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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: Category: healthcare
Oct 18, 2020

This time of year is ordinarily an extraordinarily busy period for practices with the onset of ‘business as usual’ winter pressures but what is the effect of the additional impact Covid presents, while business is not running as normal? In the third of our Practice Index Practice Manager panels, now seasoned podcast professional Nicola Davies joins Ben, along with fellow Practice Manager Michele Petrie and GP, executive coach and speaker, Dr Rachel Morris, to discuss the challenges leadership teams face right now, what low morale means in practice day to day and critically, what can be done to maintain staff resilience during this period of long term uncertainty.

 

Welcome to the panel (38 secs)

 

An introduction to Michele (49 secs)

 

All about Rachel (1 min 24 secs)

 

Morale right now in general practice (2 mins 10 secs)

 

Why is morale so low? (3 mins 24 secs)

 

Pressure from the top and the influence of the media (3 mins 46 secs)

 

Summarising the contributing factors (4 mins 18 secs)

 

What does a stressful working environment look and feel like in reality? (5 mins 20 secs)

 

The power of social media (7 mins 5 secs)

 

What can practices do to find a way through? (8 mins 21 secs)

 

The zone of power (10 mins 36 secs)

 

Recognition, reward, and the importance of saying “thank you” (11 mins 24 secs)

 

Long term impacts of low morale and maintaining wellbeing (13 mins 4 secs)

 

Pulling together as a team (14 mins 38 secs)

 

Standing in the shoes of a practice leadership team (15 mins 24 secs)

 

Coping strategies (17 mins 13 secs)

 

Rachel’s advice for self-care and sustaining resilience (19 mins 31 secs)

 

 

The link to Rachel’s I am not a frog podcast is here

The Covid-19 team wellbeing toolkit Rachel refers to can be found here

 

Oct 11, 2020

Episode 228 - Podcast – Jessica Hollingsworth & Nick Sharples – Digital group consultations

Group consultations are a relatively new concept in primary care, but one GP has taken this a step further and in the wake of the pandemic, has introduced digital group consultations at her practice. Dr Jess Hollingsworth of Linthorpe Surgery in Middlesbrough, in partnership with podcast favourite Nick Sharples of DNA Insight, saw that there was a need to better support patients recovering from Covid. Together, they decided that giving patients access to an online consultation, in the company of other individuals also struggling with the long term impact of the virus, might offer some much needed insight into its effects, whilst giving them a safe route of access to an individual consultation and to a potential network of support going forwards. Here, they talk to Ben about how the idea came about, the preparation that is required, how the consultation works in practice and what the impact has been overall on the patients that have taken part.

 

Introductions (34 secs)

 

Making the transition to virtual group consultations (55 secs)

 

The definition of a digital group consultation and its structure (1 min 29 secs)

 

Timings and patient consult allocation (2 mins 25 secs)

 

Which patient group/s were targeted and why? (2 mins 53 secs)

 

What preparation is required? (3 mins 21 secs)

 

The role of the facilitator (4 mins 7 secs)

 

Governance and consent (4 mins 46 secs)

 

Recommended group size and numbers (5 mins 56 secs)

 

A group consultation in practice (7 mins 21 secs)

 

After care (8 mins 26 secs)

 

How social prescribing link workers can help (9 mins 40 secs)

 

Patient feedback (10 mins 30 secs)

 

Reflections from a practice perspective (11 mins 40 secs)

 

Technical challenges (12 mins 34 secs)

 

Which online platform works best and why? (13 mins 19 secs)

 

Lessons learned (14 mins 36 secs)

 

Advice from Nick for practices who are in setting up a digital group consultation (15 mins 43 secs)

 

The Personalised Care Institute and the support and training on offer (17 mins 12 secs)

 

Where can I find out more about virtual group consultations? (18 mins 28 secs)

 

Further support for patients recovering from Covid-19 (19 mins 14 secs)

 

A link to the case study on Linthorpe Surgery’s digital group consultation pilot (which Nick references) can be found here

Oct 4, 2020

We are proud of the many inspirational stories that are shared and the fascinating people who feature on our podcast and none more so than this week’s guest, GP Rebecca Farrington. Rebecca works within an almost truly unique role as a GP with a special interest in asylum seeker mental health, within a specialist hub in Salford, Greater Manchester. The challenges faced by asylum seekers and refugees within the UK cannot be underestimated and the impact on mental health and wellbeing is significant. Here, Rebecca talks to Ben about these challenges in more detail, the dynamics of her role, the difficulties Covid has presented and how other providers can ensure the best care for this particularly vulnerable population, in their own areas of the country.

 

Introduction (29 secs)

 

Rebecca’s journey (41 secs)

 

How ‘typical’ is Rebecca’s role (2 mins 25 secs)

 

Life as a GP with a special interest and the model of care (2 mins 41 secs)

 

Are there other support frameworks for refugees and asylum seekers? (4 mins 12 secs)

 

The challenges faced by those seeking asylum in the UK (6 mins 5 secs)

 

How can GPs provide a better service? (7 mins 1 sec)

 

Why specialist health services make such a big difference (7 mins 50 secs)

 

The impact of Covid (10 mins 7 secs)

 

Doing things differently post Covid (12 mins 16 secs)

 

Advice and support on reaching out to the vulnerable populations in your area (13 mins 8 secs)

 

The importance of high-quality interpretation (15 mins 35 secs)

 

More information on the vital work and the services offered by Rebecca and her team (and Rebecca as a practitioner) can be found as follows:

BMJ article/interview

HEE career story

BJGP article

University of Manchester blog

Sep 27, 2020

It’s an exciting week because we are so pleased to have our first PCN Manager to feature on the Ockham podcast! Tara Dawson, PCN Manager for the Lytham St Annes network, takes us through her journey to becoming PCN Manager, her experiences, her achievements, the key relationships she has formed and then, what she hopes to achieve going forwards and more broadly, why having a manager is instrumental in establishing the setup of the network, driving the key commitments and priorities - and managing  the wellbeing of the relationships between practice and PCN.

