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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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The General Practice Podcast
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Now displaying: 2020
Apr 12, 2020

Specialist Medical Accountant James Gransby returns to the Ockham podcast to give his invaluable advice and assessment of the effect of the coronavirus pandemic on primary care finances. What is currently being offered by the government by way of support for individuals, practices and networks, where are the landmines and what should we be mindful of now and going forwards?

Introductions (9 secs)

What is in place to support practices right now? (19 secs)

The Coronavirus Act 2020: Implications for general practice explained (1 min 15 secs)

‘Furloughing’ of staff (3 mins 14 secs)

The overall picture for primary care in summary (5 mins 16 secs)

How are PCNs affected? (5 mins 56 secs)

How to reflect a pandemic within a balance sheet (8 mins)

The national return to work scheme (8 mins 51 secs)

Death in service (11 mins 50 secs)

How worried should we be about the financial impact? (12 mins 36 secs)

Relaxation of pension rules (13 mins 35 secs)

Getting in touch (15 min 35 secs)

 

James is contactable via email: James.Gransby@rsmuk.com

https://www.rsmuk.com/our-people/james-gransby

Apr 8, 2020

Cassandra Baiano and Ron McDonald are both medical students within the Scottish Graduate Entry Medicine (ScotGEM) programme at the University of St Andrews. Inspired by the quality improvement and agents of change portion of their curriculum, they have created an innovative application, HealthSHIP, which can offer support to health and social care workers in balancing the practical aspects of their home lives alongside the demands of working on the frontline of the coronavirus crisis. Here, they talk to Ben about the inception of the app, the value of voluntary support during the pandemic and why healthcare students, in particular, can be a crucial source of assistance during these difficult times.

Introductions (10 secs)

The ScotGEM Programme update (23 secs)

How HealthSHIP began (1 min 30 secs)

Why healthcare students? (2 mins 25 secs)

Where did the idea come from? (3 mins 7 secs)

HealthSHIP right now (3 mins 33 secs)

How does it work in practice? (4 mins 49 secs)

What areas are covered and where does HealthSHIP fit alongside the national voluntary schemes? (5 mins 36 secs)

When was HealthSHIP launched and which tasks are being filled? (6 mins 44 secs)

Access and signup information (7 mins 45 secs)

Requesting support and types of support on offer for general practice (9 mins 29 secs)

Getting in touch and contact information (11 mins 42 secs)

 

Web: http://healthship.org

email: hello@healthship.org

Twitter: @HealthSHIP_UK

Apr 5, 2020

In the wake of the global coronavirus crisis, GP surgeries across the UK are facing the challenge of transforming working practice within a short space of time and reducing in-person consultations with their patients, whilst protecting their staff and maximising their capacity to deal with everyday demands alongside those presented by the pandemic. Dr Ravi Tomar was part of the transition at Portland Medical ahead of time and gives his advice for managing the changes and reflects on the key outcomes that they have experienced as a result.

Introductions (38 secs)

The move towards telephone and ‘virtual’ triage (48 secs)

Portland Medical: the stats (2 mins 32 secs)

Decreasing locum use (3 mins 3 secs)

Impact on face to face consultations (4 mins 23 secs)

Reducing face to face appointments as a result of Covid-19 (5 mins 5 secs)

Video consultation (6 mins 9 secs)

What tech is required? (6 mins 58 secs)

Telephone versus video consultations (7 mins 36 secs)

Video consults: lessons learned and practical advice (8 mins 18 secs)

Telephone to video consultation: managing an in-consult switch (10 mins 37 secs)

Covid-19 effect on day-to-day practice (11 mins 20 secs)

The system for managing Covid-19 at Portland Medical (12 mins 6 secs)

The ‘hot and cold’ model (13 mins 16 secs)

The role of other healthcare professionals and upskilling the workforce (14 mins 50 secs)

What are the significant outcomes as a result of the changes? (16 mins 47 secs)

Transition from old to new processes (18 mins 18 secs)

Patient feedback (19 mins 51 secs)

Final thoughts (20 mins 17 secs)

