1. Won’t this mean my patients have to travel huge distances to get services?
No, we still need to build services around patients, that includes looking at how they would access services.
2. How will my asthma patient get the same quality of treatment as the ‘place’ down the road?
All ‘places’ will have core general practice and community services. If there are innovations in one area that could improve the care for all patients, then we will develop the infrastructure to learn from it and, if it’s appropriate, be able to implement it across Southern Derbyshire. We will share the pathways and the specifications.
3. What if I feel more comfortable working with practices that are in another place?
The ‘places’ are about the population and we will commission based on those places, this will include all health and social care providers. Not just general practice. All the providers in a place will need to work together.
However, providers (including General practice) do not have to be limited to one place. (DCHS for example works across the whole of Derbyshire & some of Leicestershire and Alexin work across Southern Derbyshire and into Staffordshire). If you have good relationships and are doing good work with other organisations that cover a different place, this does not have to stop.
It is likely that many services will need to be provided across bigger populations than the places, and that over time providers will merge into bigger units so good relationships are beneficial wherever they occur.
4. No other practice in my ‘place’ wants to get involved - should I join another ‘place’?
The places are not just about general practice. There will be opportunities to work with other organisations in your place. As above, if you want to collaborate with other practices, this does not need to be limited to your place.
We will also be working with the other practices to try to understand the barriers to collaborative working within the ‘place’ and see if we can help. We will monitor the situation and be flexible with solutions that will support the population.
5. How do we choose a clinical lead?
The clinical lead will be someone you trust and will act as an advocate for the place. We hope that it most cases this will be a GP, but it may be someone from other organisations eg social care or mental health.
If you want more support on this, then let us know. The East Midlands leadership can also help with knowing what makes a good leader.
6. I don’t feel I have enough information and want to know more.
Of course, you can contact any of the Place links (below in Q.7)
We can come and see you as a practice or as a place to discuss more. We are also building this website for you to find information. We will update it regularly so keep checking back for updates.
7. Who is my link with the CCG?
We have linked keys named individuals with each of the groups. They are supported at the CCG from more senior leaders, but also have access to a wide range of support including data and analysts.
Amber Valley North - Emma Plummer
Belper - Jo Finnegan
City Centre North - Tina Brown
City Centre South - Tina Brown
City Northeast - Jo Finnegan
City Northwest - Nwando Umeh
City South - Lem Podmore
Heanor - Emma Plummer
South Dales - Jane Hopkins
South Derbyshire - Jane Hopkins
8. What will happen with localities?
We are not sure at the moment; they are part of the CCG constitution. We want to make sure we do not lose the valuable part they play but it is likely that they evolve as the places develop.
9. I have heard a lot about capitated budgets and new contracts what does this mean?
This is for the future. At the moment there are different approaches being tested out across the vanguards but none are clear yet, and the legal frameworks for them have not yet been tested. We believe that organisational form should be developed in response to the way people need to work together and be developed to support that.
As an organisation we will keep track on national developments so that we are ready once the relationships in the places are at a point to change their organisational and contractual form.
10. Is this not just another reinvention of the wheel? Haven’t we been there with fundholding?
When you have been in healthcare a long time, it does feel like you go through cycles on the same thing, just with a different name. So many times in the past this has been tried without general practice. This does feel different this time. The focus is now on populations, looking at their health and wellbeing and making sure that everyone is involved. It is no longer about individual organisations, so there is a need for all of them to work better together.
Are the CCG hiding the real plan?
No, we have shared all the information that we have. There is always information available at NHS England (www.england.nhs.uk/ourwork/futurenhs/deliver-forward-view/stp/).
We really believe that to make healthcare sustainable we all need to work together for our population. That is what is behind this.
11. Aren’t we already doing this?
Yes, there are loads of examples across Southern Derbyshire of great collaboration.
South Derbyshire practices have previously been working with Derbyshire Community Health Services and Derby Adult care in the Unique Care Scheme. This scheme was a development to look at better managing frail elderly and complex patients.
In the city, (Hollybrook, Lister House & Village surgery) have worked collaboratively with DCHS focusing on community matrons and care co-ordinators to strengthen the Multi-disciplinary team approach set up via care coordinators in order to provide a more proactive approach.
Belper 5 have worked together with Derbyshire Community Health services and the CCG to look at collaborative working and have developed different roles around advanced Care practitioners and pharmacists.
Ripley practices have also done some excellent joint work in relation to the carers agenda and has worked jointly with Derbyshire carers to set up a carers support service at practice level.
There has been better working with secondary care and Royal Derby Hospital including better access to advice and guidance through NHS eRS and through bed bureau for ‘Clinician Connect’. These have made access to advice much better for Orthopaedics, Cardiology, Endocrinology and Imaging to name but a few.
There has been work on musculoskeletal services looking at improving pathways across Southern Derbyshire and we will be looking at linking named consultants across the places.
We want to promote this, take the lessons learnt, but doing this at a bigger scale across Southern Derbyshire.
There is also work underway on condition specific pathways i.e. Stroke, Dementia and Diabetes which can be linked into to gain better understanding of existing good practice both locally and Nationally.
12. I want to get involved, but I don’t think I have the skills.
We don’t expect everyone to have the right skills from day one. But we need to understand more specifically what development or support is needed.
We have access to leadership and facilitation skills training, and we are developing a team of data analysts & project managers who will be working directly with the groups. But this is new to all of us so those teams will have to learn as we go in the same way you will.
Again, working together, co-producing to use the trendy jargon.
13. What development support will I receive?
The CCG offers a minimum of two days per week of time from one of our transformation managers. This can support the place in a number of ways:
- Offer wider context and clarity.
- Support places to work with all key stakeholders to explore options for integration and development of services for their population.
- Facilitate joint working and collaborative working between different organisations including community providers, voluntary sector and local authorities.
- Link places with others and wider developments in the CCG and nationally.
- Access wider CCG support e.g. Data Analyst time.
Help places to understand population needs.
Provide Project Manager support to develop plans, milestones and manage risks etc.
14. Practices are finding it difficult now, how am I supposed to do this and keep the practice going?
We understand there is a need to keep practices sustainable now in order to be involved with the transformation. The diagram below tried to summarise some of those challenges, and some of the transformational ideas could be also aimed at addressing some of these areas.
We are developing support for practices to ensure they remain sustainable. There will be more details that follow.