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The General Practice Podcast

Ben Gowland explores new ways of working in general practice. He talks to those making changes happen, gets underneath what they did, how they managed to do it, and the challenges they faced along the way.
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Apr 18, 2021

Up and coming, The Physician Associate Podcast, is a brand-new resource for Physician Associates both newly qualified and established, to access a wealth of information, opinion and all the latest news relevant to the PA world. Host James Catton is this week joined by our very own Ben Gowland, who has taken time out from recording The General Practice podcast, to give new listeners a much-needed overview of and insight into general practice right now. How general practice works within the wider healthcare ecosystem, when and why Primary Care Networks were born, the financial model, partnerships and the New to Partnership Scheme, and most importantly, all the need to knows for a PA considering a career in general practice.

 

Introduction (59 secs)

Setting the scene (1 min 15 secs)

Where general practice sits within the wider NHS (2 mins 9 secs)

Recent changes and the birth of PCNs (3 mins 1 sec)

The Additional Roles Reimbursement Scheme (3 mins 58 secs)

Challenges facing PCNs (4 mins 50 secs)

James’ view of practice versus PCN placement (6 mins 26 secs)

The importance of knowing where you stand before applying for a role (6 mins 52 secs)

Getting the most out of having a PA and being a PA in a PCN (7 mins 34 secs)

What is GP partnership and the business model explained (10 mins 18 secs)

Financial challenges (11 mins 34 secs)

The New to Partnership Scheme (12 mins 26 secs)

Why have numbers of partnerships fallen in recent years? (13 mins 32 secs)

Out of hours services in general practice (15 mins 38 secs)

Quality and Outcomes Framework (QOF) explained (17 mins 58 secs)

Predicting the future (19 mins 6 secs)

Further information and getting in touch (23 mins 4 secs)

 

Apr 11, 2021

Staff across general practice are currently feeling the impact of the enormous increase in workload as a result of the pandemic and business as usual spectacularly colliding but what is life like at the top of a PCN right now? How are the Clinical Directors bearing the additional burden, managing the demands from their own workloads, and finding adequate time to support and grow new, integrated teams across their network? In this week’s podcast, we welcome back GP and executive coach Rachel Morris who offers her usual brand of practical, innovative, and accessible solutions for managing team stress and individual pressure. Rachel is joined by Dr Nicky Turner, Clinical Director for The Chalfont PCN in Buckinghamshire, who shares her experiences in the role and where her own support systems exist. Together, our panel explore where the challenges lie right now, what can be done to preserve and promote team and personal resilience – and finally how and why listeners to the podcast should access further support of their own and resources from Rachel’s Resilient Team Academy

 

Introductions (39 secs)

Nicky’s PCN demographic (55 secs)

What are the main challenges Nicky faces in her role right now? (1 min 16 secs)

Is the issue of workload the main factor or is it wider than that? (1 min 43 secs)

Working across practices within a PCN (2 mins 9 secs)

Managing people and change (3 mins 12 secs)

The impact of the Additional Roles Reimbursement Scheme (ARRS) (4 mins 13 secs)

Rachel’s view on the pressure Clinical Directors are under (4 mins 42 secs)

What is helpful in terms of support? (5 mins 21 secs)

Nicky’s perspective on reducing stress and being more effective (6 mins 16 secs)

Actively seeking support (7 mins 1 sec)

The Drama Triangle (7 mins 43 secs)

Are softer skills really beneficial? (9 mins 36 secs)

Tailoring resilience training for different leaders (10 mins 19 secs)

Finding support in difference places (11 mins 41 secs)

The Resilient Team Academy (12 mins 5 secs)

Building a stronger team (13 mins 39 secs)

Planning for team engagement, post Covid (14 mins 30 secs)

Embedding ARRS staff (15 mins 29 secs)

Lessons learned from others’ experiences…what will get from joining The Resilient Team Academy? (17 mins 27 secs)

Constructive conflict (18 mins 53 secs)

The issues of virtual meetings and the impact on building great team relations (19 mins 48 secs)

Final words from Rachel (19 mins 59 secs)

Here is the link to the Resilient Team Academy website which contains information on the resources available, the current discounted offer– and how to join up.

 

Mar 22, 2021

As the new financial year and all its uncertainties looms, our joint Practice Index / Ockham Healthcare panel return to discuss their predictions and the preparations they have in place. Podcast regulars Robyn Clark and Nicola Davies are this week joined by RSM Partner and our resident finance expert James Gransby to talk all things QOF, enhanced services and the contractual requirements for 2021/22. Where are the pressure points? Can we continue to manage business as usual alongside the Covid vaccination drive? Will our core service once again expand to include the vaccinations year on year? How do we juggle this and what can we expect to receive by way of funding? Are we simply going to break even or can primary care profit from the increased workload? Life after Covid potentially starts here…

 

Introductions (33 secs)

How does life in general practice right now compare to that of a ‘normal’ March? (49 secs)

Planning for QOF next year (1 min 47 secs)

Is it possible for networks to manage business as usual alongside the enhanced service? (2 mins 59 secs)

What networks should be considering when it comes to finance in the new year (4 mins 44 secs)

Covid vaccinations to become core practice? (6 mins 8 secs)

The implications of a year-round vaccine drive (7 mins 42 secs)

Budget 2021 in summary and what it means for primary care (8 mins 38 secs)

Contract considerations, outside of QOF (10 mins 48 secs)

Implementing the Additional Roles Reimbursement Scheme in practice (11 mins 55 secs)

Mitigating the risk of high staff turnover (14 mins 43 secs)

Are PCN structures fit for future? (16 mins 35 secs)

Utilising the £1.50 (17 mins 33 secs)

An alternative way of thinking (18 mins 40 secs)

Embedding mental health workers (19 mins 39 secs)

James’s final thoughts (20 mins 53 secs)

 

The Practice Index website can be found here

For all enquiries, please contact James Dillon here

Mar 15, 2021

We are all aware of the pressure on general practice which has ramped up considerably since the vaccine drive began back in December but with no let up in sight and in fact, with pressure increasing across primary care going forwards, how do we maintain our current resilience and productivity levels whilst succumbing to the stress and even worse, the very real threat of burn out? Luckily GP and Executive Coach turned trainer Dr Rachel Morris is our featured guest this week and offers her thoughts, and some really practical advice, to ensure the burden of responsibility can be shared and managed more constructively, to preserve and promote the wellbeing of a team (and its individuals) during what many are finding to be the most stressful period of their working lives to date.

