9 July - NHS non-executive directors webinar

12 July 2021

This week’s session opened in conversation with Dr Steve Alvis, Associate Non-Executive Director at Gloucestershire Health and Care NHS Foundation Trust.

The theme of the discussion was primary care and framed by a number of key questions including:

  • How is primary care reported and discussed at Board levels within Trusts?

  • How do Primary Care Networks operate within your health system?

  • How is General Practice evolving within your health system?

  • What will be the impact of moving away from CCGs on the connection to primary care?

  • What role will primary care play within ICS development?

Addressing the theme, Steve said: “A lot of GPs have always got on with their neighbouring practices but they’ve always been competing businesses and now they are having to work together and share resources which is new for them so there has been around the country different levels of learning required.”

“Some of the primary care networks are leaping ahead more quickly as they have better relationships and therefore are producing better work.”

“We have tried to enable our integrated locality partnerships to work efficiently and have made use of a population health tool and can now target particular areas of need from a primary care perspective but also alongside the voluntary sector.”

“We try to involve our patients as much as possible when we make developments and make use of their experience when learning and moving forwards.”

“With primary care one of the main difficulties recently has been the workforce and there has been a drive to recruit more GPs but this hasn’t worked so far. Trying to keep continuity with GPs is important but difficult as many are now part time.”

“Having the nursing staff, clinical pharmacists, paramedics etc. within the practice can be useful as you have a whole team to work with and if we can try and build this up across our networks it will make a difference. One of the difficulties with this however would be housing the team in the local area.”

Also overheard during today’s webinar:

“The people with the least means wait the longest to get expert triage. We have under-representation of the poor and Black and Asian children in our patch but over-representation of some of these groups in adult services. ACEs and social determinants of health are so critical to address. We know the need - it's about threshold - service - outcome. How are we 'place' based as well as bigger and efficient? We need a multi-agency problem solving model as some people can never have their cases 'closed'.”

“The outcome data is very clear, it gives us some of the worst results for cancer survival, cardiovascular preventable deaths and dementia. We know from trauma that you need the best expertise at the front of the system, the golden hour and for an experienced person to decide at first. Primary care should be re-named chronic care and within reason patients with new symptoms should be seen by experts first, I.e. specialist nurses or consultants. Chronic care should then be undertaken by what we now call GPs who practice under instruction and part of an integrated healthcare system in which the people with the greatest knowledge lead the team.”

“Ideas of place offer the opportunity to link citizens and sectors at different levels and thereby to make real longstanding attempts to 'put the individual at the heart of things.”

“We need better information flows. The white paper takes some of the barriers away around this but there are better ways and more can be done to coordinate the sharing of information between primary care providers.”

“Health and social care needs to make the first step in reaching out to those in the community. For example, we have put on vaccine buses that park at the end of roads in the community and this has worked better for us when tackling vaccine hesitancy than letting the community come to us.”

These meetings are by invitation and are open to all NHS non-executives directors, chairs and associate non-executive directors of NHS providers. Others may attend by special invitation. For further details, visit our events page.

If you have any comments, questions or suggestions about these webinars, please contact: events@good-governance.org.uk

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