Getting in touch (20 mins 17 secs)

 

Preparedness update letter for general practice: 27 March 2020 here

Portland Medical website: https://www.portlandmedicalcentre.co.uk/

Dr Ravi Tomar is contactable via email: ravi.tomar@nhs.net

Mar 29, 2020

How do you prepare for an upcoming crisis which is anticipated, yet unpredictable? What steps should a practice and a network be taking to manage its response and resources whilst safeguarding its people? Which issues should be tackled now and what workstreams should be put in place? Project management expert, Tara Humphrey, who supports the development of Primary Care Networks and GP Federations, chats to Ben Gowland about her experiences so far and offers practical advice for maximising efficiency ahead of time.

Introductions (22 secs)

The state of play locally (56 secs)

What support is available now for practices? (1 min 30 secs)

Practical considerations (2 mins 17 secs)

The importance of communication (3 mins 46 secs)

Site/s management (5 mins 8 secs)

What are the biggest challenges for practices and networks? (5 mins 53 secs)

Co-ordinating skills and expertise (8 mins 35 secs)

Managing communication effectively and supporting staff (8 mins 59 secs)

Crisis leadership (10 mins 59 secs)

The mood in general practice right now (14 mins 26 secs)

Next steps (16 mins 37 secs)

Supporting well-being (17 mins 50 secs)

 

NHS Confederation document (How CCGs can support PCNs and practices during the Covid-19 crisis) https://www.nhsconfed.org/-/media/Confederation/Files/Publications/Documents/How-CCGs-can-support-PCN_COVID_19.pdf

Find out more about Tara Humphrey:

Mar 23, 2020

Following the release of the budget statement and the global challenges faced by the coronavirus pandemic, Paul Gordon, MacArthur Gordon Medical Specialist Financial Planner, re-joins Ben to talk through the changes and implications for the GP pension pot.

Introductions (20 secs)

What has changed since January? (45 secs)

The details of the changes (1 min 25 secs)

The annual allowance issue (3 mins 57 secs)

Checking the status of the annual allowance (5 mins 17 secs)

Scheme Pays option (6 mins 38 secs)

Balancing pensions growth against workload demand (7 mins 56 secs)

If my income is unchanged am I exempt from tax penalties? (10 mins 2 secs)

The challenge of monitoring in-year growth (11 mins 41 secs)

Advice for those considering retirement (14 mins 8 secs)

Information for employers (16 mins 30 secs)

The Covid-19 effect (17 mins 28 secs)

NHS v private pensions schemes (18 mins 52 secs)

What else should I be aware of right now? (19 mins 45 secs)

Getting in touch (21 mins 47 secs)

 

For access to an up to date pension statement: https://www.totalrewardstatements.nhs.uk/

To request annual allowance growth figures, call the Pensions Agency on 01253 774774

Scheme Pays Election form available here: https://www.nhsbsa.nhs.uk/sites/default/files/2019-03/Annual%20Allowance%20Scheme%20Pays-SPE%202-20181217-%28V11%29.pdf

Paul is contactable via email: paul@macarthurgordon.co.uk

https://www.macarthurgordon.co.uk/

Mar 16, 2020

This week’s podcast features Tim Sacks, Chief Operating Officer at East Leicestershire and Rutland CCG, who guides Ben through the prevalence-based contract they employ for funding general practice in his area. Does it work better than the more traditional, weighted capitation-based models, where are the challenges and can it be employed within a PCN?

 

Introductions (48 secs)

Delegated commissioning (1 min 33 secs)

GP contracts: weighted capitation versus prevalence (1 min 48 secs)

How do you implement a new type of contract? (3 mins 16 secs)

Measuring the impact on investment (4 mins 7 secs)

The response from general practice so far (5 mins 31 secs)

How effectively can general practice respond to financial risk? (6 mins 29 secs)

Practice involvement in shaping new contracts (8 mins 8 secs)

PCNs and funding distribution (9 mins 46 secs)

Identifying the fairest and most appropriate funding model (11 mins 38 secs)

‘Proportionate universalism’ (12 mins 38 secs)

