CITY & HACKNEY
GP CONFEDERATION
What are we?
What have we done?
Challenges and learning
OUR AIMS:
 Voice
of primary care
 Umbrella organisation for GP practices
 Support and develop primary care
 Maintain practice financial viability
 New ways of working/innovation
COMMUNITY INTEREST COMPANY
 CIC
September 2014
 practices are shareholders (1pence share)
 legal constitution, shareholding agreement,
Individual practice agreement
 £1per patient per year fee/equity
 43 member practices, 311,056 population
(100%)
GOVERNANCE
Board
of directors/clinical board
Lay members x 2
Audit committee/external auditors
Watertight payments to practices process
WHAT HAVE WE DONE?
 Contract
model 1:
 Confederation wins contract
 Confederation sub contracts with practices which
commit to:
– deliver to specification
– seek help if at risk
– pay for practice support if needed
– (some practices deliver on behalf of others)
 100% population coverage
 Focus on quality improvement
CONTRACT MODELS 2 & 3
Direct
provision – smoking cessation
Developmental – practice support
team, QI, childhood immunisation,
health app, workforce
Total contract value 16/17 £11.9m
ACHIEVEMENTS: WORKFORCE
Salaried
GP scheme (17)
Trainee practice nurse programme (14
& 15)
Advanced HCA programme (12 & 7)
Apprenticeship programme (54 & 19)
Clinical pharmacists (5 & 3)
Trainee practice manager scheme (6)
Medical Assistants pilot site (6)
ACHIEVEMENTS – HEALTH GAIN
 Smoking
cessation – over 1800 quitters so far
 Diabetes blood pressure control - 94% in
target (top QOF score in England)
 CHD blood pressure control - 95% (top QOF
score)
 1st in 12 of the 65 QOF clinical indicators
2015/16
 Health checks – 5421 checks in 9 months
 Substance misuse – 17accredited practices
managing 255 patients in shared care
ACHIEVEMENTS – IMPROVED
CARE/PATIENT EXPERIENCE
 1887
patients on Frail home visiting register
 Duty
doctor in every practice core hours – 30
min response time
 1752
patients with a CMC plan
 Health
Visitors & GPs review all vulnerable
children
 3540
extra appointments per quarter to
improve access
ACHIEVEMENTS – ORGANISATIONAL
AND PERSONAL DEVELOPMENT
 Practice
monthly MDT meetings
 Quadrant
studies
MDT learning events on case
 Templates,
dashboards, coding, searches
 Facilitation
skills training
 Commission
education and training for
primary care (CEPN)
 Group
consultation skills via econsult
CHALLENGES AND LEARNING
Relationship
NHS
with member practices
pension scheme
VAT
Full
cost recovery
THE FUTURE?
Super-partnership(s)?
Community
nursing?
Consultants? GP specialists?
In hours and out of hours?
Bigger role in unplanned care?
Social care and carers?
Mental health?