“General practice is unsustainable as it was for the last 40-50 years”, says Dr. Donal Collins, Clinical Lead for the Multi-Specialty Community Provider (‘Better Local Care’) in Gosport.
Better Local Care in Hampshire is one of the New Care Model ‘Vanguards’, set-up to improve and better integrate health and social care. To drive this work forward they have recognised that they need to change the shape and form of General Practice. One way in which they are doing this is by creating larger practices that bring together more services under one roof. This is creating a service that makes better use of the total resources available - with patients seeing the person they need to see and everyone working together for the patient.
Patients are already seeing improved access to care, where they are able to contact and be assisted by a multi-disciplinary team who can identify the right service and make same-day appointments.
“If you get the patients to see the person who they need to see rather than the person who they want to see, that improves workloads dramatically. In a typical day I probably see about 35% of my activity when it did not need to be me, and that will buy a significant amount of time back. To do that you need intelligence at the front door.” Dr. Collins says, and goes on to give an example of redirecting care: “If I have a mental health issue I see the mental health practitioner rather than the GP. And we know that early access prevents problems in the future.”
Technology is a key enabler in realising this new and better form of care. For example, by removing the silos and bringing together patient records into a single system of support, much wider possibilities for care become available.
When Dr. Collins talks about the future vision for Gosport, he mentions the power of information: “We’re going to try to use big data to do some predictive planning around conditions coming and hopefully we can treat patients earlier. Because with the data we have already we know, for example, who is going to develop diabetes in the next 5-10 years, so should we be doing something about that now?”
The power of linking data so that everyone is within one system “gets rid of the issue of access consent because it’s all done with one big blanket” says Dr. Collins, allowing professionals to look at the ‘bigger picture’ and take steps to encourage a more healthy community, in partnership with charities, volunteers and the local authority.
However, Dr. Collins is keen to point out that it’s not just having the system that is important. “It’s by having everyone believing in the mission, vision and values. If you just create one organisation on its own, that may not do much, you have to have a very good strong narrative around that to get everyone to buy into it” he says.
Dr. Collins is a contributor to the Eduserv Executive Briefing Programme's report ‘Health and Social Care Integration – Confronting the Challenges’. The report can be downloaded here.