Do hybrid models work? (13 mins 58 secs)

Plans for the future (15 mins 17 secs)

Opportunities within a PCN framework (16 mins 27 secs)

Primary care commissioning in the future? (17 mins 33 secs)

The potential for PCNs to own their funding (19 mins 36 secs)

Getting in touch & further information (22 mins 13 secs)

 

https://eastleicestershireandrutlandccg.nhs.uk/

Tim is contactable via email: tim.sacks@eastleicestershireandrutlandccg.nhs.uk

Mar 9, 2020

The spotlight is on Practice Managers and their crucial role in shaping and influencing new ways of working in a network-based world. Gary Hughes has a wealth of experience in this area and here shares his insights on the impact of the PCNs on practice managers, where the role evolves and fits within a wider network community and how practice managers really feel about the changes.

Introductions (42 secs)

Gary’s own PCN and his involvement so far (54 secs)

Bracknell mental health project pilot (1 min 42 secs)

Embedding new processes; expectation versus reality (2 mins 27 secs)

What is the network impact on individual practices? (3 mins 8 secs)

Does the introduction of new roles herald a new era in general practice? (3 mins 50 secs)

Practice Managers and collaborative working (6 mins 6 secs)

Organisational leadership within a practice management role (7 mins 19 secs)

What do Practice Managers see that maybe GPs don’t? (9 mins 2 secs)

The Practice Management view of the PCNs (9 mins 52 secs)

The evolution of the Practice Manager role within networks (10 mins 41 secs)

What support might Practice Managers’ need to drive change? (11 mins 46 secs)

How does joint working really begin? (13 mins 7 secs)

The case for dedicated management support (14 mins 53 secs)

Advice on joined up working (15 mins 30 secs)

Keeping in touch (16 mins 51 secs)

 

You can contact Gary and keep up to date with his weekly blog via his LinkedIn profile here

Mar 2, 2020

How have PCNs impacted on local medical councils (LMCs)? What should the relationship be between LMCs and PCNs? Does the role of LMCs have to change following the introduction of PCNs? Listen as William Greenwood, Chief Executive of Cheshire LMC, shares his thoughts and experiences on this week’s podcast.

Introductions (45 secs)

PCNs: First impressions (1 min 40 secs)

Have LMCs been largely supportive of PCNs since their formation? (2 mins 40 secs)

The role of LMCs in relation to PCNs (3 mins 28 secs)

What have been the main concerns for Cheshire local members? (4 mins 37 secs)

Reaction to the original draft primary care specification (5 mins 51 secs)

…and the updated version? (6 mins 43 secs)

Are the LMCs generally happy with he updates & what are the chances of sign off? (8 mins 3 secs)

Are PCNs a “fad”? (8 mins 33 secs)

Practice based contracts versus a network specification (9 mins 32 secs)

Supporting the voice of a practice within a network (10 mins 49 secs)

The expectation of and from the LMC and its members (a two-way process) (14 mins 43 secs)

LMC skills and expertise and what they can offer as a result (15 mins 48 secs)

Are LMCs always constructive and helpful? (16 mins 29 secs)

LMC future role (18 mins 15 secs)

Getting in touch (19 mins 30 secs)

 

https://www.cheshirelmcs.org.uk/

Cheshire LMC office: 01244 313483

Feb 24, 2020

James Gransby, Partner at RSM UK and medical financial expert, summarises the key considerations and implications for practices and new networks of their financial arrangements, particularly within the context of the new - and the since updated - draft primary care contract service specification.