 

Introduction (30 secs)

 

All about Tara and how she became a PCN Manager (47 secs)

 

Has Tara’s prior experience helped? (2 mins 7 secs)

 

Organisational setup (2 mins 58 secs)

 

Incorporated status and NHS pensions implications (3 mins 54 secs)

 

Managing the incorporation process (4 mins 56 secs)

 

What does a typical working week look like for Tara? (6 mins 21 secs)

 

Recruitment and staffing (7 mins 28 secs)

 

The relationship between PCN Manager and Clinical Director (8 mins 38 secs)

 

Has having a PCN Manager in post allowed the Clinical Directors to drive the clinical priorities? (9 mins 43 secs)

 

The PCN demographic and practice engagement (10 mins 57 secs)

 

PCN Managers and Practice Managers (13 mins 5 secs)

 

The best things about being a PCN Manager (14 mins 55 secs)

 

Support network (15 mins 53 secs)

 

The forward view (17 mins 5 secs)

 

Lessons learned so far (17 mins 53 secs)

 

Following up in a year (19 mins 52 secs)

 

Getting in touch (20 mins 24 secs)

 

 

Tara is contactable at: tara.dawson1@nhs.net

Sep 20, 2020

It’s all about profitability on this week’s podcast. In the second of our Practice Index panels, Practice Managers Robyn Clark and Nicola Davies return and are this time joined by financial expert James Gransby to talk through the current pressures on practice income, particularly during this period of uncertainty. However they have also shared with us their practical advice for managing finances at a local level; how to maximise income, how to avoid commonly made mistakes, where to access the most up to date toolkits and resources to support good financial management and why some practices may operate differently but can be equally profitable.

 

Introduction (43 secs)

 

Is GP income down overall? (1 min 6 secs)

 

How do some practices maintain profitability whilst others are experiencing a drop in their income? (2 mins 43 secs)

 

Maximising income (Nicola’s approach) (3 mins 40 secs)

 

Robyn outlines the factors influencing profitability at her practice (5 mins 27 secs)

 

The importance of claiming income and checking you have been paid (6 mins 39 secs)

 

Common mistakes that practices are making (7 mins 2 secs)

 

The disparity in claim eligibility and the benefit of experience (8 mins 18 secs)

 

PCSE portal (10 mins 38 secs)

 

Dealing with the fallout of PCSE issues (10 mins 55 secs)

 

What is the decision-making process when presented with the opportunity of a new enhanced service? (11 mins 34 secs)

 

Why could an enhanced service prove profitable for one practice and not for another? (12 mins 44 secs)

 

What opportunities might practices be missing out on? (14 mins 24 secs)

 

The reasons why practices operate differently but can be equally profitable (16 mins 43 secs)

 

Final pay controls, pensions, and tax implications (19 mins 14 secs)

 

Robyn, Nicola, and James’ closing words of wisdom (20 mins 25 secs)

 

 

This is the blog James mentioned

 

Information about Practice’s Index’s PPA Toolkit can be found here

 

Another resource which has been really popular from AISMA and PI is here

 

Contact details for the panel are as follows:

Sep 13, 2020

So much has changed since the formation of PCNs at the beginning of last year in terms of availability of funding and staff and the governance of how we run our networks. As a result, many partnerships, practices, and networks are reconsidering their financial models and specifically, whether incorporation could prove more lucrative in the long run. This week’s podcast features our (almost) resident financial expert, James Gransby, Partner at RSM, who has waded through the reams of guidance and jargon to explain in simple terms what the pros and cons of PCN incorporation are likely to be; what are our options, what we need to watch out for and where the hidden benefits may be.

 

Introduction (36 secs)

What does incorporation mean and is this the direction of travel for PCNs? (55 secs)

Why PCNs may choose to change their financial model at this stage (1 min 38 secs)

VAT implications broadly (2 mins 11 secs)

Incorporation pros (3 mins 17 secs)

Setting up a PCN as a separate entity (4 mins 19 secs)

NHS pensions (5 mins 7 secs)

CQC registration (6 mins 38 secs)

What are the other governance obligations an incorporated body would have to meet? (7 mins 2 secs)

VAT and staffing setup (8 mins 11 secs)

Tax benefits? (9 mins 26 secs)

Impact and Investment Fund monies (10 mins 49 secs)

Should a PCN incorporate itself or use a local, already incorporated, federation? (11 mins 28 secs)

Will overall funding increases lead to a greater number of limited companies? (12 mins 33 secs)

A PCN in the open market… (14 mins 8 secs)

…versus as an NHS organisation (14 mins 55 secs)

GP practices and incorporation (15 mins 36 secs)

PMS agreements and GMS contracts (18 mins 12 secs)

Getting in touch (18 mins 58 secs)

 

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

Sep 6, 2020

A patient’s wellbeing underpins their physical health so what can we do to complement our existing models of care and ensure their wellbeing needs are met? One of our most popular guests (and as it turns out, podcast regular) Dr Neil Modha of Thistlemoor Medical Centre in Peterborough, is back on our sofa this week and believes the key lies in the relatively new health and wellbeing coaching roles. What are they? How do they fit within existing staffing and service models? How can practices and PCNs take advantage of these roles, particularly in line with the reimbursement scheme? And most importantly, what value do they add to practices and their patient populations?

 

Introduction (53 secs)

How has Neil’s practice coped during the pandemic? (1 min 34 secs)

The triage model at Thistlemoor (2 mins 24 secs)

The impact of Covid on general practice locally – and more broadly (3 mins 7 secs)

Integrating health and wellbeing coaches within a practice structure (4 mins 53 secs)

What is a health and wellbeing coach? What can they bring to our table? (6 mins 23 secs)

Are new people required to take on this role or can we upskill existing staff? (7 mins 30 secs)

Where Neil’s PCN are up to in the training and recruitment process (8 mins 39 secs)

The patient journey (10 mins 23 secs)

Caseload (11 mins 43 secs)

What does success look like? (12 mins 20 secs)

Who is responsible for running the training? (13 mins 33 secs)

Proving the impact (14 mins 17 secs)

Utilising funding from the Additional Roles Reimbursement Scheme (ARRS) (15 mins 49 secs)

Breaking down the financial benefits of the ARRS (17 mins 2 secs)

Where do health and wellbeing coaches fit within the context of the PCN DES? (18 mins)

Lessons learned so far (19 mins 54 secs)

Following Thistlemoor’s journey and additional resources (20 mins 57 secs)

 

Further information regarding health coaching can be found on Thistlemoor’s website here

The WHO wellbeing as a measure for wellbeing is an additional tool Neil and his team are using which should be completed at the beginning and end of the patient journey, to measure the impact of their health and wellbeing intervention.

