Primary Care Home The Thanet Way!
Thursday 2nd March 2017
Maria Howdon, Head of Membership Development
Four core characteristics of a Primary Care Home
1 The provision of care to a defined,
registered population size of 30,000
to 50,000 people
2 A combined focus on personalisation
of care with improvements in
population health planning, provision
and outcomes
3 An integrated, multi-disciplinary
workforce, with a strong focus on
partnerships spanning primary,
community, secondary, third sector,
mental health and social care
4 Financial drivers aligned with the
health needs of the whole population.
Challenges in Thanet.
• Ageing population
• More chronic, complex conditions
• High levels of deprivation
• Undiagnosed conditions
• Overstretched resources
• Workforce shortage
• Significant growth in housing
1
Westgate Surgery:
Dr D Meakin
Dr G Jha
Dr C Leire
Dr B Vishwanathan
Dr A Walton
Practice Population:
9,959
Garlinge Surgery
Branch of Limes Medical
Centre
Union Row Surgery:
Closed 28.02.17
List dispersal
The Limes Medical Centre:
Dr H McCafferty
Dr A Jain
Dr A Majeed
Dr S Thallam
Dr M Vincent
Dr R Misra
Practice Population:
13,761
Birchington Medical
Centre:
Dr A Ghazi
Dr A C Martin
Dr A Tasou
Dr E Osman
Dr I D Finlay
Practice Population:
8,918
Northdown Surgery:
Dr J De Murtinho-Braga Ossa
Dr J Geevarghese
Dr H Williams
Dr M Wolny
Practice Population:
10,664
Minster Surgery:
Dr C Crosfield
Dr M Elliott
Dr M Jansen Van Vuuren
Dr G Stern
Dr R Mangam
Practice Population:
8,067
Summerhill Surgery:
Dr S Grover
Dr S Kamal
Practice Population: 6,161
Mocketts Wood Surgery:
Dr D Reddy
Dr D Marshall
Dr S Kanumuru
Practice Population:
8,469
St Peters Surgery:
Dr A J Cunard
Dr S Goldberg
Practice Population:
4,543
Quex
Bethesda Medical Centre:
Dr Joy
Dr Martin
Dr Scott
Dr Miller
Dr Sohail
Dr Mohammed
Dr Jha
Dr Roux
Dr Su
Dr Karamat
Practice Population:
15,913
Broadstairs Medical
Practice:
Dr A Malik
Dr I Ali
Dr A Khalid
Dr S Qureshi
Practice Population:
6,873
Broadstairs
Newington Road
Surgery:
Dr A Akyol
Dr I Ali
Dr N Mohammed
Practice Population:
7,864
Ramsgate
Margate
Dashwood Medical
Centre:
Dr M Cardwell
Dr J Malasi
Dr P Wilson
Practice Population:
9,438
East Cliff Practice
Dr C A Neden
Dr J Neden
Dr C Eldred
Dr L Kent
Dr A M Macpherson
Dr E Mash
Dr A Peshen
Dr M J Pick
Dr M Sivakumar
Dr J M Woodward
Practice Population:
15,327
The Grange Medical
Practice
Dr J Bonnett
Dr J R Johnstone
Dr J M Lyell
Dr O Lyell
Dr M Maiden-Tilsen
Dr S L Marsden
Dr F Newton
Dr M Bannon
Practice Population:
11,940
Ramsgate PCH
Social Care
Intg’d
Workforce
Mental
Health
Outpatient
Clinics
Voluntary
Sector
Diagnostic
Prevention &
self care
Montefiore MC
Practices
Westbrook House
Quex PCH
Mental
Health
Outpatient
Clinics
Voluntary
Sector
Diagnostic
Prevention
Self Care
New Build
Intg’d
Workforce
IAR / Acute
Interface
Bethesda MC
Social Care
Social Care
Intg’d
Workforce
Mental
Health
Outpatient
Clinics
Voluntary
Sector
Diagnostic
Prevention
Self Care
Broadstairs
PCH
Margate PCH
Practices
Practices
Practices
Social Care
Intg’d
Workforce
Mental
Health
Outpatient
Clinics
Voluntary
Sector
Diagnostic
Prevention
Self Care
Enhanced Frailty Pathway.
• 1st Pathway Developed
• Former Over 75’s Schemes
• Nursing Homes LES
• End of Life LES
• Focus on personalisation of care, prevention and wellbeing for the
Over 60’s
• Acute Response Team (ART)
• Defined metrics and outcomes
• Integrated workforce
• Alignment of finances
• Went live on 1st October 2016 / 14th November 2016
• Robust evaluation
2
Integrated Primary Care
• Joint Nurse Clinics
• Catheter care
• Wound Care
• IV Therapy (PICC Lines)
• Joint Nurse Home Visits
• Long term condition management
• Domiciliary Carers
•
Carers being trained to deliver care to support nursing teams
• Voluntary sector
• Care Navigation - Age UK / Ageless Thanet
• Margate Task Force
3
Capitated Budget.
4
• A ‘tool’ was required to enable correlation of
data, across multiple providers in a new way.
• Working with South Kent Coast CCG and
Kent Public Health the Kent Integrated
Dataset (KID) was developed and built.
Kent Integrated Dataset
Acute Hospitals
Social Care
Community Providers
Hospice
Mental Health
Providers
Kent
Integrated
Dataset
Thanet District
Council
Fire Service
Primary Care
Police
Approach to PCH Budget Setting
• Population stratified by quinary age band (0-4,5-9,10-14 ……)
• Average annual cost; per head of population, in each age band was
calculated for EACH and EVERY service (every POD and Speciality
combination in every age band).
• Correlation between deprivation and health costs, particularly nonelective activity.
• e.g.
• PCH and practice population costs were calculated by adding up the
costs for their cohort of patients.
Thanet Benefits
£25k expected annual savings from reduced A&E attendances
enabled by Thanet’s shared patient care record. Admissions avoided
through cross practice working over bank holidays.
A&E Attendances

A&E Admissions

£530k approximate annual savings from a reduction of 15 A&E
admissions a week following the roll out of the Acute Response Team.

£216k of potential medicine review savings if the pharmacist pilot
were carried out across the whole care home population. The
average medicine review saving per resident was £165.
Prescribing
Staff Retention
Additional Savings
Zero vacancies for community nurses, falling from 24 WTE since PCH
go live.

Additional EMIS benefits will include reductions in A&E attendances and
admissions out of hours, increases in primary care capacity and reduced waits
for GP appointments.
Questions?