Introductions (48 secs)

James’ initial thoughts on the formation of PCNs and their impact (1 min 22 secs)

Workforce implications (2 mins 15 secs)

How is the PCN’s money best held? Is there an ‘ideal’ financial model? (3 mins 51 secs)

The lead practice model (5 mins 21 secs)

Lessons learned so far, advice on setting up a new financial model - and all things VAT (6 mins 27 secs)

Let’s talk about pensions (7 mins 41 secs)

Clinical Director pay (9 mins 18 secs)

Check employment status for tax / HMRC (10 mins 4 secs)

Year End accounts (13 mins)

Showing a ‘surplus’ and how to manage a PCN ‘surplus’ (14 mins 21 secs)

Impact on practice finances as a result of PCNs (16 mins 15 secs)

Reflecting on the draft service specifications (the December 2019 version) (17 mins 37 secs)

General Practice sustainability in today’s world? (20 mins 10 secs)

James’ top tips for practices and networks (21 mins 55 secs)

Getting in touch (23 mins 10 secs)

The draft GP contract update – new reflections (23 mins 31 secs)

What differences do the changes in the draft contract make? (24 mins 19 secs)

Tax implications for contract incentives? (24 mins 55 secs)

HMRC updates discussed (26 mins 25 secs)

 

James is contactable at: james.gransby@rsmuk.com

https://www.rsmuk.com/

Feb 17, 2020

Dr Riaz Jetha, GP Organisational and Leadership Development Consultant with Health Integration Partners, joins Ben on this week’s podcast to dissect and discuss the updates to the current GP contract agreement. Listen here for their analysis and interpretation of some of the key amendments and what they mean for primary care and primary care networks on a wider scale.

Introductions (9 seconds)

First impressions (57 secs)

PCN focus (1 min 29 secs)

Changes to the Additional Roles Reimbursement Scheme (1 min 50 secs)

Removal of employment liability within the roles reimbursement scheme (3 mins)

Which roles will have the most influence? (3 mins 21 secs)

Structuring new roles according to local need (4 mins 48 secs)

Support for PCNs in forming their structures and the funding timetable (5 mins 53 secs)

The impact of the draft service specification updates (7 mins 30 secs)

Changes in the ability to earn (8 mins 40 secs)

Renewing the burden + wider reaction to the service spec changes (9 mins 51 secs)

The Impact & Investment Fund (13 mins 12 secs)

Is the impact and investment funding more lucrative? Could this be a benchmark for the future? (14 mins 46 secs)

Breaking down the investment payments; cost per patient? (16 mins 9 secs)

Changes to imms and vaccs / QOF (16 mins 55 secs)

Increasing GP numbers (17 mins 55 secs)

Access improvement (19 mins 40 secs)

The Time to Care Programme and maintaining positive initiatives (20 mins 39 secs)

Current status of the contract update & draft service specification and Riaz’s final thoughts (21 mins 12 secs)

 

Riaz is contactable at: raiz.jetha@healthintegrationpartners.co.uk

Feb 10, 2020

Ben is joined by Wessex GP and Physical Activity Clinical Champion Dr Sarah Kay who outlines why physical activity is a key component in the health agenda of all providers, how to motivate patients and practices in enhancing their own health and wellbeing, why prevention is always better than cure and what support is available to enable everyone to feel the benefits.

 

Introductions (36 secs)

Physical Activity Clinical Champions: the facts (1 min 17 secs)

What are the aims of the role? (2 mins 9 secs)

The Moving Medicine website (2 mins 54 secs)

National guidelines on physical activity; where to find them and the information provided (3 mins 53 secs)

New areas of focus in management of physical activity (4 mins 59 secs)

Is general practice doing enough to promote physical wellbeing? (5 mins 42 secs)

Finding time to talk about physical activity during a restricted GP consult (7 mins 21 secs)

The potential for wider impact (8 mins 16 secs)

#parkrunPractice @parkrunUK and #GPparkrunPledge (9 mins 11 secs)

Wellbeing champions & best practice (11 mins 29 secs)

“Active Practice” resources (12 mins 5 secs)

PCNs and the health wellbeing agenda (13 mins 29 secs)

Support from the link workers (14 mins 31 secs)

How do I start the ball rolling in my area? What support is available? (15 mins 25 secs)

Where can I find my local clinical champion? (17 mins 21 secs)

Final word from Sarah (17 mins 42 secs)

 

Moving Medicine website

https://movingmedicine.ac.uk/

 

Public Health England: National guidelines on physical activity

https://www.gov.uk/government/publications/physical-activity-applying-all-our-health/physical-activity-applying-all-our-health

