Berkshire Primary Care and NHS East Berkshire CCG

Developing a Primary Care Operating Model

The challenge

Berkshire Primary Care Ltd (BPC Ltd) is a GP Federation which consists of all fifteen practices within Bracknell and Ascot Clinical Commissioning Group (CCG). The aim is for practices to work collaboratively to improve the services they are able to offer to patients and to strengthen the role of primary care within the wider NHS.

Ascot is a small town in east Berkshire with a growing population and a predicted increase in health care needs over the next 20 years. To prepare for these challenges, four local GP practices worked with the East Berkshire Clinical Commissioning Group, and their patient groups to develop the Ascot Plan, a town wide plan for primary care.  This involved bringing together the four practices, then located over five sites and to co-locate these in a transformational way into two sites within Ascot. Thus, the whole population of Ascot would have an integrated primary care service with two points of delivery.

4OC were asked to provide programme management support to the four practices, Berkshire Primary Care and the CCG, to ensure that the various tasks required to translate the Ascot Plan into operational reality were well co-ordinated. These included business case development, estates solution development and communications and engagement.  We were also asked to develop a new operating model for the four practices, which described how the practices would work together to deliver integrated clinical and back office support services.

£10 million of savings identified and delivered

The response

We agreed with the CCG and BPC that continuity and relationship building were both important components of this project, so we put in place an experienced Programme Director with experience of working in the local NHS and of developing new service models and estates solutions.

We started by reviewing the governance of the pre-existing project Steering Group and establishing clear terms of reference for the group.  We reviewed and streamlined the reports presented to the group and developed a project programme and risk and issues log.

Using the 4OC Stakeholder Mapping tool, we then conducted a stakeholder assessment and mapping to agree with whom we needed to be engaged, the appropriate forum and to what level of detail. We then ran a series of co-design Operating Model workshops and structured meetings with the Steering Group to define new ways of working which would both facilitate and get the most out of the transformation.

Our approach focused on informed, transparent decision making in the production of a model which takes into consideration the real constraints of working within the existing system.

The outcome

The primary output was an Operating Model, setting out the clinical service scope, a shared back office model and a preferred option for the distribution of clinical and administrative services across sites. The first shared back office appointment has now been made by two of the practices, and further joint appointments are planned.

We also developed a high level organisational model for the future delivery of Primary Care in Ascot, which was then incorporated into the local Primary Care Network.

We produced an Implementation Plan setting out how the transition will take place in an efficient and sustainable manner over the next 5-10 years, including a clear statement of the facilities and resources required for its delivery across two sites.