Ben is joined once again this week by Paul Gordon, our almost resident pensions expert (!) Now Head of Medical Specialist Wealth Planning at Atomos, Paul returns to update us on the most recent changes to the NHS Pension, namely the launch of a new consultation which could relieve some of the issues and confusion which surround the existing pension offer. What are the key elements of this new consultation, particularly in relation to retirement? And how could these changes lead to an improvement in the retention of staff? Ben and Paul tackle these topics (and more) in our final Ockham podcast of 2022.

Introduction (0.09)

How could the new consultation ease some of the problems related to the current NHS Pension? (0.52)

What are the main changes? (1.43)

Actively contributing whilst working (3.54)

Retention of staff (4.36)

Addressing the challenges of the Pension Scheme (5.22)

An overview of the consultation (7.07)

Resolving or ameliorating? (7.34)

Lifetime allowance (8.30)

Access to your Total Rewards Statement (9.31)

Contacting NHS Business Services Authority (10.09)

What is Pension theft? (11.20)

Tax charges advice (14.57)

PCN access to NHS Pensions information (16.03)

GP federations & wider problems (17.16)

What else should we be aware of at this stage? (18.45)

Getting in touch with Paul (20.07)

For all enquiries about the Ockham podcast, please contact Ben Gowland here.

Listen to Paul Gordon’s previous podcast here.

NHS Business Services Authority - 0300 330 1346

Accessing your Total Rewards Statement

To contact Paul directly: Paul.gordon@atomos.co.uk

Ben is in esteemed company on the podcast this week, joined by Dr Martin Allen (Consultant Physician and a Clinical Lead in Respiratory Medicine at University Hospital North Midlands), Kerry Mills (Advanced Respiratory Nurse Practitioner and Clinical Lead at Hereford Medical Group) and Andrea McConkey of the Wessex Academic Health Science Network, who brief us on all aspects of FeNO testing. Measuring fractional exhaled nitric oxide in the breath of patients, FeNO testing devices are a novel medical technology used to support the diagnosis of asthma. In this episode, we learn about how FeNO testing works in practice, the impact testing is having on the management and treatment of asthma and how others can get their hands on the devices and all available resources. Martin, Kerry and Andrea also welcome listeners to join a recently launched learning collaborative and share some incredibly useful links to further information on the FeNO revolution.

Introduction (0.54)

What is FeNO testing? (2.08)

What difference has it made to the management of asthma? (5.48)

Why are we not seeing a bigger uptake? (8.34)

The AHSN Programme (9.32)

The rollout of FeNO (12.18)

FeNO equipment costing (16.15)

Overcoming the barriers of Feno - Martin & Andrea (17.14)

Advice about getting started (20.23)

Final words (22.18)

West Midlands Academic Health Science Network's website is here.

A wealth of information about FeNO is also available within the Wessex AHSN website here.

The AHSN Network can support you in finding out how and where to get started on your FeNO journey here.

For infographics and guidance about how the devices themselves and how testing works in practice check out the Circassia device and the Bedfont device

If you're interested in finding out more about each of available devices, contact Steven who can guide you on the Circassia option, or Marc for the Bedfont device.

Information about the Rapid Uptake Programme is here.

NICE guidance is accessible here.

For all enquiries about the Ockham podcast, please contact Ben Gowland here.

To find out more information about Livi, their services and how to get in touch, check out their website here.

In this week's episode, we are joined by Hussain Gandhi who reflects on his last three and a half years as a Clinical Director. Gandhi and Ben discuss the Primary Care Network infrastructure; what has changed in terms of staffing and the introduction of the additional roles, the impact of these changes and what we might expect to see next. We also quiz Gandhi about the transition to a more hybrid pattern of working; the overall impact of this on teams and what is necessary in terms of tech, and other considerations, for supporting strong communication and maximising our effectiveness.

Introduction - Life as a PCN Clinical Director (1.13)

Re-election process for a Clinical Director (1.39)

Splitting your role as a Clinical Director (2.08)

What areas of the role do you enjoy? (2.54)

Infrastructure of a PCN (3.46)

Enhanced access (5.21)

Technology progress in PCN (6.06)

Does remote working affect your PCN? (8.11)

Any tips for making remote meetings work? (9.54)

New entrants to the IT market for General Practice (11.14)

Reflecting over the past 3 and a half years (12.37)

What’s next for PCN’s? (13.46)

The GP Assistant role (14.47)

How do you introduce new roles into PCN’s? (16.43)

Next steps for the workforce in the PCN (17.57)

Are operational requirements of PCNs manageable? (20.09)

The impact of Integrated Care Systems and what’s expected next? (21.31)

How does the BMA Current Policy & the Fuller Review affect your role? (23.41)

What lessons have you learnt since becoming a Clinical Director? (25.27)

Where to find information on EGP Learning (26.49)

The link to the eGP learning YouTube channel is here and for all enquiries about the Ockham podcast, please contact Ben Gowland here.

To find out more information about Livi, their services and how to get in touch, check out their website here.

In this month’s Practice Index sponsored panel episode, Robyn and Ben are joined by Practice Index HR guru Susi O’Brien to reflect upon a rollercoaster last three years in general practice and the resulting impact on staffing levels. Post-Covid demand and ongoing strike action across the healthcare sector (amongst other factors) are leading to a steep increase in rates of employee dissatisfaction and a culture of ‘quiet quitting’. What exactly is ‘quiet quitting’ though? What can lead to people quitting quietly? And most importantly, how can we better address the causes of demotivation, stress and burnout within the workforce, to improve staff satisfaction and retention in our own networks?

