The General Practice Podcast

Ben Gowland explores new ways of working in general practice. He talks to those making changes happen, gets underneath what they did, how they managed to do it, and the challenges they faced along the way.
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The General Practice Podcast






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Now displaying: Category: healthcare
Sep 8, 2019

For twelve and a half years Liz Phillips was a salaried GP with a portfolio career and then, during a Primary Care Improvement event in London, she had a revelation. She decided then and there to become a GP partner, with a focus on quality improvement. In this episode she describes her journey, the work she has begun with her new practice and the benefits the quality improvement process is delivering. She also explains how partnership has exceeded her expectations and changed her life.

Show Notes

Liz decides to move from salaried GP with a portfolio career to become a partner (46secs)

The Primary Care Improvement community (1min 37secs)

A moment of revelation (2mins 05secs)

A quality improvement project in the practice pushes Liz to consider partnership (2mins 33secs)

Ethos and shared purpose is a driver (3mins 54secs)

Liz’s new practice (4mins 26secs)

Partnership brings joy and satisfaction (4mins 43secs)

Quality improvement and the new practice (5mins 08secs)

Establishing a shared purpose in the practice (6mins 19secs)

Don’t assume you know people’s “why” (7mins 58secs)

A weekend away as a practice (9mins)

The value of the process (10mins 06secs)

An upward spiral (10mins 38secs)

Joint conversations take time (11mins 41secs)

Compassionate leadership (12mins 34secs)

Knowing yourself (13mins 27secs)

Building relationships at work (13mins 43secs)

Introducing a well-being pilot the in the practice (14mins 26secs)

The benefits of the pilot (15mins 24secs)

Difference in the first six months (16mins 09secs)

A more confident practice (17mins 39secs)

Being in a Primary Care Network and sustaining partnerships (18mins 20secs)

The reality of being a partner (19mins 24secs)

Advice to current partners – be brave and do something different (20mins 50secs)

Advice to prospective partners (21mins 47secs)

Sep 1, 2019

The tables are turned again and in this week’s episode Ben is interviewed about the lessons we are learning about Primary Care Networks after two months of their existence. He discusses the role of PCNs and how they are perceived, the challenges they are facing and the issues they are focussing on, their approaches to the new roles, the weight of expectations and the lessons they might learn from the establishment of CCGs.

Show Notes

Is the role of PCNs any clearer? (33secs)

The problem of mismatched expectations (2min 07secs)

The rapid rise of PCNs – a tough start (3mins 30secs)

The Clinical Directors role as inspiring leaders – quick wins (5mins 06secs)

Unforeseen challenges – backwards to move forwards (6mins 27secs)

The role of federations with PCNs (7mins 09secs)

How can ensure the roles of federations and PCNs are clear and distinct (7mins 48secs)

The perceptions of the wider NHS (9mins 28secs)

Two roles for the clinical leaders (10mins 57secs)

Too many expectations placed on PCNs too soon (11mins 19secs)

Supporting a potentially fragile system (12mins 27secs)

Building the support on firm foundations (13mins 26secs)

Approaches to the appointment of new roles (14mins 54secs)

Addressing the 30% funding gap (15mins 45secs)

The challenge of the 30% funding gap (19mins 42secs)

Lessons from setting up the CCGs (17mins 33secs)

Prioritising building relationships and trust (18mins 36secs)

Ben’s advice – control your own agenda, focus on relationships and don’t reinvent the wheel (19mins 53secs)

Aug 25, 2019

In this fourth episode of our short series on pharmacy and PCNs, Ben talks to Community Pharmacist Hala Abusin about the impact of the planned increase in pharmacists in general practice. They discuss the role and value of community pharmacy and the opportunities and challenges for community pharmacists collaborating with both GP pharmacists and hospital pharmacists.

