The Fuller Stocktake

In November 2021, NHS Surrey Heartlands Chief Executive, Professor Claire Fuller, was asked by NHS England Chief Executive, Amanda Pritchard, to lead a review into integrated primary care – looking at what’s working well, why it’s working well and how the NHS can accelerate the implementation of integrated primary care (including general practice, community pharmacy, dentistry and optometry) across systems.

The result of the review was ‘The Fuller Stocktake’ which was published by NHS England on 26th May 2022, the recommendations from which will form a key part of our strategy going forward.

As part of the review, the team engaged with almost 1,000 people through workstreams, roundtables and one-to-one meetings, alongside over 12,000 individual visits to a dedicated engagement platform, and a real consensus emerged.  What is not working in primary care is access and continuity, with frustrations shared by both patients and staff alike.  What also emerged was a consensus on what the NHS and partners can do differently:

  • Integrated neighbourhood ‘teams of teams’, need to evolve from primary care networks to work collaboratively to improve the health and wellbeing of the local population
  • Streamlined access to urgent, same-day care and advice from an expanded multi-disciplinary team, using data and digital technology to enable patients to quickly find the right support
  • Ensuring those who would most benefit from continuity of care in general practice (such as those with long term conditions) can access more proactive, personalised support from a named clinician
  • Taking a more active role in creating healthy communities and prevention by working with communities, making more effective use of data and developing closer working relationships with local authorities and the voluntary sector

The formal establishment of Integrated Care Systems could not be more timely as a vehicle for collaboration, and this report clearly signals the need for primary care voice and leadership to be at the heart of local and national priorities. Finally, the report sets out a requirement for additional support from Government and NHS England, targeted most of all at fixing workforce supply, estates, and digital infrastructure. 

Looking ahead, in Surrey Heartlands we will start to work with teams and partners to reshape our programmes of work to align to the emerging themes as well as our new Critical Five objectives. Our first three priorities – keeping people well through improved interventions and prevention; safe and effective discharge supported by an improved integrated community care environment; and high-risk care management, wrapping care around the most vulnerable – are all about delivery at place, and integrated neighbourhood teams will play a key role in how we do this.