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Tagged In:  Allied Health, Nursing

The innovative Primary Care Home model is set to be up and running in 100 locations by 2018, covering five million people.




In October 2014, the NHS Five Year Forward View called for the creation of new Multispecialty Community Providers (MCPs) to bridge the gaps between primary care, community services and hospitals, reducing the pressure on GPs and A&E departments. "Over the next five years and beyond the NHS will increasingly need to dissolve these traditional boundaries," the report stated, "Out-of-hospital care needs to become a much larger part of what the NHS does."

A year later NHS England Chief Executive Simon Stevens announced the launch of Primary Care Home (PCH), a new MCP model which delivers care to a defined, registered population using a multi-disciplinary team of health professionals, such as GPs, community nurses, hospital specialists, physiotherapists, occupational therapists and mental health nurses.



In 2014 the British Medical Association (BMA) estimated that there were 340 million GP consultations every year, a rise of 40 million since 2008. According to the NAPC's President, Dr James Kingsland, 25% of those contacts are 'administrative' and don't require the input of a GP. Of the remainder, half could be seen directly by another health or social care professional, rather than taking up the GPs time in assessment and referral. "We need to get rid of this and get in the right workforce who can provide first contact care to patients immediately," explained Dr Kingsland in a recent interview with National Health Executive.

The PCH sites are already making rapid progress in service transformation. For example, the Beacon Medical Group site in Ivybridge, Devon employs specialists in musculoskeletal disorders and dermatology as part of its first-contact care team, resulting in an estimated 70-80% of patients avoiding hospital. Other examples include direct access for services such as midwifery, physiotherapy and follow-up cataract care in East Grinstead, West Sussex, and social prescribing initiatives for lifestyle-related behaviours in patients with weight problems in St Austell, Cornwall.

The NAPC sees effective primary care as having four central features: first point of contact for all new health needs; person-centred, rather than disease-focused, continuous lifetime care; comprehensive care for all needs that are common in a population; and coordination and integration of care when a person's need is sufficiently uncommon to require special services or provision from another sector. The PCH initiative ticks all those boxes. 

Simon Stevens is in no doubt about the transformative potential of the PCH model: "This programme offers an innovative approach to strengthening and redesigning primary care, centred around the needs of local communities, and tapping into the expertise of a wide array of health professionals."

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