Senate Forum Meeting

Clinical Senate Forum 25 January 2018: Next steps for general practice in London – scale, integration and incentives – what works?

Transforming general practice is critical to transforming the wider health and care system. It is relevant to everyone. “Transforming Primary Care in London: A Strategic Commissioning Framework”, published in November 2014, set out an ambition to deliver more accessible, coordinated and proactive primary care for all patients. Since then, we have seen significant changes both in the way that primary care is delivered across London, and health and social care’s political and regulatory landscape.

It is widely recognised that collaborating at scale is a vital enabler for general practice to deliver the ambitions it outlined. Collaborating at scale supports greater resilience and sustainability of the general practice workforce, as well as investment in development and innovation in areas such as estates and digital technology.

Integration and collaboration across general practices and primary care is already taking place in London. The majority of general practices belong to an at scale organisation, such as a federation or a super-practice. However the nature and extent of collaboration beyond provision of extended access varies considerably. Developing a more explicit commitment to general practice at scale is an essential driver to transforming care in London, ensuring a consistent vision and pace of change to support new models of integrated care. Work is currently taking place across London to set out what “good” general practice at scale looks like i.e. how care is delivered, how it functions and how it participates in the wider system. This will help determine what is needed to achieve it.

This meeting of the Clinical Senate Forum supported this work. Chaired by Dr Vin Diwakar, Medical Director, NHS England London Region and Clinical Senate Forum co-Chair, it enabled participants to contribute to co-creating a vision for general practice in London and determining the next steps we need to take, in particular, how we can use, align and develop our people, processes, systems and resources to deliver.  The programme is available here and aimed to:

  1. Develop a shared view  about how general practice needs to transform to create a sustainable, integrated health and care system and effectively participate in new models of care across London;
  2. Agree what needs to happen to achieve this vision and the early priorities.

In the opening session, several speakers discussed developing general practice at scale, from different perspectives, sharing views and learning about why change is important, examples of how this could be achieved and critical factors and considerations in doing so.

What is important about General Practice? Patients’ views
Trevor Begg, Patient Representative

Why we need to change? A regional perspective (click here)
Dr Jonty Heaversedge, Medical Director for Primary Care and Digital Transformation, NHS England (London Region) and  Dr Michelle Drage, Chief Executive, Londonwide LMCs

An introduction to Primary Care Home – an integrated, multi-professional approach (click here)
Dr Nav Chana, Chair of the National Association of Primary Care

Next steps for general practice in London: learning from international  organisations (click here)
Dr Rebecca Rosen, GP and Senior Fellow, The Nuffield Trust

Organisational development is essential to support system change – lessons from London’s Primary Care Quality Academies (click here)
Professor Rebecca Malby, School of Health and Social Care, London South Bank University and Nick Downham, Independent Improvement Expert, Primary Care Quality Academy, London South Bank University

New models of care: Insights from the national vanguards
Samantha Jones

The second part of the meeting provided space for participants to consider the vision and journey so far for general practice at scale within London’s five Sustainability and Transformation Partnerships and to consider the next steps and what would assist this. In a final session, key themes from discussions were shared.

A summary report with key messages from this Forum is available here.