 

Introduction (29 secs)

Where are we at right now? (1 min 5 secs)

How do we maintain current momentum? (2 mins 19 secs)

Why you should be taking time off despite increasing pressure (4 mins 18 secs)

Taking a leap of faith (5 mins 54 secs)

Assuming the role of the rescuer (6 mins 46 secs)

Managing tensions and moving forwards (7 mins 45 secs)

Communication is key (9 mins 33 secs)

Building trust (10 mins 8 secs)

Where some PCNs have become disjointed (10 mins 54 secs)

Network challenges (11 mins 39 secs)

The Five Dysfunctions of a Team – Patrick Lencioni (12 mins 17 secs)

The importance of constructive conflict (12 mins 50 secs)

The transition of good working relationships to business as usual (15 mins 21 secs)

Mining for conflict to enable teams to function well (16 mins 22 secs)

The impact of the virtual environment (17 mins 39 secs)

Finding out more (19 mins 9 secs)

The Resilient Team Academy (20 mins 24 secs)

 

A list of the resources Rachel has mentioned:

Mar 8, 2021

The evolution of technology in general practice has been accelerated over the last 12 months but how ready were we, and are we, for further digital transformation? What are the factors that influence our willingness to embrace new ways of working and what are the barriers to progression? This was the focus of GP and Digital Fellow Dr Matt Hammerton’s recent report on digital readiness within his local integrated health partnership, a report conducted in conjunction with Wessex Academic Health Science Network (AHSN), with the support of WAHSN’s Associate Director Rachel Dominey. This week’s podcast offers a fascinating overview of the report’s findings and outcomes and includes practical advice and recommendations on readying practices and networks for the next stage of the digital journey.

 

Introductions (45 secs)

The reasons for undertaking the study (57 secs)

The reality of the tech available versus what is being used (1 min 42 secs)

Defining digital readiness (2 mins 8 secs)

Which areas of general practice does the report cover? (3 mins 6 secs)

Rachel describes her role at the AHSN (3 mins 34 secs)

How did the study work in practice? (5 mins 3 secs)

Recording the acceleration of tech use during the pandemic (5 mins 45 secs)

The difference in results, pre and post Covid-19 (6 mins 48 secs)

Does digital readiness depend on the tech we are using? (7 mins 17 secs)

Is the ability to embrace new technology more important than how the tech itself works? (8 mins 33 secs)

The AccuRx effect (9 mins 17 secs)

Does a more bespoke technology increase our willingness to use it? (9 mins 57 secs)

Other key factors impacting digital readiness (12 mins 53 secs)

Some recommendations (14 mins 6 secs)

The non-clinical profile (16 mins)

Patient age impact and influence (16 mins 38 secs)

The risk of practices and networks falling behind (17 mins 28 secs)

Further outcomes, recommendations, and advice (18 mins 33 secs)

Taking forward the recommendations from the AHSN’s perspective (19 mins 58 secs)

 

The link to the digital readiness report is here

Mar 1, 2021

Telehealth is a tool which can be used in a variety of ways; to support and enhance existing systems or to introduce a completely new way of working. Whilst telehealth is a relatively new concept in many areas, in others it is a more long-term feature of the health ecosystem.  In West Yorkshire, Immedicare offer a 24/7 digital care service to support primary care providers with the management of care home patients. Having been established for over 10 years, they know only too well what works, what does not and crucially how to realise the benefits of telehealth; enabling rapid triage and response around the clock, reducing secondary care admissions and relieving pressure on care home staff, local practices and PCNs. Rachel Binks, Nurse Practitioner for Digital and Acute Care at Airedale NHS Foundation Trust, joins Ben this week to fill us in on the Immedicare journey and why they have been instrumental in improving health outcomes for their care home patients.

 

Introduction (34 secs)

How did the concept first come about? (46 secs)

The Immedicare journey (1 min 26 secs)

Enabling a 24/7 service (2 mins 11 secs)

800 care homes and counting (3 mins 43 secs)

How does the service work in practice? (4 mins 32 secs)

What is the contractual basis of the service and where does it fit with local providers? (5 mins 12 secs)

Managing a broad spectrum of conditions and health concerns (7 mins 13 secs)

The importance of building and maintaining relationships (7 mins 56 secs)

The Immedicare clinical workforce (9 mins 27 secs)

Making the service viable (10 mins 15 secs)

Balancing relationships with local PCNs and practices (11 mins 16 secs)

Multi-disciplinary team meetings (12 mins 59 secs)

What has been the impact of the service? (13 mins 36 secs)

Technical limitations? (14 mins 16 secs)

Reducing community care visits and admissions (14 mins 50 secs)

Aligning with new PCN services and staff teams (15 mins 51 secs)

Feedback from the care homes (16 mins 42 secs)

Financial and contractual setup (17 mins 14 secs)

What’s next as far as developing the service is concerned? (18 mins 23 secs)

Finding out more (19 mins 17 secs)

 

