Investing in leadership to transform primary care in Lambeth and Southwark
We are supporting a wide-ranging, innovative primary care development programme in Lambeth and Southwark that is fostering strong leadership in general practice and providing the building blocks for better integration across the whole health and care system.
Who: Lambeth and Southwark clinical commissioning groups
Start date: March 2014
Grant value: £1.2 million
A new health provider landscape is emerging in Lambeth and Southwark that is transforming the way primary care is delivered in the boroughs.
The changes are being driven by a group of general practice leaders, as part of an innovative primary care development programme led by NHS Lambeth and Southwark Clinical Commissioning Groups (CCG), in partnership with Local LMCs (Local Medical Committees).
At the heart of the programme is the idea that by having a strong collective voice and delivering new primary care models ‘at scale; care can be better integrated, more efficient and effective, and provide a better experience for patients.
The programme is supporting GPs and practice managers to have protected time and headspace in order to develop the skills necessary to lead change, create and manage large federations of practices, and introduce innovative new ways to improve care for people locally. These ‘emerging leaders’ are not only spearheading change to general practice locally, but also influencing other major health and care programmes, bringing the perspective and views of primary care to the forefront.
Work on the primary care development programme begins, with the first phase focusing on identifying and recruiting the emerging leaders and building a shared vision for primary care in Lambeth and Southwark.
March - September 2014
Visioning workshops are held where local leaders representing primary care from Southwark and Lambeth CCGs come together to create a shared vision for primary care in the boroughs.
The initial phase of the programme involved identifying and recruiting a group of ‘emerging leaders’. These GPs and practice managers then went through a six-month leadership programme that provided them with the tools and skills needed to lead large-scale change in primary care.
Alongside this, a series of workshops were held to visualise what primary care should look like in the future: how it could better support health and service improvement in the boroughs, and reflect the likely changes in commissioning and in particular the move towards integrated care.
The next phase involved applying the capability learned by the emerging leaders to influence behaviour change. It focused on building a collective leadership infrastructure for formal decision making; engaging with neighbouring teams; and supporting the transition to new models of integrated care.
The emerging leaders have played a key role in the development of GP federations in Lambeth and Southwark, and are engaged in emerging Local Care Networks (which form the basis for integration with health and care partners locally). They have also supported the Southwark and Lambeth Integrated Care (SLIC) programme by providing strategic leadership on behalf of local general practice.
The programme has led to the development of a ‘unified voice’ across GP federation leaders that ensures that the collective views of general practice are represented when engaging with key partners, and delivering new models of care. The next phase will involve continuing to support the ongoing delivery of collaborative working, and ensuring that the GP federations are able to deliver the vision for primary care in Lambeth and Southwark – recognising that strong primary care is essential and will provide the basis for wider system integration.
”We’ve been really fortunate to have the investment from Guy’s and St Thomas’ Charity, recognising the importance of developing leadership in primary care. Without that we would have not achieved as much as we have.”
Dr Sian Howell, GP and Clinical Lead for Primary Care Development, Southwark CCG
“Transforming general practice is vital to the future of the NHS and I’m delighted that we have supported this work, led by GPs for GPs. Not only has the work started to transform local primary care but it has also accelerated change across the local health system, notably integrating care across hospitals and GPs.”
Oliver Smith, Director of Strategy and Innovation, Guy’s and St Thomas’ Charity
Ninety per cent of patient contact in the NHS takes place in general practice. However, with a growing and ageing population, and on-going financial pressures, steps must be taken to radically change how these services are delivered in the future.
The primary care development programme is aiming to build capability to enable general practice across Lambeth and Southwark to shape and develop integrated models of primary care that are generalist-led, bottom-up and clinically driven.
Through engagement with all involved in primary care in Lambeth and Southwark, the programme identified the need for a primary care system that is better configured to deliver an increased range of services to patients; that is integrated with other services on a population health basis; that reduces variation in access and quality; and that delivers better quality and value for money.
NHS Lambeth Clinical Commissioning Group and NHS Southwark Clinical Commissioning Group are responsible for commissioning or ‘buying’ healthcare services for the people who live and work in the boroughs. They plan, monitor and pay for most of the health services available to people in the boroughs. The CCGs are membership organisations made up of all the GP practices in the respective boroughs.
An independent evaluation has found that the programme not only created a cohort of new local leaders but it also enabled the successful development of five GP federations in the two London boroughs. These have brought practices together to improve access and outcomes for patients and to explore new ways of delivering care such as care navigation and holistic assessments for people with complex needs.
Along with the federations, the evaluation found the programme helped to grow the engagement of general practice in the integration of the wider healthcare system and deliver seven-day primary care access in the two boroughs.
A stakeholder interviewed for the evaluation described the programme as “very successful in creating a cadre of GPs that are both engaged and developing clinical leaderships skills and authority to have difficult conversations across boundaries. It has given them the time and skills to do this.”