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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
Apr 8, 2020

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

Introductions (10 secs)

The ScotGEM Programme update (23 secs)

How HealthSHIP began (1 min 30 secs)

Why healthcare students? (2 mins 25 secs)

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

HealthSHIP right now (3 mins 33 secs)

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

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

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

Access and signup information (7 mins 45 secs)

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

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

 

Web: http://healthship.org

email: hello@healthship.org

Twitter: @HealthSHIP_UK

Apr 5, 2020

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

Introductions (38 secs)

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

Portland Medical: the stats (2 mins 32 secs)

Decreasing locum use (3 mins 3 secs)

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

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

Video consultation (6 mins 9 secs)

What tech is required? (6 mins 58 secs)

Telephone versus video consultations (7 mins 36 secs)

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

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

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

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

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

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

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

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

Patient feedback (19 mins 51 secs)

Final thoughts (20 mins 17 secs)

Getting in touch (20 mins 17 secs)

 

Preparedness update letter for general practice: 27 March 2020 here

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

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

Mar 29, 2020

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

Introductions (22 secs)

The state of play locally (56 secs)

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

Practical considerations (2 mins 17 secs)

The importance of communication (3 mins 46 secs)

Site/s management (5 mins 8 secs)

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

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

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

Crisis leadership (10 mins 59 secs)

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

Next steps (16 mins 37 secs)

Supporting well-being (17 mins 50 secs)

 

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

Find out more about Tara Humphrey:

Mar 16, 2020

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

 

Introductions (48 secs)

Delegated commissioning (1 min 33 secs)

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

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

Measuring the impact on investment (4 mins 7 secs)

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

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

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

PCNs and funding distribution (9 mins 46 secs)

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

‘Proportionate universalism’ (12 mins 38 secs)

Do hybrid models work? (13 mins 58 secs)

Plans for the future (15 mins 17 secs)

Opportunities within a PCN framework (16 mins 27 secs)

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

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

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

 

https://eastleicestershireandrutlandccg.nhs.uk/

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

Mar 9, 2020

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

Introductions (42 secs)

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

Bracknell mental health project pilot (1 min 42 secs)

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

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

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

Practice Managers and collaborative working (6 mins 6 secs)

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

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

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

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

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

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

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

Advice on joined up working (15 mins 30 secs)

Keeping in touch (16 mins 51 secs)

 

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

Mar 2, 2020

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

Introductions (45 secs)

PCNs: First impressions (1 min 40 secs)

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

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

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

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

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

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

Are PCNs a “fad”? (8 mins 33 secs)

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

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

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

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

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

LMC future role (18 mins 15 secs)

Getting in touch (19 mins 30 secs)

 

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

Cheshire LMC office: 01244 313483

Feb 24, 2020

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

Introductions (48 secs)

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

Workforce implications (2 mins 15 secs)

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

The lead practice model (5 mins 21 secs)

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

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

Clinical Director pay (9 mins 18 secs)

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

Year End accounts (13 mins)

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

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

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

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

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

Getting in touch (23 mins 10 secs)

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

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

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

HMRC updates discussed (26 mins 25 secs)

 

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

https://www.rsmuk.com/

Feb 17, 2020

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

Introductions (9 seconds)

First impressions (57 secs)

PCN focus (1 min 29 secs)

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

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

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

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

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

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

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

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

The Impact & Investment Fund (13 mins 12 secs)

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

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

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

Increasing GP numbers (17 mins 55 secs)

Access improvement (19 mins 40 secs)

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

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

 

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

Feb 10, 2020

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

 

Introductions (36 secs)

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

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

The Moving Medicine website (2 mins 54 secs)

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

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

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

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

The potential for wider impact (8 mins 16 secs)

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

Wellbeing champions & best practice (11 mins 29 secs)

“Active Practice” resources (12 mins 5 secs)

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

Support from the link workers (14 mins 31 secs)

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

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

Final word from Sarah (17 mins 42 secs)