Immedicare website is here

Rachel is happy to discuss any aspect of the service on offer from Immedicare or telehealth more broadly. Her email address is here

Feb 22, 2021

It is undeniable that the success of the Covid vaccination programme so far is due to the efficiency and the herculean efforts of general practice staff across the board; from volunteers, to drivers, Practice Managers, doctors, nursing, and administration teams who all continue to go the extra mile to try to get the country back on its feet. On our dedicated monthly Practice Index / Ockham podcast, we have closely followed the progress of our Practice Managers (and their teams) from the beginning in December and January - and this week we revisit their journeys at a pivotal point as they smash their initial target of vaccinating the most vulnerable patient groups with their first doses. On this month’s panel, podcast regular Nicola Davies is joined by her colleagues Kay Keane of Alvanley Family Practice (and network manager for Werneth PCN) and Andrew Athale, Practice Manager for Eastmoor and Alverthorpe GP practices, to discuss their largely positive experiences so far but also the additional pressure they and their wider colleagues are feeling, their views on ensuring full and accurate financial reimbursement across their networks and what comes next as far as core general practice demand and delivery of second doses are concerned.

 

Introductions (34 secs)

Progress on the vaccination programme in each area; starting with Nicola’s (1 min 30 secs)

Kay tells us about her experiences in Stockport so far (2 mins 26 secs)

Kay’s role in the process (3 mins 1 secs)

Patient inspiration (3 mins 29 secs)

How has it gone so far in Andrew’s network? (4 mins 5 secs)

Meeting the challenge of vaccinating care home residents and house bound patients (5 mins 3 secs)

Processing payment (7 mins 51 secs)

The problem with Pinnacle (9 mins 20 secs)

Ensuring accurate and timely distribution of funds (10 mins 5 secs)

The pressure of working at scale when it comes to financial reimbursement (10 mins 58 secs)

Wider network impacts (12 mins 22 secs)

Could this be the making of PCNs? (13 mins 13 secs)

How has the set up of the mass vaccination sites affected local practices? (14 mins 14 secs)

Are PCNs really in competition with the mass vaccinations sites? (15 mins 55 secs)

Delivery of vaccines at a more local level (17 mins 30 secs)

Preparations for second doses (18 mins 56 secs)

Why delivery notifications need to be right (19 mins 30 secs)

Managing core general practice demand alongside the vaccine drive (20 mins 2 secs)

Pressure on Practice Managers (20 mins 49 secs)

Ben’s closing remarks (22 mins 25 secs)

 

The Practice Index website can be found here

For all enquiries, please contact James Dillon here

Feb 15, 2021

With demand on general practice already at an all-time high, many practices and networks require a smarter solution to manage staffing and rotas, to ensure the pressure of core primary care work, alongside the mass vaccination drive, can be effectively delivered. Dr Ishani Patel, GP and co-founder of the digital staff bank solution Lantum is back on the podcast and joined by colleague, Lantum account manager, Tom Herbert-Maynard, to update us on the progress that Lantum has made, how their solution is supporting ICSs up and down the country to create a fully flexible workforce across the NHS eco-system, their influence on staffing the vaccination sites and most importantly, to provide information on the NHSEI funding available now for ICSs to enable procurement of and access to a digital staff bank.

 

Introductions (38 secs)

Who are Lantum and what role are they playing in supporting the vaccination rollout? (51 secs)

How does a digital staff bank work where the vaccination programme is concerned? (1 min 39 secs)

Lessons learned from the programme so far (3 mins 28 secs)

What advantages does a digital system offer versus traditional methods of rota management? (5 mins 38 secs)

How would a rota manager organise staffing using an online portal, in practice? (6 mins 8 secs)

Governance considerations (8 mins 14 secs)

Maintaining a good rate of vaccinations and how the system could support this (8 mins 26 secs)

The key differences between smaller vaccination hubs and larger scale vaccination sites (9 mins 28 secs)

NHSEI funding availability (11 mins 5 secs)

Putting a flexible staffing pool in place across an ICS (12 mins 46 secs)

Which roles can be managed within a digital staff bank? (14 mins 34 secs)

Enabling delivery of truly integrated care (15 mins 22 secs)

Breaking down organisational boundaries (16 mins 29 secs)

How do I access the NHSEI funding offer? (17 mins 29 secs)

I am a Clinical Director, and I would like to find out more (18 mins 29 secs)

Getting in touch (19 mins 20 secs)

 

The Lantum website is here

Ishani is contactable here

This page explains a little more about how Lantum can provide 'connected scheduling' between staff banks.

What should be the key considerations when sourcing a digital staff bank provider? Lantum’s blog post is here

Feb 8, 2021

With the right training and support in place, Physician Associates can play an important part in relieving a proportion of the clinical burden on GPs and their wider staff. As the role is now included in those available through the Additional Roles Reimbursement Scheme, we persuaded Ria Agarwal, herself an experienced Physician Associate (PA), to make a return to the podcast, to share her experiences and her tips for getting the best out of a newly recruited PA. Why she believes they can really make a difference to practice productivity, what PA preceptorships (such as the scheme currently on offer in Sheffield) can bring in the way of support and how to get the best out of your newest recruit.

