Tower Hamlets
New models of care in primary care – ‘at-scale general
practice’
Networks
8 Networks1 were formed in the borough during 2009
Tower Hamlets before
networks
23
5
6
3
2 4
1
23
Pop: 33,186
20
19
2122
2627
24
3
2
1
7
10
8
9
13
1516
4
30
32
31
29
28
• 36 practices
36
35
25
14
18
17
26
27
Pop: 28,995
9
17
33
22
21
24
10
8
12
11
• 8 LAPs
20
19
Pop: 35,720 7
25
14
12
11
5 Pop: 29,801
6
13
30
Pop: 18,027
15 16
32
29
28
31
Pop: 27,839
Pop: 29,892
18
Pop: 31,975
34
33
36
• Total population of ~245,000
• Practice list sizes of 3,000 to 11,000
35
34
Why networks?
• Focus on population health across a geography
• Collaborative relationships with wide range of partners (e.g. Borough, schools, charities)
• Sufficient scale for specialisation of staff, ability to access rare skills and ensure access, resources (e.g.
equipment)
• Integration with estates plan
Case for Networks
 Wide variation in clinical practice and outcomes for
•
•
•
•
•
•
•
diabetes patients
Economies of scale
Poor uptake of diabetes education and retinal
screening
Need to do things differently
The right people to do the right tasks at the right time
Specialist support
Transparency of data
Putting the patient at the centre of their care
GP Care Group Journey
April 2009
Development of 8 Primary Care networks
November 2013
Formation of the GP Care Group
September 2014
GPCG registered as a CIC
November 2014
CEPN & Open Doors transferred to the GPCG
March 2015
THT awarded Vanguard status/GPCG awarded PMCF
April 2016
Preferred bidder for CHS contract
April 2016
Commencement of Health Visiting services
April 2017
Commencement of CHS
GP Care Group
 Community Interest Company limited by shares
 Membership organisation
 36 general practices
 1 homeless access centre
 Board comprises:
 8 elected GPs representing each network
 2 elected Network Managers; 1 elected Practice Manager and 1
elected Practice Nurse
 Purpose
 to be the voice of primary care working at scale
 to ensure sustainability of primary care
Primary Care at Scale
Current Portfolio
Pipeline

Surgical aftercare

Network incentive scheme

Pathology transport

Out of Hours/Urgent Care

Websites

Single Point of Access

CEPN

Health advocacy and interpreting

Open Doors

CHS alliance manager/system leadership

Extended access hubs

Medical indemnity

Social prescribing pilots

Business Intelligence

Health visiting

QI/ Primary Care resilience

System leadership – MCP Vanguard

Sexual Health
Tower Hamlets Together
 MCP Vanguard
 GPCG, Barts Health, ELFT, CCG, LBTH, CVS
 Now = alliance via MOU
 Imminent = alliance partnership (stage 1 of MCP)
 Future = accountable care system




Joint commissioner/provider board
CCG devolves commissioning intentions to THT
Outcomes framework
Health and wellbeing strategy alignment
CHS Alliance
Alliance Partnership
CHS CONTRACT & GOVERNANCE
COLLABORATION
CCG
Alliance Board
SPR
CQRM
System
Management
Commi ee
Quality and
Safety
Commi ee
Alliance
Manager
Locality Integrated Care Boards x4
Contractor
GPCG
Contractor
Barts
Health
Contractor
ELFT
Contractor
GPCG
Contractor
Barts
Health
Contractor
ELFT
Challenges & Learning
 Last year has been more about system than about
primary care
 CHS procurement – somewhat distracting
 The future of partnership model – mixed views
 Practice and network sovereignty
 Communication and buy-in