The government plans to shake up the provision of public health as part of wider reforms to the NHS, by moving public health teams into local authorities and setting up a new central body, Public Health England. What will this mean for GP commissioners, who will also be looking to promote good health in their communities?

Dr Sam Everington, GP at Bromley by Bow Centre in Tower Hamlets, spoke at the first in a series of GP commissioning seminars about his experience of embedding public health in primary care and beyond.  He spoke to Senior Fellow Ruth Thorlby  about the opportunities and challenges for both GPs and public health professionals arising from the proposed reforms.

Find out more about the Nuffield Trust at: http://www.nuffieldtrust.org.uk.

Sam Everington: GP commissioning and public health reforms – a new dawn for public health?

GP commissioning faces a number of hurdles, including how to ensure that patients and the public have a meaningful say in the decisions about allocating scarce resources locally. PCTs had a patchy record in engaging with the public, although there were some examples of good practice. 

The government's plans to replace PCTs with GP consortia have been criticised for diluting patient and public engagement with commissioning even further.  These issues were discussed at a recent Nuffield Trust seminar, after which Ruth Thorlby spoke to Don Redding, Director of Policy, National Voices, an umbrella group for health and social care charities.

Find out more about the Nuffield Trust at: http://www.nuffieldtrust.org.uk.

Don Redding: how can patients and the public influence GP commissioning?

The development of integrated care in Trafford is underpinned by a number of streams of work. The Advanced Training Programme is one of these streams. It focuses on both leadership development and quality improvement, encouraging senior executives allied to health and social care to participate in a five-day programme overseen by a national partnership focused on delivering and evaluating. If appropriate, the intention is to spread the work introducing the ATP to the wider NHS. 

Dr Michael Gregory, Programme Lead for the Advanced Training Programme and local GP, describes how the advanced training programme has developed and how it is contributing to integrated care.

Michael Gregory: An advanced training programme to support integrated care

One of the things that makes Trafford stand out is its focus on developing an integrated care system across the health care economy.  The aim is to bring together a number of streams of work including service redesign, telehealth and data sharing across health and social care. The development of this system is intended to help clinicians across primary and secondary care shift into a more integrated way of working.

Sam Nicol, Programme Director for the Integrated Care System, summarises the integrated care system, describes how integrated services are developing, and outlines the main challenges that Trafford now faces.


Sam Nicol: The components of an integrated care system in Trafford

The Nuffield Trust Rock Carling Fellowship, established in memory of the late Sir Ernest Rock Carling, is awarded to a distinguished individual who is invited to review the current state of knowledge and prospects in a critical area of health care reform.

At the 2011 Rock Carling Lecture, Professor Alan Garber, the next Provost of Harvard University, discussed the role of incentives to improve the efficiency of care in the English NHS, and in particular to describe how they support or hinder care integration. He also reflected on the wider reforms to the NHS in England given the programme of reform of health care in the United States.

Professor Garber is the Henry J. Kaiser Jr. Professor and Professor of Medicine at Stanford University where he directs the Center for Health Policy and the Center for Primary Care and Outcomes Research.  

Alan Garber: Rock Carling Fellowship Lecture 2011

In this talk, Dr Sara Shaw, Nuffield Trust Visiting Senior Fellow, outlines the findings of a research study to examine the experience of NHS organisations in Trafford, Greater Manchester, in developing a new integrated care system across the whole health economy.

Dr Shaw outlines the objectives of the study – to track the progress of change in implementing an integrated system – and explains some of the key drivers for developing more joined-up and efficient services, particularly in relation to the need to address the financial challenges faced by Trafford.

Dr Shaw explains how Trafford’s vision ties in with the current programme of NHS reforms,  highlighting their drive to promote clinical leadership, develop high quality and efficient care, create a balance between competition and integration, and develop health improvement across the Trafford population.

She concludes by summarising Trafford’s successes so far and the key lessons to be learned from their experiences.

The full findings of this study have been published in the report: Towards integrated care in Trafford (November 2011), by Dr Sara Shaw and Ros Levenson. This work forms part of an on-going Nuffield Trust project: Tracking the journey towards an integrated care system in Trafford. Visit our dedicated project page for further details.






Visit the Nuffield Trust website for further details about our work in this area: http://www.nuffieldtrust.org.uk

Sara Shaw: Developing an integrated care system in Trafford

23 June 2016

Large scale general practice: can we rise to the challenge

Arvind Madan, Director of Primary Care, NHS England, addresses the Nuffield Trust's large-scale general practice conference. 

The future role of the GP - Arvind Madan

In this talk Dr Douglas Noble, Director, Catalyst Network, speaks to Dr Chris Packham, Clinical Champion for Public Health, Royal College of General Practitioners Centre for Commissioning, about the enthusiasm of GPs to take up a commissioning role.

During the course of the interview they address how GPs might utilise the skills of the existing public health workforce to inform their commissioning decisions, and the potential conflict that might arise from clinical commissioners being required to both ration and deliver care.


Evolving relationships: public health specialists and CCGs

In this interview, Professor Naoki Ikegami, Chair, Department of Health Policy and Management, Keio University School of Medicine, compares Japan and the UK in the economic challenges they face and considers how the Japanese long term care insurance model can be maintained as the pressure of an ageing population increases.

Visit the Nuffield Trust website for further details about our work in this area: http://www.nuffieldtrust.org.uk

Naoki Ikegami: Long-term care insurance in Japan

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