 

Introduction (34 secs)

 

Four years in the life of a Physician Associate (PA) (48 secs)

 

Is the PA role now more widely accepted in general practice? (2 mins 5 secs)

 

The inclusion of PAs in the additional roles’ reimbursement scheme (2 mins 39 secs)

 

Preceptorship schemes (2 mins 58 secs)

 

What is involved in a preceptorship typically? (3 mins 46 secs)

 

Structuring PA consulting appointments in the first year (6 mins 24 secs)

 

Progression and training (7 mins 16 secs)

 

The influence of a practice in enhancing the potential of a PA (8 mins 26 secs)

 

Is there a benefit to newly qualified PAs having access to and mentorship from a more experienced PA? (11 mins 3 secs)

 

Tackling recruitment (12 mins 31 secs)

 

Expectation versus reality (15 mins 11 secs)

 

Why where you base your PA matters (16 mins 24 secs)

 

Preceptorship funding (17 mins 22 secs)

 

The key to success (18 mins 30 secs)

 

Final thoughts and advice (19 mins 44 secs)

 

 

A link to Ria’s paper on the preceptorship scheme available in Sheffield is here

 

Feb 1, 2021

When primary care networks were first launched, many believed this might spell the end for GP federations, but this is not necessarily the case. There are numerous examples of some innovative partnership models developing across the country to support PCNs in delivering the best quality care and whereby federations are providing the resources to absorb some of the key workstreams, thus removing the burden from practice and network staff. Alliance for Better Care, or ABC as they are commonly known, are a typical example of a GP federation who are achieving success by working collaboratively with their PCNs. This is due, in part, to the expertise of their two Network Development Managers, Caroline Upton and Lena Abdu, who join Ben on the podcast to give an insight into their roles, what they entail, where they have made a difference and why partnership working might be the way forward.

 

 

Introductions (38 secs)

 

ABC demographic and mission (57 secs)

 

Lena’s background (1 min 39 secs)

 

Caroline’s journey to becoming a Network Development Manager (2 mins 42 secs)

 

Sharing the management of networks from a federation perspective (3 mins 14 secs)

 

Ownership of dedicated work packages (4 mins 2 secs)

 

The importance of maintaining strong relationships with individual clinical directors (4 mins 48 secs)

 

Communication and engagement with wider teams (5 mins 34 secs)

 

Other available support for PCNs (6 mins 42 secs)

 

All about recruitment (7 mins 53 secs)

 

The additional roles scheme (10 mins 23 secs)

 

Managing workload and demand capacity (12 mins 4 secs)

 

Meeting the new general practice service specifications (13 mins 13 secs)

 

Meeting representation (15 mins 38 secs)

 

What are the main challenges? (17 mins 31 secs)

 

How are the Network Development Manager roles costed? (19 mins 43 secs)

 

Finding out more and getting in touch (21 mins 32 secs)

 

 

Alliance for Better Care’s website can be found here

 

 

Email: caroline.upton@nhs.net and / or lena.abdu@nhs.net

Jan 25, 2021

It has been arguably some of the toughest few weeks general practice has ever known. The pressure of the delivery of the vaccination programme has been felt by teams up and down the country and our joint Ockham / Practice Index podcast regulars are no different. In this sixth instalment of our hugely popular practice manager panel posts, Nicola Davies, Robyn Clark and Ben are joined by Business Manager Amita Gokani to discuss their experiences of working at the forefront of the vaccination programme, so far. Each have faced their own challenges locally and are at different stages in the immunisation campaign and we have been fortunate to get their insights on how the first six weeks have gone for each of them; the highs, the lows and then what comes next.

 

Introductions (35 secs)

 

Robyn in the headlines (1 min)

 

The Institute of General Practice Management (IGPM) update (2 mins 47 secs)

 

The last 6 weeks in Nicola’s patch (3 mins 1 sec)

 

Dealing with local frustrations (3 mins 57 secs)

 

Amita’s recent experiences in Redbridge (5 mins 9 secs)

 

The impact of short notice, unannounced and cancelled deliveries (6 mins 49 secs)

 

Working through the cohorts versus potential for wastage (7 mins 30 secs)

 

Progress in Robyn’s area (8 mins 15 secs)

 

The potential for increased flexibility and where this has been limited (9 mins 3 secs)

 

What happened when the guidelines for administering the second dosage changed? (10 mins 57 secs)

 

The challenges presented by continually changing guidance and regulation (11 mins 42 secs)

 

Nicola’s view on these continuous changes (12 mins)

 

Managing staffing and rotas (14 mins 19 secs)

 

The limitations of running services on staffing good will (15 mins 45 secs)

 

The approach to care homes and housebound patients in Robyn’s area (17 mins 15 secs)

 

Anticipating the weeks ahead: Robyn and Amita (18 mins 9 secs)

 

All systems go for Nicola (19 mins 31 secs)

 

The Practice Index website can be found here

 

For all enquiries, please contact James Dillon here

Jan 18, 2021

Recruiting from the Additional Roles Reimbursement Scheme (ARRS) pot isn’t simply a case of picking out which services and posts you think would best suit your network or practice. As many are discovering, it requires a bit of a step back and some critical thinking as to what might work now versus in the future, what the needs of the local population are, how much capacity there might be to support new, additional team members and how they can best function across large networks and / or multiple practices. In this week’s podcast, we welcome back Dr Riaz Jetha, GP and Director of Health Integration Partners, whose team have adopted a novel approach to managing the process of applying for, funding and integrating new clinical posts into existing teams. Can there really be a magic formula which supports us in identifying the right roles, which can ensure we better meet the needs of the PCN and stay within the funding budget?

