Transformation Unit

Developing a Strategic Outline Case for the transformation of a group of APMS GP practices in Merseyside

The Client

Primary Care 24 (PC24) is a social enterprise, delivering a range of primary and urgent care services to just under one million people across Halton, Knowsley, Liverpool, St Helens and South Sefton in Merseyside.

The Challenge

In 2017, PC24 acquired responsibility for delivery of primary care services at seven GP practices in Sefton serving approximately 20,000 registered patients. These services are delivered by GPs, nurses and other clinical and administrative staff that are employed (or contracted) by PC24. These services are delivered under Alternative Provider Medical Services (APMS) contracts which were awarded following a successful tender process in Summer 2017.

All seven practices are significantly challenged in terms of financial sustainability and with salaried workforce recruitment and retention issues – not unlike many individual practices across the country.

A strategic outline case was required to document PC24’s aspirational transformation plan to mitigate identified financial, workforce and clinical governance risks associated with the practices in scope.

Our Approach

Working closely with PC24 clinical and non-clinical staff on-site, the TU helped to articulate a realistic transformation strategy to deliver their vision for a financially sustainable Sefton GP Practice portfolio, delivered by a resilient salaried workforce and connected to world-class medical training and academic research institutions in the future. This drew upon NHS England primary care transformation best-practice and learning from elsewhere in the country.

The Outcome

The TU delivered a comprehensive strategic outline case on time and budget for PC24 Executive staff to agree and present to NHS England Primary Care including:

  • Evidence based case for change
  • A proposed network model for the seven practices that makes best use of available resources whilst maintaining a local community focus
  • Description of a new multi-disciplinary staffing model that maximises GP time for complex patients and utilises shared resources across the practices such as pharmacy, physiotherapy and mental health nursing
  • Indicative income and expenditure profile highlighting phased reductions in expenditure towards closing the financial gap
  • Phased transformation plan with associated resource costs over the next three years.

‘Without the TU, we would simply not have been able to produce a costed, credible and robust plan to present to our commissioners in the short time we had. They understood our requirements and quickly produced an excellent piece of work which did not compromise on quality’

Dr Mary Ryan, Chief Executive, Primary Care 24