The future of primary care? It’s already happening in Tower Hamlets


Those who attended the Cambridge Health Network’s Future of primary care event last night left inspired by the lessons from East London’s Tower Hamlets.

Chair of NHS Tower Hamlets CCG, Sir Sam Everington and Primary Care Director at Barts NHS Foundation Trust, Dr Shera Chok shared examples of innovation and collaborative working at Tower Hamlets Clinical Commissioning Group (CCG) and how they have eliminated silos by building strong relationships between acute and primary in the area.

A primary care director, works with primary and acute care colleagues to improve patient safety, reduce the barriers between acute and primary care and brings a primary care perspective to the Board and, according to Everington, every hospital should have one. Said Everington: “Shera and I work as a system in Tower Hamlets and the relationship between primary and acute care should mirror this. System-working can speed up referrals, empty outpatients and, if digital services are used provide a much-needed upgrade of archaic choose-and-book systems.”

Every practice in Tower Hamlets has access to a social-prescribing team. In a ten-minute consultation, GPs can refer a patient to the social-prescribing team, who are, says Everington: “A group of emotionally intelligent, motivational, non-clinicians with a good knowledge of what is available in the community.” The key to success has been reversing, ‘What is the matter with you?’ to, ‘What matters to you?’

Everington championed these methods for the past 20 years, but it is only recently that they have begun to gain wider currency. So, what is it that makes it all happen? Leadership and relationships.

Tower Hamlets CCG has established a staff college offering leadership training for every member of staff, with a focus on team learning. The GP surgeries close every month and come together to learn and become incentivised to meet targets together. Sharing, support, respect, networks; all critical for a future of primary care grounded in effective system-working.

Everington and Chok were unfazed by the honest, realistic questioning. “The innovation shared last night was infectious, but what of the rest of the country beyond Tower Hamlets?” “How can primary care move towards this vision in areas whose leaders struggle to adopt change?” “How does one achieve sustained, enthusiastic change?”. Everington and Chok had one answer: find your clinical champions.

So, identify the Sam Everingtons and Shera Choks in your organisation and connect them with whomever they need to ignite the process of change.

The future of primary care looks pretty good: management knowing its clinicians, getting the right people together to solve problems, and stopping teams working in silos. Strong relationships and good leadership are the key to the evolution of primary care.