 

 

Introduction (40 secs)

 

How did the adoption of the process mapping methodology come about? (1 min)

 

How would we use a role instead of what role should we get (an alternative mindset) (3 mins 3 secs)

 

Where to begin (4 mins 26 secs)

Some surprising outcomes (7 mins 47 secs)

 

The value of the non-clinical functions (9 mins 33 secs)

 

Summing up a phased approach to the ARRS process (12 mins 28 secs)

 

Blending clinical and leadership skills (13 mins 30 secs)

 

Plugging the gaps in developmental and holistic support for newly recruited ARRS staff (13 mins 52 secs)

 

Alleviating the burden on PCNs and practices (15 mins 11 secs)

 

Riaz’s view on ARRS funding models (15 mins 51 secs)

 

Applying the funding more flexibly (17 mins 43 secs)

 

Being more creative when it comes to recruitment (18 mins 44 secs)

 

Key lessons learned (19 mins 45 secs)

 

Measuring the benefits of process mapping (20 mins 38 secs)

 

Getting in touch (21 mins 37 secs)

 

 

 

The link to the Health Integration Partners website can be found here

 

Contact email for Riaz here

 

A sample presentation showing the analysis of staffing a new service can be found here

Jan 11, 2021

With the recent inclusion of pharmacists within the Additional Roles Reimbursement Scheme offer, many practices and networks are seriously considering utilising the skills and services a pharmacist can bring to their table. However, many are equally uncertain as to what the pharmacists can cover, how to integrate them best within their teams and more practically, what the best model of employment might be to benefit both the new post holder and the PCN, amongst other things. Luckily, Mahmud Yusupov and Runa Salim, both Senior Clinical Pharmacists and joint founders of the innovative Clinical Pharmacist Solutions join Ben this week to talk us through all of the key practical aspects that PCNs must consider during the recruitment process and beyond – and from a third-party perspective, how they can support primary care in getting the best out of the new roles.

 

 

Introductions (36 secs)

 

Mahmud’s background and an introduction to Clinical Pharmacist Solutions’ mission (55 secs)

 

All about Runa (1 min 26 secs)

 

Attracting pharmacists to primary care and ensuring they can practice effectively (1 min 57 secs)

 

What are pharmacists looking for specifically when it comes to a career in general practice? (3 mins 23 secs)

 

The importance of the interview (5 mins 19 secs)

 

What support can Clinical Pharmacist Solutions for PCNs during the recruitment process? (6 mins 12 secs)

 

Matching the requirements of a practice to the skillset of a pharmacist (7 mins 44 secs)

 

Assessments of skills / training needs analysis (8 mins 14 secs)

 

How long does it take to upskill a pharmacist? (10 mins 15 secs)

 

Blending externally provided learning with CPPE training (11 mins 49 secs)

 

Reducing staff turnover (13 mins 1 sec)

 

Mahmud and Runa’s thoughts on potential employment models (14 mins 23 secs)

 

Funding challenges (16 mins 9 secs)

 

Getting in touch (18 mins 5 secs)

 

 

The link to the Clinical Pharmacist Solutions website can be found here

 

Their LinkedIn page is here

Jan 6, 2021

At the end of last year Ben recorded a review of 2020 with Dr Hussain Gandhi and Dr Andrew Foster from the eGPlearning podblast.  We cover the impact of Covid on general practice, how that changed over the course of the year, and reflect on what the lasting implications of this might be for the service.  It is a slightly longer listen than our normal podcast episodes at 45 minutes – primarily because there is so much to cover! 

Jan 4, 2021

There are generally more failures than success stories when it comes to launching and maintaining community based urgent care services across the country so what have the team in Rochdale done differently? To kick off the new year, Ben is joined by GP Dr Zalan Alam, Clinical Director for the hugely successful and pioneering Heywood, Middleton and Rochdale Urgent Community Care Team who gives an inspiring insight into their five-year journey to date; from establishing a business case, to taking a more flexible approach to their service specification, where they have grown and continually adapted, the lessons learned and their future aspirations.

 

Introduction (34 secs)

 

Zalan’s role and an overview of the service model (51 secs)

 

Establishment of the service and some key factors in its success to date (1 min 56 secs)

 

The business case (3 mins 7 secs)

 

A typical patient journey (4 mins 58 secs)

 

Capacity challenges? (6 mins 29 secs)

 

Impact of Covid (7 mins 11 secs)

 

Integrating social prescribers (8 mins 50 secs)

 

The five-year evolution of the service (9 mins 50 secs)

 

Lessons learned (11 mins 30 secs)

 

Zalan’s thoughts on integrated care (13 mins 4 secs)

 

Cultivating a shared vision (14 mins 57 secs)

 

An alternative approach to the service specification (15 mins 33 secs)

 

What’s next? (16 mins 36 secs)

 

Finding out more (18 mins 14 secs)

 

 

Heywood, Middleton & Rochdale’s Intermediate Care Team website

 

Contact points for the service as follows:

 

Dr Zalan Alam Clinical Director for Intermediate Tier Services 

 

Wendy Antil Service Manager 

 

Ruth Chamberlain Directorate Manager

 

The link to Zalan’s first podcast episode is here

 

Dec 14, 2020

The publication of the enhanced service landed at the beginning of December and with it comes further, additional challenges for general practice and places us firmly in the spotlight of the current healthcare agenda. Our ever-popular Practice Index panel return and as well as providing an update following their last episode, they are this week joined by podcast favourite Dr Hussain Gandhi (Dr Gandalf) to consider the implications of and considerations required for the delivery of the Covid vaccination programme locally and nationally. How do we engage with a partially sceptical public? How will we fare balancing immunisations alongside business as usual? How delivery will be managed in practice? Whilst also not forgetting the management of finances and workforce planning…

 

Introductions (35 secs)

An update on the establishment of a nationally recognised organisation for Practice Managers (46 secs)

The Institute of General Practice Management contact points (2 mins 22 secs)

The panel’s reaction to the Enhanced Service publication (2 mins 53 secs)

Moving from practice to network wide delivery (3 mins 56 secs)

Robyn’s perspective (5 mins 23 secs)

Identification of a designated site for Nicola’s network area (6 mins 31 secs)

The plans for Nottingham City East (7 mins 6 secs)

