Helen Northall, chief executive of PCC, discusses what this year is likely to hold for general practice
We are now in 2022 and the health service has already been challenged and has responded well once again. Booster vaccinations have been delivered, another wave of COVID is being managed, and business as usual has been continued. So, what next in 2022?
In a year where we are expecting to see integrated care boards (ICBs) become statutory bodies, clinical commissioning groups (CCGs) being subsumed and integrated care systems (ICSs) finding their feet and starting to deliver joined-up services at place and system level. What are the hurdles that will need to be overcome?
Pressure on staff is one of the biggest challenges – with high sickness rates seen over winter, requirements to self-isolate, and the toll of working under pressure for such an extended period it’s crucial to ensure that all members of the team work supportively together and and that new roles, responsibilities, and multi-organisational, multi-disciplinary team function effectively together. There is also a need for those needing care to have tolerance and understanding that they may be seeing different professionals, and be accessing care in different ways, so the whole team can continue to work safely and effectively.
The planning guidance signposts the extended role of community care and virtual wards and this will have an impact on how teams need to work to manage increased numbers of patients in out of hospital settings. The multi-disciplinary team will be crucial to ensuring the success of virtual wards which, if waiting times are to be managed, will be essential. How this will all be co-ordinated, and the role of primary care networks (PCNs) and place as system players, will be key. Enabling capacity to allow this to happen is vitally important, with PCN clinical directors playing a vital role. They have already delivered hot and cold hubs, vaccination programmes and vastly expanded multi-disciplinary team working in primary care; to now support increased numbers of people needing care in the community who would previously have been in hospital will be a challenge.
Headspace, and time for the clinical directors, will be vital, as will increased working at place level. Many PCNs have already come together to work at place level, to enable the additional roles funded via the additional role reimbursement scheme to be most effectively employed, managed and deployed. It’s now time to work at this level to enable care to be managed. It’s crucial to allow these clinical leaders the headspace and time to manage these roles successfully; they have already proven themselves and need every support to do it again. Failure to allow this could jeopardise the success of PCNs and the vital support they can give to practices.
The clinical directors will also play a crucial role in the expansion of population health management and addressing health inequalities, supporting work to prevent ill health in the first place. Again, work at place level will help, but each network may have different patient needs, and population health needs considering at a local level. Finding the time to work upstream and prevent future illness is vitally important and will be where all in the ICS need to work together – as many of the answers are not within health care, but across local authorities, the voluntary sector and local community. To realise the vision of PCNs’ engagement across the system and with local communities is important; finding time and headspace will be the biggest challenge.
It would be easy to overlook the technicalities of the wider organisational changes but, with CCGs due to be no more by July, and ICBs starting on their journey, they need good governance and oversight to work effectively. ICBs will in time take on additional commissioning roles – dental, eyecare and pharmaceutical services – as well as current CCG responsibilities, and the challenge is how can all work most effectively together to deliver the best care possible for the population.
It will not be an easy year, and the most important areas to address will be headspace for clinical leaders to plan how care can best be delivered with effective multi-disciplinary teams, and all parts of the system working together. Good community engagement to ensure that the strengths in the community are fully used, and the understanding of the new ways services are delivered are communicated at community level is needed to enable understanding of the different ways health care will operate in the future.
Helen Northall is the chief executive of PCC, a not-for-profit organisation providing expert support, leadership programmes, personal and team development to practices, PCNs and all across health and care services. www.pcc-cic.org.uk
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