Primary care in the Eastern Region

Kellie Norris, Primary Care Advisor for the Eastern RegionSharing news and views

Welcome to the Eastern Region primary care and public health webpage. Many of the current health service reforms are focused on primary and community care. Currently with both world class commissioning and transforming community services there are rapid developments and changes.

This page will keep you up to date with new developments in primary care in the Eastern region. The RCN needs your help to achieve this, so please send your news and comments on what is happening in your area to: kellie.norris@rcn.org.uk.

Transforming Community Services

Transforming Community Services is a programme focused on improving community services. The policy supporting this reform is Lord Darzi's, 'High Quality Care for All (2008)'. Lord Darzi defines quality of care as: clinically effective, personal and safe.  One of the requirements in 'High Quality Care for All', was the need for each strategic health authority to establish a formal quality observatory. The purpose of these observatories would be to:

  • enable local benchmaking
  • development quality metrics
  • identify opportunities to help frontline staff be innovative and improve patient care.

The East of England website Quality Intelligence East (QIE) can be accessed at www.qie.eoe.nhs.uk.

Quality is a central theme to these changes; there is now a national quality board to lead this. Additionally, there is a quality framework to support this with proposed quality indicators for use in the community, Transforming Community Services quality framework - guidance for community services [PDF 230KB] [see how to access PDF files].

 In June 2009 six transformational guides for community services were launched, with the themes, ambition, action, and achievement. The aim of these guides is to support frontline practitioners in transforming services locally. The guides focus on six key areas:

  • health, well-being and reducing inequalities
  • acute care closer to home
  • people with long term conditions
  • rehabilitation services
  • services for children, young people and families
  • end of life care.

These guides are available from the Department of Health website. 

Transforming Community Services and organisational models for provider arms of PCTs in East of England

The policy guidance from the Department of Health on Transforming Community Services has been changeable. In December 2009 the 'NHS Operations Framework 2010/2011', was launched. It was made clear in this document that PCTs must hae plans for the organisational form of their provider arms signed off in principle by the strategic health authority by 31 March 2010. These plans should be implemented by March 2011.

The Department of Health also issued further guidance for Transforming Community Services in February 2010 which reduced the choices organisations had for the development of their provider arms. Transforming Community Services stated that the most likely options for organisations would be:

  • integration with an NHS acute or mental health provider
  • integration with another community based provider
  • social enterprise.

There would now only be a few Community Foundation Trusts and the number of PCTs who would be allowed to continue with the direct provision of services would be very limited. In the East of England, the strategic health authority had already made the decision that this was not a viable option.

Proposed organisational forms for provider arms of PCTs in the East of England

 There are 14 PCTs in the East of England:

  • Norfolk - Community Foundation Trust
  • Hertfordshire - Community Foundation Trust
  • Cambridgeshire - Community Foundation Trust
  • Great Yarmouth and Waveney - unclear as yet
  • Luton - managed transfer or integration with another organisation
  • Mid Essex - are pursuing social enterprise
  • NE Essex - are pursuing social enterprise
  • SE Essex - are now exploring options around integtration with other organisations
  • SW Essex - continuing with exploring intregration with 2 NHS organisations
  • West Essex - staff were balloted on whether they wanted to explore the option of developing into a social enterprise. 70% voted against the proposal., therefore West Essex is still exploring options
  • Suffolk - are proposing to integrate different services with different organisations, including local government for children's services
  • Peterborough - looking at integration
  • Bedfordshire - managed transfer or integration with other organisations.

Supporting documents for Transforming Community Services

The following documents are available from the Department of Health website: www.dh.gov.uk.

  • Transforming community services; enabling new patterns of provision
  • Transforming community Services and World Class Commissioning
  • Transforming Community Services, currency and pricing options for community services
  • Social enterprise making a difference: a guide to the right to request
  • A national contract for community services 
  • Transforming community services quarterly framework: guidance for community services
  • Transforming community services. The assurance and approvals process for PCT provided community services.
  • PCT procrurement guide for health services commercial skills for the NHS.

You could also go to Transforming Community Services in support for you for further information.