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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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Now displaying: 2019
Dec 16, 2019

In our final podcast of 2019, Ben talks to David Cowan, Care Navigation Lead at Conexus Healthcare, about how care navigation and the newly introduced link worker roles can assist in easing the pressure on PCNs. What are the key elements of the link worker role, where do link workers sit within existing staffing frameworks and how can they make the biggest impact?

David explains his journey to becoming Care Navigation Lead (1 min 3 secs)

What does David’s role involve now and how is it structured? (2 mins 2 secs)

“As well as, not instead of”; the importance of care navigation complimenting social prescribing (3 mins)

“Patients with a social need should not have to see a GP to access social prescribing support” (5 mins 8 secs)

NHS England key elements of the social prescribing role (5 mins 35 secs)

Starting from scratch; how to best implement social prescribing roles within a PCN (5 mins 54 secs)

How care navigation works and maximising its effectiveness (7 mins 5 secs)

Referral criteria & training requirements for existing practice staff (8 mins 43 secs)

Building relationships on a practice by practice basis (11 mins 22 secs)

Ben and David explore the challenges faced by a newly placed link worker and the training they require (12 mins 8 secs)

“Micro-commissioning” the link worker / travel agency analogy (13 mins 40 secs)

From a PCN perspective: What level of experience and expertise can be expected of a new link worker? (15 mins 12 secs)

How do you measure the impact of a link worker? (16 mins 31 secs)

Getting in touch (18 mins 10 secs)

 

For more information on the social prescribing qualifications and training David mentions head to https://conexus-healthcare.org/social-prescribing-qualification-training/

To get in touch with David and Conexus Healthcare:

contact@conexus-healthcare.org

or via Twitter:

@HealthyDaveC or @ConexusHealthUK

 

 

 

 

Dec 9, 2019

Dr Paul Bennett is back on the Ockham sofa for a second week to discuss his practice’s revolutionary new approach to home visiting. Borne partly from a a technical constraint, Paul describes how the project was started, who has been involved and how it has evolved into more than an atypical Skype consultation.

Welcome and introduction (40 secs)

The constraints enabling change (58 secs)

The role of nurses within the new model (2 mins 45 secs)

Keeping the technology simple (3 mins 20 secs)

The difference between moving to Skype consulting and a fully transformative approach (4 mins)

GP consultations in the new world and the logistical setup (4 mins 45 secs)

A whole team approach (6 mins 26 secs)

The role of tech: challenges and benefits (7 mins 7 secs)

Crunching the numbers (8 mins 22 secs)

What has been the impact on the practice and its GPs? (9 mins 47 secs)

What’s stopped the rollout progressing further? (10 mins 23 secs)

Patient feedback and a case in point (10 mins 38 secs)

Could this work across a wider Primary Care Network? (12 mins 25 secs)

Paramedic involvement (13 mins 30 secs)

Virtual consulting with nursing homes? (14 mins 19 secs)

Just do it! (16 mins 58 secs)

Getting in touch (17 mins 45 secs)

The importance of sharing best practice and learning (18 mins 19 secs)

 

Paul is contactable at: paul.bennett5@nhs.net

Dec 2, 2019

Joining Ben this week is Dr Paul Bennett, a GP Partner in Portchester, who describes the revolutionary new approach to managing the duty system within his practice; how it works, how the system has been implemented, the impact on managing demand and most importantly, the benefits felt by both staff and patients alike.

Show Notes

Welcome and introduction (38 secs)

What triggered the changes? (57 secs)

Could a triage system work? What was the appetite for change? (1 min 26 secs)

Kick-off and implementation (2 mins 34 secs)

The role of the Healthcare Support Worker (3 mins 10 secs)

GP involvement and “stress-testing” the new system (4 mins 30 secs)

How is the new working day structured? (5 mins 24 secs)

Room setup and crunching the (patient) numbers (6 mins 7 secs)

What’s happening right now? The positive effects (7 mins 25 secs)

More decisions + more patients = reduced fatigue? (8 mins 19 secs)

Perceived drawbacks versus positive reality (9 mins 46 secs)

Impact, experiences & training for Healthcare Support Workers (11 mins 14 secs)

Patient feedback (12 mins 30 secs)

Where does they go from here? Plans for the future (14 mins 23 secs)

What does the rota look like? (15 mins 5 secs)

Could the system work at PCN level? (16 mins)

Getting in touch (18 mins 4 secs)

The importance of shared experiences and learning (18 mins 48 secs)

 

Paul is contactable at: paul.bennett5@nhs.net

Nov 25, 2019

Episode 184 – Shashi Khandavalli & Harry Evans – Population Health Management

Joining Ben on the Ockham sofa this week are Dr Shashi Khandavalli, Clinical Director for Chorley Central PCN and Harry Evans, Senior Programme Manager at NHS England and Improvement, who discuss all things Population Health Management; what it is, how it is key in meeting the health needs of your local population, the importance of working in partnership with local stakeholders and a story involving bins which underpins this key workstream.