 

Moving Medicine website

https://movingmedicine.ac.uk/

 

Public Health England: National guidelines on physical activity

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

 

RCGP Guidance

parkrunpractice

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

Physical Activity & Lifestyle Toolkit

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

GP On-Call Bike

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

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

 

Where to find your local Physical Activity Clinical Champion

email: physicalactivity@phe.gov.uk

 

Jan 13, 2020

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

Introductions (46 secs)

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

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

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

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

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

The PCN paradox (8 mins 14 secs)

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

The challenges of linear development (10 mins 15 secs)

The Maturity Matrix (11 mins 34 secs)

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

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

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

…and the challenges (16 mins 33 secs)

The current perception of PCNs (16 mins 54 secs)

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

Working at scale = larger resources (21 mins)

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

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

NAPC resources and case studies (24 mins 7 secs)

Greater Manchester GP Excellence Programme (25 mins 9 secs)

 

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

https://napc.co.uk

https://gpexcellencegm.org.uk   

 

 

Jan 6, 2020

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

 

Introductions (31 secs)

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

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

Importance of collaboration (2 mins 2 secs)

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

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

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

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

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

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

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

Defining PCN membership (9 mins 30 secs)

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

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

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

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

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

Just say “no” (17 mins 23 secs)

Further information (19 mins 35 secs)

 

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

www.beckymalby.wordpress.com

www.source4networks.org.uk

Dec 16, 2019

In our final podcast of 2019, Ben talks to David Cowan, Care Navigation Lead at Conexus Healthcare, about how care navigation and the newly introduced link worker roles can assist in easing the pressure on PCNs. What are the key elements of the link worker role, where do link workers sit within existing staffing frameworks and how can they make the biggest impact?

David explains his journey to becoming Care Navigation Lead (1 min 3 secs)

What does David’s role involve now and how is it structured? (2 mins 2 secs)

“As well as, not instead of”; the importance of care navigation complimenting social prescribing (3 mins)

“Patients with a social need should not have to see a GP to access social prescribing support” (5 mins 8 secs)

NHS England key elements of the social prescribing role (5 mins 35 secs)

Starting from scratch; how to best implement social prescribing roles within a PCN (5 mins 54 secs)

How care navigation works and maximising its effectiveness (7 mins 5 secs)

Referral criteria & training requirements for existing practice staff (8 mins 43 secs)

Building relationships on a practice by practice basis (11 mins 22 secs)

Ben and David explore the challenges faced by a newly placed link worker and the training they require (12 mins 8 secs)

“Micro-commissioning” the link worker / travel agency analogy (13 mins 40 secs)

From a PCN perspective: What level of experience and expertise can be expected of a new link worker? (15 mins 12 secs)

How do you measure the impact of a link worker? (16 mins 31 secs)

Getting in touch (18 mins 10 secs)

 

For more information on the social prescribing qualifications and training David mentions head to https://conexus-healthcare.org/social-prescribing-qualification-training/

To get in touch with David and Conexus Healthcare:

contact@conexus-healthcare.org

or via Twitter:

@HealthyDaveC or @ConexusHealthUK

 

 

 

 

Dec 9, 2019

Dr Paul Bennett is back on the Ockham sofa for a second week to discuss his practice’s revolutionary new approach to home visiting. Borne partly from a a technical constraint, Paul describes how the project was started, who has been involved and how it has evolved into more than an atypical Skype consultation.

