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Getting to grips with the primary care challenges

As some of you will be aware, almost a month ago I was asked to step into the role of Acting Director of Primary Care.

The past few weeks have been complicated and challenging, but often the pressures feel the same. Whether in practice, in the CCG or working in another setting entirely, balancing the delivery of high quality care now and in the future is an art.

I want to use my experience as a mum of two, a GP in South East London and previously as a Chief Clinical Officer of a CCG, and someone who has worked in acute and community trusts and more to help guide the way forward for Primary Care. And that means always trying to develop a better service for our population and a better working life for our colleagues.

I think we have an opportunity to create more resilient, more sustainable and more innovative primary care. Through the partnership review, GMS contract negotiations and the long term plan, we can start to find a way to describe a vision that feels achievable, and exciting.

As I settle in to this role, our attention is very definitely on developing a long term plan for primary care.

On 18 June the Prime Minister set out a funding settlement for the NHS in England for the next five years. In return, the NHS has been asked to set out a long term plan for the future of the NHS, with our ambitions for improvement over the next decade, and our plans to meet them over the five years of the funding settlement.

The development of the long term plan for the NHS will need to be based on the advice and experience of yourselves and the wider public. As part of this process it is vital that all those who rely on and work in or alongside the NHS have the opportunity to contribute their ideas and insights.

To make it easy for you to have your say on the different aspects of the plan we have created a discussion guide for staff, clinicians, patients and the public to help stimulate those ideas and understand views across three key themes – life stage, clinical priorities and enablers of improvement – each covers a number of different areas which we believe have the greatest potential to deliver improvements to the way the NHS provides care.

Please take a look, especially at the Primary Care section, and try to send us online feedback, or let me know how you are working locally to deliver better care.

We are working with stakeholders to help shape the plan including RCGP, BMA, NHS Clinical Commissioners, Queens Nursing Institute, National Association of Patient Participation and other members of the General Practice Forward View Oversight Group.

Some of you will have begun to work in networks of practices (as Primary Care Networks, or similar), with pooled resources, to address health inequalities and offer care differently.

The development of networks is designed to support collaboration between practices and is not about actively encouraging (or otherwise) practice mergers. The ambition is for all practices – irrespective of size – to be part of a network to enable general practice to work with local partners to reduce health inequalities, improve the health span of a population and create a sustainable and resilient multidisciplinary workforce. Take a look at this animation which explains more, and please share your experiences with me.

I look forward to hearing from you, and meeting more of you over the coming months.

  • This article was first run in the latest GP Bulletin for September.

Dr Nikki Kanani is a GP in south-east London and is Medical Director of Primary Care for NHS England and NHS Improvement. Prior to joining NHS England she was Chief Clinical Officer of NHS Bexley Clinical Commissioning Group (CCG).

Nikki has held a range of positions within healthcare to support the development of innovative models of care, highly engaged clinical, patient and public leadership and is passionate about supporting primary care, improving service provision and population wellbeing.

She is a member of The King’s Fund General Advisory Council and holds a MSc in health care commissioning. With her sister she co-founded STEMMsisters, a social enterprise supporting young people to study science, technology, engineering, maths and medicine. She has two young children.

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