Show Notes

Hala describes her progress to her current position (48secs)

The role of and value of community pharmacy (2min 14secs)

Extending the role of community pharmacy – a practical example (3mins 34secs)

Community pharmacy view of pharmacists in general practice (6mins 37secs)

Sharing new ways of working (7mins 44secs)

The new five year contract for community pharmacy (8mins 17secs)

Community pharmacies working with PCNs (9mins 47secs)

Engaging community pharmacists (10mins 44secs)

Preparing to work with PCNs (11mins 41secs)

Pharmacists working together across organisations (13mins 23secs)

The differences between clinical and community pharmacists (14mins 09secs)

The challenges of collaboration (15mins 28secs)

The Community Pharmacy Consultation Service and other opportunities where community pharmacies can help (17mins 22secs)

Finding out more (18mins 43secs)

The challenge of the 30% funding gap (19mins 42secs)

Planning to build a team of pharmacists (20mins 50secs)

The relationship between GP and community pharmacists (22mins 27secs)

Finding out more (23mins 39secs)

Hala has provided some useful links for those looking for more information:

Details about the Joint Pain Advice project are available here and here

The Primary Care Pharmacy Network briefing on PCNs for pharmacists can be downloaded here

The PSNC guidance for supporting community pharmacists to engage with PCNs can be downloaded here

An article from Chemist and Druggist on the opportunity for community pharmacy in PCNs is available here

And the Community Pharmacy Contractual Framework can be downloaded here

Aug 18, 2019

This is the third in our short series of podcasts on Pharmacists and PCNs. In this episode Ben talks to Paul Deffley, a GP partner in Hove who is also a Clinical Director of Practice Unbound, a not-for-profit organisation based in Brighton which aims to help general practice “work smarter”. Paul has considerable experience of working with pharmacists and introducing them into networks of practices. He explains the three key steps practices should take to successfully implement a pharmacist and discusses the challenges for them working across multiple practices.

Show Notes

Paul explains what Practice Unbound is (56secs)

Paul is also the clinical champion for GP workload at the RCGP (1min 43secs)

The outcomes of Paul’s work on workload (2mins 49secs)

Paul’s experience of working with pharmacists (3mins 13secs)

A new pharmacy-led service (4mins 09secs)

Building pharmacists into the team (5mins 09secs)

Logistics – induction and starting work (6mins 00secs)

Activity – work and workload (7mins 17secs)

Impact – transition, managing uncertainty and measurement (8mins 50secs)

Variation of impact and visibility (11mins 45secs)

Developing the data dashboard (13mins 45secs)

The challenge of working across multiple practices (14mins 24secs)

Introducing the pharmacist (15mins 58secs)

The issues of using a “host” practice model (18mins 05secs)

The challenge of the 30% funding gap (19mins 42secs)

Planning to build a team of pharmacists (20mins 50secs)

The relationship between GP and community pharmacists (22mins 27secs)

Finding out more (23mins 39secs)

Resources are available on the Practice Unbound website here

You can sign up to the Practice Unbound Newsletter here

Paul is on Twitter @deffley_paul

He is also on LinkedIn:

The Practice Unbound Twitter handle is @PracticeUnbound

The previous episode Ben mentioned with Paul’s colleague Jonathan Serjeant on delegating clinical correspondence is available here

Aug 11, 2019

This is the second in our short series of podcasts on Pharmacists and PCNs and this week we talk to Peterborough GP, Neil Modha. Neil (who’s innovative approach we covered in this previous episode) has gone from employing one to three pharmacists in just over a year. He explains why and how they have proven invaluable in everything from self-care, shared care drug monitoring and document management to audits and chronic disease management.

Show Notes

Neil reminds us how his practice operates (44secs)

From one to three pharmacists – how they help (1min 39secs)

The journey of introducing a pharmacist (2mins 32secs)

What are pharmacists doing in Neil’s practice (3mins 41secs)

Pharmacists and self-care prescribing (4mins 19secs)

The outcome of self-care prescribing (5mins 10secs)

Signposting to self-manage conditions (6mins 08secs)

Shared care drug monitoring (6mins 50secs)

How the rapid growth in pharmacists took place (7mins 50secs)

The impact on the practice (9mins 16secs)

How productive are pharmacists? (10mins 23secs)

The financial benefits (11mins 54secs)

Impact on the drug budget (12mins 53secs)

A vision for the future (13mins 23secs)

How does the pharmacist work in the federation/PCN? (14mins 36secs)

“Home” practice or not? (16mins 23secs)

Advice for other practices thinking of employing a pharmacist (16mins 59secs)

The challenge of the 30% gap in funding (18mins 06secs)

What’s next for Neil’s practice? (19mins 12secs)

What’s next for Neil’s practice? (21mins 35secs)

Neil’s practice website can be found here

His email address is

Our previous podcast with Neil is available on our website here


Aug 4, 2019

All PCNs have the opportunity to recruit clinical pharmacists into general practice and this week we begin a four part series of podcasts to support that recruitment. We begin, in Episode One, by talking to GP Pharmacist Hala Jawad. Hala discusses the role of a pharmacist within general practice, the way a pharmacist can work within a PCN and how a PCN can make themselves more attractive to pharmacists.