Show Notes

What is Population Health Management (PHM)? (1 min 10 secs)

Populations, not individuals (1 min 45 secs)

Understanding the health of local populations and identifying their needs (2 mins 37 secs)

The importance of using data (3 mins 15 secs)

Shashi and Harry tell us how they became involved with PHM (3 mins 38 secs)

#datasaveslives (4 mins 29 secs)

Establishing strong relationships with key partners (5 mins 18 secs)

A strategic approach (6 mins)

How to get started? (6 mins 20 secs)

“Don’t wait for perfect to get in the way of good enough” (6 mins 45 secs)

Data sampling to target area of need and to enable strategic intervention (7 mins 10 secs)

Breaking down the barrier of scepticism and working partnership to identify positive outcomes or ‘the bin theory’ (8 mins 9 secs)

The role of social prescribers and link workers and the structural approach (10 mins 15 secs)

How are interventions made? (11 mins 17 secs)

Lessons learned (12 mins 30 secs)

10% data 90% culture (14 mins 17 secs)

Engaging local partners and building relationships (14 mins 48 secs)

The role of open meetings and who to involve (15 mins 12 secs)

PCN core skills (15 mins 35 secs)

Establishing, harnessing and understanding your vision (16 mins 25 secs)

“Activation day” (17 mins 6 secs)

What happens next? (17 mins 31 secs)

PHM programme rollout and support from NHS England & Improvement (17 mins 45 secs)

PHM platform access details (19 mins 26 secs)

Chorley PCN next steps (19 mins 42 secs)

Getting in touch (21 mins 55 secs)

Harry is contactable @harryaevans or at harry.evans2@nhs.net

Shashi is @kshashi79 or shashidar.khandivalli@nhs.net

The NHSE/I PHM Academy is available here. It contains information and learning about population health management from the PHM development programme and other sources. Please email england.STGPHM@nhs.net to be signed up for access.

This blog that Shashi wrote is hot off the press..

Nov 18, 2019

In this week’s podcast, Ben chats to Dr Hussain Gandhi (known to one and all through his eGPLearning Podblast as Gandhi) about life as a new PCN Clinical Director; the challenges versus the outcomes, his goals and aspirations, the importance of collaborative working and the role of technology within general practice.

Show Notes

How Clinical Directorship happened (46 secs)

Impact of PCN formation (1min 20secs)

Notts City East: the stats (1min 55secs)

The journey to becoming Clinical Director (2mins 15secs)

Balancing clinical sessions and the role of Clinical Director (2mins 55secs)

Gandhi outlines the aims and objectives of his role (3mins 25secs)

The challenges! (4mins 9secs)

Focus on collaborative working (4mins 32secs)

The process of engagement & PCN open meetings (5mins 10secs)

What is the PCN vision? (5mins 45secs)

Blue sky thinking (6mins 3secs)

The first few months as Clinical Director (6mins 28secs)

Laying the groundwork for PCN formation (6mins 40secs)

The role of social prescribing and clinical pharmacists (7mins 5secs)

What are the demands on a Clinical Director? (7mins 45secs)

Time management and the pressure of deadlines (8mins)

What have been the key lessons learned so far? (8mins 47secs)

Technology within PCNs (9ins 20secs)

Staying in touch: group chat and instant messaging (10mins 20secs)

The role of video conferencing (11mins 28secs)

Are we using technology enough in general practice? Are PCNs a platform to develop tech further? (16mins 12 sec)

PCN goals moving forwards (18mins 16secs)

Getting in touch (20mins 40secs)

Gandhi’s website can be found here

On all social media platforms he can be found at eGPLearning

For the podcast look for the eGPLearning Podblast

 

Nov 11, 2019

Rachel Morris “starred” in two of our most popular podcasts and through her work on GP resilience she was inspired to set up her own “You Are Not A Frog” podcast. In a recent edition of that podcast she interviewed our own Ben Gowland to discuss ways in which general practice can effectively introduce change, particularly against a background of resistance.

Show Notes

Ben explains how his career progressed to setting up Ockham Healthcare (52secs)

How Ockham Healthcare developed its unique offering (2min 02secs)

Working with at-scale general practice – a means to an end (2mins 47secs)

The goals for working at scale (3mins 37secs)

Making a difference – Time for Care (4mins 29secs)

Difficulties in implementing the high impact changes (5mins 36secs)

Change is difficult so how do we approach it? (7mins 01secs)

Introducing pharmacists – a practical example (7mins 32secs)

Resistance to change - a systematic approach (9mins 15secs)

The problem is obvious why we need to change? Isn’t it? (11mins 25secs)

The system and what you can control (12mins 22secs)

Overcoming the emotional response (13mins 28secs)

Picking the changes you pursue – small or large (14mins 34secs)

Ockham Healthcare’s role in supporting joint working (16mins 39secs)

Influencing without hierarchical “power” – a practice’s relationship with the PCN (17mins 56secs)

What’s the one big thing a PCN should be doing? (19mins 43secs)

Expect resistance – dealing with your “No Nos” (21mins 02secs)

Becoming positive about change (22mins 17secs)

Contacting Ben (23mins 28secs)

Ben is available on email ben@ockhamhealthcare

He is on Twitter @benxgowland

The Ockham website is here

The You Are Not a Frog podcast is available in a number of places including here

Nov 4, 2019

Farzana Hussain has been a GP for 18 years. Three months ago she was successful in becoming the Clinical Director of a new Primary Care Network in Newham comprising seven practices serving 65,000 patients. In this podcast she explains how she has met this new challenge; the approach she has taken, the aims of her PCN and the support she has received. She talks about how difficult and how rewarding (and how exciting) the new role can be.