If you would like to join the discussion or get in touch, both Neil and Thistlemoor are active in all the usual places:

Twitter:                https://twitter.com/ThistlemoorMC

https://twitter.com/neilmo

Instagram:           https://www.instagram.com/thistlemoorhealth/

Raw Horizons Academy are a recognised training provider for health and wellbeing coaches and their contact details are as follows:

Website:              academy.rawhorizons.co.uk/

Twitter:                https://twitter.com/RHA_Wellbeing

Facebook:           https://www.facebook.com/rawhorizons

Instagram:           https://www.instagram.com/rawhorizons/

Finally, the link to Neil’s podcast on his practice’s triage model (which Ben refers to) can be found here

Aug 30, 2020

The ability to be resilient, as an individual and as a team, has never been more important, particularly over the last 6 months and it is particularly difficult to maintain resilience during a period of such intense change and unpredictability. Luckily for us, executive coach Janice Steed has agreed to return to the podcast to dissect how resilience applies to Covid, how the changes faced by general practice have truly tested our ability to be resilient and offers a wealth of advice and practical tips on supporting primary care staff through the impacts of Covid - and the positive steps that can be taken to move forward from here.

 

Introduction (31 secs)

Janice’s initial thoughts (48 secs)

The impact of Covid on healthcare more broadly (1 min 35 secs)

….and on primary care staff (2 mins 37 secs)

Different phases of stress throughout the pandemic (3 mins 9 secs)

The ‘prepare’ phase (3 mins 56 secs)

The ‘active’ phase (4 mins 34 secs)

The implications of having low levels of resilience (5 mins 20 secs)

The ‘recovery’ phase and adjusting to life after the acute period of Covid (6 mins)

How do we take forward the positive solutions we have embedded and avoid reverting to old, more comfortable behaviours? (6 mins 50 secs)

Focus on communication, support for others and recognising that we may go backwards before we go forwards again (8 mins 5 secs)

Practical advice on establishing a support forum locally (10 mins 6 secs)

Who should be involved in a support forum? (12 mins 46 secs)

Can a support forum work virtually? (13 mins 4 secs)

The role of facilitator (14 mins 38 secs)

Getting in touch (15 mins 17 secs)

 

For further support and advice, please visit Janice’s website here

Janice is also contactable via janice@steedconsulting.co.uk

Aug 23, 2020

With the publication of a new Asthma UK report about how the use of data and technology can shape and transform the management of asthma in primary care, a wider discussion has now been prompted about how the same principles and recommendations within the report could shape chronic disease management in general practice overall. Dr Minal Bakhai and Dr Andy Whittamore have returned to the podcast to break down the specifics of the report, to share their experiences of implementing some of the recommendations, to discuss how we can better use data and tech to support innovation, how the improvement measures employed now could serve as a springboard for further success and the instant and long term impact on patients with asthma.

 

Introduction (35 secs)

Why has the report been published? (1 min 7 secs)

The current picture of asthma management in the UK and some stats (1 min 22 secs)

What has Asthma UK done so far? (3 mins 6 secs)

Asthma as a gateway condition for trial of tech in chronic disease management (3 mins 58 secs)

Has Covid been a contributing factor? (4 mins 14 secs)

Minal’s view; does asthma hold the key for successful implementation of tech in managing long term conditions? (5 mins 27 secs)

Total digital triage (6 mins 59 secs)

Digital First Primary Care accelerators and the work towards integrated care pathways (8 mins 11 secs)

The Portsdown experience (9 mins 32 secs)

Employing better analytics; what data skills are required? Which data samples should we be focused on? Who is responsible? (10 mins 58 secs)

Other improvement measures that Andy and Portsdown have employed (12 mins 30 secs)

The results of the changes at Portsdown (14 mins 36 secs)

The role of PCNs (15 mins 22 secs)

Minal’s view on the potential for influence and outcomes at PCN level (16 mins 37 secs)

A permanent change in the future of general practice? (18 mins 14 secs)

Resources, guidance, capacity support, accelerated procurement pathways and training – all available from Digital First Primary Care (19 mins 40 secs)

Accessing the report and support from Asthma UK (22 mins 48 secs)

 

Here is the link to the report

Asthma UK: https://www.asthma.org.uk/

Digital First Primary Care home page: https://www.england.nhs.uk/gp/digital-first-primary-care/

Aug 16, 2020

Networks and practices are planning in earnest for a more complex flu vaccination season involving all the normal the challenges of ensuring adequate staffing numbers, facilities and PPE are in place – and the right levels of vaccine are in stock. This year’s campaign is additionally complicated by the confusion about how the immunisation programme can be delivered practically in the era of Covid and the near constant changes in national guidance. This week’s podcast features a panel of experts in Practice Managers Robyn Clark and Nicola Davies who, together with Ben, try to unpick some of the issues and give an insight into their own preparations in order to support others in their planning for winter 2020.

