ࡱ> HJG@ Z'bjbj.. *>DDifff p |||,,2222222      $Rp.|t22tt.||22Ct|2|2t||2 ``2F$Y0AxA||||A|@2^L`222.. APPENDIX 2 NEXT STAGE REVIEW INTERIM REPORT: GPC SUMMARY OF KEY POINTS 1 INTRODUCTION 1.1 The interim report of Lord Darzis Next Stage Review was published on 4 October; the report can be accessed online at the following website address:  HYPERLINK "http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/dh_079077" www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/dh_079077 1.2 Lord Darzi states that the interim report has been informed by discussions held over the past 3 months with staff in NHS organisations, representatives of stakeholder groups and feedback from the deliberative events for patients and the public held at SHA level on 18 September 2007. 1.3 The four principles that underpin Lord Darzis vision for a world-class NHS are that it should be fair, personalised, effective and safe. In addition to national measures being put in place to embed these principles, the SHA clinical pathway groups will consider them as part of their work. 1.4 The report recommends some immediate areas for action before publication of the final report in June 2008. Those most pertinent to GPs include recommendations around flexible working, extended opening hours, new practices in under doctored areas and new GP-led health centres. 2 ACCESS 2.1 Open up supply of GP services in deprived communities by introducing a wider range of providers. 2.2 At least 100 new practices to be set up in the 25% of PCTs with poorest provision, defined by fewest primary care clinicians, lowest patients satisfaction with access and poorest health outcomes. New resources mentioned. Can be traditional independent contractor model or new private providers. This will include up to 900 GPs, nurses and healthcare assistants. These new practices to offer a range of services including extended opening hours. 2.3 PCTs to set up 150 GP-led health centres in easily accessible locations providing a range of services available to all patients, including those not registered with the GPs working in the centres. New resources mentioned. This should include pre-bookable appointments and walk-in services. Guiding principle is that all patients should have access to GP services from 8am-8pm, 7 days a week. These centres should maximise co-location with other community based services including diagnostics, therapies, pharmacies and social care. PCTs will be expected to commission these new health centres on a level playing field from existing GP groups or other providers. 2.4 PCTs to work with new and existing practices to put in place greater flexibility in opening hours. Stated aim is that at least half of all practices open every weekend or one or more weekday evenings. Resources mentioned. Where practices do not comply, PCTs to use the funding to commission extended hours from other GP practices, GP federations or other providers. Note that the review will also consider whether more convenient hours should apply to services provided in secondary care settings. 2.5 We will ensure that an increasing proportion of the NHS payments made to GP practices are linked to their success in attracting patients, and the views of their patients, including the ability to book advance appointments and the ability to see a GP within 48 hours. 3 CHOICE & PERSONAL CONTROL 3.1 NHS Choices website to be used to help patients choose best GP for their needs (using information on patient survey results, opening times and QOF) and change their GP practice if necessary. 3.2 Encourage practice based commissioners to use NHS funds more flexibly (i.e. social care as per proposals made in Commissioning framework for health and well-being March 2007). 4 FUTURE STRATEGY FOR PRIMARY AND COMMUNITY CARE 4.1 Advisory board set up to develop a vision for world-class primary and community care services. Includes GPs, community nurses and other health care professionals. Work to include proposals for new models of care and re-shaping incentives. Mention of a more equitable link between the funding GP practices receive and the number of patients they treat; money follows the patient. 4.2 Expansion of patient choice in primary care, including exploring new models that enable patients to switch GPs more easily and register with GP practices near their workplace, and how to make it easier for the new entrants to start providing primary care on contract to the NHS as of right in underdoctored areas without a slow and bureaucractic procurement process. 4.3 Shift from national procurement to locally procured services, leading to a greater role for private and voluntary sector in primary, out-of-hospital services. 5 HEALTH INEQUALITIES 5.1 Secretary of State strategy for reducing health inequalities (published August 2007). Health inequalities intervention tool to be used by Spearhead PCTs and partner local authorities to ensure better local planning, commissioning, local development plans (LDPs) and local area agreements (LAAs). 6 QUALITY 6.1 CMO, Sir Liam Donaldson to develop a standard quality framework and proposals for systematic measurement. NHS Medical Director, Professor Sir Bruce Keogh will advise on implementation. 7 INNOVATION 7.1 New Health Innovation Council to be established to hold the DH and NHS to account for taking up innovation. 7.2 Academic Health Sciences Centres (AHSCs) to be rolled-out across major teaching centres. 8 SAFETY 8.1 MRSA screening of all elective admissions from 2008 and all emergency admissions as soon as possible, within 3 years. 8.2 New health and adult social care regulator. 8.3 Annual infection control inspections of all acute trusts. 8.4 Plan/guidance to increase power of local staff including matrons to report hygiene concerns to National Patient Safety Agency (NPSA) Patient Safety Direct, a new single-point to which frontline workers can report incidents. 9 LOCAL ACCOUNTABILITY 9.1 Guidelines to be issued by the end of the year, based on Carruthers Review (Feb 2007), for making major changes to NHS services. Process will involve greater public and clinical scrutiny. Will also involve independent assessment prior to consultation by the Office of Government Commerces Gateway review process. 9.2 There will be a consultation on options for streamlining reconfiguration process. 9.3 National clinical evidence base to be made available to commissioners, practitioners, patients and the public. 10 SECOND STAGE OF THE REVIEW 10.1 SHA clinical pathway groups. 10.2 Staying healthy and NHS as well-being service. 10.3 OOH services: will consider a 3-digit number in addition to 999 to simplify access to urgent care and how pharmacies can support seamless care. 10.4 Workforce planning, education and training. 10.5 Leadership: NHS Chief Executive, David Nicholson, chairing a working group which will include professional and representational bodies. 10.6 Information to support excellence: Connecting for Health. 10.7 Enabling systems and processes: world-class commissioning and extensive use of framework for external support for commissioners (FESC). 10.8 Case for a NHS Constitution: NHS Chief Executive, David Nicholson, chairing a working group to consider this. 10.9 Lord Darzi plans to work with a senior NHS leadership team, comprising clinicians and managers from here and abroad. This will involve professional bodies, trade unions, voluntary sector organisations and other partners. He will also commission research, analysis and contributions from a range of organisations, including from abroad.  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