Welcome and introduction (40 secs)

The constraints enabling change (58 secs)

The role of nurses within the new model (2 mins 45 secs)

Keeping the technology simple (3 mins 20 secs)

The difference between moving to Skype consulting and a fully transformative approach (4 mins)

GP consultations in the new world and the logistical setup (4 mins 45 secs)

A whole team approach (6 mins 26 secs)

The role of tech: challenges and benefits (7 mins 7 secs)

Crunching the numbers (8 mins 22 secs)

What has been the impact on the practice and its GPs? (9 mins 47 secs)

What’s stopped the rollout progressing further? (10 mins 23 secs)

Patient feedback and a case in point (10 mins 38 secs)

Could this work across a wider Primary Care Network? (12 mins 25 secs)

Paramedic involvement (13 mins 30 secs)

Virtual consulting with nursing homes? (14 mins 19 secs)

Just do it! (16 mins 58 secs)

Getting in touch (17 mins 45 secs)

The importance of sharing best practice and learning (18 mins 19 secs)

 

Paul is contactable at: paul.bennett5@nhs.net

Dec 2, 2019

Joining Ben this week is Dr Paul Bennett, a GP Partner in Portchester, who describes the revolutionary new approach to managing the duty system within his practice; how it works, how the system has been implemented, the impact on managing demand and most importantly, the benefits felt by both staff and patients alike.

Show Notes

Welcome and introduction (38 secs)

What triggered the changes? (57 secs)

Could a triage system work? What was the appetite for change? (1 min 26 secs)

Kick-off and implementation (2 mins 34 secs)

The role of the Healthcare Support Worker (3 mins 10 secs)

GP involvement and “stress-testing” the new system (4 mins 30 secs)

How is the new working day structured? (5 mins 24 secs)

Room setup and crunching the (patient) numbers (6 mins 7 secs)

What’s happening right now? The positive effects (7 mins 25 secs)

More decisions + more patients = reduced fatigue? (8 mins 19 secs)

Perceived drawbacks versus positive reality (9 mins 46 secs)

Impact, experiences & training for Healthcare Support Workers (11 mins 14 secs)

Patient feedback (12 mins 30 secs)

Where does they go from here? Plans for the future (14 mins 23 secs)

What does the rota look like? (15 mins 5 secs)

Could the system work at PCN level? (16 mins)

Getting in touch (18 mins 4 secs)

The importance of shared experiences and learning (18 mins 48 secs)

 

Paul is contactable at: paul.bennett5@nhs.net

Nov 25, 2019

Episode 184 – Shashi Khandavalli & Harry Evans – Population Health Management

Joining Ben on the Ockham sofa this week are Dr Shashi Khandavalli, Clinical Director for Chorley Central PCN and Harry Evans, Senior Programme Manager at NHS England and Improvement, who discuss all things Population Health Management; what it is, how it is key in meeting the health needs of your local population, the importance of working in partnership with local stakeholders and a story involving bins which underpins this key workstream.

Show Notes

What is Population Health Management (PHM)? (1 min 10 secs)

Populations, not individuals (1 min 45 secs)

Understanding the health of local populations and identifying their needs (2 mins 37 secs)

The importance of using data (3 mins 15 secs)

Shashi and Harry tell us how they became involved with PHM (3 mins 38 secs)

#datasaveslives (4 mins 29 secs)

Establishing strong relationships with key partners (5 mins 18 secs)

A strategic approach (6 mins)

How to get started? (6 mins 20 secs)

“Don’t wait for perfect to get in the way of good enough” (6 mins 45 secs)

Data sampling to target area of need and to enable strategic intervention (7 mins 10 secs)

Breaking down the barrier of scepticism and working partnership to identify positive outcomes or ‘the bin theory’ (8 mins 9 secs)

The role of social prescribers and link workers and the structural approach (10 mins 15 secs)

How are interventions made? (11 mins 17 secs)

Lessons learned (12 mins 30 secs)

10% data 90% culture (14 mins 17 secs)

Engaging local partners and building relationships (14 mins 48 secs)

The role of open meetings and who to involve (15 mins 12 secs)

PCN core skills (15 mins 35 secs)

Establishing, harnessing and understanding your vision (16 mins 25 secs)

“Activation day” (17 mins 6 secs)

What happens next? (17 mins 31 secs)

PHM programme rollout and support from NHS England & Improvement (17 mins 45 secs)

PHM platform access details (19 mins 26 secs)

Chorley PCN next steps (19 mins 42 secs)

Getting in touch (21 mins 55 secs)

Harry is contactable @harryaevans or at harry.evans2@nhs.net

Shashi is @kshashi79 or shashidar.khandivalli@nhs.net

The NHSE/I PHM Academy is available here. It contains information and learning about population health management from the PHM development programme and other sources. Please email england.STGPHM@nhs.net to be signed up for access.

