• Nuffield Trust finds model improved relationships and working between GPs and other healthcare professionals
  • Evaluation of national primary care home model finds sites had limited resources for evaluation
  • Some sites “lacked clear explanation” of how they would achieve outcomes
  • Analysis suggests size of sites means it will be a long time before major changes are seen 

Areas developing a “scale” primary care model, previously praised by Simon Stevens, lack the resources to fully evaluate their models and have yet to work out how they will meet desired outcomes, new research has found.

Analysis of 13 “primary care home” models by the Nuffield Trust has found the sites had limited resources to evaluate of their models and “lacked a clear explanation of how the planned interventions would deliver expected impacts”.

The report, shared exclusively with HSJ, also found that models led by clinical commissioning groups had “stronger buy-in from local partners” and suggested that due to their small population coverage it could be “a long time before changes will be seen”.

The think tank also warned that developing the PCH model “requires significant investment” and advised that national funding for primary care needs to be balanced between funding for individual practices and money to support multidisciplinary work.

However, the analysis did find that providers participating in the models showed improved working between GPs and other health professionals, and the models themselves have “stimulated new services and ways of working”.

The PCH model, launched by the National Association of Primary Care, is a model of primary care in which practices work in multidisciplinary teams across populations of 30,000-50,000.

The model has previously been praised by the NHS England chief executive and in the Next Steps for the Five Year Forward View the national commissioning body indicated it wanted all GP practices to work in “networks or hubs” covering a similar population size.

The Nuffield Trust was commissioned by the NAPC to evaluate its 15 “rapid test sites” from July 2016 to March 2017. Each site received £40,000 in start-up funding from NHS England.

The model has since expanded to more than 180 sites across England, covering 8 million patients.

The Nuffield Trust said its evaluation did not examine patient outcomes because “it was too early to evaluate the impacts the sites had” and instead carried out a “formative evaluation”.

The report said: “Whilst most [sites] initially reported having capacity and the ability to define what to measure, access data and the skills to analyse relevant data, their financial and human resources to do this appeared to be limited.”

The report, published today, added: “Although there was no one clear explanation, we observed that the CCG leads were able to allocate considerable staff time to PCH development and this may have helped to build collaboration at a faster pace.”

Dr Rebecca Rosen, senior fellow in Health Policy at the Nuffield Trust and a GP in Greenwich, said: “As a GP working on these projects, it has been really encouraging to see how they have rekindled relationships between GPs, community nurses and other professionals”

Dr Nav Chana, chair for the NAPC said: “This was an early evaluation at the beginning of the rapid test sites journey to develop the primary care home model and was commissioned as a guide to help with their future progress.

”With a small amount of money, the sites have made encouraging progress in a short time stimulating partnership working, leading frontline change, making a difference to patients and we’ve seen improvements to staff morale which is key to their future success. Testimony to this is is the more than 180 sites which are now developing the model.”

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