Introduction (0.43)

Common findings from the clinics Robyn and Susi hold (1.19)

What is quiet quitting? (1.48)

Quiet quitting in the workplace (3.44)

Is quiet quitting linked to pay and inflation? (5.0)

Has the pressure of the past three years caused staff to burn out? (7.02)

Addressing quiet quitting (8.11)

Impact of remote working (10.28)

Managers supporting each other (12.28)

Impact of strikes - Robyn (14.56)

Impact of strikes - Susi (16.35)

How to be proactive regarding quiet quitting (18.04)

For all enquiries about the Practice Index / Ockham podcast, please contact James Dillon here or Ben Gowland here 

This week, we are proud to introduce none other than Sir David Haslam, former Chair & President of the Royal College of GPs, former President of the British Medical Association, and former NICE Chair, amongst his countless other guises. Within this ‘must-listen’ episode, David talks to Ben about some of the key areas of focus within his fascinating new book; ‘Side Effects….’ and to offer his views on more the more problematic areas of general practice, as well as where we can and should be more progressive, from his perspective as a former GP, and as things stand currently.

Introduction (9 secs)

Meeting David (1 min 8 secs)

What prompted David to write his book? (1 min 31 secs)

Identifying what we are trying to achieve (3 mins 2 secs)

Choosing what and where to prioritise (4 mins 49 secs)

Applying rationality to what we can (and can’t) provide support for at system level (6 mins 55 secs)

Managing public expectation (8 mins 26 secs)

The impact focusing on individuals has on maintaining effective delivery (10 mins 53 secs)

Investment in preventative care and what that looks like (11 mins 59 secs)

‘Sexing up’ general practice? (13 mins 55 secs)

The risks to continuity of care (16 mins 6 secs)

ICS implications where the loss of financial ownership is concerned (17 mins 41 secs)

The role of communities in the creation of a more sustainable future (18 mins 53 secs)

How we deliver services within a community-based model (20 mins 12 secs)

David’s take on the Additional Roles Reimbursement Scheme (21 mins 34 secs)

Where does David see effective and positive changes happening going forwards? (23 mins 13 secs)

Getting your hands on a copy of the book…. (24 mins 30 secs)

‘Side Effects: How Our Healthcare Lost its Way and How We Fix it’ by David Haslam is available in all the usual places but here’s a link to the outlet David mentioned within the episode.

You can learn more about David and his work via his dedicated website here.

Most of us are aware of the impact of having pharmacy expertise within our practice and network teams but in many areas, the continuing issue of sourcing (and retaining) pharmacists is proving to be a very challenge. In this week’s episode, we meet Holly Laurence and Ruhina Kassam from Clinical Pharmacist Solutions (CPS), an award-winning training, recruitment and clinical services provider that specialise in providing much-needed, skilled pharmacy resources to practices and primary care networks. Holly and Ruhina talk to Ben about the problem of sourcing staff, why it can be so difficult to hold on to good pharmacists, what we can be doing to incentivise potential new pharmacy staff (and hold onto them), and what CPS can offer by way of support.

Introduction (9 secs)

Meeting Holly, Head of Primary Care Support (26 secs)

…and Service Manager Ruhina (1 min 10 secs)

Is recruitment of Clinical Pharmacists a widespread problem, generally? And if so, why? (1 min 29 secs)

Working out what you want from your pharmacist (3 mins 29 secs)

Setting up dedicated support networks (4 mins 51 secs)

Expectations of salary (5 mins 30 secs)

Handling pay scales (6 mins 41 secs)

Meeting pharmacist expectations (7 mins 20 secs)

Maintaining retention (8 mins 2 secs)

Working within a multi practice network? (8 mins 39 secs)

Holly’s role and how she can ease the burden of recruitment on primary care staff (9 mins 36 secs)

Access and availability of pharmacists (11 mins 11 secs)

The CPS training programme (12 mins 8 secs)

Objective structured clinical examination (OSCE) assessment (14 mins 38 secs)

What else do CPS offer by way of support to practices (15 mins 10 secs)

Slotting in alongside the national pharmacy training programme (16 mins 9 secs)

Pricing schedules (16 mins 45 secs)

Getting in touch (17 mins 41 secs)

If you’d like further information please check out the CPS website or their LinkedIn page here.

Rightly or wrongly, we often find ourselves neglecting basic policy and procedural elements of the job, when patient demand, clinical priorities and a never-ending stream of new directives are cascaded down from on high. So, with this in mind, we invited regulatory solicitor and lecturer David Sinclair to feature on today’s podcast, to bring governance and cyber security more sharply into focus. With the threat of cyber-attacks on the rise, coupled with a quickly evolving policy landscape when it comes to GDPR, data protection and information security, we discuss what practices should be doing now to ready themselves, who should take responsibility for this critical area of work, and what to expect going forwards.

Introduction (9 secs)

Meeting David (1 min 5 secs)

Current prevalence of cyber attacks on GP practices (1 min 22 secs)

What do practices need to be doing right now to protect themselves against the risk of cyber security breaches? (2 mins 26 secs)

Management of governance and data protection protocols (3 mins 1 sec)

The importance of employing the services of those with the required, specialist knowledge (4 mins 21 secs)

Establishment of a named Data Protection Officer (DPO) (5 mins 24 secs)

Who is accountable if / when something goes wrong? (7 mins)

Proactive proof of compliance (8 mins 15 secs)

How do we best demonstrate GDPR compliance? (9 mins 35 secs)

Commonly made mistakes and issues (11 mins 26 secs)

Responding to data subject access requests (13 mins 29 secs)

Who should we consult when seeking advice specifically related to data subject access requests? (14 mins 45 secs)

Strategies for managing subject access requests (15 mins 21 secs)

Other commonly faced issues and things to be aware of going forwards (16 mins 59 secs)

What the future might look like when it comes to governance and security (18 mins 12 secs)

Summarising today’s discussions (19 mins 6 secs)

A final word from David (19 mins 56 secs)

Getting in touch (20 mins 41 secs)

If you’d like further information, and / or to connect with David directly, please check out the DR Solicitors website.

