Main Report of the National Review of Primary Care Out of Hours Services

16 Finance and Best Use of Resources

Finance

Over the next decade it is unlikely that health funding will grow at the same rate as the increase on demand for services. All of our services will therefore need to deliver increased efficiency and productivity in order to deliver the safe, high quality care required. Increased investment in primary care generally and OOH services specifically will need to demonstrate best value for money in the context of this overall pressure on budgets. Similarly, we will need to consider and identify areas of disinvestment to allow for a higher proportion of overall health and care spend to be allocated to primary care services.

Recommendation 28 refers to finance and best use of resources

The Review highlights a range of areas where financial investments will be required and risks will arise including:

• The proposed new Urgent Care Resource Centres primarily envisage drawing upon existing staff working in the OOH period. As detailed models start to develop in individual Board areas it is likely that investment in new multidisciplinary teams will be required but will vary considerably across Boards.
• It is realistic to assume that further investment in eHealth will be required, aligned with national eHealth strategies to improved consistency and efficiency of systems to support the working of teams.
• The future increasing roles of multidisciplinary teams within OOH and other primary care urgent care services is seen as contributing significantly to our future service delivery solutions: GPs, Advanced Nurse Practitioners, Paramedical Practitioners, other AHPs, community nursing staff - including mental health, physician associates, social services workers, support staff and other workers. Investment on a national basis for training of practitioners is essential to ensure future workforce models can be effectively and efficiently delivered.
• The proposed closer alignment of NHS 24 and SAS (Recommendation 2) and the services they provide must consider the resource implications, avoidance of potential duplication and pursuit of efficiencies. Any investment in roll-out of the SAS strategy: Towards 2020: Taking Care to the Patient, should ensure maximisation of service benefits
• It is likely that the changes envisaged for local Urgent Care Centres (formerly PCECs) may require some capital investment as physical modifications to accommodation are required to deliver the new service models. This should be recognised as a priority through Boards capital programmes and the Capital Investment Group. The service benefits of co-location and co-working should be fully explored and assessed.

Summary

Recognising significant financial challenges in the next 10 years it will be particularly important that all services produce increased efficiency and productivity in order to deliver safe, high quality person-centred care. Increased investment in primary care OOH and urgent care services specifically will need to demonstrate best value for money and areas of disinvestment pursued. Particular areas for resource allocation are identified and where maximising service benefits will be essential.