Service Redesign: The future of primary health

“Keep your hands open, and all the sands of the desert can pass through them.  Close them, and all you can feel is a bit of grit”- Taisen Deshimaru

 

PHD is completely redesigning the way that we provide services within primary healthcare (General Practice). We are designing services around those who use it and those who deliver it.

 

To do this we are working closely with patients, staff and the broader community, supported by a robust research programme.

 

We are going into communities, listening to what people want and are shaping services around what they need alongside those who deliver them. We believe this will be extremely beneficial to patients – and will be cost effective.

 

This work is being piloted in Smethwick, part of the Borough of Sandwell.

 

Our Vision

We intend to develop a new model for primary care with quality and people informing its heart.

1. A service that is designed around the people who use, work in and work with them
2. Customer focus, treat people with respect
3. Listening and hearing- then acting
4. Creating good life balance
5. Communication, communication, communication

 

Why?

 

Currently the access to the right person in the health service is difficult and often requires several steps. This service will ensure efficient and streamlined access to the right person at the right time, in the right place.

 

Currently people have to come to the surgery to access health care, but this model will take the surgery to them on their terms.

 

Currently the health service promotes a dependency culture on health professionals. This service will promote confidence in self management of care. Provide an opportunity for communitymembers to develop skills that improve the health of others in the community. By actively lookingfor patients at risk of ill health this service will reduce inequalities in health.

 

 

Implementing Change

We have developed a model of work that will reshape services to benefit everyone. The model includes:

Self Care. Developing personal care packages working with people in their homes and looking at how new technology can help them.

 

Outreach/inreach. Working within communities that have until now not been contacted proactively, for example within church communities, Gurdwararas, mosques, pubs and shopping centres.

 

Fast track referral and treatment. Triage/clinical assessment terms working closely together to ensure people are no longer slowed down by the system. Clinicians and support staff will be streamlined into effective multi-disciplinary teams.

 

Holistic health view. Working with complementary therapists to look at the whole person and find solutions to problems. This will lead to less clinical intervention and hospitalisation.

 

Community empowerment. Raising expectations within a community that traditionally, have low aspirations. Working together to develop solutions to some of the most difficult health issues such as CVD, diabetes, chronic obstructive pulmonary disease (COPD) and mental health.

 

Primary care as an agent of regeneration. Employing community members, leading group consultations, patient-led education with the aim of ‘patients helping other patients’.

 

Managing PBC (practice based commissioning) budgets actively at practice level. We will base much of the new patient pathway design on real patient experience, working together with the clinical and non-clinical teams.

 

 

Two Models to consider:

Fig. 1 The social determinants of health - i.e. all the factors that determine a person's wellbeing

 

 

Fig 2. The service redesign model

 

 

How this will be achieved

 

This will free people up to:

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