As part of a series of sponsored podcasts, we meet Livi’s Lead GP Dr Bryony Henderson to discuss the dynamics of virtual consultations and life as a Livi GP. Bryony talks us through her own experiences; her background as a GP Partner and subsequent transition to virtual working, why she feels the flexibility it affords has made such a profound difference to managing her own workload and meeting patient needs, how her schedule of work runs in practice and the support networks which are available within Livi’s network, and why the numbers of healthcare staff opting to join the Livi revolution is increasing.  

Introduction (9 secs)

Livi GPs in numbers (1 min 11 secs)

An offer of flexible working (1 min 39 secs)

Is there a typical route in for Livi GPs? (2 mins 20 secs)

How does a shift with Livi run in practice? (3 mins 6 secs)

How are patients referred and what’s the appointment process? (3 mins 56 secs)

Sacrificing continuity of care? (5 mins 35 secs)

Looking after the wellbeing of a virtual GP cohort (6 mins 55 secs)

What are the most important factors when it comes to maintaining wellbeing? (8 mins 27 secs)

Measuring job satisfaction (9 mins 8 secs)

Contracted appointment schedules (9 mins 44 secs)

Patient reaction (10 mins 26 secs)

Managing onwards referrals, where face to face consultation is required (11 mins 21 secs)

How do we change current public perception where demand for face-to-face appointments is concerned? (12 mins)

What’s next for Livi? (13 mins 56 secs)

Is there an impact on GP numbers across the board? (14 mins 27 secs)

Working patterns as a virtual GP (15mins 8 secs)

Where can I get more information? (15 mins 51 secs)

Opportunities for other staffing groups (6 mins 24 secs)

To find out more information about Livi, their services and how to get in touch, check out their website here.

In this month’s Practice Index sponsored Practice Manager panel, Nicola, Robyn, and Ben turn their attentions to planning for, funding, and staffing the winter months ahead. With the recent NHS England announcement of a Primary Care funding package, the group discuss the parameters of this, how the funding model has been set out and how we might utilise the allocated monies to best effect, and also discuss the wider ramifications such as the influence of the media, policy makers and public perception on managing and meeting demand during a time when pressure is at its highest and staffing levels remain at the lowest they have ever been.

Introduction (9 secs)

Will NHS England’s package of support be of benefit this year? Nicola’s view (35 secs)

Robyn’s initial thoughts (1 min 44 secs)

Flexibility of funding? (2 mins 14 secs)

System development funding and framework – the application process from a Practice Manager perspective (3 mins 16 secs)

Establishment of two-way communication (5 mins 59 secs)

Urgent care demand and the impact on general practice workload (7 mins 36 secs)

A change in central communications (8 mins 52 secs)

Issues of consistency when it comes to messaging (11 mins 32 secs)

Impact on staffing and recruitment (12 mins 47 secs)

‘Sexing up’ Primary Care (14 mins 37 secs)

What can practices do to make the most of the winter funding pot? (16 mins 3 secs)

Applying flexibility in funding local needs (17 mins 38 secs)

A creative and community-based approach (18 mins 34 secs)

“Seeking forgiveness, rather than permission” (19 mins 24 secs)

For all enquiries about the Practice Index / Ockham podcast, please contact James Dillon here or Ben Gowland here

In the latest of our podcast episodes sponsored by Livi, we meet GPs Nicole Atkinson and Nicola Decker, who have similarly considerable experience of working in leadership roles, both within the outgoing Clinical Commissioning Groups (CCGs), and now within the newer Integrated Care Systems (ICSs), and critically, in supporting and managing the transition within their own local areas. They offer Ben their thoughts on where the main challenges may lie, the lessons they have learned whilst on their own, respective journeys, where we should be focusing our energies and priorities right now, and why they feel general practice (and primary care as a whole) has what it takes to succeed in a wider and a possibly less level playing field.

Intro (9 secs)

Meeting Nicola Decker (1 min 4 secs)

Nicole’s remit and experience (2 mins 5 secs)

…and her take on what ICSs are and how she feels they differ from CCGs (2 mins 45 secs)

Nicola’s views on the newer models of care (4 mins 12 secs)

Organisation of resources, having influence and establishment of a voice within a larger system (5 mins 25 secs)

How do we enable general practice to be an effective partner? (7 mins 40 secs)

The Primary Care Collaborative….at place or system level? (9 mins 53 secs)

Consideration of the task, the ask and the purpose (10 mins 48 secs)

How does Primary Care take ownership and hold their influence across the system? (11 mins 20 secs)

Managing the transition and ensuring that we can be as proactive as possible (13 mins 49 secs)

Has there ever been a better time for general practice to collaborate effectively? (15 mins 7 secs)

Is this a time limited opportunity? (17 mins 27 secs)

Are we united by a shared challenge? (18 mins 10 secs)

Working out where to start (19 mins 45 secs)

A change of mindset and working across boundaries (20 mins 35 secs)

A final word from Nicola (22 mins 46 secs)

To find out more information about Livi, their services and how to get in touch, check out their website here.

As chair of the Fuller Report workstream focused on data, population health management, demand/capacity, risk stratification and health inequalities, GP Partner and Clinical Chair of the Greater Peterborough Network, Dr Neil Modha is well placed to offer further insight into the objectives and outcomes of the report, and what it really means for the general practice of the future. Fortunately, Ben has managed to grab 23 minutes of Neil’s time to discuss some of the key takeaways such as; when and how do we embed some of the report’s recommendations, how do we adapt these to ensure we are able to meet local needs, how do these fit within the new backdrop of integrated care, and what are the expectations of primary care now, and in the future?

