Building a new clinical community to deliver the NHS Five Year Forward View

Clinical associates to the new care models programme have been tasked with helping vanguards translate their visions into action and fulfil the aims of the NHS Five Year Forward View by delivering a better patient experience, value for money and improved outcomes.

Dr Shera Chok is one of those clinical associates, a GP in Tower Hamlets Together vanguard (@TH2GETHER) and Director of Primary Care, Barts Health NHS Trust. She discusses the importance of relationships in making the changes happen.

As a clinical associate, one of my key messages is that successful implementation of the new care models will require new ways of working more closely together.

As Sir Sam Everington, Chair of Tower Hamlets Clinical Commissioning Group and national advisor for the new care models programme, said: The thing you have got to crack is relationships. Put all your time and energy into this. If you are to create really good, comprehensive services for patients, particularly those with complex needs and chronic disease, it’s all about co-production and integration.”

This is something we in East London have invested in heavily, developing the relationships that underpin the Tower Hamlets Together vanguard and the programme to deliver our local sustainability and transformation plan.

Our acute trust, Barts Health NHS Trust, is one of the few trusts in the country to have senior GP directors advising the board on its clinical strategy, listening to our primary care practices and improving safety. This brings a system-wide perspective to the board and is a great example of cross-boundary working.

These underpinning relationships don’t start and end at a board or strategic level though – it’s essential that we develop new working relationships and practices across the entire health and care workforce.

In Tower Hamlets we have introduced multi-disciplinary teams of consultants, GPs, pharmacists, nurse specialists and others that are based in the community and provide care closer to home – with significantly improved health outcomes.

We also achieve some of the best outcomes in diabetes in England by having network-level incentives and sharing performance data across primary care. Groups of GP practices are incentivised to pool their resources and support each other to deliver better care. This work is backed up by an academic GP ‘powerhouse’ – the clinical effectiveness group – which makes research real by crunching data and designing electronic templates to support better clinical coding and measurement.

And consultants like consultant Diabetologist, Dr Tahseen Chowdhury, are helping to rewrite traditional consultant job descriptions by working in the community, developing the skills of practice teams and advising on complex patients. Described as “a shining light of integrated working” by GPs, his ideas can easily be replicated in other medical specialties by forward-thinking acute trusts.

So the key to transforming care is building successful relationships across organisational boundaries and developing a clinical community to lead these changes. I have shared our experience in East London with the vanguards I have worked with and have been deeply impressed by the progress many have achieved so far.

Dr Shera Chok

Dr Shera Chok is a GP in Tower Hamlets Together vanguard and Director of Primary Care, Barts Health NHS Trust.

Shera is a GP in Tower Hamlets, a member of the Tower Hamlets multispecialty community provider vanguard and Director of Primary Care at Barts Health. Her role involves bringing a primary care voice and perspective to the largest acute trust in England, shaping their clinical strategy, listening to our GP partners, improving patient safety, delivering new models of care and building relationships with primary care and CCGs. Shera is also a member of the national Independent Reconfiguration Panel which advises ministers on NHS reconfiguration, and a Clinical Associate with NHS England’s new care models team.

Shera’s MBA and MA in Inter-Professional Education focused on patient experience and clinical leadership. She won a Nuffield Trust Fellowship on cross-organisational learning and studied at the Harvard Kennedy School, Harvard School of Public Health and the Institute of Health Improvement (IHI) in Boston as part of the prestigious NHS Executive Fast Track Programme. She has worked in Sudan, Indonesia, Laos and Greece as a clinician with leading NGOs.