The final draft sustainability and transformation plan (STP) for the south west London footprint was published by the London Borough of Sutton this week following the final submission deadline.
The five-year plan includes a proposal to roll out the Sutton care home vanguard across the footprint area, covering six boroughs and a population of around 1.4m.
Sutton LMC chairwoman Dr Rebekah Dowdy said the scheme, which funded regular named-GP visits to local care homes to provide healthcare, health and wellbeing reviews and end-of-life planning, was good for patients. But she warned the plan was ‘difficult to envisage’ without core general practice first being stabilsed .
The vanguard, which Dr Dowdy said had ended when funding stopped, covered six care homes in Sutton, requiring around one GP session a week for participating practices.
‘While it is a very good project, we currently don't have the capacity for it,’ said Dr Dowdy, whose own practice was involved in the initial vanguard.
‘It allowed us to give the quality of care we wanted, that we would ideally love to give all of the time,' she said. ‘And it was funded for that. Unfortunately the funding has come to an end. So we are no longer able to offer that service.’
‘Without the extra funding that isn't something we can offer. There just isn't the time.'
A timeline in the STP suggested the care homes vanguard could be implemented from 2017/18. However, NHS and council leaders suggested in the document that funding for the proposal had not yet been found.
‘Further work is needed on the funding implications of expanding the Sutton vanguard,' it said. ‘To date there has been a level of national funding which we understand will not be available going forward’.
Proposals lack detail
Dr Dowdy said her LMC had not been consulted on the proposals, which she said lacked detail.
Other plans for transforming primary care in south west London include new multidisciplinary locality teams, which will be aligned to GP localities and take a role in managing long-term conditions, wellbeing and early intervention to prevent admissions.
Primary care access hubs will be established with social care, physio and mental health wraparound services and integrated with urgent care services.
The plan also says that practices will also have access to social prescribing. Practice federations will be embedded from 2017/18 and able to bid for enhanced service contracts and an MCP-type organisation will be formed to go live in 2018/19.
There were ‘lots of things in the STP that are good ideas’, Dr Dowdy said. But ‘before the STP we need to stabilise general practice and then look at transformation. That for me is the key; maintaining existing services that we have.’
Following the publication by Birmingham council of the Birmingham and Solihull STP earlier this week, LMC chief executive Dr Robert Morley warned the plans to shift significant workload into primary care were ‘undeliverable’ given the ‘meagre’ investment and ‘unambitious’ GP recruitment target.