Show Notes

Farzana explains how she became a PCN clinical director (54secs)

The PCN is formed (2min 09secs)

The joy of the first 100 days (2mins 53secs)

Early conversations with other stakeholders (4mins 52secs)

Strengthening the practices (6mins 11secs)

What will success in the role look like? (7mins 27secs)

True collaborative working (7mins 59secs)

Aligning the seven practices (9mins 04secs)

Time for the practices (10mins 22secs)

Communication and governance of the network (10mins 54secs)

Aiming for an inclusive group (12mins 40secs)

Involving other partners in the network (13mins 35secs)

The most difficult aspects of the role (14mins 24secs)

Managing time (15mins 19secs)

Getting support as a leader (16mins 16secs)

Distributive leadership (17mins 52secs)

Is there enough support available? Setting up a CD support group (18mins 12secs)

The nature of a support group for new leaders (19mins 04secs)

Contacting Farzana (20mins 31secs)

Contact Farzana on farzana.hussain@nhs.net

Oct 28, 2019

Suffolk Primary Care is a super-practice incorporating twelve original practices with 33 partners covering 110,000 patients. Nick Rayner, their Executive Chair and Neil Macey, their co-Chief Medical Officer with responsibility for transformation talk to Ben about bringing the practices together. They explain the journey they followed, the benefits, what they are achieving together and how a solution has been found to the problem of property ownership.

Show Notes

Neil and Nick introduce themselves (58secs)

The journey to Suffolk Primary Care (1min 39secs)

A single practice from May 2019 with partner groups (3mins 38secs)

From shadow form to a single entity with an executive team (4mins 25secs)

What we’re doing – employee staff record (5mins 41secs)

Provider support function – centralising admin functions (6mins 50secs)

Central finance function (7mins 18secs)

Complexity (7mins 40secs)

Keeping practices on board – trust and communication (8mins 05secs)

“Bottom-up” design of services (8mins 57secs)

Employing a Chief Executive (9mins 46secs)

Clinical services (10mins 35secs)

Long term conditions (11mins 17secs)

Introducing new roles and “growing our own” (11mins 52secs)

Maintaining flexibility with new roles (13mins 06secs)

The introduction of Primary Care Networks (14mins 16secs)

Becoming a PCN? (15mins 50secs)

Single CQC registration (16mins 45secs)

Sharing central services (17mins 17secs)

New income streams (17mins 40secs)

Recruitment and retention of partners (17mins 59secs)

A “property solution” (19mins)

The challenge of introducing the property solution (20mins 20secs)

Advice for practices in a similar situation (21mins 49secs)

Finding out more (23mins 11secs)

The Suffolk Primary Care website is here

Email Nick at Nicholas.rayner@nhs.net

Or Neil at Nmacey@nhs.net

Oct 20, 2019

Dustyn Saint is a GP in Norfolk with an interest in IT from an early age. In 2017 he and an equally enthusiastic practice IT manager began to develop a set of tools on EMIS Web to be used in his own practice. But, from little acorns mighty oaks grew. Dustyn began to focus more of his energies on optimising EMIS and sharing his tools with other practices and this eventually led to the birth of Primary Care Pathways. In this episode Dustyn describes the journey to what is now an ever-evolving set of searches, templates, protocols and documents optimised for EMIS web and available to all.

Show Notes

Dustyn’s interest in IT (58secs)

Working with EMIS Web (2min)

Making the system more useful for clinicians and patients (2mins 57secs)

GPs reaction to the changes (3mins 56secs)

Allocating Dustyn’s time (5mins 19secs)

Sharing the learning (6mins 26secs)

National interest (7mins 28secs)

The involvement of EMIS and not reinventing the wheel (8mins 50secs)

Doing it “properly” – a team of nine (9mins 45secs)

Uptake of other surgeries (10mins 56secs)

A separate limited company (11mins 21secs)

Developing the offering for practices (11mins 38secs)

The enhanced package – tailored training and support (13mins 36secs)

Feedback from practices (14mins 14secs)

Working with Primary Care Networks – new roles and metrics (15mins 49secs)

Is it critical to be on the same system? (18mins 26secs)

Advice for using IT in a network (19mins 55secs)

More information (21mins 10secs)

The website is available here

And Dustyn can be contacted at dustyn@primarycareit.co.uk

Oct 13, 2019

Executive coaching can be defined as a professional relationship between an experienced coach and a client which is designed to enhance the client’s leadership capabilities. Dr Karen Castille is a skilled, qualified executive coach who has considerable experience of working with clinical leaders. In this episode she explains what coaching is, how it works and how it can benefit those in leadership roles. She also talks about self-coaching and her book “The Self-Coaching Workbook”.