What differences are there between the Enhanced Service and the original, local plan in Gandhi’s area? (7 mins 55 secs)

The challenges in summary (8 mins 59 secs)

Workforce organisation (10 mins 28 secs)

Nicola’s thoughts on staffing the enhanced service (11 mins 59 secs)

Managing a vaccination programme alongside business as usual (13 mins 8 secs)

Financial reimbursement in South Gloucestershire (13 mins 46 secs)

How Gandhi is handling the financial flow in his network (14 mins 41 secs)

Comms / engagement with the public – and managing concerns (15 mins 47 secs)

Recording appointments and immunisation numbers (18 mins 10 secs)

The process for vaccination clinics in practice (20 mins 27 secs)

eGP Learning and Practice Index resources (21 mins 57 secs)

 

For more information on The Institute of General Practice Management:

Twitter   Facebook   Email

Practice Index

YouTube channel for Dr Gandalf’s eGP Learning podblast

  

Dec 7, 2020

Amongst the host of new roles available to PCNs are First Contact Physiotherapists (FCPs); a service designed to signpost patients directly into a physiotherapy service and therefore saving valuable GP and GP referral to treatment times. As this is a relatively new concept for most, we speak this week to Larry Koyama, Head of FCP Implementation at the Chartered Society of Physiotherapy to get the lowdown on what an FCP actually is, what the role can offer in terms of supporting practice efficiency, the suggested models for successfully embedding FCPs in both an employment sense and in terms of integration within the wider network, the lessons learned so far and more.

Introduction (35 secs)

The background to Larry’s role (46 secs)

Making the case for First Contact Physiotherapists (1 min 34 secs)

What is an FCP? (2 mins 34 secs)

What is the difference between a Physiotherapist and an FCP? (3 mins 38 secs)

Patient pathway and service access (4 mins 28 secs)

Crunching the numbers; caseload and appointment sizes (5 mins 11 secs)

FCPs per population size (5 mins 52 secs)

Lessons learned so far (6 mins 51 secs)

FCPs within the wider practice and network teams (8 mins 19 secs)

Optimising working experience within a network environment (10 mins 3 secs)

3 suggested employment models (12 mins 37 secs)

Exploring the implications of direct and indirect employment (14 mins 21 secs)

Current availability of FCPs (15 mins 45 secs)

Larry’s final thoughts on making the most of your FCP (16 mins 46 secs)

Finding out more (18 mins 27 secs)

 

Please visit the Chartered Society of Physiotherapy’s website for a range of resources from making the business case for employment of an FCP to supporting implementation and tools for evaluating the effectiveness of the role.

The link to the Phase 3 FCP evaluation data Larry refers to is here

Nov 30, 2020

Has there ever been a year which has been more tough in terms of demand and output in general practice? Covid landed and with it a whole host of immediate and long-term issues which have all had a direct impact on practice and network cashflow. Our resident finance guru James Gransby of RSM UK is back this week to give his thoughts and his advice on available funding now, what may be up for grabs in future, where savings could be identified, whether general practice overall is thriving in spite of the pressure and most importantly, what to do if your financial position is already precarious.

 

Introduction (33 secs)

Is it harder for practices to stay on top of finances now? (43 secs)

What support is available from NHS England? (1 min 12 secs)

The influence of individual CCGs (2 mins 18 secs)

Income protection (2 mins 47 secs)

Where is income being lost? (4 mins)

Has the £150m Covid expansion funding really made a difference?  (4 mins 46 secs)

Practical and financial implications of taking on additional roles (6 mins 2 secs)

The pressure from two, large-scale immunisations programmes in one financial year (6 mins 53 secs)

Direct support from government (8 mins 21 secs)

James’s take on the overall financial impact of Covid (10 mins 8 secs)

What actions should we be taking right now? (11 mins 31 secs)

Advice for those who are struggling (12 mins 52 secs)

Utilising a PCN surplus (14 mins 3 secs)

How the additional roles can help from a network perspective (14 mins 34 secs)

Will there be any further opportunities to boost income at any point? (15 mins 8 secs)

Transformation of working process = savings? (16 mins 14 secs)

James’s final thoughts (17 mins 29 secs)

Further information, resources and getting in touch (17 mins 56 secs)

 

The COVID article can be found here and the Autumn version which also contains COVID tips (including Christmas gifts) can be requested from your local AISMA accountant or by emailing James at james.gransby@rsmuk.com

 

Nov 23, 2020

Following our recent podcast featuring Dr Farzana Hussain, we catch up this week with Dr Hussain Gandhi, aka Dr Gandalf to his own eGPlearning Podblast listeners, to hear about how his year in post as Clinical Director for Nottingham City East PCN has gone, in the backdrop of all the challenges presented by Covid, the flu vaccination programme and the new PCN DES specs (to name but a few). Gandhi talks to Ben about his own reflections within his role, how his teams have fared, how they are dealing with increased pressure and their plans for the future which include expansion of the team and the services they can offer.

