Appendix 1

Primary care in Brighton and Hove

Increasing resilience in Primary care

HOSC has discussed the current pressures on Primary care in previous meetings; and how this is impacting on the potential for Primary care to meet the future needs of the Brighton population.  The CCG will be working with the other Sussex CCGs to deliver a programme of work in 2019/2020, based on four key themes, to support practices as follows

· Practice Resilience –The adoption of a Sussex wide approach to use regional funds to  target the most challenged areas to improve resilience; continue to provide dedicated CCG support to individual practices; and sharing good practice across the county to ensure practices learn from and support each other wherever possible.

· GP Retention Programme -  Development of more wide ranging career opportunities outside traditional practice partner role; aimed at locum GPs and GPs expressing a desire to leave the profession; Development of GP with Special Interest (GPwSI) posts in mental health; Supporting the development of First Contact Practitioner roles for Multi-skeletal and Mental Health services; and the promotion of GP Fellowships which include more flexible arrangements tailored to the needs of the individual GP.

· Reception and clerical staff training – funding has been made available to provide training opportunities for all general practices in Care Navigation (helping patients find the right service for them); Workflow and Medical Terminology training; and enhanced reception and clerical staff training

· Online Consultation – the CCG will procure the right technology to allow practices the opportunity to offer patients online consultation appointments.  This is addition to, and not replacing current face to face provision.

The above programme illustrates the support available to all practices in the city.  The attached diagram describes the process by which the CCG works with a practice when they are considering closure and/or merger with another practice.

Primary Care Networks

The development of Primary care networks (PCNs) is intrinsic to the successful delivery of the NHS long-term plan. These are groups of general practices who agree to work together at scale to deliver a wider range of services to patients that are integrated with other health and social are providers; manage financial and estates pressures; which in turn will increase the likelihood of practices recruiting and retaining staff. The seven PCNs in Brighton were established on 1 July and are all delivering the national requirements.  They are currently considering the potential for employing a range of additional staff (for which funding has been made available), including first contact physiotherapy, additional appointments (extended access) and social prescribing.  The CCG is supporting them in these discussions, including exploring the potential for alignment with the current CCG commissioning social prescribing contract held by Together Co (formerly Impetus).

Public Health colleagues in Brighton and Hove City Council are working with their East and West Sussex counterparts, and the CCG, to compile population Health packs to help PCNs make informed decisions regarding their priorities for development and strategic direction.  PCNs are currently completing a self-assessment against the national NHSE maturity matrix; and respond to a prospectus detailing the national support offer.

The Director of Primary Care meets regularly with each PCN to discuss their plans and how CCGs can support them, and the wider CCG primary and Community Care team members are being repositioned as more externally focussed in order to directly support PCNs.  This support offer includes funding legal support; hosting meetings; and the provision of a PCN accelerator fund which offers financial support to bring forward key elements of the Long Term Plan, support the desired integration of services, and reduce clinical variation across the Sussex Healthcare Partnership foot print.