Integrated healthcare across a whole community

The implementation of the 'Planning and Priorities Framework for 2003-06' and NSFs is seeing the development of patient pathways and clinical networks. These require PCTs to work in a more integrated way with other healthcare and social care providers in their locality.

Primary care premises are no longer being developed in isolation. Instead each PCT is advised to develop a SSDP for service delivery across their locality. Accessibility and the needs of the local community should be the driving force for new primary care premises.

The implementation of the 'Planning and Priorities Framework for 2003-06' and NSFs is seeing the development of patient pathways and clinical networks. These require PCTs, alongside other local stakeholders, to work in a more integrated, innovative way – both 'vertically' (e.g. between local hospital clinicians and GPs) and 'horizontally' between primary and social care professionals.

These networks are enabling more complex interventions to be carried out locally, sometimes in people’s homes or in appropriately designed local healthcare premises. The intention is that patient pathways through each clinical network will be bookable from primary care level and will eventually be linked by electronic records. Primary care premises are no longer being developed as individual doctor’s surgeries. Each PCT is advised to develop an SSDP for service delivery across their locality. Plans should be based on local needs for primary and community care and existing provision of these services. The development of SSDPs allows a full and robust assessment of healthcare premises requirements across a particular locality or community. Location of care – in terms of providing better access for patients and avoiding social exclusion – is the driving force in developing these plans. Inevitably there will still be a need for centralisation of specialist facilities. Patients are treated in appropriate surroundings (locally, if possible) by teams readily able to meet their needs. They receive more co-ordinated care with access to specialist advice when needed. If this approach is to succeed the design and organisation of local primary care premises must be suitable for the delivery of more complex medical care as well as being able to accommodate social care services.