Show Notes

Karen describes her career in leadership roles in the NHS (45secs)

Defining coaching “a structured conversation…to unlock potential” (1min 23secs)

Coaching is ACE (2mins 06secs)

Often about “dealing with difficult people” (2mins 51secs)

Does coaching have any practical outcomes? (4mins 10secs)

The relationship between client and coach (5mins 31secs)

Achieving personal goals through coaching (6mins 33secs)

What can coaching achieve? (7mins 38secs)

A hypothetical example (8mins 22secs)

Developing a tangible plan (9mins 08secs)

The coaching process – is not therapy (9mins 56secs)

The advantages of coaching as a development opportunity (11mins 22secs)

Finding a coach (13mins 33secs)

How much does coaching cost? (14mins 23secs)

The length of a coaching session (14mins 57secs)

Getting coaching funded (15mins 31secs)

If you can’t access coaching - try self-coaching (16mins 14secs)

What is self-coaching? Why write a handbook? (17mins 02secs)

Self-coaching as a reasonable alternative or an addition to coaching (18mins 29secs)

Contact Karen and find the book (19mins 24secs)

You can contact Karen via email here

Karen’s website (where you can find The Self-Coaching Workbook) is here

The book is also available at Amazon here

Oct 6, 2019

Robert Varnam almost needs no introduction. He is a GP in Manchester and Head of General Practice Development at NHS England. He will be known to most people in general practice for his work around the national Time for Care Programme. In his second visit to the General Practice Podcast he talks to Ben about the development of Primary Care Networks and how the learning needs of PCN clinical leaders might be identified and met.

Show Notes

Robert describes the recent changes to his role – focussing on improvement (58secs)

The introduction of Primary Care Networks (1min 54secs)

Variations in the progress of PCNs (3mins 28secs)

How delivering “improvement” to general practice is impacted by PCNs (4mins 44secs)

Establishing the PCN – a collaborative opportunity (6mins 54secs)

Making the best use of the development resources available (8mins 32secs)

Networks using expert facilitation to support development (10mins 24secs)

Developing the PCN clinical directors – a collective approach to leadership (12mins 40secs)

The value of investing in leaders (14mins 30secs)

A network of networks (15mins 04secs)

Establishing the learning needs of clinical directors (15mins 44secs)

Working with peers (17mins 29secs)

Practical resources for networks (18mins 57secs)

Contacting Robert (20mins 05secs)

The website Source4Networks can be found here

Robert can be contacted directly at robert.varnam@nhs.net

The first podcast we ran with Robert can be accessed here

Sep 29, 2019

This is the second conversation between Ben and Paul Deffley, Hove GP and clinical director of Practice Unbound; a not-for-profit organisation devoted to “helping general practice work smarter”. In this episode Paul uses the example of a pathology delegation pilot to look at how practices can effectively work together across networks, how they can better manage change and, working at scale, deliver network solutions to collective problems.

Show Notes

Paul outlines his background and his positive view of PCNs (48secs)

An example of working together – a pilot for pathology delegation (2min 55secs)

Tests not needing a clinical context (5mins)

Understanding the pathology activity – what’s safe to delegate (6mins 07secs)

Clinical variation in pathology requests – and reducing requesting patterns (7mins 20secs)

Managing the delegated requests – a non-clinical team approach (8mins 37secs)

Group consultations? Testing different ways of managing patients (9mins 16secs)

Overcoming the concerns about risk (9mins 47secs)

Understanding the fears (10mins 59secs)

Grouping routine tests (11mins 17secs)

Auditing the administrators (12mins 54secs)

The impact on GP workload – 90% of routine bloods are handled by the admin team (13mins 27secs)

Working smarter (14mins 05secs)

Clinical variation down (15mins 02secs)

Is this a legitimate use of PCN time and energy? (15mins 33secs)

PCNs looking at individual GP practice (16mins 49secs)

Establishing and maintaining trust (18mins 37secs)

The impact of networks on shared problems (19mins 47secs)

Making the most of development funding (20mins 47secs)

An end-to-end flow exercise (22mins 49secs)

Positive relationships (23mins 33secs)

Further information (24mins 20secs)

Practice Unbound’s web address is www.practiceunbound.org.uk

And Paul can be emailed directly at Pauldeffley@nhs.net

 

Sep 22, 2019

Charlotte Osborn Forde is the Chief Executive of Involve Kent, a large registered charity that delivers services to vulnerable people. It has developed a primary focus in recent years on social prescribing. In this episode Charlotte explains how the charity contracts with the NHS to deliver Link Workers. She talks about the results for patients and practices of using Link Workers including an increase of 66% of referred patients becoming more physically active. The scheme has delighted GPs with one saying that social prescribing has become “the most transformative thing” in his career.

