

Associated piece of work to understand if general practice websites are accessible and usable

GM Primary Care Commissioning Committee

GM Primary Care Board, GM Primary Care Digital Board

Locality IM&T Teams, individual General Practice providers

6.5 Digitisation of GP Lloyd George records

Plan for the digitisation of more Lloyd George notes providing funding is received

GM Primary Care Commissioning Committee

GM Primary Care Board, GM Primary Care Digital Board, Digital First Programme

Primary Care providers

6.6 Development and expansion of GM Care Record

GM Care Record (GMCR) access for Community Pharmacy to ensure that providers have the appropriate information to provide excellent care

Continuing to roll out and embed care plans on the GMCR in GM localities, including those for Electronic Palliative Care Coordination Systems (EPaCCs), dementia, frailty and heart failure

GM Digital Transformation Board

GMCR Oversight Board, GM Primary Care Board

Health Innovation Manchester, individual providers

6.7 Alignment with Capacity and Access chapter for deliverables on digital access routes

Connections with access chapter to be facilitated by Blueprint Delivery Unit

6.8 Alignment with GMCA pledge to make GM a 100% digitally enabled city region

As an enabler to deliverable 6.2, work to develop a digital inclusion strategy for GM Primary Care in line with GMCA strategy

GM Primary Care Commissioning Committee

GM Primary Care Board, GM Primary Care Digital Board, Digital First Programme

Primary Care providers

6.9 Electronic prescribing availability to all prescribers

Progression of early work to scope pilot sites and departments for electronic prescribing from secondary care in line with GM Digital Strategy

GM Digital Transformation Board

TBC

Trusts and Primary Care providers

Chapter 7: Estates

7.1 Maximise use of the wider public sector estate to promote integrated working

Completion of PCN Clinical plans and estates strategies by End of December 2023

Development of prioritisation plans at locality and GM level

Agree ICB estates utilisation principles, processes and procedures (As of December 2023 this is currently out for comment with strategic group. Broader engagement with localities and NHS Providers in May 2024)

Development of prioritisation plans at locality and GM level

Establish and improve accommodation utilisation levels to achieve financial efficiencies and more effective and appropriate use of the estate

Completion of core/flex/tail property assessments – Health estate assessment

GM Primary Care Commissioning Committee

GM Primary Care Estates team

System, locality and PCN level

Development of a suite of aide memoires to assist GP primary care on estates related processes, procedures and developing policies including a prioritisation tool to enable capital funding to be assigned to schemes/areas with the greatest need

Completion and engagement with aide memoires to proceed throughout year 1

GM Primary Care Commissioning Committee

GM Primary Care Estates team

General Practice Providers to utilise aide memoires

7.2 Patient records digitalisation to enable vacated space to be converted/reconfigured into clinical accommodation

Plans for the conversion of former patient records storage footprint in GP Practice premises to increase clinical capacity with no revenue consequence

Assessing broader estate which have the potential to be converted

GM Primary Care Commissioning Committee

GM Primary Care Estates team

System, Localities and General Practice Providers

7.3 To develop a consistent funding strategy toward one-off cost elements

One off costs of:

  • Stamp duty land tax
  • Corporate estate proposals
  • Progressing GP practice lease completions resulting in one off costs such as legals and SDLT
  • DVS, legals and other professional costs in general
  • Decommissioning and commissioning and premises dilapidations
  • Open Space Model: two parts, 1. developing a funding model for open space work

Decommissioning premises dilapidations – financial approach needed for each scenario

GM Primary Care Commissioning Committee

Capital Steering Group

Capital Steering Group

Chapter 8: Quality, improvement and innovation

8.1 Medical Examiner community rollout process confirmed

Establishing shared, inclusive learning networks, linking to delivery of patient safety strategy

GM Integrated Care Board

Patient Safety Steering Group

Trusts, with input at GP practice level as key record holders

8.2 Seek to ensure that all GP Practices are CQC rated Good or Outstanding

This deliverable is a part of the other deliverables in this chapter

8.3 Comprehensive review of current ‘quality contract’ arrangements

Baseline data collection, option appraisal with recommendation for commissioning from
2024/25 to be agreed.