 

A panel of experts (9 secs)

 

Introductions (45 secs)

 

Robyn practice and professional background (1 min 11 secs)

 

Nicola’s PCN, practice and career history (1 min 54 secs)

 

Changes to the flu vaccination programme for 2020 (2 mins 52 secs)

 

Issues with supply (3 mins 51 secs)

 

Staff anxieties (4 mins 11 secs)

 

Flu targets and the eligibility criteria (4 mins 32 secs)

 

Current guidance (5 mins 49 secs)

 

Vaccine demand (6 mins 13 secs)

 

Is there anything we can be doing now to boost our supply? (9 mins 12 secs)

 

Vaccination storage (9 mins 31 secs)

 

Mutual aid (10 mins 9 secs)

 

PPE (11 mins 6 secs)

 

Debating the use of PPE and advice on maintaining stock (13 mins 24 secs)

 

How will administration of the vaccines work in practice? (14 mins 53 secs)

 

Are there benefits to non-clinical staff being trained in vaccine administration? (18 mins 1 sec)

 

Medico-legal implications (18 mins 45 secs)

 

Car park clinics and drive throughs (20 mins 20 secs)

 

Practice versus PCN delivery models (21 mins 44 secs)

 

Data collection and recording information (23 mins 12 secs)

 

Final thoughts (25 mins 27 secs)

 

This episode of the podcast is a joint collaboration between Ockham Healthcare and Practice Index and we’d love to get your thoughts and feedback! To get in touch you can email Ben via ben@ockham.healthcare or James Dillon via james.dillon@practiceindex.co.uk

Aug 9, 2020

It can be tough at the top for many clinical directors but does being in the role as a nurse offer an alternative perspective? Do the challenges differ or are there additional benefits to coming to the role from a slightly different background? Ben Scott is an ANP and Clinical Director for Doncaster South PCN and has taken time out of his busy schedule to speak to us about his experiences from starting life as a professional footballer, to health professional and leader - and his journey to becoming a clinical director.

 

Introductions (33 secs)

An unlikely route into general practice (50 secs)

Ben’s journey as a health service professional (1 min 39 secs)

The transition to general practice (2 mins)

A clinical directorship post beckons (2 mins 34 secs)

Doncaster South PCN: the stats (3 mins 10 secs)

….and the culture (3 mins 47 secs)

Working amongst GPs as a nurse clinical director (4 mins 41 secs)

Does Ben feel he’s had to work harder to establish himself in the leadership role? (5 mins 36 secs)

The experience of other CDs and their influence on Ben (6 mins 25 secs)

Developing as a leader (7 mins 12 secs)

Establishing a support network (7 mins 37 secs)

What are the benefits to being a nurse clinical director? (8 mins 38 secs)

The effect on recruiting additional roles (9 mins 39 secs)

The first year as a CD; focusing on the good and learning from the not so good (11 mins 13 secs)

Lessons learned (12 mins 19 secs)

Overcoming mistrust (12 mins 57 secs)

Words of wisdom for those considering a clinical leadership position (13 mins 41 secs)

Getting in touch (14 mins 38 secs)

 

Ben is contactable via @ScottyANP35

If you want to hear more from Ben, he will be speaking at the Best Practice Show which is taking place in October and is free for all healthcare professionals to attend. You can reserve your place here

Aug 2, 2020

What is population health management, and can it really make a difference? Does it really offer a holistic solution to meeting health needs, supporting better integrated care and relieving day to day pressure on practices and networks? Dr Dan Alton is a GP at the Wargrave Surgery in Berkshire and the Population Health Management (PHM) clinical lead for West Berkshire CCG. In addition, he is an NHS England PHM Champion and has a wealth of experience in applying the PHM principles and is on our sofa this week to shine a light on all things PHM; what it is, how it can be applied at scale yet tailored locally, the lessons he has learned and most importantly, how to realise the benefits.

Introductions (32 secs)

What is Population Health Management (PHM)? (1 min 4 secs)

Joining up data with local knowledge (1 min 25 secs)

Embedding proactive integrated care which meets individual and whole community health needs (2 mins 53 secs)

Dan explains how he became involved in PHM (4 mins)

Finding from the national NHS England wave 1 PHM Development Programme in Berkshire West (5 mins 28 secs)

Resulting interventions (7 mins 16 secs)

The conclusions (8 mins 17 secs)

What were the datasets that led to those interventions and how were they identified? (8 mins 41 secs)

How data can be used effectively regardless of its complexity (9 mins 45 secs)

10% PHM data 90% cultural change (10 mins 21 secs)

How do you convert data into patient conversations? (11 mins 51 secs)

Positive, measurable outcomes as a result of a PHM approach (13 mins 32 secs)

Applying PHM principles in response to Covid (14 mins 38 secs)

Accelerating the process to identify areas of need during the pandemic (17 mins 4 secs)

Can PHM support the development of the PCN? (18 mins 49 secs)

Access to further information and PHM resources (20 mins 16 secs)

 

The NHSE/I PHM Academy website contains a wealth of resources, contacts and materials to support practices and PCNs in engaging with the PHM agenda

The NHS England Population Health Management Development website is here

If you want to hear more from Dan, he will be speaking at the Best Practice Show which is taking place in October and is free for all healthcare professionals to attend – you can reserve your place here

 

Jul 26, 2020

accuRx have been on an interesting journey and one that they may not always be given credit for, given the overnight and overwhelming success of the simple, yet game changing software they have introduced to general practice over the last four months. From modest beginnings, working out of small numbers of practices on process improvement measures, to the inception of the messaging service and video consultations, super rapid rollouts, continuous reinvention and pioneering tech in scope for the future, co-founder Jacob Haddad takes Ben through, arguably, one of tech's biggest triumphs in healthcare and what accuRx means for primary care and beyond.

 

Introductions (45 secs)

Where accuRx began (1min 8 secs)

A turning point (1 min 36 secs)

The messaging service (2 mins 5 secs)

The cause for the change in direction (2 mins 45 secs)

Communication, communication, communication (4 mins 25 secs)

A new approach to rollout (5 mins 16 secs)

Video consultations and Covid triage (6 mins 15 secs)

Feature design with patients and practice in mind (8 mins 9 secs)

Rollout timeline (8 mins 24 secs)

Identifying the need for more effective patient communication tools (9 mins)

The surge in demand (9 mins 50 secs)

Filling a gap in the market (10 mins 17 secs)

Has the messaging service been the key enabler of change and improvement in healthcare? (11 mins 31 secs)

Security, governance and information sharing (12 mins 1 sec)

How long will the service continue to be free to use? (14 mins 17 secs)

The "plus" tier (15 mins 50 secs)

accuRx ethos (16 mins 6 secs)

Working alongside health to build great tech (17 mins 54 secs)

What's next for accuRx? (18 mins 55 secs)

Staying up to date / more information (21 mins 49 secs)

 

For updates on what's next on the accuRx horizon:

Twitter @accuRx

The accuRx Facebook user group is here

Jul 19, 2020

accuRx have been hailed as the overwhelming success story of the Covid crisis, with a rapid deployment of much needed virtual tech into practices up and down the country and enabling primary teams to maintain high quality care for their patients. Ben is joined on this week’s podcast by GP and IT champion Dustyn Saint of Primary Care Pathways, to discuss the accuRx journey, what their breakout success has meant for general practice and how their influence is likely to extend beyond the pandemic.

