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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: September, 2019
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)

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