This blog that Shashi wrote is hot off the press..

Nov 18, 2019

In this week’s podcast, Ben chats to Dr Hussain Gandhi (known to one and all through his eGPLearning Podblast as Gandhi) about life as a new PCN Clinical Director; the challenges versus the outcomes, his goals and aspirations, the importance of collaborative working and the role of technology within general practice.

Show Notes

How Clinical Directorship happened (46 secs)

Impact of PCN formation (1min 20secs)

Notts City East: the stats (1min 55secs)

The journey to becoming Clinical Director (2mins 15secs)

Balancing clinical sessions and the role of Clinical Director (2mins 55secs)

Gandhi outlines the aims and objectives of his role (3mins 25secs)

The challenges! (4mins 9secs)

Focus on collaborative working (4mins 32secs)

The process of engagement & PCN open meetings (5mins 10secs)

What is the PCN vision? (5mins 45secs)

Blue sky thinking (6mins 3secs)

The first few months as Clinical Director (6mins 28secs)

Laying the groundwork for PCN formation (6mins 40secs)

The role of social prescribing and clinical pharmacists (7mins 5secs)

What are the demands on a Clinical Director? (7mins 45secs)

Time management and the pressure of deadlines (8mins)

What have been the key lessons learned so far? (8mins 47secs)

Technology within PCNs (9ins 20secs)

Staying in touch: group chat and instant messaging (10mins 20secs)

The role of video conferencing (11mins 28secs)

Are we using technology enough in general practice? Are PCNs a platform to develop tech further? (16mins 12 sec)

PCN goals moving forwards (18mins 16secs)

Getting in touch (20mins 40secs)

Gandhi’s website can be found here

On all social media platforms he can be found at eGPLearning

For the podcast look for the eGPLearning Podblast

 

Nov 11, 2019

Rachel Morris “starred” in two of our most popular podcasts and through her work on GP resilience she was inspired to set up her own “You Are Not A Frog” podcast. In a recent edition of that podcast she interviewed our own Ben Gowland to discuss ways in which general practice can effectively introduce change, particularly against a background of resistance.

Show Notes

Ben explains how his career progressed to setting up Ockham Healthcare (52secs)

How Ockham Healthcare developed its unique offering (2min 02secs)

Working with at-scale general practice – a means to an end (2mins 47secs)

The goals for working at scale (3mins 37secs)

Making a difference – Time for Care (4mins 29secs)

Difficulties in implementing the high impact changes (5mins 36secs)

Change is difficult so how do we approach it? (7mins 01secs)

Introducing pharmacists – a practical example (7mins 32secs)

Resistance to change - a systematic approach (9mins 15secs)

The problem is obvious why we need to change? Isn’t it? (11mins 25secs)

The system and what you can control (12mins 22secs)

Overcoming the emotional response (13mins 28secs)

Picking the changes you pursue – small or large (14mins 34secs)

Ockham Healthcare’s role in supporting joint working (16mins 39secs)

Influencing without hierarchical “power” – a practice’s relationship with the PCN (17mins 56secs)

What’s the one big thing a PCN should be doing? (19mins 43secs)

Expect resistance – dealing with your “No Nos” (21mins 02secs)

Becoming positive about change (22mins 17secs)

Contacting Ben (23mins 28secs)

Ben is available on email ben@ockhamhealthcare

He is on Twitter @benxgowland

The Ockham website is here

The You Are Not a Frog podcast is available in a number of places including here

Nov 4, 2019

Farzana Hussain has been a GP for 18 years. Three months ago she was successful in becoming the Clinical Director of a new Primary Care Network in Newham comprising seven practices serving 65,000 patients. In this podcast she explains how she has met this new challenge; the approach she has taken, the aims of her PCN and the support she has received. She talks about how difficult and how rewarding (and how exciting) the new role can be.