Show Notes

Charlotte describes Involve Kent (38secs)

Early adoption of social prescribing (1min 48secs)

Funding for the voluntary sector (3mins 04secs)

A joint bid with the CCG to work with GP practices (4mins 07secs)

Building a partnership with GPs (4mins 48secs)

The scale of the practices (5mins 38secs)

A Link Worker in each practice and their caseload (6mins 43secs)

Receiving referrals (7mins 37secs)

The early results – the ONS wellbeing measure (8mins 22secs)

Physical activity levels (9mins 53secs)

Levels of loneliness and health (11mins 06secs)

The impact on the practices – difficulties with the data (12mins 10secs)

Anecdotal reaction of practices (13mins 14secs)

Link workers working across practices (14mins 35secs)

Vital links to a proper infrastructure (15mins 41secs)

Working with PCNs (16mins 27secs)

Buying in the service (18mins 29secs)

Charlotte’s advice – find a local champion and follow the guidance (19mins 03secs)

Selecting the right Link Workers (20mins 25secs)

Key qualities for effective Link Workers (21mins 05secs)

The selection process (22mins 01secs)

Work with others (22mins 34secs)

System data (23mins 23secs)

For other podcasts on social prescribing visit our Podcast Index here

The Involve Kent website is here

They are on Twitter @InvolveKent

Sep 15, 2019

Neil Modha, Peterborough GP, joins us again this week to talk about his experience in whole system working. In the Cambridgeshire and Peterborough area all the local providers have come together in Provider Alliances, funded by pooled resources. In this podcast Neil explains how this works, how primary care is engaged and describes two practical examples. He also offers useful advice to new Clinical Leaders who are starting out on this journey.

Show Notes

The PCN “landscape” in Neil’s area (40secs)

What are “Provider Alliances” (1min 34secs)

Two provider alliances focussed on the main hospitals (2mins 54secs)

Primary Care’s involvement (3mins 30secs)

Engagement at practice level – using the PCNs (5mins 02secs)

Ensuring everyone gets a voice (6mins 35secs)

The Innovation Academy (7mins 36secs)

Joint working – an opportunity or a burden? (8mins 19secs)

Focussing on the local population – services closer to home (9mins 26secs)

Working with other providers is key (11mins 26secs)

Integrated case management (11mins 53secs)

Focus on specific projects to build relationships (13mins 20secs)

Advice for new clinical leaders (14mins 14secs)

Developing new leaders (16mins 22secs)

The role of federations in the wider system (18mins 10secs)

Top tips in getting started – focusing on a tangible change (20mins 02secs)

Neil’s other podcasts with us are available as follows:

An innovative model for general practice

Pharmacists and PCNs – a GP’s perspective

The podcast we recorded with Neil’s colleague James Morrow can be accessed below:

An innovative model for delivering and governing general practice

Sep 8, 2019

For twelve and a half years Liz Phillips was a salaried GP with a portfolio career and then, during a Primary Care Improvement event in London, she had a revelation. She decided then and there to become a GP partner, with a focus on quality improvement. In this episode she describes her journey, the work she has begun with her new practice and the benefits the quality improvement process is delivering. She also explains how partnership has exceeded her expectations and changed her life.

Show Notes

Liz decides to move from salaried GP with a portfolio career to become a partner (46secs)

The Primary Care Improvement community (1min 37secs)

A moment of revelation (2mins 05secs)

A quality improvement project in the practice pushes Liz to consider partnership (2mins 33secs)

Ethos and shared purpose is a driver (3mins 54secs)

Liz’s new practice (4mins 26secs)

Partnership brings joy and satisfaction (4mins 43secs)

Quality improvement and the new practice (5mins 08secs)

Establishing a shared purpose in the practice (6mins 19secs)

Don’t assume you know people’s “why” (7mins 58secs)

A weekend away as a practice (9mins)

The value of the process (10mins 06secs)

An upward spiral (10mins 38secs)

Joint conversations take time (11mins 41secs)

Compassionate leadership (12mins 34secs)

Knowing yourself (13mins 27secs)

Building relationships at work (13mins 43secs)

Introducing a well-being pilot the in the practice (14mins 26secs)

The benefits of the pilot (15mins 24secs)

Difference in the first six months (16mins 09secs)

A more confident practice (17mins 39secs)

Being in a Primary Care Network and sustaining partnerships (18mins 20secs)

The reality of being a partner (19mins 24secs)

Advice to current partners – be brave and do something different (20mins 50secs)

Advice to prospective partners (21mins 47secs)

Sep 1, 2019

The tables are turned again and in this week’s episode Ben is interviewed about the lessons we are learning about Primary Care Networks after two months of their existence. He discusses the role of PCNs and how they are perceived, the challenges they are facing and the issues they are focussing on, their approaches to the new roles, the weight of expectations and the lessons they might learn from the establishment of CCGs.

Show Notes

Is the role of PCNs any clearer? (33secs)

The problem of mismatched expectations (2min 07secs)

The rapid rise of PCNs – a tough start (3mins 30secs)

The Clinical Directors role as inspiring leaders – quick wins (5mins 06secs)

Unforeseen challenges – backwards to move forwards (6mins 27secs)

The role of federations with PCNs (7mins 09secs)

How can ensure the roles of federations and PCNs are clear and distinct (7mins 48secs)

The perceptions of the wider NHS (9mins 28secs)

Two roles for the clinical leaders (10mins 57secs)

Too many expectations placed on PCNs too soon (11mins 19secs)

Supporting a potentially fragile system (12mins 27secs)

Building the support on firm foundations (13mins 26secs)

Approaches to the appointment of new roles (14mins 54secs)

Addressing the 30% funding gap (15mins 45secs)

The challenge of the 30% funding gap (19mins 42secs)

Lessons from setting up the CCGs (17mins 33secs)

Prioritising building relationships and trust (18mins 36secs)

Ben’s advice – control your own agenda, focus on relationships and don’t reinvent the wheel (19mins 53secs)

Aug 25, 2019

In this fourth episode of our short series on pharmacy and PCNs, Ben talks to Community Pharmacist Hala Abusin about the impact of the planned increase in pharmacists in general practice. They discuss the role and value of community pharmacy and the opportunities and challenges for community pharmacists collaborating with both GP pharmacists and hospital pharmacists.

