Foundry Healthcare Lewes: Thought Leadership Piece

The thought leadership piece, produced by Unity Insights and commissioned by KSS AHSN (now trading as Health Innovation KSS), explores whether the Foundry model of care constitutes a local reply to the ambitions of the Fuller Stocktake report by using the findings from the evaluation and insights from key stakeholders.

Over the last 5 years, the Foundry Healthcare Lewes PCN has implemented transformational changes based on a population health management approach. Less than one year after the publication of the Fuller Stocktake report, this thought leadership piece explores whether the Foundry model of care constitutes a local reply to the ambitions of the Fuller Stocktake report. Firstly, it presents the main interventions constituting the make-up of the Foundry model. Secondly, it explores to what extent it fulfils the ambitions of the Fuller Stocktake report, highlighting the objectives that were not met, and areas where the Foundry model goes further than the Fuller report. Finally, it addresses the question of the replicability of the Foundry model.

The interventions implemented by the Foundry echo and answer many of the ambitions presented in the Fuller Stocktake report. Whilst some dimensions of the integrated care agenda (such as collaborative working with secondary care) are yet to be delivered at the Foundry, the enablers listed mirror closely the recommendations of the Fuller report. These include the need for local leadership, widely spread buy-in from staff members, long-term strategic planning supported by regional and national partners as well as the systematic use of data. The model has the potential to benefit many other PCNs, but tailoring of the interventions and local sense of ownership will be pivotal to successful adopt the Foundry principles.

Despite being the lynchpin of the healthcare system, primary care faces many pressures including increased GP workload, staff shortages, and decreased patient satisfaction particularly due to long wait times. The ‘Fuller Stocktake’ report reviews how PCNs can best be supported within the emergent ICSs and presents numerous innovative projects looking to address current challenges. This is with the aim to ensure primary care remains the lynchpin of community-facing healthcare while also meeting the needs of people in their local area. Subsequently, this piece aims to answer the question, “The Foundry model: a local answer to the Fuller Stocktake ambitions?”.

To understand whether the Foundry model answered the Fuller Stocktake ambitions, the thought leadership piece looked at each dimension presented in the Fuller Stocktake report and explored whether they were addressed by the Foundry model, whilst also highlighting any challenges and enablers. Dimensions developed in the report were as follows:

• Building integrated teams in every neighbourhood.
• Working with people and communities.
• Improving same-day access for urgent care.
• National environment supporting locally driven change.
• Workforce model.
• New approach to primary care estates.
• Data, data, data.

The piece also examines the replicability of the Foundry model by considering the following:

• The factors at play at the Foundry which influenced the deployment of this model of care.
• The conditions and principles needed for its adoption by another PCN.
• The estimated impact of the Foundry model and its potential variability in other areas.

The thought leadership piece, which was developed in parallel to the Foundry evaluation report, aims to answer the question, “The Foundry model: a local answer to the Fuller Stocktake ambitions?”. Depending on whether the model address the Fuller Stocktake ambitions and to what extent, there is potential for the Foundry model to benefit other PCNs and transform primary care.

Whilst the Foundry model answers many of the ambitions laid out in the Fuller Stocktake report, it also highlights important dimensions of integrated care which are yet to be targeted by the model. This thought leadership piece therefore provides understanding and clarity on what works to achieve the Fuller Stocktake ambitions, it also quantifies the opportunity for improvement. These insights, highlighting successes and lessons learned, provide the building blocks for the development of a blueprint supporting the spread of the model across the wider system.