Completion of mapping of quality related activities and services across GM

Development of a GM quality contract for General Practice

GM Primary Care Commissioning Committee

BeCCoR Working Group

General Practice providers

8.4 Development of a consistent set of GM Primary Care Quality Standards

Standards applied to all four disciplines as appropriate to the relative commissioning opportunities and regulatory frameworks that exist

Standards Rollout of the LFPSE system across primary care (Patient safety system), initially with general practice and community pharmacy, linked to PSIRF (patient safety incident response framework) implementation

GM Primary Care Commissioning Committee

BeCCoR Working Group

General Practice and Community Pharmacy providers with broader expansion after year 2

8.5 Explore future quality contracting arrangement options for Pharmacy, Optometry and Dental

Ongoing work into quality through optometry excellence and continued development of the Dental Quality Scheme to name examples

8.6 Identify funding stream to roll out Employee Assistance Programme offer

8.7 Establish clear governance for the escalation and reporting of PC quality matters for NHS GM

To explore and develop links with locality quality governance and PC Board, aligning quality governance reporting to the NHS GM escalation and assurance framework, ensuring that it is relevant and applicable to Primary Care

GM Primary Care Commissioning Committee, System Quality Group

Primary Care Quality Group

Primary Care Quality Leads Network

Ongoing review of the PC sitrep, contributing to SCC, including system response to support resolution (Years 1-5)

GM Primary Care Commissioning Committee, System Quality Group

Primary Care Quality Group

Primary Care Quality Leads Network

Chapter 9: Workforce

9.1 Retention: Developing the temperature check

Exploring options for a discipline-focused workforce survey to support listening to and supporting all PC Staff

Develop a task and finish group to take forward responses to key themes found in survey results (‘you said – we did’ approach).

Developing a live feedback mechanism for staff exit interviews and temperature checks to support engagement/staff feel listened to

GM Primary Care Commissioning Committee, People and Culture Health and Care Group

Primary Care Retention sub-group

Individual surveys stay with the disciplines

9.2 Retention: Joint appointment and flexible roles

Task and finish group to be developed at GM to perform a piece of work to define the deliverable and scope in year 1

Led by workforce survey, to better understand the needs of the workforce, analysing existing intelligence/identify gaps where further survey may be neede

GM Primary Care Commissioning Committee, People and Culture Health and Care Group

Primary Care Retention sub-group

Provider Board to support dissemination

9.3 Recruitment: Grow our own

Establish oversight arrangements and steering group

Map offers and progression pathways into primary care roles

Increase access to the apprenticeship levy across all disciplines

Offer work experience and placements within structure

Support ongoing training and education standards for Community Pharmacy independent prescribers to provider more clinical services

GM Primary Care Commissioning Committee, People and Culture Health and Care Group

New to Primary Care Group

New to Primary Care Group, Community Pharmacy Providers

9.4 Education and development: Career pathways

New to Primary Care Programme offer to be broadened across all four disciplines

Fellowship opportunities to support all new or newly qualified staff to understand GM and access peer support

Cancer fellows – opportunity to use of model as a template for different disciplines

GM Primary Care Commissioning Committee, People and Culture Health and Care Group

New to Primary Care Group, GM PC Workforce Retention Group

TBC

9.5 Education and development: Learning environment expansion

Create accredited learning environments across neighbourhoods to support all disciplines

Evaluation of cancer pilot (due to end August 2024)

Co create offer and roll out from March 2025

GM Primary Care Commissioning Committee, People and Culture Health and Care Group

Continuing Professional Development Group

TBC

General Practice Manager development programme

GM Primary Care Commissioning Committee

GM Primary Care Provider Board Continuing Professional Development Group

GM Primary Care Provider Board Delivery Team

9.6 Education and development: GM Primary Care Passport

Develop a unified GM Primary Care Passport, bringing existing offers into a single access point with simplified navigation

Expand new to primary care offer to all disciplines

Explore opportunities to ensure protected learning time for all disciplines

GM Primary Care Commissioning Committee, People and Culture Health and Care Group

New to Primary Care Group, GM PC Workforce Retention Group

TBC

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