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PHM is ‘golden thread’ between primary care and ICBs

PHM is ‘golden thread’ between primary care and ICBs

Primary care leaders should use population health management (PHM) as a ‘golden thread’ to help communicate needs to integrated care boards (ICBs), it has been suggested.

PHM focuses on the wider determinants of health and is centred around local health systems using data to design new models for care.

Speaking at Pulse PCN’s Birmingham live event (21 June), Dr Dan Alton, GP and national PHM clinical advisor for NHS England, told clinical directors that the model is ‘a golden thread’, noting that the ‘buzzword’ appears in a number of ICS documents, including the ICS design framework.

He said: ‘If you are in primary care, go to your local leadership and ask what they are doing about PHM because it is a buzzword at the moment: tap into that locally.’

It comes amid growing concern that the primary care voice will be lost in the shift from CCGs to ICS.

Dr Alton – who is also interim chief clinical information officer for Buckinghamshire, Oxfordshire and Berkshire West ICS – said that his practice presented patient population data to the ICB to secure geriatric and social care services.

He said the practice team identified those patients who regularly interact with the NHS and who utilise multiple GP, secondary care and social care appointments, however, the practice often struggles to involve secondary care.

He said: ‘When we put this to the ICB and the CCG, we said we would like a session of geriatrician time a month, we would like an equivalent session of social care time in order to run an MDT – for these patients who are costing the system overall a lot of money – to try and resolve their problems.

‘It was very hard for them to say ‘no’ when presented with the data.’

PCN directors recently met with Pulse PCN to discuss their current population health management projects and whether or not the approach is working for their area.

Earlier this year, Andi Orlowski, senior adviser to NHS England on population health management, told Pulse PCN that PCNs should ‘not to wait for the ICS to come knocking but to actively engage with them now’.

A number of ICBs this month set out that only GPs with PCN director experience will be eligible to sit on the Board, prompting criticism over the restricted pool of appointees.

More information on upcoming Pulse PCN discussion forums can be found at