GP Provider Support Unit, Birmingham and Solihull

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The ICB’s commitment

The ICB has renewed its commitment to support primary care to enable delivery, quality improvement and transformation.

Work has been undertaken to produce a strategy for the primary care sector called ‘Enabling Primary Care in BSol’. This will articulate ambitions for the sector, reflect national priorities and consider the role of primary care in contributing to transformation across the ICS.

The ICB has reviewed its primary care facing structures and incorporated two key teams into it’s management establishment. The first is the ICB Primary Care Commissioning function and the second is the General Practice Provider Support Unit.

This builds on the call from primary care to develop an infrastructure to maximise primary care’s contribution to delivery of system priorities and improve care.

Developing the role

What the PSU’s role should be, as developed by the PSU Steering Group

The GP Partnership Board set up the GP PSU Steering Group, nominated its members, and agreed its terms of reference. The inaugural meeting of the PSU Steering Group took place in February 2023 and began its work in resetting the PSU’s vision, purpose and functions.

Surveys about the PSU’s purpose were carried out with members of the group and other sector representatives, resulting in the core messages noted below.

What is the PSU’s purpose, and what are we trying to achieve through it?

  • Corporate stability: To promote primary care sustainability and create an infrastructure with critical mass, like the primary care equivalent of a Trust
  • Change leadership: To support primary care through complex and transformational change
  • Singular representation: To help present a unified ‘face’ of general practice, promoting collaboration across partners, facilitating a united position on system issues, and avoiding fragmented approaches
  • Innovation: To drive innovation through the use of quality improvement methodologies and other techniques, working up and then disseminating and rolling out new approaches
  • System contribution: To provide an inward-looking lens to support primary care, but also an outward-looking lens to the system to ensure primary care help lead ICS-wide change, promoting sector identity and credibility with system partners
  • Defining the ambition
    What the PSU aims to achieve, and how this differs from legacy arrangements

How the PSU differs

Historically, management capacity to support primary care has been grouped together with a strong focus on contracting/commissioning.

The GP Provider Support Unit will be developed with primary care, primarily through the GP partnership board. It will have a focus on collaboration and delivery, working on behalf of the sector. This will enable primary care to influence wider system discussions more effectively.

The PSU will enable work across the ICS at different levels: BSOL-, place-, locality- and neighbourhood-level.

These structures will evolve and, where possible, be devolved to the most local level in line with the ethos of subsidiarity.

Moving FROM…

 

…TOWARDS

Primary care viewed as a collection of separate providers rather than a coordinated sector.

→→→

Primary care viewed as a credible, coherent sector that works effectively with partners and is driven by a culture of improvement and openness.

Practices as the main unit of planning. 

→→→

Localities and PCNs as the key units of planning for primary care, particularly for integrated working to complement existing provider structures (e.g. providers at scale).

Uncoordinated primary care support from the ICB predecessor organisation, with planning driven from the top down.

→→→

Primary care dedicated infrastructure geared towards delivery, data driven and directed by primary care. 

A centralised agenda dominated by transactional, short-term and ‘one size fits all’ solutions.

→→→

Bottom-up agenda driven by local needs with an evidence base from general practice, and implementation of innovative and locally-specific solutions to regulatory imperatives.

Disparate and varied governance arrangements involving primary care.

→→→

Robust accountability framework, clear decision making which is connected across the ICS.

Clinical leads appointed by CCGs and guided by central agendas.

→→→

Clinical leads appointed or nominated by, and connected to, general practice, and guided by primary care lead work programmes.

Agreeing key functions

What the PSU would be expected to deliver, support and influence, and what would be out of scope

Relatedly, the PSU Steering Group has also carried out representative work to identify its integral functions. Fundamentally, the PSU needs to enable delivery of the new ‘Right Access First Time’ (RAFT) programme, support additional must-do priorities, and provide some business as usual activities. The functions elicited and identified are below.

Proposed functions for the PSU

Note there are a number of other areas that will need to be considered over the coming months. These include estates, information governance/DPO, IPC and safeguarding. The functional alignment of these areas may change as the ICB evolves and front-line general practice becomes more engaged in the PSU.

GPPSU : steps in our development

Nov 22 : ‘Lift and shift’ of previous primary care facing CCG functions into the GP PSU
Mar 23 : Reset of purpose & functions, directed by GP steering group chaired by Dr Subeena Suleman
Mar – July 23: Options appraisal of future hosting arrangements
Apr 23: RAFT scoping meeting with all PCN directors & managers
Jun 23 onwards: Engagement with localities around desired RAFT programme support
21 Jun: Programme group launched, with Dr Subeena Suleman (BSol Clinical advisor for access), GPPSU medical directors for integration, GPPSU managers & external improvement coach

Key Next Steps

  • Locality discussions to continue informing priorities and plans
  • Refine the functions needed to deliver what practices want from the GPPSU
  • Management of change to commence June 22 +/- recruitment after consultation