Introductions (35 secs)

Primary Care Pathways (44 secs)

When did Dustyn first hear about accuRx? (1 min 33 secs)

Text messaging (1 min 58 secs)

How does the accuRx messaging service work alongside existing clinical systems? (3 mins 28 secs)

What other features does the messaging tool offer? (4 mins 6 secs)

A “game changing” video consultation service and its effect on general practice during the pandemic (4 mins 49 secs)

A comparison with previous video consultation applications (5 mins 54 secs)

How easy was it for colleagues and staff to adapt to using the accuRx systems? (6 mins 56 secs)

Widespread adoption across general practice (7 mins 41 secs)

Working with other providers and additional functionality (8 mins 8 secs)

Are virtual consults here to stay? (8 mins 35 secs)

The effect of tech on managing care going forwards (9 mins 21 secs)

Remote monitoring (10 mins 38 secs)

A turning point for primary care? (11 mins 30 secs)

The accuRx journey (12 mins 10 secs)

accuRx financial model and the procurement process (12 mins 53 secs)

A comparison against other business models; past and present (14 mins 8 secs)

The impact on working practices and benefits to patients (14 mins 4 secs)

Security and governance (15 mins 37 secs)

GP testimonial (16 mins 38 secs)

What’s next for Primary Care Pathways? (16 mins 58 secs)

Getting in touch (18 mins 11 secs)

 

For more information on Primary Care Pathways and making direct contact with Dustyn:

Primary Care Pathways website here

Primary Care Pathways first Ockham podcast episode is available here

Contact @PrimaryCareIT / @DustynSaint

Jul 12, 2020

Resilience in primary care has been truly tested by recent events but we are going back to basics on this week’s podcast as we talk to former midwife turned executive coach Janice Steed about why the resilience of a practice and its people is key to its success overall. What are the indicators of a resilient practice, where are the red flags and what are the clear elements that we must consider if we are to make improvements? Janice offers advice, gives her thoughts and shines a light on the Beds and Herts journey, following the introduction of their resilience programme there.

 

Introductions (44 secs)

 

What inspired Janice to become involved in resilience improvement? (1 min 16 secs)

 

The general practice resilience programme in Bedfordshire and Hertfordshire (1 min 50 secs)

 

Why the programme was introduced (2 mins 21 secs)

 

How the programme began (2 mins 41 secs)

 

Resilience: key indicators that a practice may be struggling (4 mins 3 secs)

 

Practice versus personal resilience (5 mins 47 secs)

 

Engaging the whole practice through its individuals (7 mins 30 secs)

 

The LMC’s role in improving resilience (8 mins 29 secs)

 

Practical elements for consideration (9 mins 16 secs)

 

The Beds and Herts resilience programme outline (10 mins 32 secs)

 

An overview of the programme’s six modules (12 mins 5 secs_

 

The impact of Covid on general practice resilience (15 mins 28 secs)

 

PCNs and their influence (15 mins 41 secs)

 

Getting in touch / further information (17 mins 49 secs)

 

 

For more information about Janice, her website is here

Details on the Beds and Herts resilience journey can be found on their LMC website here

Jul 5, 2020

Covid-19 has presented many challenges for GPs, not least the changes they have had to enact to ensure they are able to continue safe and effective management of patients with long terms health conditions. This week’s podcast features GP Dr Andrew Whittamore, Clinical Lead at the Asthma UK and British Lung Foundation Partnership and fellow GP Dr Minal Bakhai, National Clinical Director for Digital First Primary Care, who discuss the impact that the rapid introduction of tech and a more tech based approach in primary care has meant overall but also more crucially, how the opportunities presented by Covid have enabled them to offer increased flexibility and adaptability to meet patients’ needs - and to reach previously untapped patient populations.  

 

Introductions (35 secs)

 

Which of the changes has had the most beneficial effect? (1 min 1 sec)

 

A total triage model of care (1 min 31 secs)

 

Remote consultations in numbers (2 mins 12 secs)

 

Using the wider workforce and rapid progress in other areas (3 mins 17 secs)

 

Remote monitoring and the impact on management of long-term conditions (4 mins 10 secs)

 

Andy’s experience from Portsdown Group Practice

 

The opportunities presented by Covid (5 mins 54 secs)

 

Was Covid the enabler for change or was this already the direction of travel? (6 mins 37 secs)

 

The power of shared purpose and streamlining services (8 mins 24 secs)

 

How has the shift to digital changed the management of patients with long term conditions? (8 mins 41 secs)

 

The risks new ways of working may present to patients with asthma and other lung conditions (10 mins 32 secs)

 

Asthma: the facts (and the ways digital transformation can improve outcomes) (11 mina 44 secs)

 

What happens next? (14 mins 38 secs)

 

Continuing the momentum at PCN level (17 mins 45 secs)

 

The importance of being able to align primary care services to patient lifestyle and preference (18 mins 38 secs)

 

Getting in touch and further information (19 mins 18 secs)

 

 

Links for guidance and support in setting up a digital model:

 

Advice on how to establish a 'total triage' model in general practice using online consultations

 

Health Education England e-learning on remote total triage model in general practice

 

Principles for safe video consulting during Covid-19

 

Digital First Primary Care home page: https://www.england.nhs.uk/gp/digital-first-primary-care/

 

Contact Digital First Primary Care: england.digitalfirstprimarycare@nhs.net

 

 

Specific links related to management of asthma:

 

Here is the link to all of the asthma uk publications

 

Specifically digital asthma: reimagining primary care

 

Minal mentioned this report looking at data sharing and technology exploring the attitudes of people with asthma  

 

asthma.org.uk

 

blf.org.uk

Jun 21, 2020

With the focus shifting back towards the normality of day to day working, primary care now has scope to reconsider the opportunities presented by the Additional Roles Reimbursement Scheme in building workforce capacity and to establish further transformative working practices. This week’s spotlight is on the role of the pharmacist and we are fortunate to be joined by the experienced and progressive Steve Williams, who is a Clinical Pharmacist and network lead in his area of expertise based at Westbourne Medical Centre in Dorset. Here, Steve explains how his role fits both at practice and at network level - and gives his advice on making the best use of pharmacy professionals, and the additional roles more broadly, in general practice.