Introduction (9 secs)

Neil’s take on the final version of the Fuller Report (30 secs)

How mindful of the report are we in general practice right now? (1 min 24 secs)

A muted reaction? (2 mins 23 secs)

What are the key implications of the report? (3 mins 39 secs)

Access and urgent care (4 mins 28 secs)

Where does responsibility sit for meeting and managing the urgent care demand? (6 mins 30 secs)

Are we moving towards a ‘hub’ style of working practice? (8 mins 19 secs)

Why we should be proactive in shaping the future, and in embedding the recommendations within the report (10 mins)

Integrated Neighbourhood Teams; the end of the road for PCNs? (10 mins 52 secs)

Where does general practice sit in terms of a leadership perspective (13 mins 42 secs)

Funding new models of care (15 mins 21 secs)

Thoughts on maintaining influence within a wider context (17 mins 50 secs)

Neil’s advice for networks and practices on ensuring preparedness (19 mins 45 secs)

We last spoke with GP Dr Paul Bennett way back in December 2019 BC (before Covid) when his Porchester based surgery was in the process of trialling new and innovative ways of meeting and managing patient demand. Fast forward to almost three years later; post pandemic, within a rapidly evolving general practice landscape, and with the pressure to provide more appointments at an all-time high, Paul and his team have had to adapt and improve their previous strategies, to offset the needs of their patient population against decreasing numbers of medical professionals. In this week’s podcast instalment, Paul talks Ben through the new systems they have embedded to manage the challenge of capacity and demand, and why he feels that in Porchester, they are able to offer a safer, more streamlined, and equitable service.

Introduction (10 secs)

What’s been happening since we last spoke to Paul? (47 secs)

How does the ‘pod’ system work? (2 mins 5 secs)

The role of the Care Navigator (2 mins 25 secs)

eConsult platforms and eForm creation (2 mins 44 secs)

Breaking down the two components of demand (3 mins 34 secs)

Managing patient access (4 mins 38 secs)

Allocation of a designated pod team (5 mins 30 secs)

Management of those requiring urgent treatment (6 mins 5 secs)

Transferring patients from routine to urgent care pathways (8 mins 22 secs)

The red flag form (9 mins 19 secs)

Forms for more specific conditions and concerns (10 mins 4 secs)

Aligning the process within the wider network (11 mins 40 secs)

Managing triage, decision-making and proactively signposting patients (12 mins 25 secs)

Development of the case managers and the pod team skill mix (13 mins 9 secs)

Positive impacts and lessons learned (14 mins 44 secs)

Measuring outcomes (15 mins 53 secs)

What have been the main issues or problems? (16 mins 26 secs)

Reaction from the doctors to newer ways of working (17 mins 18 secs)

Next steps (19 mins 9 secs)

Finding out more and getting in touch (20 mins 37 secs)

If you’d like to find out more about the systems in place at Westlands Medical Centre, Paul’s is contactable here.

In the latest of our Livi-sponsored podcast episodes, Ben speaks to Dr Harriet Bradley, GP, and Medical Director at Livi, and Dan Kane, GP Federation Chief Executive Officer at Northampton General Practice Alliance, about the widespread shortage of GPs across the country, and how Livi are working with local systems to support them in meeting patient demand and increasing capacity. Harriet talks to us about the Livi ethos, their work and how they operate as a service and also, from the perspective of local practices and networks, Dan is able to offer valuable insight into the impact that employment of Livi’s services has made on them in not only increasing the availability of doctors but as to how the service has been received by primary care staff and the benefits felt by the patients they serve.   

Introductions (1 min 4 secs)

Meeting Livi’s Harriet Bradley (1 min 20 secs)

Meeting Dan Kane, Northampton General Practice Alliance’s CEO (1 min 49 secs)

The relationship between Livi and GPA (2 mins 15 secs)

How does the service work in practice and how are the Livi GPs embedded within existing local systems? (3 mins 24 secs)

Tailored support models for each individual area (4 mins 22 secs)

The response from practices (5 mins 34 secs)

Support at federation level (7 mins 26 secs)

Building trust and effective communication channels (8 mins 30 secs)

Dan fills us in on the GPA journey with Livi and why they decided to use their services (9 mins 36 secs)

How do local GPs feel about Livi? (10 mins 40 secs)

Getting buy-in from the get-go (11 mins 50 secs)

Integration with EMIS and SystmOne (12 mins 57 secs)

Building up the reserves of doctor capacity from Livi’s perspective (14 mins 21 secs)

IT access and requirements (15 mins 26 secs)

Funding and payment to Livi (15 mins 58 secs)

Who typically commissions Livi’s services? (16 mins 55 secs)

What’s next for Dan and GPA? (17 mins 37 secs)

What are Livi’s aims and aspirations, going forwards? (19 mins 5 secs)

Advice from Dan on key considerations and what works (20 mins 1 sec)

Getting in touch with Livi and finding out more (21 mins 39 secs)

To find out more information about Livi, their services and how to get in touch, check out their website here.

With the nights now beginning to draw in, the reality of the cost-of-living crisis is looming large over general practice. With charges for heating, lighting, and overall maintenance of our premises going up, coupled with the impact of inflation on pay, the promised staff pay rises and the difficulty of balancing the books ever more challenging, and with all the usual winter pressures now around the corner…something has got to give. Our ever-popular Practice Index panel members, and Institute of General Practice Management (IGPM) directors, Robyn, and Nicola, return to discuss their own concerns, the approaches they are taking in their own practice areas, and share their thoughts about the key considerations for primary care, as a whole.