Show Notes

Farzana explains how she became a PCN clinical director (54secs)

The PCN is formed (2min 09secs)

The joy of the first 100 days (2mins 53secs)

Early conversations with other stakeholders (4mins 52secs)

Strengthening the practices (6mins 11secs)

What will success in the role look like? (7mins 27secs)

True collaborative working (7mins 59secs)

Aligning the seven practices (9mins 04secs)

Time for the practices (10mins 22secs)

Communication and governance of the network (10mins 54secs)

Aiming for an inclusive group (12mins 40secs)

Involving other partners in the network (13mins 35secs)

The most difficult aspects of the role (14mins 24secs)

Managing time (15mins 19secs)

Getting support as a leader (16mins 16secs)

Distributive leadership (17mins 52secs)

Is there enough support available? Setting up a CD support group (18mins 12secs)

The nature of a support group for new leaders (19mins 04secs)

Contacting Farzana (20mins 31secs)

Contact Farzana on farzana.hussain@nhs.net

Oct 28, 2019

Suffolk Primary Care is a super-practice incorporating twelve original practices with 33 partners covering 110,000 patients. Nick Rayner, their Executive Chair and Neil Macey, their co-Chief Medical Officer with responsibility for transformation talk to Ben about bringing the practices together. They explain the journey they followed, the benefits, what they are achieving together and how a solution has been found to the problem of property ownership.

Show Notes

Neil and Nick introduce themselves (58secs)

The journey to Suffolk Primary Care (1min 39secs)

A single practice from May 2019 with partner groups (3mins 38secs)

From shadow form to a single entity with an executive team (4mins 25secs)

What we’re doing – employee staff record (5mins 41secs)

Provider support function – centralising admin functions (6mins 50secs)

Central finance function (7mins 18secs)

Complexity (7mins 40secs)

Keeping practices on board – trust and communication (8mins 05secs)

“Bottom-up” design of services (8mins 57secs)

Employing a Chief Executive (9mins 46secs)

Clinical services (10mins 35secs)

Long term conditions (11mins 17secs)

Introducing new roles and “growing our own” (11mins 52secs)

Maintaining flexibility with new roles (13mins 06secs)

The introduction of Primary Care Networks (14mins 16secs)

Becoming a PCN? (15mins 50secs)

Single CQC registration (16mins 45secs)

Sharing central services (17mins 17secs)

New income streams (17mins 40secs)

Recruitment and retention of partners (17mins 59secs)

A “property solution” (19mins)

The challenge of introducing the property solution (20mins 20secs)

Advice for practices in a similar situation (21mins 49secs)

Finding out more (23mins 11secs)

The Suffolk Primary Care website is here

Email Nick at Nicholas.rayner@nhs.net

Or Neil at Nmacey@nhs.net

Oct 13, 2019

Executive coaching can be defined as a professional relationship between an experienced coach and a client which is designed to enhance the client’s leadership capabilities. Dr Karen Castille is a skilled, qualified executive coach who has considerable experience of working with clinical leaders. In this episode she explains what coaching is, how it works and how it can benefit those in leadership roles. She also talks about self-coaching and her book “The Self-Coaching Workbook”.

