Summary
Dr Tracey Vell, MBE, Chief Officer of Greater Manchester Primary Care Provider Board (GMPCB), shares her thoughts from this year’s NHS ConfedExpo in a blog post.
The NHS ConfedExpo is over for another year, and it is always a chance to see colleagues from all over the country and share ideas.
This year, I had the great honour of joining the agenda as a speaker, which allowed me to present the reality of life in the NHS!
I joined Ben Richardson, Managing Partner at Carnell Farrar, to discuss how collaboration can drive the three big shifts in healthcare, from sickness to prevention.
This was delivered as a ‘fireside chat’, which sounds cosy but involved questions and thoughts from the other 150 colleagues in the room!
As part of another panel I was involved in, ‘Breaking barriers together: a cross-system approach to delivering impact’, we discussed what collaboratives really are and what makes them work.
This brought lots of food for thought, especially at a time when we are facing ICB reform and anticipating a new NHS 10-year health plan, along with the three governmental shifts I mentioned.
The challenges ahead
I noted that there are some issues the NHS needs to address to meaningfully accelerate population health:
- 1. In-year financial balance needs reform if we are ever to reach prevention that yields savings later in a three to five-year cycle. The quote “Pennies saved today are costing pounds in years to come” rings true, and we need financial reform.
- 2. The commissioning of pathways, and not organisations, will bring the right collaboratives forward for the desired outcome, rather than more interfaces between organisations. We know that strategic commissioning is a goal, so perhaps we look at commissioning differently?
- 3. Providers are definitely going to be important in the new world – and that’s all providers. It is necessary to get together and think about delivery in all primary care spaces, and form strategic partnerships to help improve patient outcomes.
The role of primary care
From the keynote speech given by Wes Streeting, it was clear that GPs are the natural neighbourhood providers. Later in the day, it was revealed more explicitly that general practice at scale will be asked to lead neighbourhood health services, if they can demonstrate the desire, capability and an operating structure.
Thankfully, we have been working on this for some time in Greater Manchester and already deliver many improvement programmes via the PCB, as well as many services via our federations – including national primary care capability.
We will await the call to co-produce what this looks like with the 41 other systems, hosted jointly by the Department of Health and Social Care (DHSC) and NHS England, led by Sir John Oldham.
Of course, we need to be prepared for this eventuality – and we are in a good position with a GM GP Federation already in place. The Greater Manchester Primary Care Community Interest Company (GMPC CIC) involves 10 locality directors and operates under subsidiarity rules to choose the best spatial level for services.
Advisory members from the PCB sit on its board to ensure there is no duplication, to facilitate allegiance with us and to help guide its strategic direction.
We also have the same opportunity to grow closer to wider primary care providers, with Primary Eyecare Services (PES) being nationally recognised as an optometry provider – and we know that ALL of primary care contributes to neighbourhood activity.
Currently, we are using the CIC – as an operational and federated asset – to contract for community gynaecology services, community dermatology services, and an accelerated population health service. This falls within the category called ‘left shift’, which is simply moving services closer to home.
We have two active areas of discussion at the moment. One is ‘care transformation’, and we’ll be assisting our ICS with performance and financial stability, as well as being poised to help with re-imagining services. The other area is ‘productivity’, looking at what is required to improve the sustainability of our organisations and services – collaborating over Artificial Intelligence (AI) functions and tests will be important.
Final thoughts
In a world where the only constant thing is ‘change’, we are reminded to think about every decision carefully. The complex answer may be difficult, but the correct one.
Also, looking after each other through change is part of the journey, so I will leave you with this pertinent quote from James Norbury’s book ‘Big Panda and Tiny Dragon’:
“Which is more important,” asked Big Panda, “the journey or the destination?”
“The company,” said Tiny Dragon.