Introduction (9 secs)

What has Nicola been up to since our last conversation? (22 secs)

And what’s keeping Robyn busy right now? (43 secs)

What are the challenges of the cost-of-living crisis at practice level? (59 secs)

Balancing staff pay rises (2 mins 35 secs)

Maintenance of buildings and services and rising utilities costs (4 mins 37 secs)

Travelling, home visits, and fuel charges (5 mins 25 secs)

Staff turnover (6 mins 39 secs)

Patient health and wellbeing and the potential for a further increase in demand (8 mins 3 secs)

Implications for GP Partners (9 mins 47 secs)

Sustainability of the practice as a business (11 mins 43 secs)

Is there any support available? (13 mins 4 secs)

Action from the Institute of General Practice Management (14 mins 2 secs)

Making the primary care voice heard (15 mins 14 secs)

For all enquiries about the Practice Index / Ockham podcast, please contact James Dillon here or Ben Gowland here

Integrated Care Systems are here and with them, the advent of new ways of working and yet more healthcare terminology! Integrated Neighbourhood Teams (INTs) may be an original concept to many of us in general practice but in Suffolk and North East Essex, they have been in existence for a little bit longer. In this week’s podcast episode, sponsored by Livi, we are privileged to be joined by Maddie Baker-Woods, Director of Ipswich and East Suffolk Alliance at Suffolk and North East Essex Integrated Care Board, and Paul Little, Director for Integrated Health and Care at Suffolk County Council and East Suffolk and North Essex Foundation Trust, who explain how their own, established network of INTs work, how the teams interact with PCNs and primary care more widely, the challenges, and rewards, they have encountered on their own journey – and why localised care is key to meeting the needs of individual population areas, rather than a more widespread approach.

Introduction (9 secs)

Meeting Maddie and Paul (1 min 6 secs)

Maddie’s role (1 min 16 secs)

All about Paul (2 mins 9 secs)

Building Integrated Neighbourhood Teams (3 mins)

Organising services and a locality-based model (4 mins 33 secs)

Balancing relationships between integrated neighbourhoods and primary care networks (6 mins 53 secs)

Overcoming barriers (7 mins 24 secs)

Working with constraints and challenges (8 mins 30 secs)

How does general practice feed into the integrated neighbourhood teams? (9 mins 8 secs)

Accountability (10 mins 48 secs)

A place-based versus organisational (top down) approach (12 mins 55 secs)

The influence of local demographic (14 mins 28 secs)

Positive outcomes (15 mins 42 secs)

Helping people to be as independently functioning as possible (17 mins 44 secs)

Advice from Paul for others embarking on the same journey (18 mins 51 secs)

Maddie’s top tips (20 mins 45 secs)

Estates and co-location (21 mins 6 secs)

Where general practice should be prioritising their efforts (21 mins 30 secs)

Finding out more (24 mins 14 secs)

To learn more about the work of NHS Suffolk and North East Essex Integrated Care Board, check out their website here.

This podcast episode is sponsored by Livi, the first digital healthcare provider to be rated Outstanding by the CQC. Further information about Livi and what’s on offer can be found here.

This week heralds the start of the new term and a return to weekly podcasts, and we are incredibly privileged to be joined by Dr Naj Seedat; GP Principal and Partner at a large practice in Ilford, northeast London, LMC Board member, GP appraiser and one of the founding fathers of his local GP federation. In this episode, Naj and Ben discuss the challenges faced by those new to GP partnership; the key considerations for those debating whether or not to make the leap into partnership, the experiences of both old hands and those who are just starting out, partnership in the context of the ever evolving primary care landscape, the rewards of partnership and why the New to General Practice Partnership Programme Naj and Ben are launching can be instrumental in shaping and supporting the journey to partnership, and beyond.

Introduction (9 secs)

A bit about Naj (17 secs)

What’s life in partnership like right now? (38 secs)

Is partnership still an attractive prospect whilst nationalism of general practice is being mooted? (2 mins 24 secs)

Working autonomously (4 mins 23 secs)

Transition to partnership and how the programme can help (6 mins 15 secs)

Navigating the Human Resources minefield (9 mins 3 secs)

Managing finance (10 mins 31 secs)

Monitoring practice performance and local KPIs (13 mins 34 secs)

Understanding how to best manage your business and benchmarking progress (15 mins 51 secs)

The external environment / Integrated Care Systems (16 mins 35 secs)

Signing up to cohort three of the New to Partnership Programme (17 mins 57 secs)

It’s not just for GPs! (18 mins 30 secs)

Access to resources and knowledge (19 mins 25 secs)

The next cohort of the New to General Practice Partnership training programme begins on Tuesday 11 October. To find out more and to grab one of the remaining spaces, please follow this link.

Our Practice Index Practice Manager panel return and this week, Robyn and Nicola are joined by two special guests, Brigadier Robin Simpson, RCGP Veterans Champion and the Professor of Military Primary Healthcare and Veterans Health at the University of Chester, and by Darren Davies, former Royal Military Police Staff Sergeant to highlight the issues faced by military veterans in accessing healthcare and how we in primary care can ensure there is better support for our veterans, post service, who frequently suffer in silence with seemingly invisible and escalating health conditions and concerns. With this in mind, the RCGP have launched their veterans’ healthcare toolkit and the GP practice veteran friendly accreditation, which offer insight and much needed guidance on making healthcare more accessible for those in our society who have sacrificed the most, but whose needs are all too often overlooked.  

