Today Dr Lisa Harrod-Rothwell, Deputy CEO, Londonwide LMCs spoke at the Royal Society of Medicine’s 43rd General Practice and Primary Care update, her main points included:
Making a success of change
“The keys to successfully delivering change are:
- Giving those closest to the problems or the opportunities for evolution) – those delivering care, in collaboration with those receiving care – the autonomy to, and ownership for, identifying the solutions.
- Creating the conditions for innovation to thrive – the people delivering services need an appropriately skilled and sized workforce, thinking time for new ideas, funding, the freedom to try and fail at first, and learn and adapt.
- Wider strategic alignment –adoption and spread enabled though alignment of elements such as contracts, national prioritisation and policy and regulation.
“Successful change can only be delivered by empowering people at a micro level, giving the people delivering care the autonomy to develop solutions that meet bespoke needs of their incredibly diverse populations.”
“We need to embrace digital, AI, segmentation but not at the expense of holistic and personalised care and access to those who need it most. Again, the risks and benefits of all trade-offs need to be considered.
“And we must protect against top down initiatives that further erode the core values and characteristics, such as:
- holistic care,
- continuity of care,
- appropriately managing complex undifferentiated illness,
- simultaneously managing the acute and chronic health problems
- coordinating care, and
- promoting the health and wellbeing of individuals and local communities
“Erosion of this has been in no-one’s best interests – the evidence overwhelmingly demonstrates that these are requisites for highly cost-effective quality care and value to patients and communities, and whole NHS financial efficiency.
Given the increasing complexity of patient needs and the financial constraints, never has it been more important to enable these characteristics to thrive.
The Government’s priorities
On the recent change in Government and Darzi report into the NHS:
“I welcome this Darzi report, with the issues laid bare for all to see. Across the NHS, we feel heard and it’s enabled the start of conversations like this – honest reflections with learning. And I’m particularly reassured that Keir Starmer says he want to bring back the family doctor.
“I am assuming he doesn’t intend to do this by rounding up the GPs sunning themselves on Bondi beach and ship them back. But, if he truly wants to bring back the family doctor, and the place of the family doctor in the NHS, there’s an army of us ready, waiting and capable to help him – he just needs to trust us to do it.”
Learning from the experience of GPs and their local medical committee representatives in London
“We saw a huge de-stabilising impact of PCNs on practices in the early days. Practices, who had different cultures, structures and served patients of different demographics and needs, were forced to come together and put in place complex governance arrangements and make decisions about distribution of funding.
“As practices navigated this, they encountered many national barriers and challenges that hadn’t been identified and mitigated prior to the introduction of the contract. This complex development work took clinicians and managers away from the pressured front line and there was very little implementation and change management support.”