Rick Stern, Chief Executive,

1

• Rick Stern, Chief Executive,
• Bexhill Rother PCT
• A national pilot for integrated out of hours care
  and a pathfinder for mutual governance

NAGPC conference
a consortium
for integrated out of hours care
2
Introduction

• Consortium of 6 PCTs and an out of hours Co-op
• Identified OOH as a key priority for 2003/04
• Supported by NHS pilot status and as a pathfinder
  for mutual governance
• Work in progress
• What I will cover
• What we need to know before agreeing to opt out
• Mutual governance concerns and benefits
• Learning so far

NAGPC conference
a consortium
for integrated out of hours care
3
What PCTs need to know before agreeing to a GP
opt out

• What the service will cost
• Staff are signed up to deliver the new service
• There is clarity about Saturday mornings (with
  support from NHS Direct)
• That all stakeholders are signed up with good
  communications in place
• A competent, confident organisation is in place
  to deliver the new service

NAGPC conference
a consortium
for integrated out of hours care
4
Mutual reservations
1
PCT Concerns

• Why do we need yet another organisation?

Mutual benefits

• Co-ops worked for the last 10 years, but we now
  need organisations fit for purpose for the new
  world after a GP opt out

NAGPC conference
a consortium
for integrated out of hours care
5
Mutual reservations
2
PCT Concerns

• Is this a bureaucratic and costly solution?

Mutual benefits

• Retain simplicity and flexibility of Co-ops with
  wider ownership. Need not cost much more,
  although there is a cost to active membership.

NAGPC conference
a consortium
for integrated out of hours care
6
Mutual reservations
3
PCT Concerns

• We were set up to represent the views of our
  communities

Mutual benefits

• Offers a more radical approach to membership and
  engagement

NAGPC conference
a consortium
for integrated out of hours care
7
Mutual reservations
4
PCT Concerns

• This needs to be a local service

Mutual benefits

• An organisation working across a bigger area can
  still focus on local concerns and offer local
  variation

NAGPC conference
a consortium
for integrated out of hours care
8
Mutual reservations
5
PCT Concerns
Mutual benefits

• We seem to be asked to do almost everything else,
  why cant we do this ourselves?

• This is a complex function requiring specific
  expertise.
• Accreditation is very demanding.
• PCTs are too small to do this efficiently.
• The cost of failure will be very high.

NAGPC conference
a consortium
for integrated out of hours care
9
Reflections, so far

• Partnerships are very challenging
• Leadership from the top
• Managing the process
• Clarity of vision and
• stakeholder engagement
• are not enough without effective implementation
• Opportunities for creating organisations to
  manage much more than OOHs
• Clarity about commissioning
• Benefits of early opt out, cost of going too soon
• Paradox of centrally driven community ownership

NAGPC conference
a consortium
for integrated out of hours care