Introduction (9 secs)

Congratulations to our Nicola! (22 secs)

Meeting our guest panel members (41 secs)

The advent of the veteran friendly practice programme (1 min 12 secs)

What are the differences between recognised veteran friendly practice and those who aren’t yet accredited? (2 mins 50 secs)

Darren’s take on the initiative and the impact on veterans (4 mins 8 secs)

The struggle of those returning from tour and access to healthcare (5 mins 37 secs)

Comparison with the more established support systems in the US (6 mins 38 secs)

Promoting practice sign up within a landscape of competing demands (8 mins 38 secs)

The accreditation process (10 mins 11 secs)

Nicola and Robyn’s experiences of sign up (11 mins 12 secs)

PCN accreditation (13 mins 30 secs)

Meeting the health inequalities agenda (14 mins)

Identification of a clinical lead (15 mins 19 secs)

What would it mean for veterans if every practice became accredited? – Robin’s perspective (15 mins 52 secs)

Darren’s view (18 mins 14 secs)

Finding out more and signing up (19 mins 16 secs)

If you’d like to find out more, or even better, spend 15 minutes signing up for the RCGP veteran friendly GP practice accreditation, we strongly encourage you to follow the link here.

For all enquiries about the Practice Index / Ockham podcast, please contact James Dillon or Ben Gowland.

Here at Ockham, we are always keen to explore how we deliver high quality content to our audiences and this week Ben is trialling something new. In a change to our usual format, Ben has recorded a solo, “bite size” episode offering his thoughts and advice for practices about the implications of the changing healthcare landscape. Starting from the top, with what Integrated Care Systems (ICSs) actually are, how they are comprised and how resources and funding are likely to be organised, onto what the new systems mean for practices and staff on the ground, the influence of the Fuller Report, how we could and should react and where the priorities and challenges lie, we hope you find our latest podcast offering as insightful and informative as ever!

All by myself…. (9 secs)

What are Integrated Care Systems (ICSs) and why is the recent transition so fundamental? (36 secs)

The history and lead up to integrated care (1 min 11 secs)

Why size matters (2 mins 32 secs)

Priorities, challenges, and funding implications (2 mins 57 secs)

Partnership working with other providers (4 mins 8 secs)

Policy direction and the Fuller Report (5 mins 6 secs)

What do all the changes and proposals mean for individual practices? (7 mins 58 secs)

Local priorities; two approaches (9 mins 2 secs)

Maintaining independence whilst creating unity (10 mins 39 secs)

Why cohesive working and collaboration is key (12 mins 7 secs)

Working out how to best align to the strategic directives set out in the Fuller Report (12 mins 52 secs)

Integrated Neighbourhood Teams (14 mins 17 secs)

In Summary (16 mins 16 secs)

We need your feedback! (16 mins 58 secs)

We’d love to hear your views about Ben’s first solo podcast and whether you’ve found this shorter, summary edition helpful! Please do get in touch via email, via our website comment area, or via Twitter, Instagram or Facebook….

It has not escaped our notice that the regularity of our (now almost resident) pensions expert Paul Gordon’s appearances on the podcast is increasing as further changes to the NHS pension (and our wider entitlements) are introduced. Thankfully, with the wisdom of Paul, now Sanlam Wealth’s Head of Medical Specialist Wealth Planners, leading on the NHS pensions proposition, we can keep our listeners abreast of the changes. What are the headlines? How do we ensure we avoid any potential financial landmines? Where can we access further information about our own pension position and get further support? It’s all covered in this week’s podcast episode…

Introduction (9 secs)

A change of circumstance for Paul (20 secs)

What’s the latest on GP pensions? (1 min 26 secs)

Standard annual allowance (2 mins 52 secs)

Exceeding the allowance (3 mins 51 secs)

The financial impact of going above the annual allowance (5 mins 17 secs)

Payment of tax charges (6 mins 58 secs)

Annual allowance calculations (8 mins 42 secs)

Working out how much to pay (10 mins 22 secs)

Annual allowance compensation scheme (12 mins 11 secs)

Understanding my own pension status and key contact points (14 mins 15 secs)

What are the options for those with potentially significant tax liabilities and implications of opting out (15 mins 33 secs)

https://www.totalrewardstatements.nhs.uk/ (18 mins 39 secs)

BMA response to the government’s handling of the NHS pension (19 mins 7 secs)

When a pension is not index linked (22 mins 2 secs)

Finding out more and further support (23 mins 11 secs)

What to be aware of and what’s coming next (25 mins 36 secs)

If you haven’t done so already, you should speak to NHS Business Services Authority (NHSBSA) to request at least seven years of annual allowance growth figures. Their telephone number is 0300 330 1346.

You should also visit https://www.totalrewardstatements.nhs.uk/ to access your personal pension benefit statement. Your Total Reward Statement additionally offers personalised information about the value of your employment package and includes details about remuneration and the benefits on offer from your employer at a more local level.

If you’d like to get in touch with Paul directly, you can email him here.

Episode 311 - Podcast – Practice Index – Credit where accreditation is due…

We at Ockham Healthcare have closely followed the journey of the Institute of General Practice Management (IGPM) since its inception at the beginning of 2021. Its four founding Directors, Robyn Clark, Nicola Davies, Kay Keane, and Jo Wadey have worked hard to establish the IGPM presence and ensure the voices of those working in general practice management are represented and heard. This week in a return to our joint Ockham / Practice Index Practice Manager panel podcast, Robyn, Nicola, and Kay talk to us about a major new development in the IGPM world, that of their recently launched accreditation framework which is now on offer to all managers in primary care with a minimum of two years’ experience. It is something the Directors and their regional representatives have put in tireless effort to pull together and in this episode, they explain the process from top to bottom, and why it is beneficial not only for those in Primary Care management roles, but also what the positive knock-on effect will be for wider practice teams and GP partners.