Show Notes

Hala describes her progress to her current position (48secs)

The role of and value of community pharmacy (2min 14secs)

Extending the role of community pharmacy – a practical example (3mins 34secs)

Community pharmacy view of pharmacists in general practice (6mins 37secs)

Sharing new ways of working (7mins 44secs)

The new five year contract for community pharmacy (8mins 17secs)

Community pharmacies working with PCNs (9mins 47secs)

Engaging community pharmacists (10mins 44secs)

Preparing to work with PCNs (11mins 41secs)

Pharmacists working together across organisations (13mins 23secs)

The differences between clinical and community pharmacists (14mins 09secs)

The challenges of collaboration (15mins 28secs)

The Community Pharmacy Consultation Service and other opportunities where community pharmacies can help (17mins 22secs)

Finding out more (18mins 43secs)

The challenge of the 30% funding gap (19mins 42secs)

Planning to build a team of pharmacists (20mins 50secs)

The relationship between GP and community pharmacists (22mins 27secs)

Finding out more (23mins 39secs)

Hala has provided some useful links for those looking for more information:

Details about the Joint Pain Advice project are available here and here

The Primary Care Pharmacy Network briefing on PCNs for pharmacists can be downloaded here

The PSNC guidance for supporting community pharmacists to engage with PCNs can be downloaded here

An article from Chemist and Druggist on the opportunity for community pharmacy in PCNs is available here

And the Community Pharmacy Contractual Framework can be downloaded here

Aug 18, 2019

This is the third in our short series of podcasts on Pharmacists and PCNs. In this episode Ben talks to Paul Deffley, a GP partner in Hove who is also a Clinical Director of Practice Unbound, a not-for-profit organisation based in Brighton which aims to help general practice “work smarter”. Paul has considerable experience of working with pharmacists and introducing them into networks of practices. He explains the three key steps practices should take to successfully implement a pharmacist and discusses the challenges for them working across multiple practices.

Show Notes

Paul explains what Practice Unbound is (56secs)

Paul is also the clinical champion for GP workload at the RCGP (1min 43secs)

The outcomes of Paul’s work on workload (2mins 49secs)

Paul’s experience of working with pharmacists (3mins 13secs)

A new pharmacy-led service (4mins 09secs)

Building pharmacists into the team (5mins 09secs)

Logistics – induction and starting work (6mins 00secs)

Activity – work and workload (7mins 17secs)

Impact – transition, managing uncertainty and measurement (8mins 50secs)

Variation of impact and visibility (11mins 45secs)

Developing the data dashboard (13mins 45secs)

The challenge of working across multiple practices (14mins 24secs)

Introducing the pharmacist (15mins 58secs)

The issues of using a “host” practice model (18mins 05secs)

The challenge of the 30% funding gap (19mins 42secs)

Planning to build a team of pharmacists (20mins 50secs)

The relationship between GP and community pharmacists (22mins 27secs)

Finding out more (23mins 39secs)

Resources are available on the Practice Unbound website here

You can sign up to the Practice Unbound Newsletter here

Paul is on Twitter @deffley_paul

He is also on LinkedIn: https://www.linkedin.com/in/paul-deffley-17a7a8136/

The Practice Unbound Twitter handle is @PracticeUnbound

The previous episode Ben mentioned with Paul’s colleague Jonathan Serjeant on delegating clinical correspondence is available here

Aug 11, 2019

This is the second in our short series of podcasts on Pharmacists and PCNs and this week we talk to Peterborough GP, Neil Modha. Neil (who’s innovative approach we covered in this previous episode) has gone from employing one to three pharmacists in just over a year. He explains why and how they have proven invaluable in everything from self-care, shared care drug monitoring and document management to audits and chronic disease management.

Show Notes

Neil reminds us how his practice operates (44secs)

From one to three pharmacists – how they help (1min 39secs)

The journey of introducing a pharmacist (2mins 32secs)

What are pharmacists doing in Neil’s practice (3mins 41secs)

Pharmacists and self-care prescribing (4mins 19secs)

The outcome of self-care prescribing (5mins 10secs)

Signposting to self-manage conditions (6mins 08secs)

Shared care drug monitoring (6mins 50secs)

How the rapid growth in pharmacists took place (7mins 50secs)

The impact on the practice (9mins 16secs)

How productive are pharmacists? (10mins 23secs)

The financial benefits (11mins 54secs)

Impact on the drug budget (12mins 53secs)

A vision for the future (13mins 23secs)

How does the pharmacist work in the federation/PCN? (14mins 36secs)

“Home” practice or not? (16mins 23secs)

Advice for other practices thinking of employing a pharmacist (16mins 59secs)

The challenge of the 30% gap in funding (18mins 06secs)

What’s next for Neil’s practice? (19mins 12secs)

What’s next for Neil’s practice? (21mins 35secs)

Neil’s practice website can be found here

His email address is neil.modha1@nhs.net

Our previous podcast with Neil is available on our website here

 

Aug 4, 2019

All PCNs have the opportunity to recruit clinical pharmacists into general practice and this week we begin a four part series of podcasts to support that recruitment. We begin, in Episode One, by talking to GP Pharmacist Hala Jawad. Hala discusses the role of a pharmacist within general practice, the way a pharmacist can work within a PCN and how a PCN can make themselves more attractive to pharmacists.

