As part of Healthcare Leader’s focus on shifting care out of hospital and into the community Kathy Oxtoby writes about primary care transformation in Black Country ICB
The Black Country Primary Care Collaborative is leading the change in primary care in the region, supported and guided by the ICB.
‘For primary care to truly transform, it must be a process that comes from provider organisations, working with our Place-based partnerships,’ says Dr Ryan Hobson, Black Country GP and chair of the Black Country Primary Care Collaborative.
Recognising this, the ICB has provided the means and funding to engage on ‘a very reflective process’ to develop a five-year primary care transformation strategy, Future Primary Care in the Black Country.
‘This transformation strategy will alter the way we look at the provision of care,’ says Dr Hobson.
‘It will help us transition from a focus on acute same day problems, to a focus on planned and preventative care, helping the Black Country population manage their chronic conditions better and living healthier lives.
‘Ultimately, this will lead to reduced pressures in both primary and secondary care.’
The development of a consistent Black Country local incentive framework for general practice with a focus on the three pillars of planned, unplanned and preventative care, ‘will act as a key enabler in delivering the future operating model for general practice’, says Sarb Basi, director of primary care for the NHS Black Country Integrated Care Board
‘The harmonised framework will take account of the tools, policies, processes and resources deployed by the ICB’s Modern General Practice exemplar sites.
‘This is with a view to developing the right mix of incentives to drive rollout and contribute to the establishment of the standardised access model. ‘We are going to work with our peer support practices -. Modern General Practice exemplars – to set out in a clear specification on people, systems and processes and digital in relation to what good primary care access looks like and how we commission a standardised approach,’ says Mr Basi.
He describes the framework as ‘an integral transformation lever within this five-year programme, to elicit the required behaviours across practices and primary care networks (PCNs) to deliver our vision of equitable access to high-quality healthcare for all’.
The framework will act as the ‘key incentive tool’ to encourage the implementation of the future operating model across primary care and start to address the balance of spend across the three pillars of planned, unplanned and preventative care in the future, says Mr Basi.
The ICB is in ‘Horizon 1’ – the first 12 months of the detailed design in the primary care transformation strategy.
From 12 August 2024 to 20 September 2024, the ICB invited local people to participate in the ‘Future Primary Care Conversation’ – an involvement exercise to share their views on areas in the strategy and help shape the future of primary care in response to local needs.
Overall, 1,208 people provided feedback during the involvement exercise by completing a survey, joining a focus group or by taking part in a community conversation hosted by a voluntary, community, faith and sector enterprises (VCFSE) sector partner.
Some 685 people responded to the survey and 35 people participated in five focus group discussions hosted in the four Places across the Black Country. There were 27 organisations awarded microgrants through which the ICB was able to collect insights from 488 people about the barriers and unique challenges minoritised groups face in accessing primary care services.
A series of People Panels and over 40 community conversations were hosted during the involvement period.
The perspectives and feedback gathered through the Future Primary Care conversation with local communities across the Black Country are now being considered as part of the co-design work to develop the ICB’s future operating model.
As the programme progresses, business cases will be presented setting out any proposed service changes, their benefits and the associated funding to be able to implement and embed.
As part of the ICBs transformation strategy, it identified the need for structures to support the transformation work and help providers improve and become more resilient.
In response, the ICB has supported the creation of a Primary Care Support and Development Unit, which will provide and host a number of functions. This will be a provider lead unit, supporting primary care clinical leaders and practices with the implementation of the transformation strategy.
The ICB also has plans to establish an Improvement Academy, which will ‘help cultivate and embed continuous quality improvement and evidence-based practice into primary care’, says Mr Basi.
Currently, the main focus of the Black Country Primary Care collaborative is the implementation of the transformation strategy horizons, the establishment of the Primary Care Support and Development Unit (which is one of the ‘horizons’) and representation of primary care at place, system, regional, and national levels.
Dr Hobson says: ‘The focus of this representation is on how primary care can help improve the health of the population it serves, the resources it needs to do this and its inherent value as a provider sector in a financially challenged system.’