Show Notes

Karen describes her career in leadership roles in the NHS (45secs)

Defining coaching “a structured conversation…to unlock potential” (1min 23secs)

Coaching is ACE (2mins 06secs)

Often about “dealing with difficult people” (2mins 51secs)

Does coaching have any practical outcomes? (4mins 10secs)

The relationship between client and coach (5mins 31secs)

Achieving personal goals through coaching (6mins 33secs)

What can coaching achieve? (7mins 38secs)

A hypothetical example (8mins 22secs)

Developing a tangible plan (9mins 08secs)

The coaching process – is not therapy (9mins 56secs)

The advantages of coaching as a development opportunity (11mins 22secs)

Finding a coach (13mins 33secs)

How much does coaching cost? (14mins 23secs)

The length of a coaching session (14mins 57secs)

Getting coaching funded (15mins 31secs)

If you can’t access coaching - try self-coaching (16mins 14secs)

What is self-coaching? Why write a handbook? (17mins 02secs)

Self-coaching as a reasonable alternative or an addition to coaching (18mins 29secs)

Contact Karen and find the book (19mins 24secs)

You can contact Karen via email here

Karen’s website (where you can find The Self-Coaching Workbook) is here

The book is also available at Amazon here

Oct 6, 2019

Robert Varnam almost needs no introduction. He is a GP in Manchester and Head of General Practice Development at NHS England. He will be known to most people in general practice for his work around the national Time for Care Programme. In his second visit to the General Practice Podcast he talks to Ben about the development of Primary Care Networks and how the learning needs of PCN clinical leaders might be identified and met.

Show Notes

Robert describes the recent changes to his role – focussing on improvement (58secs)

The introduction of Primary Care Networks (1min 54secs)

Variations in the progress of PCNs (3mins 28secs)

How delivering “improvement” to general practice is impacted by PCNs (4mins 44secs)

Establishing the PCN – a collaborative opportunity (6mins 54secs)

Making the best use of the development resources available (8mins 32secs)

Networks using expert facilitation to support development (10mins 24secs)

Developing the PCN clinical directors – a collective approach to leadership (12mins 40secs)

The value of investing in leaders (14mins 30secs)

A network of networks (15mins 04secs)

Establishing the learning needs of clinical directors (15mins 44secs)

Working with peers (17mins 29secs)

Practical resources for networks (18mins 57secs)

Contacting Robert (20mins 05secs)

The website Source4Networks can be found here

Robert can be contacted directly at robert.varnam@nhs.net

The first podcast we ran with Robert can be accessed here

Sep 22, 2019

Charlotte Osborn Forde is the Chief Executive of Involve Kent, a large registered charity that delivers services to vulnerable people. It has developed a primary focus in recent years on social prescribing. In this episode Charlotte explains how the charity contracts with the NHS to deliver Link Workers. She talks about the results for patients and practices of using Link Workers including an increase of 66% of referred patients becoming more physically active. The scheme has delighted GPs with one saying that social prescribing has become “the most transformative thing” in his career.

Show Notes

Charlotte describes Involve Kent (38secs)

Early adoption of social prescribing (1min 48secs)

Funding for the voluntary sector (3mins 04secs)

A joint bid with the CCG to work with GP practices (4mins 07secs)

Building a partnership with GPs (4mins 48secs)

The scale of the practices (5mins 38secs)

A Link Worker in each practice and their caseload (6mins 43secs)

Receiving referrals (7mins 37secs)

The early results – the ONS wellbeing measure (8mins 22secs)

Physical activity levels (9mins 53secs)

Levels of loneliness and health (11mins 06secs)

The impact on the practices – difficulties with the data (12mins 10secs)

Anecdotal reaction of practices (13mins 14secs)

Link workers working across practices (14mins 35secs)

Vital links to a proper infrastructure (15mins 41secs)

Working with PCNs (16mins 27secs)

Buying in the service (18mins 29secs)

Charlotte’s advice – find a local champion and follow the guidance (19mins 03secs)

Selecting the right Link Workers (20mins 25secs)

Key qualities for effective Link Workers (21mins 05secs)

The selection process (22mins 01secs)

Work with others (22mins 34secs)

System data (23mins 23secs)

For other podcasts on social prescribing visit our Podcast Index here

The Involve Kent website is here

They are on Twitter @InvolveKent

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