 

Introductions (36 secs)

 

Steve’s journey to becoming a PCN pharmacist (1 min 3 secs)

 

Why a move into general practice? (2 mins 33 secs)

 

Steve describes the transition from secondary to primary care (3 mins 15 secs)

 

The key differences (3 mins 44 secs)

 

What was the practice’s initial reaction to taking on a pharmacist? (4 mins 53 secs)

 

Embedding new roles; advice on induction and adapting your structures (6 mins 23 secs)

 

Maximising the impact from a network perspective (7 mins 18 secs)

 

An opportunity for innovation (9 mins 59 secs)

 

The role of a pharmacy technician and the skills they can offer (10 mins 50 secs)

 

Future plans and further expansion (12 mins 17 secs)

 

The influence of the DES on utilising new roles (13 mins 50 secs)

 

How will the role of the pharmacist develop further? (15 mins 28 secs)

 

Getting in touch (16 mins 42 secs)

 

Steve is contactable via email, Twitter and through Westbourne Medical Centre:

stevethechemist@onelesspill.com

@stevechemist

https://www.westbournemedical.com/

@BayPcn

 

The links for the supporting documents Steve references:

Link re "Practice to PCN role – A Pharmacist’s journey" presentation for Dorset CCG PCN Development Event on Understanding and establishing Clinical Pharmacy in PCNs 15th January 2020  

https://youtu.be/5O5WFcdZFDM 

 

Structured medication reviews research at WMC

Steve Williams, Lawrence D Brad. Impact of practice based clinical pharmacist led medication reviews on ambulatory patients with hyper polypharmacy. Br J Gen Pract 2018; 68 (suppl 1) https://doi.org/10.3399/bjgp18X697097

 

Viewpoints on pharmacists in primary care published with GP Prescribing lead Dr Lawrence Brad 

Williams SD, Hayes JM, Brad LD.  Clinical pharmacists in general practice: a necessity not a luxury? British Journal of General Practice. Br J Gen Pract 2018; 68 (667): 85. DOI: https://doi.org/10.3399/bjgp18X694697

https://blogs.bmj.com/bmj/2018/06/26/time-pharmacist-support-general-practice-improve-medicines-optimisation/

https://bjgplife.com/2020/06/17/clinical-pharmacists-within-primary-care-networks-another-driver-for-collaborative-general-practice/

 

Useful documents / websites re pharmacy professionals working in primary care RPS Wales Multidisciplinary Teams (MDT) in General Practice

https://www.rpharms.com/Portals/0/RPS%20document%20library/Open%20access/Wales/00215%202001-Welsh-MDT-English-AWD.pdf?ver=2020-02-07-140429-840

 

PRESQIPP

NHS funded not-for-profit organisation that supports quality, optimized prescribing for patients Virtual Professional Network for pharmacy starting April 2020 (membership required) 

https://www.prescqipp.info/news/prescqipp-practice-plus/

 

Primary Care Pharmacy Association (PCPA)

https://www.pcpa.org.uk/ (membership required)

https://pcpa.org.uk/assets/documents/Guide-for-GPs-considering-employing-pharmacist.pdf

Jun 14, 2020

We have been fortunate to have been able to share a number of best practice stories throughout the Covid-19 crisis and this week’s podcast is no exception. Ben is joined by Dr Lorenz Kemper, a GP who co-founded MedLink Solutions, a unique online platform which allows practices to remotely manage reviews of patients with long term conditions and chronic disease. Lorenz explains how the system was launched, how it works, and the impact it is having - allowing clinical teams to reach previously inactive patients, creating greater flexibility in management of clinical time and crucially, enabling practices to continue vital routine care for their patients safely.

Introductions (36 secs)

The challenge of remotely monitoring primary care’s ‘routine’ workload (47 secs)

Who was involved in setting up MedLink? (1 min 27 secs)

How the MedLink solution was designed (1 min 55 secs)

The first patient cohort and system rollout (2 mins 35 secs)

Reaching previously inactive patients (3 mins 8 secs)

The mechanics of the solution and establishing patient contact (3 mins 47 secs)

What about the patients who can’t be reached via MedLink? (4 mins 48 secs)

Impact on practice workload and how the process is managed (5 min 30 secs)

Capacity creation (6 mins 58 secs)

What are the key benefits of MedLink? (7 mins 22 secs)

How has MedLink been grown and extended beyond Lorenz’s practice? (8 mins 17 secs)

The Covid effect (8 mins 55 secs)

How flexible is the system? (9 mins 15 secs)

The process for designing the review questionnaires (10 mins 5 secs)

Patient and practice feedback (11 mins 26 secs)

A gateway to safer and more flexible care in the current climate? (12 mins 25 secs)

Future plans and further development (13 mins 41 secs)

Getting in touch (15 mins)

 

This week’s podcast has been sponsored by MedLink Solutions

Medlink solutions are offering a 3-month free trial to help practices during COVID. To find out more simply visit their website or email Lorenz at info@medlinksolutions.co.uk

Jun 7, 2020

Covid has presented many challenges for practices and networks but many have risen to the challenge and found that, as a result, they have been able to accelerate many existing projects and are seeing hugely positive outcomes. Sovereign Health, made up of three practices based in Hampshire, are one example of a network who have enacted rapid change as a result of the crisis and are now at the point of considering what to keep, how to rebalance network versus local priorities and how to maintain momentum going forwards. Clinical Director Dr Tom Bertram, Network lead Amanda Gray and Nursing lead Laura Miller share their story of what they did, what they achieved and where they are now. .