 

Introduction (31 secs)

Sustaining the initial excitement of being Clinical Director despite a particularly gruelling year (45 secs)

Relationship development within the network area (1 min 23 secs)

Sink or swim? (2 mins 49 secs)

The explosion of tech in general practice (3 mins 31 secs)

Adoption of digital process and the impact on multi-disciplinary working and setting up new services (4 mins 36 secs)

How are Nottingham City East using the additional roles scheme? (6 mins 17 secs)

Gandhi’s thoughts on the network manager post and recognising the efforts of Practice Managers over the last 12 months (8 mins 16 secs)

The practicalities of employing a network manager / designing the role (9 mins 42 secs)

Progress on the additional clinical roles (10 mins 27 secs)

Time management (11 mins 56 secs)

Short and long-term strategies for employment of additional roles (12 mins 26 secs)

PCN DES specs (13 mins 42 secs)

Coping with an escalating workload (15 mins 12 secs)

The importance of saying “no” (16 mins 4 secs)

Main reflections and highlights from the last 12 months (16 mins 41 secs)

What happens next? (17 mins 45 secs)

The eGPlearning Podblast (19 mins 8 secs)

Finding out more (19 mins 57 secs)

 

 

The link to the eGPlearning YouTube channel is here

Nov 16, 2020

With a whopping 55% of Practice Managers intending to leave their posts in the next 12 months, this is a clear sign that there is growing discontent and therefore, a potentially huge problem for general practice that needs to be tackled sooner, rather than later. In the latest of our series of Practice Manager panels, Nicola Davies and Robyn Clark return and are this week joined by Jo Wadey, fellow Practice Manager and Chair of the West Sussex Practice Managers Association and by Carole Cusack, Director of Primary Care at Wessex LMCS to discuss the issue of continuing disregard and lack of recognition nationally for Practice Management as a profession. Where and how do Practice Managers get their concerns heard? How effective are LMCs in addressing their needs? Should there be national accreditation of Practice Managers? And the million-dollar question; is there a role for collectivism and the establishment of a union?

 

Introductions (28 secs)

What is the reason for low morale amongst Practice Managers right now? (1 min 5 secs)

Robyn’s views (2 mins 55 secs)

Jo shares her experiences (3 mins 45 secs)

Carole’s sense from an LMC perspective (4 mins 47 secs)

The exclusion of Practice Managers from the New to Partnership Payment Scheme (5 mins 57 secs)

Clinical versus non-clinical (6 mins 29 secs)

The Practice Management Network (7 mins 18 secs)

Percentages of Practice Managers leaving post in the next 12 months and the implications for general practice (7 mins 57 secs)

Why there is a need for a nationally recognised professional body for Practice Managers (9 mins 6 secs)

Membership and / or accreditation (10 mins 48 secs)

The complexities and variation in becoming a Practice Manager (13 mins 41 secs)

Which existing organisations could be a model for a national body of Practice Management? (16 mins 11 secs)

How it feels to be disregarded by existing, recognised bodies (18 mins 14 secs)

Where do we go from here? (19 mins 48 secs)

Ben’s closing remarks / summary (20mins 56 secs)

Nov 9, 2020

This time last year we caught up with Clinical Director and now GP of the Year Dr Farzana Hussain to get her early thoughts about her (then) new role as a PCN lead. Fast forward 12 months and Farzana is back to share an update on the challenges she and her network team have faced and where they have achieved success, in spite of the pressures of meeting the demands of the primary care contract and the small matter of a global pandemic. From developing and managing relationships, to understanding and embedding additional roles and identifying where further support is required across the board, this week’s podcast is a fascinating insight into the world of a Clinical Director during the early life of a PCN.

Introduction (33 secs)

Becoming GP of the Year (47 secs)

Stand out moments in the last year, in summary (1 min 34 secs)

Evolving relationships between practices and the network more broadly (2 mins 38 secs)

Working on shared purpose (4 mins 14 secs)

How has Covid impacted on PCN relationships and the development of the network itself (5 mins 45 secs)

Recruitment of additional roles (6 mins 52 secs)

Meeting the challenge of embedding new roles in practice (10 mins 7 secs)

When will the positive impact of the new roles be felt? (12 mins 33 secs)

Is there adequate support in place for managing the establishment of new teams? (14 mins 12 secs)
Managing the demands for time and meetings (15 mins 29 secs)

What support is available for clinical directors themselves? (16 mins 46 secs)

The £1.50 challenge (19 mins 7 secs)

What’s next for Farzana? (20 mins 44 secs)

Nov 2, 2020

The Primary Care Home programme is an innovative approach to strengthening and redesigning primary care, which was founded by the National Association of Primary Care (NAPC) in 2017. Since that time, there has been the emergence of primary care networks so how have the radical differences which have swept across the general practice system affected the programme and its development? This week’s podcast features Dr Minesh Patel, current NAPC Chair, who talks to Ben about the progress of the Primary Care Home movement, the impact of PCNs and their influence broadly and what is next in terms of both models.

 

Introductions (10 secs)

 

The role of the NAPC (21 secs)

 

Primary Care Home (PCH) initiative and the relationship with PCNs (1 min 2 secs)

 

How is the work of the Primary Care Home being carried out now? (2 mins 2 secs)

 

Are PCNs a risk to the Primary Care Home movement? (3 mins 24 secs)

 

PCN new roles (5 mins 13 secs)

 

The key differences of Primary Care Home and PCN – and the resulting impacts (6 mins 40 secs)

 

Are networks operating differently in different areas when it comes to recruitment of the new roles? (8 mins 11 secs)

 

The timeline for embedding new staff (9 mins 34 secs)

 

Where PCNs fit as far as integrated care is concerned (10 mins 8 secs)

 

Lessons in engagement from the Primary Care Home programme (13 mins 4 secs)

 

Relationship development (14 mins 33 secs)

 

How has Covid affected the development of PCNs? (15 mins 32 secs)

 

NAPC forward view and how they can help practices and networks right now (16 mins 49 secs)

 

Getting in touch (18 mins 26 secs)

 

 

The NAPC website is here

 

To get in touch via Twitter

 

Or you can call: 020 7636 7228

Oct 26, 2020

There has been an explosion of digital innovation within primary care over recent months, particularly where maintaining contact between practices and their patient populations is concerned. But what about joining up practices with other practices, within Primary Care Networks (PCNs) and GP Federations, as well as other cross-sector organisations, to enable secure information sharing across care providers? This week’s podcast features GPs Dr Susannah Thompson and Dr Eleanor Holmes from TyneHealth GP Federation who, together with Nigel Walker, CDO and Co-Founder of leading data security provider CyVolve, share a fascinating insight into the transformative approach they are taking in North Tyneside to truly put patients at the heart of integrated care pathways; how they are able to safeguard security around the sharing of information and ultimately, finally, break down the barriers of silo working.

