Today’s blog, which I am reliably informed takes 5 mins to read, perhaps a little long for most blogs, outlines our proposal to our membership for the creation of a start up fund. This would initially be available for a 2 year period to support our membership to deliver innovation and greater benefit to those we serve. We want to discuss this more at our next shareholder meeting on Wednesday 27 January 2016 at 6.30 pm. If you are a shareholder and you haven’t yet responded please let Gillian.Howson@nhs.net know that you are coming.
Here’s some background
Members created BICS in 2008 to serve our community and to support General Practice locally to work together and in part to protect the primary care market from independent sector. We are a membership organisation, owned by 270 shareholders (70% of these are GPs, practice nurses and practice managers in Brighton and Hove, the other 30% are our staff).
Since 2008 BICS has developed community services that traditionally sat in hospital settings, it has developed as an organisation that is capable of holding significant contracts over long periods of time, of bringing NHS and other partners together to deliver more integrated services between primary, secondary, and specialist services.
We have always sought to deliver all our services in partnership with our primary care members, every service with the exception of Croydon is delivered in partnership with our primary care membership. Over the last 9 years we have brought additional revenue of over £6 million into primary care locally, as well as creating employment opportunities for now over 280 local people.
Our purpose over this time period has evolved and developed as our capability has developed. Our starting purpose was to
“enable patients to receive the right care at the right time and place”
As we have developed as an organisation and understood both the local, Sussex and national landscape and the needs of the communities we serve we have shifted our purpose to
“Care Unbound. To create more possibilities for care in every moment”
This provides a broader platform upon which we can develop our offer to those we serve. It also speaks to what we consider to be necessary to achieve in our communities right now. More on our beliefs, purpose and commitments can be found on our the about page on this blog.
Our vision of what’s needed in our communities is one we know that many people share: we want to create a place where when citizens ask for our help we understand what matters to them, and we deliver that first time. A place where we put skills to meet those needs above roles and organisational boundaries, and a place where we reduce waste and lower costs, a place we work less hard and where we deliver more value to the people we serve.
What’s going on in our health communities that requires a new response?
Over the last 24 months it has become increasingly clear that the problems our health and social care systems will face in the coming years cannot be solved with the same thinking that created them. We are all familiar with the financial and demand constraints that all parts of health and social care system face. This picture does not look any less bleak in the coming years for any part of the system. Perhaps we are most familiar with our experience in our practices, our services that we work for, our families lives, or the lives of our friends? We know that the third sector, community, social care, education, criminal justice, housing and many other sectors that affect the health and wellbeing of our communities are all facing unprecedented challenges.
We established BICS as a means to develop and protect our primary care membership and also to create the environment for innovation. We have done this by acting as an enabler and catalyst for change in our health communities, bringing NHS partners together to improve care and outcomes for people for example our role in developing the Wellbeing Service, and our role in MSK services locally. We also have created the organisation to develop the capability of our staff, and the staff of those partners we work with to radically shift the paradigm of delivery from “what’s the matter to what matters to you”.
So, what’s going on within our membership and organisation that also requires a new response?
As a primary care community we are considering our options on how best to face these challenges including how to strengthen our collaboration arrangements through Cluster working, Proactive Care delivery, integrated teams and maybe formalising our federating options. We are excited about the work the Federating Working Group is doing to look at the options, and we look forward to working with members and the wider primary care community to see how best we can all work together. We are especially keen to see how we can all use the resources of BICS in its widest sense to support the future development of primary care as part of wider system of care in our city.
As part of the Cluster development, BICS and practices are working with all our other care providers to form a new Integrated Provider across the city; whilst this is in it’s early development, the role of this new provider will not be successful without a well organised and united voice of General Practice and primary care more widely.
Within our BICS teams and services we are also devolving more and more responsibility, with some teams developing new model of shared management (responsibility without managers). This approach of self or shared management is one that we are embracing across all our services and encouraging our partners to also experiment with. We firmly believe that autonomy in decision making operates best closest to the customer, patient, people we are serving. For example, all of our services operate as autonomous business units, and we recognise the need to ensure that all services work together with our broader membership to the benefit of the whole organisation and also the wider community.
Creating a start up fund
It seems to us that these times call for bolder decisions and action than perhaps in the past we thought were necessary. We also believe that these times call for greater trust and support for each other in our health communities. We intend to put our beliefs, purpose and commitments into action in every existing contract, and every contribution we make to the health community, whether that is informally or formally.
We also intend to create a resource for members/shareholders that will support pump priming of initiatives, programmes, services or ways of working that further our purpose:
“To create more possibilities for care in every moment”
In creating this start up fund we are formalising what we have done for many years and invest in new developments and new ideas. We think we need to do this in a way that is transparent, open, innovative and fair to all our membership.
The fund will be available initially for a 2 year period and is created to develop innovative solutions to further progress our purpose in any community we serve. We want to support members coming together to solve problems they see need solving. It seeks to foster collaboration between members, and teams of people as well as those it serves. We are seeking to establish new projects, services and offers to our communities and members that over time become successful and self-sustaining, ensuring that the project can pay back the back the original investment over an agreed time period. At our next meeting of our membership we will share the detail of this idea.
Is there a decision for members now?
We would welcome a discussion at our next shareholder meeting, on Wednesday 27th January. If you want to contribute but can’t come please send Gill an email on the address above.
We don’t need your approval just yet, and we would like your sense of whether this might be a useful idea to develop further at our AGM on March 10th.
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