Introductions (39 secs)

The first year as a primary care network (1 min 45 secs)

Creation of a same day service (2 mins 1 sec)

Amanda’s transition from practice manager to practice manager and network lead (3 mins 6 secs)

When Covid happened (4 mins 17 secs)

A ‘command and control’ approach (5 mins 1 sec)

Mixing up the workforce; working by risk profile (5 mins 35 secs)

The challenge of losing a practice’s identity (6 mins 53 secs)

Staff reaction (admin and management) (7 mins 59 secs)

Support for the wider teams, both clinical and non-clinical (8 mins 52 secs)

What was the impact on the nursing teams and how did Laura manage this? (9 mins 43 secs)

How do the nurses feel now? (11 mins 5 secs)

Results from the staff survey (11 mins 31 secs)

What other changes have been made? (12 mins 4 secs)

A shared pharmacy service (12 mins 31 secs)

The telephone hub (13 mins 25 secs)

Single route access to the network (13 mins 41 secs)

Patient feedback (14 mins 33 secs)

Rebalancing network and practice priorities post Covid (15 mins 5 secs)

Population health management (15 mins 54 secs)

Juggling practice and network priorities as a local manager and network lead (16 mins 58 secs)

Summarising the overall effect of Covid on the network (17 mins 54 secs)

Getting in touch (19 mins 9 secs)

 

Amanda Gray, Sovereign Health Network lead: amanda.gray2@nhs.net

Dr Tom Bertram, Clinical Director, Sovereign Health Network: tom.bertram@nhs.net

May 31, 2020

The challenges presented by the Covid crisis have seen an acceleration of many existing transformation projects in general practice, particularly where use of tech and a move to a digital infrastructure is concerned. This week’s podcast features a panel of experts from the London region who bring a clinical, project and programme perspective on the hugely successful transition to online and video consultations and an insight into the brand-new NHS app. From triage and the creation of a digital front door to managing an incredibly rapid deployment, the importance of effective communication and the public response, here is how, in a few short weeks, they have enabled 91% of London practices to offer online consultations and 100% who now have the ability to deliver video consultations to support their patients.

Introductions (36 secs)

The challenge presented by Covid (2 mins 11 secs)

How was the transition to online and video consultations enabled? (3 mins 17 secs)

The deployment from a clinical perspective (5 mins 8 secs)

Patient response (7 mins 30 secs)

The NHS app (9 mins 19 secs)

Rollout across the STP area (10 mins 57 secs)

Why each London borough was managed differently (13 mins 44 secs)

What has been the impact of both online and video consults? Has one proved more successful than the other? (14 mins 54 secs)

Was hardware a critical success factor? (16 mins 33 secs)

Future plans (18 mins 22 secs)

Life after Covid? (19 mins 55 secs)

What happens next from a practice point of view? (20 mins 48 secs)

Getting in touch (22 mins 51 secs)

 

If you would like to know more, you can contact the London Digital First Programme team and / or Emily, Sustainability and Transformation Partnership (STP) project lead for North Central London:

Digital First Programme (London): england.londondtt@nhs.net

STP lead: Emily.mitchell9@nhs.net

May 24, 2020

Robert McCartney and Stephen Kemp specialise in supporting and developing innovative and sustainable primary care services. Here, they take us through their experiences of setting up Covid ‘hot’ sites in the south Kent area, in response to the global pandemic; how the projects were mobilised, what were the key consideration factors and what they learned along the way.

Introductions (9 secs)

The network set up (1 min 54 secs)

When did the planning for a ‘hot’ hub begin? (3 mins 1 sec)

Overcoming the logistical challenges (4 mins 56 secs)

From idea to go-live (6 mins 12 secs)

Staffing a ‘hot’ site (6 mins 42 secs)

The cost implications for a practice or network (8 mins 23 secs)

Activity levels so far (9 mins 6 secs)

Boosting the numbers (9 mins 54 secs)

Lessons learned (11 mins 24 secs)

Internal versus external spaces (12 mins 24 secs)

Can there be a centralised model? (14 mins 20 secs)

Planning for the future of Covid (15 mins 39 secs)

Getting in touch (17 mins 19 secs)

Robert’s email: rm@mccartneyhealth.co.uk

Stephen’s email: skemp@mccartneyhealth.co.uk

McCartney Healthcare Associates website here

Twitter: @McCartneyHealth

LinkedIn

May 17, 2020

With PCNs and practices facing the impending deadline for their decision on the Network Contract Directed Enhanced Service (DES) Contract Specification for2020/21, Ben talks to Justin Cumberlege, who specialises in providing legal advice to the primary care healthcare sector as a partner at Hempsons Solicitors. From the contract specifics, to the key considerations and the legal and practical implications in between, this week’s podcast offers a bitesize overview of what primary care should be mindful of before 31 May 2020.

Introductions (14 secs)

How is this year’s network DES different? (38 secs)

The challenges so far (1 min 41 secs)

Publication timing (2 mins 53 secs)

What does sign up mean for practices and networks? What are the timescales? (4 mins 26 secs)

What if a practice does not want to be part of their PCN going forwards? (5 mins 49 secs)

Can the PCN configuration be changed at this point? (7 mins 15 secs)

The thorny issue of ‘expelling’ a practice from a network (7 mins 46 secs)

Justin’s highlights the key considerations for practices and networks, ahead of the sign-up deadline (8 mins 15 secs)

Reviewing the network agreement (9 mins 35 secs)

Requirements of collaboration (11 mins 39 secs)

The repercussions of breaching the contract (14 mins 15 secs)

Defining the difference between the PCN DES and the PMS agreement and GMS contract (17 mins 23 secs)

Focusing on the small print and implications of worst-case scenarios (18 mins 18 secs)

If practices sign up this year, what are the implications for opt out next year? (19 mins 9 secs)

Getting in touch (20 mins 6 secs)

 

Hempsons website here

Justin is contactable via email: j.cumberlege@hempsons.co.uk

May 10, 2020

Tara Humphrey, our 'almost' resident Project Management expert supporting the development of Primary Care Networks and GP Federations, returns for a third episode in a series of podcasts covering the pandemic from a management and support perspective. This week Tara and Ben reflect on where they are up to in their own roles, within their own areas, with their focus shifting towards life after Covid and more traditional priorities – but with the added benefit and experience of the best practice that has taken place during recent times.

