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Transforming Primary Care

Safe, proactive, personalised care for those who need it most. . .

The document covers:

Click here to download the full Transforming Primary Care document.


Foreword from Jeremy Hunt, the Secretary of State for Health. . .

When the NHS was set up over 60 years ago life expectancy was 66 for men and 70 for women. This year a third of babies born can expect to live beyond 100. The NHS should be congratulated for the part it has played in driving these improvements. However, an ageing population also brings new challenges, and as the population it serves changes so must the NHS.

There are now 4.4 million people aged over 75 in England and by 2026 there will be more than 6.3 million. Advances in medicine also mean that people of all ages, not just the over 75s, are living with complex health needs – it is estimated that by 2018 three million people will have three or more long-term conditions, whether physical, mental, or both.

People with complex health needs are not properly supported. More than a quarter of people who have long-term conditions say that they are not well cared for by the NHS, and two fifths expect their care to get worse over the coming years. People are frustrated by using different services that do not speak to each other, and feel that their conditions are treated in isolation.

If the NHS is to continue to deliver high quality, sustainable care it needs to shift away from providing 20 century solutions that are based on a fix and treat model. A system that waits until crisis and then forgets about people once treated. One that sees people as a series of conditions rather than a whole person.  At present, people are too often enduring rather than enjoying their longer lives.

This change is not only good for patients and carers but vital for the future of the NHS. Over the past ten years emergency admissions per head have risen by a quarter with at least a fifth of these estimated to be directly avoidable in some way. Every preventable admission represents a failure of the system. Being admitted to hospital when it could have been avoided is not only distressing for people and their families but can also trigger further health problems. It is a waste of NHS resources, and one that we cannot afford.

Change is what patients want and the NHS needs and in many areas it is already happening. Local clinicians and local authorities have been empowered through the creation of clinical commissioning groups and health and wellbeing boards to bring together health and social care. Integrated Care Pioneers up and down the country are breaking out of the traditional mould to develop new services, and the Better Care Fund, from 2015/16, will provide £3.8 billion to accelerate integration everywhere. The appetite and will is there and this document sets out how we will support local areas in making this change a reality across the country.

Transforming Primary Care is the next step towards safe, personalised, proactive out of-hospital care for all.  We are starting with the 800,000 patients with the most complex health and care needs who will be given a personal care and support plan, a named accountable GP, a professional to coordinate their care and same-day telephone consultations if needed. The transformation will be built around one of the NHS’ greatest assets – the GP practice, building on existing relationships that often span over many years.

These changes have the potential to achieve savings of £0.5 billion a year in hospital costs. Over the longer-term, improving primary and community services for people with long-term conditions will not only improve quality but also has the potential to achieve further savings. We will also be supporting commissioners to make joined-up care the norm. Clinical commissioning groups will invest £250 million to support the shift to more primary and community care and recognising this is the first step on a long journey we are planning to make available 10,000 primary and community care professionals by 2020.

This, alongside the Better Care Fund, will bring the health and care systems together to drive delivery of this transformation of out-of-hospital care. This transformation is a vital step towards achieving a financially unstainable system that delivers safe, personalised, proactive care to an ageing population. Working together, we can achieve these changes and ensure that we have a health and care system ready to face the challenges of the 21st Century.

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Updated on Wednesday, 5 July 2017 2089 views