Introduction (9 secs)

An important announcement… (31 secs)

Why accreditation? (1 min 19 secs)

Putting the framework together (2 mins 2 secs)

What does the accreditation process look like and what competencies do you need to demonstrate as a Practice Manager? (3 mins 47 secs)

Improvement in standards (6 mins 3 secs)

Benefits of accreditation to practices and partners (7 mins 5 secs)

MIGPM explained (8 mins 1 sec)

The application process (8 mins 8 secs)

Support in preparing for accreditation assessment (9 mins 37 secs)

Active involvement from the IGPM regional representatives (10 mins 12 secs)

Empowerment and a celebration of skills of achievement (10 mins 59 secs)

Reaction from Practice Managers (11 mins 25 secs)

Establishing Practice Management as a recognised and respected profession (12 mins 48 secs)

Minimum experience criteria (14 mins 21 secs)

Moving from ‘nice to have’ to widespread recognition of skill (15 mins 16 secs)

The New to Partnership Scheme and Practice Managers (16 mins)

Expansion of influence (18 mins 6 secs)

What’s next for the IGPM? (18 mins 51 secs)

More representatives required! (21 mins)

Finding out more (21 min 46 secs)

All the information you need about accreditation, membership, and the work of the IGPM is available on their website here.

For all enquiries about the Practice Index / Ockham podcast, please contact James Dillon here or Ben Gowland here

Many practices and networks up and down the country are already aware of the benefits that pharmacists and pharmacy technicians can offer however in Suffolk Primary Care, they have taken this to a whole new level with the establishment not only of a centralised Pharmacy team, but in also embedding a standardised pathway across a so-called super PCN area. On this week’s podcast, Ben is joined by Henri Cresswell, East Suffolk PCN’s Head of Pharmacy, and Dr Neil Macey, Medical Director at Suffolk Primary Care, to talk about their journey from the beginning of the Additional Roles Reimbursement Scheme (ARRS) journey and the birth of the Pharmacy team, to where they are now, the lessons they have learned, how they managed to successfully embed a centralised team and processes, within the backdrop of the pandemic and where they are aiming next.

Introductions (9 secs)

Suffolk Primary Care and the relationship with East Suffolk PCN (22 secs)

ARRS and the birth of the Pharmacy team (1 min 19 secs)

All about Henri (2 mins 51 secs)

Getting buy in for a single, standardised process from multiple practices (4 mins 7 secs)

Supporting the change process (5 mins 32 secs)

What were the major challenges? (6 mins 14 secs)

Management of a centrally based team (6 mins 53 secs)

What happens within a pharmacy clinic? (8 mins)

How the temporary shift to remote working helped to embed the service (8 mins 35 secs)

Neil’s role in promoting the team (9 mins 11 secs)

Measuring impact (10 mins 34 secs)

What has the experience been like from the pharmacists’ perspective? (11 mins 40 secs)

Training and supervision (13 mins 49 secs)

Development and progression of the staff (14 mins 33 secs)

Challenges of recruitment (15 mins 44 secs)

What does the future look like? (16 mins 4 secs)

Support from the Care Coordinators (16 mins 45 secs)

Neil’s thoughts on what comes next for the Pharmacy, and wider ARRS team (17 mins 22 secs)

Lesson learned – Neil’s view (18 mins 32 secs)

Henri’s reflections (20 mins 19 secs)

To find out more about the evolution of the Suffolk Primary Care Pharmacy Team, Henri and Neil are both happy to be contacted via their respective emails.

The Suffolk Primary Care website is here.

Here on the Ockham podcast, we are proud to have been able to feature many inspiring success stories where utilisation of the Additional Roles Reimbursement Scheme funding and the introduction of new roles into Primary Care. This week’s is no less thought-provoking. Our guests, GP, and Clinical Director Dr John Stevenson, PCN Development Manager Anna Straker and most importantly, Safeguarding Coordinator Sam Beaumont, talk to Ben about the incredible impact Sam’s role has made on relieving GP workload pressures, establishing and maintaining strong connections with other local systems and providers, and most importantly, ensuring that safeguarding concerns are proactively flagged and managed, to promote safer and more responsive patient care whilst building PCN and wider workforce resilience.

Introduction (9 secs)

PCN make-up (25 secs)

The inception of the Safeguarding Coordinator (51 secs)

How was the Safeguarding process managed previously? (1 min 53 secs)

Anna’s approach to implementation (2 mins 50 secs)

Working out the skills and experienced required (4 mins 37 secs)

Sam’s background and what attracted her to the role (5 mins 45 secs)

Establishment of the role and Sam’s day to day practice (7 mins 27 secs)

Linking back with the clinicians (10 mins 22 secs)

How has the role evolved since Sam started in August / September 2021? (12 mins 18 secs)

Impact on PCN and practices – from John’s perspective (13 mins 34 secs)

Anna’s endorsement (14 mins 51 secs)

Lessons learned (16 mins 17 secs)

The importance of early critical thinking (18 mins 44 secs)

Getting in touch (20 mins 31 secs)

To find out more about the Safeguarding Coordinator, and WBC’s wider approach to embedding their ARRS team members, you can contact John here, or check out the WBC website here.

We are all aware that the practice workload balance is already, or about to, tip over and with this in mind, it is more important than ever to regularly take stock, check in on our colleagues, proactively plan ahead, take our leave (even if it’s not necessarily when we want to!), and if need be, reach out to others for support. With this in mind, our ever-popular Practice Index Practice Manager panel return to the podcast this week and are joined by GP, executive coach, and resilience expert Dr Rachel Morris to dissect and discuss a situation of which unfortunately many of us are more and more likely to identify with, where a GP partner has been forced to cancel leave due to a mixture of demand and a lack of locum availability. How can we avoid the same fate and how do we start to build resilience whilst most of us are feeling very much like we are close to the same level of vulnerability?