Introductions (14 secs)

Drive through immunisations (1 min 14 secs)

What has been happening in Tara’s world? (2 mins 35 secs)

Planning for life after Covid? (3 mins 6 secs)

Considering new priorities in a GP Federation schedule (4 mins 6 secs)

The Care Home challenge (4 mins 56 secs)

Modelling a new Care Home scheme (5 mins 47 secs)

Ben’s experiences of aligning care homes to practices and PCNs (6 mins 46 secs)

The network mindset (8 mins 19 secs)

Tara and Ben discuss the PCN DES more broadly (9 mins 14 secs)

Positive impacts as a result of the pandemic? (9 mins 57 secs)

Building on the positives; opportunities for further partnership working (11 mins 1 sec)

The theory of change and maintaining momentum (13 mins 16 secs)

Th effect of crisis working (14 mins 43 secs)

Learning lessons (15 mins 27 secs)

What’s next for Tara? (16 mins 6 secs)

…and for Ben? (16 mins 58 secs)

 

Find out more about Tara Humphrey:

May 3, 2020

During a time when many GP surgeries across the nation are managing near total transformation of their working practices, James Davies, a Practice Manager at Amicus Health, features on this week’s podcast to tell their story. From the highs to the not so highs, to the tech they’ve employed, the valuable lessons they have learned and the bits of their new processes they would like to retain for the future, this week’s podcast is a one stop shop for all things remote working during the era of Covid-19.

Introductions (26 secs)

Amicus Health – the stats (41 secs)

The ‘GP heavy’ model (58 secs)

When did their transformation journey begin? (1 min 51 secs)

How to embed a system of remote working and enabling staff to work from home (2 mins 34 secs)

Away From My Desk (4 mins)

Access to full clinical software (4 mins 44 secs)

Explaining the ‘soft phones’ system (5 mins 18 secs)

What does a typical day look like in the new world? (6 mins 11 secs)

Staff reactions (7 mins 59 secs)

Striking the balance of staffing cover (9 mins 1 sec)

Which roles fit remote working best? (10 mins 7 secs)

Continuing effective staff management (11 mins)

Is dedicated IT support required? (12 mins 24 secs)

What happens next? (13 mins 8 secs)

Opportunities for further transformation and planning for the future (14 mins 47 secs)

What will Amicus Health retain going forwards? (15 mins 41 secs)

Lessons learned (16 mins 41 secs)

Getting in touch (18 mins 41 secs)

 

James is contactable at: jamesw.davies@nhs.net

https://www.amicushealth.nhs.uk/

Apr 27, 2020

Is now the right time to making the most of the funded social prescribing link worker roles? Christiana Melam, Chief Executive at the National Association of Link Workers and Nicola Gitsham, Head of Social Prescribing at NHS England think so. Here, they talk to Ben about the history of the role, how practices and PCNs can maximise holistic patient care through the employment of the link workers and why they are a crucial element in managing the impact and the effects of the Covid-19 crisis.

Introductions (14 secs)

The evolution of the link worker role (1 min 21 secs)

What has been the impact of the pandemic on social prescribing link workers? (2 mins 50 secs)

How has the role changed in recent weeks? (7 mins 56 secs)

Why the link workers are the key to maintaining joined up patient care during the pandemic (9 mins 16 secs)

Recruitment of a social prescribing link worker (11 mins 21 secs)

Maximising the effectiveness of a social prescribing link worker in practice (12 min 53 secs)

NHS England and NALW resources (14 mins 42 secs)

 

NHS England links, contacts and resources:

Guidance on the role social prescribing link workers in supporting the response to COVID 19

GP Preparedness Letter: 27 March and Covid/GP Standard Operating Procedure (SOP) updated 6 April set out the role of the SPLW in supporting the response to COVID19

“Social prescribing link workers form part of the multidisciplinary teams in primary care networks (PCNs) and are uniquely placed to work closely with GPs, local authorities, health and care professionals and voluntary sector partners to coordinate support for these people whilst they are self-isolating.”

Network Contract Directed Enhanced Service (DES) Specification 2020/21:

https://www.england.nhs.uk/wp-content/uploads/2020/03/network-contract-des-specification-pcn-requirements-entitlements-2020-21.pdf

Key sections for social prescribing link workers:

Learning and development (Annex B/B3.2)

Referrals to social prescribing link workers must be recorded using the SNOMED codes (Annex B/B3.6)

All the additional roles employed by a PCN or engaged via a sub-contract (including social prescribing link workers) must have access to other healthcare professionals, electronic ‘live’ and paper based record systems of the PCN’s Core Network Practices (section 6.4.1.)

Details on the NHSE delivery support offer

Social prescribing collaborative platform – with active discussion forum. To sign up to the collaborative platform, email england.socialprescribing@nhs.net

Weekly webinars for SP link workers specific to the  COVID-19 response. More information is on the collaborative platform.

Regional learning coordinators facilitate virtual peer support for link workers and providing additional support and information.  Contact details available from england.socialprescribing@nhs.net

Existing resources and support for social prescribing link workers (such as ) : https://www.england.nhs.uk/personalisedcare/social-prescribing/support-and-resources/

Regional facilitators and regional delivery teams available to support recruitment of link workers

 

Nicola has also included a blog she did for the National Academy of Social Prescribing: http://www.socialprescribingacademy.org.uk/time-to-come-together/

 

National Association of Link Workers resources and contacts:

Covid 19-Hub

Learning syllabus

Code of practice

Other resources

 

 

 

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