Sutton Integrated Care Place (PCN development)

Success is predicated on developing trusting relationships, getting the governance right and focusing on delivery in equal measure. It is difficult to make progress without this. I also think it’s important to recognise achieving integration across systems is not easy.. …the need to continuously manage complex relationships cannot be underestimated.

Michelle Rahman, Director of Transformation, Sutton Place Team

About the partnership

1. Sutton Integrated Care Place is a partnership of local health and care partners in Sutton. Over the last two years, the partnership has focused significantly on its Primary Care Network (PCN) development to ensure the readiness of primary care to work in an integrated way.

What has gone well

1. Sutton Place Organisational Development (OD) was delivered by The Health Integration Partners. It focused on building a shared narrative of the needs and ambition of communities, staff and partners around the development of the healthcare ‘ecosystem’ in Sutton.
2. Further OD work with PCN Clinical Directors (CDs) is seen as an important step in ensuring readiness of primary care to work in an integrated way.

Challenges experienced and overcome

1. Shifting the GP’s role from clinical commissioner to equal partner without the majority vote is historically challenging.
2. Developing trusted relationships and avoiding a ‘tussle’ for contracts, and instead having conversations around delivering for local communities.
3. Staff workload and low morale due to negative media coverage of primary care.
4. There is a lack of capacity for innovation and thinking more broadly around where skills and services are best provided.

Results

1. Four Sutton PCNs have aligned with the Sutton GP Services (GP Federation) under a single delivery vehicle rebranded as Sutton PCNs.
2. PCN CDs are now the board members of the federation, meaning that there is a single voice in Sutton for primary care.
3. Progress towards developing relationships as equal partners, with a joint focus to deliver for patients.

What made the difference

1. Partnership priorities reflect and align the ‘must dos’ of different health partners: enables them to have a definitive list of priorities.
2. Ability to have difficult discussions: with the openness to challenge what isn’t working in a solution-driven way.
3. Investment in and utilisation of the third sector: with an allocated nominal fee to cover third sector partner expenses to encourage involvement.
4. Communication of benefits to the system: wherever the contracts sit.
5. Alliance Agreement: this sets out the mechanics by which the partners will establish an improved financial, governance and contractual framework for the delivery of integrated health and social care.
6. Equal weighting of governance, trust and together delivery: meaning that decisions are not blocked by conversations around governance structures.