Show Notes

Hala was the first “Pharma Face” and is known as “The Brighton Titan” (55secs)

She moved from running a restaurant to becoming a pharmacist (2min 02secs)

Getting involved with general practice (2mins 47secs)

Trying GP out for a week (3mins 48secs)

The benefits of working in a practice (5mins 01secs)

Learning in general practice (6mins 31secs)

The role of a pharmacist in GP (7mins 32secs)

Support for pharmacists (8mins 30secs)

Pharmacists in PCNs (9mins 39secs)

Advice to make an appointment successful (10mins 41secs)

Overcoming isolation (11mins 51secs)

How attractive is working in GP to a pharmacist? (12mins 42secs)

What makes one role more attractive than another? (14mins 15secs)

How will the pharmacist/GP relationship develop? (15mins 51secs)

Contacting Hala (16mins 44secs)

Hala can be found on Twitter - @jawad_hala

She is also on Facebook and LinkedIn

Her Ask Hala public website is here and her You Tube channel is here

Jul 28, 2019

Hugh Reeve is a GP in Grange-Over-Sands in Cumbria. The practice wanted to improve the way they met patient demand and initially began to look at introducing an online consultation system. They soon concluded that this could not be simply about introducing a “bolt on” digital system and it quickly became a process that forced them to radically reconsider all aspects of their patient flow. In this episode Hugh explains how they went about transforming their practice, how the new system now works for GPs and patients with the resultant outcomes including the fact that only 40% of patient contacts are now face-to-face.

Show Notes

Why introduce an online consultation system? (59secs)

Improving continuity of care (1min 49secs)

Researching the options (2mins 57secs)

The kind of system they didn’t want (4mins)

A much bigger task than choosing a system (4mins 44secs)

Improving the “flow” of patients (5mins 21secs)

How the system works for GPs (6mins 13secs)

Changing the way they work rather than “bolting on” a system (7mins 16secs)

Radically rethinking “flow” (8mins 03secs)

Only 40% of contacts are face-to-face (9mins 33secs)

Not just introducing online (10mins 05secs)

Establishing what capacity is needed (10mins 45secs)

Introducing the new system (11mins 19secs)

Patients using the system (12mins 07secs)

Not about workforce challenges (13mins 15secs)

A typical day for a GP in the practice (14mins 13secs)

The reaction of patients (18mins 45secs)

Pilot site for the Health Foundation Programme on Continuity of Care (19mins 39secs)

Hugh’s advice for others (22mins 03secs)

You can email Hugh at

The askMyGP website is available here

Jul 7, 2019

Today (8th July) is the first ever National Social Prescribing Link Worker Day! Organised by the National Association of Link Workers it aims “…to celebrate and showcase the contribution of social prescribing link workers in improving population health and wellbeing.” In support of this our podcast this week is the fifth in our series looking at Social Prescribing. Nick Sharples is Managing Partner at DNA Insight, a specialist training consultancy that is increasingly involved in training Social Prescribing Link Workers. In this episode he talks about the various models that are emerging for employing, recruiting and training Link Workers.

Show Notes

Nick describes his involvement in social prescribing (44secs)

Who employs the Link Workers? (1min 53secs)

Reluctance to outsource the role (3mins 30secs)

Outsourcing the role (4mins 16secs)

Competition for Link Workers – three options for recruitment (5mins 36secs)

External recruitment (6mins 40secs)

Recruiting from within the practice (7mins 16secs)

Advantages of the options – building an appropriate model (7mins 54secs)

The provision of training (9mins 18secs)

Resources for training (10mins 28secs)

How much budget to put aside? (11mins 02secs)

Effective working with large scale – prioritising (11mins 58secs)

Average workload (13mins 13secs)

