Primary Care Infrastructure Development Programme
The development of primary and community care infrastructure as part of the strategy for improving overall health and wellbeing
Primary and community care services are a key element in the delivery of health and social care in Northern Ireland. They provide approximately 85-90% of all health and social care treatments.
A service model, based on the co-location of Trust and GP led primary care services, was developed to support the direction of travel as set out in the “Transforming Your Care” (TYC) report of December 2011. This proposes a “shift-left” of the delivery of services from secondary care closer to people’s homes and in the community where appropriate.
This position was further reinforced as part of the out workings of the Bengoa Expert Panel Review as set out in the Minister’s Vision ‘Health and Wellbeing 2026: Delivering Together’. In this regard, a core theme of the direction of travel set out in the Minister’s Vision is the importance of the role of the primary and community care sector in delivering a new model of person-centred care.
In response to the TYC findings, the Minister for Health, Social Services and Public Safety indicated that he wanted to see investment in the development of primary and community care infrastructure as part of the strategy for improving the overall health and wellbeing of the community and for improving the delivery of integrated primary, community and secondary care services. A Strategic Implementation Plan for investment in primary care infrastructure was developed based on a ‘hub and spoke’ model for primary care, with hub facilities providing core services for its range of spokes. Spoke facilities include smaller health centres and GP surgeries which accommodate the provision of General Medical Services (GMS), supported by multidisciplinary teams (e.g. pharmacists, nurses, social care) based on the needs of the local population.
The primary care infrastructure development programme (PCID) involves ongoing and targeted investment in both hub and spoke facilities across the region; with a particular focus on ensuring that the infrastructure can meet the future needs of primary care services (including the implementation of multi-disciplinary teams alongside GPs, as well as enhanced levels of GP and undergraduate medical training). To date the programme has utilised a range of funding options, including conventional capital, financial transactions capital, and revenue funded third party development.
Two pathfinder hub schemes (Newry and Lisburn) were identified in 2013 to test the Third Party Development (3PD) approach.
The Lisburn pathfinder scheme achieved contract award in late 2018 and is currently in the construction stage, with operational commencement expected by Summer 2021.
Following a more protracted period in obtaining the necessary statutory approvals, the Newry pathfinder scheme is currently at the preferred bidder stage with contract award anticipated in the latter half of FY2020/21. Construction will commence shortly thereafter with operational commencement anticipated by 2023.
SIB has provided legal and financial/commercial advice and support to the Southern and South Eastern Health and Social Care Trusts, as well as the Health and Social Care Board (HSCB) and Department of Health, in respect to the procurement of the two 3PD pathfinder projects.
SIB also provided strategic and commercial advice to the HSCB in respect to the establishment of the GP Loan scheme (utilising Financial Transactions Capital). This repayable investment in GP spoke practices complements the programme of investment in large primary and community care hubs.
SIB also provides a representative to the PCID Programme Board with a role in providing ongoing support and advice in respect to the strategic / commercial direction of the programme and the delivery / funding options available to support this much needed infrastructure investment