changes to the Primary Care Sector

WQ.34/2019

WRITTEN QUESTION TO THE MINISTER FOR HEALTH AND SOCIAL SERVICES

BY DEPUTY M.R. HIGGINS OF ST. HELIER

ANSWER TO BE TABLED ON TUESDAY 15th JANUARY 2019

Question

Will the Minister set out for members where changes to the primary care sector agreed within Health and Social Services: A New Way Forward' (P.82/2018) currently stand; will he advise what further proposals in respect of primary care, if any, beyond P.82/2012 are currently in development; and will he detail all the meetings that have taken place with the sector over the last two years, setting out what has been agreed and the timetable for implementation of any such agreements?

Answer

The Sustainable Primary Care strategy was published in December 2015 and was developed following the agreement of the States Assembly to P.82/2012.

It set out our commitments to:

• Develop a better understanding of our health needs
• Support Islanders to lead healthy lives and encourage them to manage their own conditions
• Explore how taxpayers' money can be used more effectively to support primary care services
• Work in a more integrated way across the whole system
• Develop the skills required to meet future challenges, such as long-term conditions
• Develop governance and IT processes to support quality, safe, and efficient delivery of care.

The ambitions of the strategy remain convincing and I am committed to working in partnership with primary care professionals to develop and test new models of delivering primary health care, which encourage prevention and keep our population healthy.

After the strategy was published, primary care professionals were given the opportunity to put forward plans for pilot projects testing out the ideas within the strategy. Three pilots were chosen for funding and have been implemented. These pilots concerned diabetes, COPD (chronic obstructive pulmonary disease ie lung diseases) and medicines support on leaving hospital. They are now all complete and are in the process of being evaluated, which will provide valuable lessons learned and operational intelligence about successes and challenges of delivering care in different ways.

We've also developed projections of how many people will be living with long-term conditions in the future, which will help us to address some of the biggest challenges.

Other work is under way that will develop additional services to deliver the strategy's ambitions:

• GPs and pharmacists working closely with partners from FNHC, Hospice and Jersey General Hospital to ensure that discharges from hospital are safe, planned and as early as possible, with support for patients in the community or closer to home. This will:

• Help patients recover more quickly by effectively coordinating their post-discharge care and reducing the risk of institutionalisation
• Improve end of life care

• Support service users with low-level mental health problems by introducing psychological interventions in general practice, including social prescribing to direct individuals to appropriate voluntary and community sector services.

The Department for Health and Community Services has also set out its key objectives for 2019 in the Transition Report 2019 (R.155/2018). This includes a number of key developments that will involve close work with primary care:

• Encourage professional groups to begin to shift more resources into preventative and primary care services
• Complete a review of children's dental health services
• Strengthen community-based services to support people with long-term conditions, so they can live more independently
• Improve processes and systems for obtaining and addressing feedback, complaints and compliments from service users
• Work in partnership with voluntary and community organisations to improve delivery of services
• Review funding mechanisms and user-pay arrangements, which have long acted as barriers to change on the island.

Officers representing Health and Community Services and the island's social security function meet on a regular basis with stakeholders from across primary care and as such developing an accurate, detailed schedule of past meetings would be impracticable.

Specifically:

• Representatives from general practice, community pharmacy, and Family Nursing and Home Care meet every other week with States of Jersey officers about ongoing strategy and planning
• GPs are involved in regular discussions about operational challenges, Jersey Quality Improvement Framework, and pathway and business development opportunities
• A number of discussions with community dentists about developing new models of governance and care for Jersey
• GPs, community pharmacists, FNHC, Hospice and community dentists have provided valuable input and feedback into the design of the Jersey Care Model and Health and Community System organisational structure, which was published as part of the OneHCS target operating model consultation. The proposed structure raises the profile of primary care within an integrated health and care system and demonstrates Health and Community Services' commitment as system leader to developing primary and community services.