Show Notes

Hala was the first “Pharma Face” and is known as “The Brighton Titan” (55secs)

She moved from running a restaurant to becoming a pharmacist (2min 02secs)

Getting involved with general practice (2mins 47secs)

Trying GP out for a week (3mins 48secs)

The benefits of working in a practice (5mins 01secs)

Learning in general practice (6mins 31secs)

The role of a pharmacist in GP (7mins 32secs)

Support for pharmacists (8mins 30secs)

Pharmacists in PCNs (9mins 39secs)

Advice to make an appointment successful (10mins 41secs)

Overcoming isolation (11mins 51secs)

How attractive is working in GP to a pharmacist? (12mins 42secs)

What makes one role more attractive than another? (14mins 15secs)

How will the pharmacist/GP relationship develop? (15mins 51secs)

Contacting Hala (16mins 44secs)

Hala can be found on Twitter - @jawad_hala

She is also on Facebook and LinkedIn

Her Ask Hala public website is here and her You Tube channel is here

Jul 28, 2019

Hugh Reeve is a GP in Grange-Over-Sands in Cumbria. The practice wanted to improve the way they met patient demand and initially began to look at introducing an online consultation system. They soon concluded that this could not be simply about introducing a “bolt on” digital system and it quickly became a process that forced them to radically reconsider all aspects of their patient flow. In this episode Hugh explains how they went about transforming their practice, how the new system now works for GPs and patients with the resultant outcomes including the fact that only 40% of patient contacts are now face-to-face.

Show Notes

Why introduce an online consultation system? (59secs)

Improving continuity of care (1min 49secs)

Researching the options (2mins 57secs)

The kind of system they didn’t want (4mins)

A much bigger task than choosing a system (4mins 44secs)

Improving the “flow” of patients (5mins 21secs)

How the system works for GPs (6mins 13secs)

Changing the way they work rather than “bolting on” a system (7mins 16secs)

Radically rethinking “flow” (8mins 03secs)

Only 40% of contacts are face-to-face (9mins 33secs)

Not just introducing online (10mins 05secs)

Establishing what capacity is needed (10mins 45secs)

Introducing the new system (11mins 19secs)

Patients using the system (12mins 07secs)

Not about workforce challenges (13mins 15secs)

A typical day for a GP in the practice (14mins 13secs)

The reaction of patients (18mins 45secs)

Pilot site for the Health Foundation Programme on Continuity of Care (19mins 39secs)

Hugh’s advice for others (22mins 03secs)

You can email Hugh at hugh.reeve@gp-a82053.nhs.uk

The askMyGP website is available here

Jul 7, 2019

Today (8th July) is the first ever National Social Prescribing Link Worker Day! Organised by the National Association of Link Workers it aims “…to celebrate and showcase the contribution of social prescribing link workers in improving population health and wellbeing.” In support of this our podcast this week is the fifth in our series looking at Social Prescribing. Nick Sharples is Managing Partner at DNA Insight, a specialist training consultancy that is increasingly involved in training Social Prescribing Link Workers. In this episode he talks about the various models that are emerging for employing, recruiting and training Link Workers.

Show Notes

Nick describes his involvement in social prescribing (44secs)

Who employs the Link Workers? (1min 53secs)

Reluctance to outsource the role (3mins 30secs)

Outsourcing the role (4mins 16secs)

Competition for Link Workers – three options for recruitment (5mins 36secs)

External recruitment (6mins 40secs)

Recruiting from within the practice (7mins 16secs)

Advantages of the options – building an appropriate model (7mins 54secs)

The provision of training (9mins 18secs)

Resources for training (10mins 28secs)

How much budget to put aside? (11mins 02secs)

Effective working with large scale – prioritising (11mins 58secs)

Average workload (13mins 13secs)

Managing a caseload (13mins 53secs)

A practical example from Scotland (15mins 32secs)

Sharing best practice – learning co-ordinators (16mins 33secs)

Finding out more (17mins 31secs)

The DNA Insight Social Prescribing pages are here

Nick has put together a list of useful resources below:

 

 

  • Twitter Social Prescribing Wednesday - @SocialPresHour – every other Wednesday and hosted/organised by Elemental

 

 

  • National Association of Link Workers www.connectlink.org Christiana Melam christiana@connectlink.org   Professional body representing Social Prescribers/Link Workers with lots of useful resources for Link Workers and those employing them.
Jun 30, 2019

Gerry Morrow was a full time GP for twenty years before he joined Clarity Informatics as their Medical Director. Clarity, (who describe themselves as “international leaders in healthcare solutions”) developed TeamNet “a web-based sharing and compliance platform for primary care”. In this podcast Gerry explains how TeamNet enables practices and other agencies to share information, how it is adaptable to individual circumstances and what the future might hold.

