With the introduction of New Models of Care for the provision of services at scale through, for example, an Integrated Care Systems (ICS), Multispecialty Community Provider (MCP), Primary and Acute Care Systems (PACS), and Accountable Care Organisations (ACO) – all of which include the Primary Care Home (http://www.napc.co.uk/primary-care-home) – it is essential that General Practice takes the time to explore its future model and how locally you want to work “at scale”, which is a requirement within all the aforementioned New Models of Care.
The alternative is being told how you will operate as a business by someone else leading one of the models.
As you might expect, the reasons for selecting the preferred model will vary from place to pace, based upon local circumstance. No matter the preferred model, the key to success is to bring together people with genuine like-mindedness. Where you have that you can achieve remarkable outcomes; however, where people must be coerced to adopt a model, you are likely to face an ongoing uphill battle.
Consequently, our recommended approach to developing any New Model of Care is to start with General Practice, right at the outset before any decisions have been made. That way you are genuinely engaging them, rather than consulting them on decisions someone else has made on their behalf.
If you are leading the development of New Models of Care, we recommend you stop and take time to ask 6 questions of your General Practices (message me if you want the questions). On answering those questions, you can offer a guarantee that you will include their input and feedback to develop the vision.
The answer to the 6 questions will prime the hub development. Those answers allow you to group the Practices sensibly, based on the key ingredient of like-mindedness. Added to that you can include sensible geography, ethos, vision, culture etc.
The best hubs we work with are built like this and you quickly see remarkable outcomes being achieved. Ultimately, by taking this approach and developing vision and change on the basis of like-mindedness, you will rapidly get the outcomes you want, need and have agreed.
This requires a shift in the way CCGs and wider Health Economy stakeholders would usually engage General Practice, which is often after decisions have been made, meaning you are consulting, not engaging.
Alternatively, will you come at the process from top down, with the need for them to “engage” to create the “new system”, with a vision already created by a small sub-committee of people who will tell everyone where they are going wrong, and how implementing “x” will create exactly what “we” need?
Disengagement of General Practice, whether it be a conscious decision or otherwise, will lead to failure, which creates a significant problem as every new model is predicated on having General Practice, operated “at scale”, at its heart.
Why would you not openly and formally engage General Practice? Why would you risk failure? What are you worried about? What have you got to lose that trumps what you stand to gain?