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Primary Care Home has positive impact on care and services

Community nurses easier to recruit as job satisfaction improves with ‘pioneering’ approach

Louise Prime

Tuesday, 10 May 2016

A new approach to primary care – Primary Care Home – is already having a positive impact on care and services in its first four months, pilot sites have reported. Some have found that community nurse recruitment has become much easier, and others are finding new approaches to tackling problems related to capacity.

The National Association of Primary Care (NAPC), which is leading the programme with the NHS Confederation, gathered together GPs and colleagues from the 15 Primary Care Home Rapid Test Sites to see what progress they had made in reshaping primary care in their areas, and to share and learn from each others’ ideas. The sites are spread right across England, from Cumbria and Durham down to Nottingham and Norfolk, and from Cornwall over to southwest London and Kent. Despite the sites’ very varied nature, they reported positively on the programme’s impact.

Primary Care Home, a form of multispecialty community provider model that fits in with the Five Year Forward View vision, aims to reshape delivery of primary care according to each local population’s needs. It allows patients in a defined, registered population of about 30,000 to 50,000 to have access to a single integrated, multidisciplinary team that includes GPs, community nurses, physiotherapists, pharmacists and specialists from social care. Working with this size of population and team, said the NHS Confederation, means that team members all know each other and patients no longer have to deal separately with multiple specialists and organisations.

The NAPC said the model encourages a combined focus on personalisation of care, with resulting improvements in population health outcomes. Having a unified, capitated budget with clear clinical financial drivers also allows for appropriate shared risks and rewards, it added.

At the Primary Care Home progress meeting, test sites reported:

  • a step change in recruitment of community nurses, as nurses see the benefits of the pioneering way of working and are keen to get involved
  • making progress towards reconfiguring care – several GP practices are using and developing different approaches to deal with capacity issues
  • focusing on colocation of community staff within GP services
  • developing specific roles to look at improving prescribing and medication control
  • developing joined-up IT systems to better share data and resources.

However, the pilots also reported challenges, such as concerns over long-term sustainability, problems with IT system integration, and getting their clinical commissioning groups to engage and ‘buy in’ to the programme.

The NAPC commented: “Several of the 15 [test sites] are working with academic institutions to evaluate their impact and this will be the real test for being able to demonstrate value.”

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