Show Notes

Gerry begins working Clarity (54secs)

The importance of sharing information (1min 20secs)

Clarity develops TeamNet as a natural extension of their business (1mins 53secs)

The benefits of sharing information through TeamNet (2mins 37secs)

Where does the information come from? (3mins 29secs)

The opportunities of practices moving into PCNs (4mins 15secs)

Transparency – sharing information and building trust (5mins 08secs)

How TeamNet works in practice (6mins 41secs)

Practices and community teams working together (7mins 39secs)

Structuring sharing with other agencies (8mins 53secs)

Controlling the flow of information (9mins 55secs)

Who uses TeamNet now? (11mins 16secs)

Two way communication with practices (11mins 46secs)

The future of information sharing – interoperability (12mins 45secs)

Sharing patient-identifiable data (13mins 37secs)

Future projects for Clarity (14mins 23secs)

Finding out more (15mins 06secs)

The Clarity TeamNet web pages are here

The email address is teamnet@clarity.co.uk

Jun 23, 2019

Dr Mark Newbold is an experienced NHS doctor, manager and academic who, until recently, was Managing Director of the Birmingham super-practice, Our Health Partnership. In this wide-ranging discussion Ben and Mark focus on the bigger picture: the strategic implications of Primary Care Networks and the role of general practice in integrated care systems. They cover everything from leadership and influence to scale and accountability. Mark begins by describing the introduction of PCNs as “an NHS led…radical process of transformation

Show Notes

Mark updates us on what he has been doing (1min 06secs)

NHS-led transformation (1min 39secs)

Moving from “institution” to “system” (2mins 43secs)

Bringing general practice into the system (3mins 18secs)

General practice is the foundation of integrated care (3mins 46secs)

Size, scale and influence (4mins 53secs)

The question of existing at-scale general practice (6mins 23secs)

Tiers of collaboration (7mins 36secs)

Geographic spread and the “offer” of working at-scale (9mins 47secs)

Differentiating the “offer” for member and non-member practices in an at-scale organisation (10mins 34secs)

The Clinical Director role (11mins 56secs)

The future for Community Trusts (12mins 44secs)

The balance of power between general practice and Community Trusts – emerging GP leaders (13mins 27secs)

PCNs – beginning of the end for independent general practice? (14mins 58secs)

A collective approach (16mins 06secs)

Evolving a new model of general practice (17mins 20secs)

The accountability of integrated care systems (18mins 04secs)

Taking a long term view (19mins 01secs)

A discussion forum for GPs (20mins 36secs)

The GP View website Mark mentions can be accessed here

Our previous podcasts with Mark on the setting up of Our Health Partnership can be found below:

Episode 13 – Our Health Partnership: The story so far

Episode 41 – Progress with a super-partnership

Episode 79 – The further adventures of a super-partnership

Episode 109 – Our Health Partnership – the story continues

Jun 16, 2019

This is the episode all about VAT. No, come back! It’s complex but vitally important stuff for PCNs and you’ll regret not listening... We are delighted to welcome Katie Collin, Client Services Partner at Ramsay Brown Chartered Accountant to explain it all. She covers who needs to be registered for VAT, what services incur VAT, Cost Sharing Groups and the VAT implications of the three models for PCNs. She has also produced a frequently asked questions document which you can access at the end of these Show Notes.

Show Notes

VAT – the hot topic of the moment (45secs)

Who has to be registered for VAT (1min 04secs)

The three main reasons why a GP might be registered for VAT (1mins 47secs)

What services incur VAT – provision of services and staff (2mins 54secs)

Holding the contract and keeping control (5mins 12secs)

Other services – admin and back-office functions attract VAT (6mins 19secs)

Part of an overall contract – an example (6mins 58secs)

How does a Cost Sharing Group work? (8mins 23secs)

Members of a legal entity (9mins 16secs)

On-costs but not a management charge (10mins 23secs)

Is VAT chargeable on what PCNs are being asked to do? (11mins 13secs)

Employing a Link Worker (12mins 47secs)

The VAT implications for the three models for PCNs:

1 The Lead Practice Model (13mins 26secs)

Is the lead practice registered for VAT (15mins 28secs)

2 The Flat Model – the easiest model? (16mins 38secs)

Liabilities of joint employment (17mins 45secs)

3 The Federation Model (18mins 26secs)

The big issues with federations (19mins 54secs)

The federation as a cost sharing group (20mins 36secs)

Core members/non-core members of networks (21mins 43secs)

Setting up a legal entity now – is it worth it? (23mins 06secs)

Employing staff and pensions (23mins 57secs)

Other things to consider (25mins 06secs)

Don’t go it alone (25mins 51secs)

Getting in touch and finding out more (26mins 20secs)

You can find Ramsay Brown’s “VAT and Primary Care Network FAQs here

The Ramsay Brown website is here

Katie’s email address is katiecollin@ramsaybrown.com

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