 

Introductions (44 secs)

All about TyneHealth GP Federation (1 min)

The extended access service (1 min 47 secs)

The birth of CyVolve and their mission (2 mins 22 secs)

CyVolve’s role in supporting safe information sharing (3 mins 7 secs)

Sharing the right information, at the right time, with the right people (6 mins 5 secs)

Motivating multiple practices to trust in the technology (7 mins 30 secs)

The challenges faced by CyVolve (8 mins 4 secs)

Bringing benefit to business continuity during the pandemic (8 mins 50 secs)

What are the key differences of the CyVolve technology? (9 mins 20 secs)

How is information stored? (10 mins 34 secs)

What types of data are being managed? (11 mins 20 secs)

Handling pushback (12 mins 12 secs)

The TyneHealth Covid-19 resource hub (14 mins 11 secs)

What has been the impact of the new system being in place? (15 mins 7 secs)

Lessons learned from CyVolve’s perspective (16 mins 3 secs)

Finding out more (17 mins 16 secs)

 

To find out more and to get in touch with Susannah and Eleanor at TyneHealth:

The TyneHealth website is here  

Dr Susannah Thompson MD / GP

Dr Eleanor Holmes (GP / QI & Communications Manager)

 

A case study published by CyVolve on their work with TyneHealth (n.b. same title as the podcast: 'Patient Data: Who Holds The Key?')

The CyVolve website for more info about NHS secure collaboration can be found here

Oct 18, 2020

This time of year is ordinarily an extraordinarily busy period for practices with the onset of ‘business as usual’ winter pressures but what is the effect of the additional impact Covid presents, while business is not running as normal? In the third of our Practice Index Practice Manager panels, now seasoned podcast professional Nicola Davies joins Ben, along with fellow Practice Manager Michele Petrie and GP, executive coach and speaker, Dr Rachel Morris, to discuss the challenges leadership teams face right now, what low morale means in practice day to day and critically, what can be done to maintain staff resilience during this period of long term uncertainty.

 

Welcome to the panel (38 secs)

 

An introduction to Michele (49 secs)

 

All about Rachel (1 min 24 secs)

 

Morale right now in general practice (2 mins 10 secs)

 

Why is morale so low? (3 mins 24 secs)

 

Pressure from the top and the influence of the media (3 mins 46 secs)

 

Summarising the contributing factors (4 mins 18 secs)

 

What does a stressful working environment look and feel like in reality? (5 mins 20 secs)

 

The power of social media (7 mins 5 secs)

 

What can practices do to find a way through? (8 mins 21 secs)

 

The zone of power (10 mins 36 secs)

 

Recognition, reward, and the importance of saying “thank you” (11 mins 24 secs)

 

Long term impacts of low morale and maintaining wellbeing (13 mins 4 secs)

 

Pulling together as a team (14 mins 38 secs)

 

Standing in the shoes of a practice leadership team (15 mins 24 secs)

 

Coping strategies (17 mins 13 secs)

 

Rachel’s advice for self-care and sustaining resilience (19 mins 31 secs)

 

 

The link to Rachel’s I am not a frog podcast is here

The Covid-19 team wellbeing toolkit Rachel refers to can be found here

 

Oct 11, 2020

Episode 228 - Podcast – Jessica Hollingsworth & Nick Sharples – Digital group consultations

Group consultations are a relatively new concept in primary care, but one GP has taken this a step further and in the wake of the pandemic, has introduced digital group consultations at her practice. Dr Jess Hollingsworth of Linthorpe Surgery in Middlesbrough, in partnership with podcast favourite Nick Sharples of DNA Insight, saw that there was a need to better support patients recovering from Covid. Together, they decided that giving patients access to an online consultation, in the company of other individuals also struggling with the long term impact of the virus, might offer some much needed insight into its effects, whilst giving them a safe route of access to an individual consultation and to a potential network of support going forwards. Here, they talk to Ben about how the idea came about, the preparation that is required, how the consultation works in practice and what the impact has been overall on the patients that have taken part.

 

Introductions (34 secs)

 

Making the transition to virtual group consultations (55 secs)

 

The definition of a digital group consultation and its structure (1 min 29 secs)

 

Timings and patient consult allocation (2 mins 25 secs)

 

Which patient group/s were targeted and why? (2 mins 53 secs)

 

What preparation is required? (3 mins 21 secs)

 

The role of the facilitator (4 mins 7 secs)

 

Governance and consent (4 mins 46 secs)

 

Recommended group size and numbers (5 mins 56 secs)

 

A group consultation in practice (7 mins 21 secs)

 

After care (8 mins 26 secs)

 

How social prescribing link workers can help (9 mins 40 secs)

 

Patient feedback (10 mins 30 secs)

 

Reflections from a practice perspective (11 mins 40 secs)

 

Technical challenges (12 mins 34 secs)

 

Which online platform works best and why? (13 mins 19 secs)

 

Lessons learned (14 mins 36 secs)

 

Advice from Nick for practices who are in setting up a digital group consultation (15 mins 43 secs)

 

The Personalised Care Institute and the support and training on offer (17 mins 12 secs)

 

Where can I find out more about virtual group consultations? (18 mins 28 secs)

 

Further support for patients recovering from Covid-19 (19 mins 14 secs)

 

A link to the case study on Linthorpe Surgery’s digital group consultation pilot (which Nick references) can be found here

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