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Primary Care Home

Primary care home is an innovative approach to strengthening and redesigning primary care. Developed by the NAPC, the model brings together a range of
health and social care professionals to work together to provide enhanced personalised and preventative care for their local community.

Staff come together as a complete care community – drawn from GP surgeries, community, mental health and acute trusts, social care and the voluntary sector – to
focus on local population needs and provide care closer to patients’ homes.

Primary care home shares some of the features of the multispecialty community provider (MCP) – but it has four characteristics which form its distinctive identity. Its
focus is on a smaller population enabling primary care transformation to happen at a fast pace, either on its own or as a foundation for larger models.

RAPID EXPANSION

NHS England Chief Executive Simon Stevens launched the primary care home programme in the autumn of 2015, with rapid test sites selected in December 2015.

Since then the programme has rapidly expanded – in 2016 more than 70 sites joined and this year so far a further 100 sites have successfully applied, bringing the
total number of primary care home sites to 192 across England, serving eight million patients, 14 per cent of the population. Applications continue to come in.

All the sites are developing and testing the model as part of a community of practice.

PRIMARY CARE HOME PART OF LATEST NHS REFORMS

The primary care home model is featured in the Next Steps on the NHS Five Year Forward View and part of the practical delivery plans to transform primary care over the next two years to provide high quality services for patients and staff. Practices are encouraged to work together serving a combined patient population of between 30,000 – 50,000. This is the size that the NAPC believes is right – the right size for developing highly effective, unified, multiprofessional teams – the right size to care – the right size to scale and the right size to ultimately take budgetary responsibility together.

KEY FEATURES

There are four key characteristics that make up a primary care home:

  • a combined focus on personalisation of care with improvements in population health outcomes
  • an integrated workforce, with a strong focus on partnerships spanning primary, secondary and social care
  • aligned clinical and financial drivers through a unified, capitated budget with appropriate shared risks and rewards
  • provision of care to a defined, registered population of between 30,000 and 50,000.

STAGES OF PRIMARY CARE HOME

The development of a primary care home is a journey which begins with practices and other first contact care providers coming together, forming relationships and developing a sense of belonging among patients and staff. The adoption of a whole population health management approach is critical to its success. This is a proactive approach to managing the health and wellbeing of a population. It incorporates the total care needs, costs and outcomes of the population. A unified team is then built around the health needs of the population. Staff are given the freedom to act, encouraging innovation, improving staff satisfaction and in turn recruitment
and retention. Health is determined by a complex interaction between individual characteristics, lifestyle and the physical, social and economic environment. These
broader determinants of health are considered more important than health care in ensuring a healthy population and need to be built into a PCH plan.