 

RCGP Guidance

parkrunpractice

https://r1.dotdigital-pages.com/p/49LX-52M/parkrunpractice

Physical Activity & Lifestyle Toolkit

https://www.rcgp.org.uk/clinical-and-research/resources/toolkits/physical-activity-and-lifestyle.aspx

GP On-Call Bike

https://www.gponline.com/gps-offered-subsidised-bikes-home-visits-rcgp-scheme/article/1661079

https://www.wessexfaculty.co.uk/product-page/gp-on-call-bike

 

Where to find your local Physical Activity Clinical Champion

email: physicalactivity@phe.gov.uk

 

Jan 13, 2020

Following on from last week’s theme, Ben asks Dr Nav Chana and Dr Tracey Vell for their views on the problems and the progress of PCNs. What are their experiences of PCNs? What are the perceptions of the new models of care across general practice? Where do the threats and opportunities lie?

Introductions (46 secs)

Tracey and Nav’s personal experiences of PCNs summed up (1 min 15 secs)

Working together; impact on structure and investment opportunities (2 mins 45 secs)

What’s happening in Nav’s PCN (3 mins 47 secs)

Are PCNs too inward looking from a general practice perspective? (5 mins 48 secs)

The impact of change and using change as a mechanism for improvement (7 mins)

The PCN paradox (8 mins 14 secs)

Tracey: where practices can use PCNs to focus on their priorities (9 mins 20 secs)

The challenges of linear development (10 mins 15 secs)

The Maturity Matrix (11 mins 34 secs)

How do we support enable innovative working in PCNs from the start? (12 mins 14 secs)

Plug in now to integrated care systems and why not to wait (13 mins 24 secs)

Benefits at practice level from working within a network (15 mins 16 secs)

…and the challenges (16 mins 33 secs)

The current perception of PCNs (16 mins 54 secs)

A threat to command and control? (18 mins 47 secs)

Working at scale = larger resources (21 mins)

Integration of PCNs within the wider healthcare system (22 mins 4 secs)

Population Health Management as a tool for building a successful PCN (23 mins 1 sec)

NAPC resources and case studies (24 mins 7 secs)

Greater Manchester GP Excellence Programme (25 mins 9 secs)

 

The links for both the NAPC’s material and the Greater Manchester GP Excellence programme:

https://napc.co.uk

https://gpexcellencegm.org.uk   

 

 

Jan 6, 2020

In our first podcast of the new decade, Ben chats to PCN guru Becky Malby, Professor of Health Systems Innovation at London South Bank University, about the introduction and progress of network-based working. Listen for her take on their establishment, on the critical success factors and navigating the minefield of structural challenges versus meeting local population need.

 

Introductions (31 secs)

Becky’s take on the first few months since PCN formation (47 secs)

Difficulty of contracting versus meeting complex needs (1 min 18 secs)

Importance of collaboration (2 mins 2 secs)

A crystal-clear purpose is key to a successful PCN (3 mins 2 secs)

Change should happen at practice as well as at network level (3 mins 45 secs)

How to reach agreement on purpose (4 mins 29 secs)

Data analysis and the gateway to collaboration and collaborative working (4 mins 55 secs)

What is the relationship between the network and its practices? (6 mins 5 secs)

PCN priorities: three main aims (7 mins 11 secs)

How setting network priorities can achieve local goals (8 mins 29 secs)

Defining PCN membership (9 mins 30 secs)

How do practices hurdle barriers to reciprocal working? (10 mins 8 secs)

“Strategy is measured by the speed of trust” and why talking matters (11 mins 28 secs)

Contractual requirements and where these fit with holistic vision (12 mins 38 secs)

Introduction of new roles into new network models (13 ins 29 secs)

Management of time, capacity and funding; striking a balance (15 mins 15 secs)

Just say “no” (17 mins 23 secs)

Further information (19 mins 35 secs)

 

For Becky’s podcast and access to the resources she mentions, head to:

www.beckymalby.wordpress.com

www.source4networks.org.uk

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