Introduction (33 secs)

Sourcing locums from a practice manager’s perspective (1 min 14 secs)

The situation in Kay’s area in Manchester (1 min 55 secs)

How have we got to a situation where locums are in such high demand? (2 mins 25 secs)

Facing the reality of having to cancel annual leave (3 mins 26 secs)

Working out what you’re in control of and what you’re not (4 mins 29 secs)

Planning leave, proactive rota management and the role of the practice manager (6 mins 21 secs)

Sustainability in a smaller practice (7 mins 31 secs)

Building resilience in larger practices (8 mins 21 secs)

Acknowledging our vulnerabilities and planning for them (9 mins 7 secs)

Added pressure as a GP partner (10 mins 8 secs)

Protecting the workload (10 mins 37 secs)

Support for the wider workforce (11 mins 9 secs)

Collaboration and co-dependence (12 mins 7 secs)

Working out where you can influence and what you can change (13 mins 58 secs)

Why asking for help is not a sign of weakness (15 mins 8 secs)

Buddy practices and increased reliance on others (16 mins 15 secs)

Managing the dearth of GPs and developing practice skill mix (17 mins 26 secs)

Effective communications (18 mins 50 secs)

An analogy of managing patient demand (19 mins 40 secs)

Making the most of the ARRS funding (20 mins 50 secs)

Time management and maximising impact (21 mins 50 secs)

Staff wellbeing is paramount (23 mins 8 secs)

Final thoughts from Robyn and Kay (23 mins 33 secs)

Rachel’s incredibly popular ‘You are not a frog’ podcast can be found here

For all enquiries about the Practice Index / Ockham podcast, please contact James Dillon here or Ben Gowland here

In another episode documenting general practice preparations for integrated care, we welcome back Dr Jon Griffiths, GP Advisor for Cheshire and Merseyside Health and Care Partnership, NHS North West Leadership Academy board member, RCGP Mersey Faculty Board deputy council rep and Cheshire LMC member. As part of his GP Advisor role, Jon has worked with colleagues across Cheshire and Merseyside to produce a consensus document focused on the Primary and Secondary Care Interface and improving cohesion and clinical pathways between these two key areas of healthcare. Based on a set of guiding principles and with the aim of establishing a common architecture of good quality, patient-centred communication within the new integrated care systems, Jon talks to Ben about the input from both primary and secondary care, striking a balance between meeting the needs of the wider system and more local requirements, and the key milestones for both sectors when embedding a truly successful system of integrated care.

What is Jonathan’s role and remit right now? (23 secs)

Responsibilities of the ICS GP Advisor (59 secs)

Myth-busting (3 mins 41 secs)

Primary Care views of secondary care (5 mins 25 secs)

Reaction from the secondary care consultants (8 mins 30 secs)

…and the secondary care ask of general practice (10 mins 45 secs)

Establishing mutual benefit (13 mins 14 secs)

Building consistency across primary care (14 mins 41 secs)

Where does the real opportunity for truly integrated care lie and how do we strike a balance between real-time need and the PCN DES requirements? (15 mins 31 secs)

What is needed to enable a strong and united primary and secondary care interface? (17 mins 7 secs)

Life after CCGs (19 mins 37 secs)

Strengthening GP representation (21 min 12 secs)

Accessing the consensus (22 mins 7 secs)

The Consensus document is available within the Cheshire and Merseyside Health and Care Partnership website here.

As ever, here at Ockham, we are fortunate to have been able to have taken some time out from business as usual to put our feet up and properly digest, review, and summarise the recent Fuller report publication on integrated Primary Care (and what this might look like in the context of the wider Integrated Care world). As with everything, our conclusions are our own and having spoken to our allies over at THC Primary Care, it’s clear that the report can be interpreted in many different ways, depending on who you are, where you sit, what your remit is and how prepared you may (or may not) be feeling ahead of the upcoming transition. In this week’s episode, Ben and THC Primary Care founder and MD, and PCN Management expert Tara Humphrey discuss their key takeaways from the stocktake and what they both feel general practice should be doing right now to ready themselves for integrated primary care, and ICSs beyond.

Introduction (9 secs)

Setting the scene…. our differing perspectives (19 secs)

Tara and Ben’s initial thoughts (29 secs)

What’s missing? (45 secs)

Ben’s concerns (1 min 17 secs)

What would Ben liked to have seen within the report? (2 mins 54 secs)

Shaping the debate (4 mins 46 secs)

A threat to the PCN model as we know it? (5 mins 52 secs)

Tara’s views and getting the most out of a larger network infrastructure (8 mins 3 secs)

Readying general practice, as it stands (9 mins 21 secs)

Acknowledgement of existing constraints and what this means going into an ICS environment (9 mins 58 secs)

Do the recommendations within the report pose a risk to the PCN management structure? (11 mins 6 secs)

General Practice influence at an ICS level (12 mins 44 secs)

The importance of a united primary care voice (14 mins 27 secs)

Time pressures and maintaining influence as a GP leader (15 mins 15 secs)

What should we be doing right now in preparation? (16 mins 55 secs)

Tara’s predictions ahead of the transition (17 mins 47 secs)

Recommendations from Ben (18 mins 53 secs)

Tara advises (19 mins 53 secs)

Navigation of bureaucracy versus responsive decision-making (20 mins 43 secs)

We need you! (21 mins 45 secs)

Next steps for integrating primary care: Fuller stocktake report (final report) is available here.

There is still plenty to discuss where the report is concerned and absolutely no way to cover it all this 22-minute podcast instalment. We are keen to hear views and even better, feature representatives from across general practice on the podcast to discuss the transition into the integrated care, what this feels like from your part of the world and your own take on the Fuller Report. So if you (or your team) are interested in taking part, please contact Ben at ben@ockham.healthcare or get in touch via Twitter.