In what is a dose of pure positivity for a Monday, Alvanley Family Practice’s award-winning Nursing Director and Practice Nurse Katherine Parker joins Ben on this week’s Ockham podcast to give us an insight into the work of Primary Care nurses and how they can make a difference when stepping into leadership roles. Katherine details her own journey; where she sits within the wider practice team, the empowerment she has been given oversee the clinical workload and the innovation that she and her team continue to champion in their area. She also reflects on the impact of PCNs, the pandemic and how other practices and networks can better attract, retain, recognise, and champion their own nursing workforce, so that there is greater confidence in promoting general practice nursing across the board.
Introduction (10 secs)
Katherine’s role within the practice (24 secs)
The remit of a Nursing Director (1 min 10 secs)
Alignment with Practice Manager, Kay (1 min 56 secs)
Celebrating and championing innovation (2 mins 42 secs)
Group Consultations (3 mins 33 secs)
Why group consultations work (5 mins 5 secs)
A more efficient use of time? (5 mins 53 secs)
Social prescribing and the Alvanley Health Champions (6 mins 47 secs)
What are Alvanley’s key objectives when it comes to social presciribing? (8 mins 19 secs)
Wellness Navigators (9 mins 4 secs)
The benefits of a non-medical approach (11 mins 5 secs)
Katherine’s view of PCNs, from a nursing perspective (11 mins 37 secs)
Valuing Primary Care nurses (12 mins 33 secs)
Recruitment and retention (13 mins 25 secs)
Advocacy and empowerment of nurses (14 mins 54 secs)
The impact of Covid (16 mins 28 secs)
Ninja nursing! (18 mins 38 secs)
Advice for GPs and practices (19 mins 19 secs)
Finding out more & getting in touch (20 mins 34 secs)
The Alvanley Family Practice Facebook page can be found here
A wealth of resources can be found when searching for Katherine Parker and / or Kay Keane online (other search engines are available!)
More about Katherine the Ninja Nurse here
Finally, you can make direct contact with Katherine here
The landscape of primary care has altered significantly, and many of the changes practices have made to prioritise patients and protect their staff during the Covid crisis are here to stay. This week’s podcast features Practice Manager Kay Keane and QCS Head of Primary Care Tracy Green, who talk through their experiences of the pandemic, how they have worked together to support the implementation of Alvanley Family Practice’s new systems of working and their thoughts on where we go from here as life returns to the new normal.
Introductions (36 secs)
About Alvanley Family Practice and their practice manager, Kay (1 min 20 secs)
‘Feed the birds’ project (1 min 40 secs)
Further innovation: group consultations (2 mins 57 secs)
The advantages of Zoom (4 mins 2 secs)
Tracy’s background and experience (4 mins 15 secs)
What have been the biggest challenges for Alvanley? (5 mins 43 secs)
Increased volume of work versus the need to do things differently (6 mins 42 secs)
Changes to the operating model (7 mins 17 secs)
Which new processes would Kay keep? (8 mins 5 secs)
The effect of rapid changes on team dynamics (9 mins 22 secs)
The loss of in-person contact (9 mins 54 secs)
Has general practice changed for the long term? (10 mins 39 secs)
Partnership working with local providers (11 mins 4 secs)
Have we been boosted in some ways? (11 mins 37 secs)
Maintaining momentum during a crisis (12 mins 41 secs)
The QCS response to Covid (14 mins 5 secs)
Who are QCS and what do they do? (16 mins 4 secs)
Governance and general hints and tips (16 mins 59 secs)
The QCS impact on an individual practice (17 mins 33 secs)
Time for reflection (18 mins 6 secs)
Managing the after effects of such a rapid period of change (19 mins 28 secs)
Lessons learned from Tracy’s perspective (20 mins 34 secs)
Further information (21 mins 18 secs)
This week’s podcast has been sponsored by Quality Compliance Systems (QCS)
QCS are offering a free trial to help support practices in embedding their new procedures and processes following the Covid crisis. To find out more, you can visit their website here
Content can also be found via the QCS Facebook general practice discussion group:
www.facebook.com/Alvanleyfamilypractice
Additional support in relation to Covid-19 is here
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)
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
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
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
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
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
How to realise the benefits of operating at scale: part 1. This week Ben talks to Dr Andrew Whittamore from Portsdown Group Practice in Portsmouth, which has grown to cover a population of 40,000, about the growing pains of increasing in practice size, and making size an asset.
The practice has energetically pursued a policy of expansion and are continuing to grow, aiming to double in size again over the next few years. Their focus is first and foremost what is best for patient care in their area and believe that working at increasing scale brings significant benefits for patients, practice staff and the health economy as a whole.