Managing a caseload (13mins 53secs)

A practical example from Scotland (15mins 32secs)

Sharing best practice – learning co-ordinators (16mins 33secs)

Finding out more (17mins 31secs)

The DNA Insight Social Prescribing pages are here

Nick has put together a list of useful resources below:



  • Twitter Social Prescribing Wednesday - @SocialPresHour – every other Wednesday and hosted/organised by Elemental



  • National Association of Link Workers Christiana Melam   Professional body representing Social Prescribers/Link Workers with lots of useful resources for Link Workers and those employing them.
Jun 30, 2019

Gerry Morrow was a full time GP for twenty years before he joined Clarity Informatics as their Medical Director. Clarity, (who describe themselves as “international leaders in healthcare solutions”) developed TeamNet “a web-based sharing and compliance platform for primary care”. In this podcast Gerry explains how TeamNet enables practices and other agencies to share information, how it is adaptable to individual circumstances and what the future might hold.

Show Notes

Gerry begins working Clarity (54secs)

The importance of sharing information (1min 20secs)

Clarity develops TeamNet as a natural extension of their business (1mins 53secs)

The benefits of sharing information through TeamNet (2mins 37secs)

Where does the information come from? (3mins 29secs)

The opportunities of practices moving into PCNs (4mins 15secs)

Transparency – sharing information and building trust (5mins 08secs)

How TeamNet works in practice (6mins 41secs)

Practices and community teams working together (7mins 39secs)

Structuring sharing with other agencies (8mins 53secs)

Controlling the flow of information (9mins 55secs)

Who uses TeamNet now? (11mins 16secs)

Two way communication with practices (11mins 46secs)

The future of information sharing – interoperability (12mins 45secs)

Sharing patient-identifiable data (13mins 37secs)

Future projects for Clarity (14mins 23secs)

Finding out more (15mins 06secs)

The Clarity TeamNet web pages are here

The email address is

Jun 16, 2019

This is the episode all about VAT. No, come back! It’s complex but vitally important stuff for PCNs and you’ll regret not listening... We are delighted to welcome Katie Collin, Client Services Partner at Ramsay Brown Chartered Accountant to explain it all. She covers who needs to be registered for VAT, what services incur VAT, Cost Sharing Groups and the VAT implications of the three models for PCNs. She has also produced a frequently asked questions document which you can access at the end of these Show Notes.

Show Notes

VAT – the hot topic of the moment (45secs)

Who has to be registered for VAT (1min 04secs)

The three main reasons why a GP might be registered for VAT (1mins 47secs)

What services incur VAT – provision of services and staff (2mins 54secs)

Holding the contract and keeping control (5mins 12secs)

Other services – admin and back-office functions attract VAT (6mins 19secs)

Part of an overall contract – an example (6mins 58secs)

How does a Cost Sharing Group work? (8mins 23secs)

Members of a legal entity (9mins 16secs)

On-costs but not a management charge (10mins 23secs)

Is VAT chargeable on what PCNs are being asked to do? (11mins 13secs)

Employing a Link Worker (12mins 47secs)

The VAT implications for the three models for PCNs:

1 The Lead Practice Model (13mins 26secs)

Is the lead practice registered for VAT (15mins 28secs)

2 The Flat Model – the easiest model? (16mins 38secs)

Liabilities of joint employment (17mins 45secs)

3 The Federation Model (18mins 26secs)

The big issues with federations (19mins 54secs)

The federation as a cost sharing group (20mins 36secs)

Core members/non-core members of networks (21mins 43secs)

Setting up a legal entity now – is it worth it? (23mins 06secs)

Employing staff and pensions (23mins 57secs)

Other things to consider (25mins 06secs)

Don’t go it alone (25mins 51secs)

Getting in touch and finding out more (26mins 20secs)

You can find Ramsay Brown’s “VAT and Primary Care Network FAQs here

The Ramsay Brown website is here

Katie’s email address is

Jun 9, 2019

Draft national guidance has been produced by NHS England to help Primary Care Networks introduce the role of Social Prescribing Link Worker. In this episode Social Prescribing enthusiast and GP, Dr Marie-Anne Essam, explains the value of the new guidance and takes Ben through a number of the elements it contains. They look at the Framework for Social Prescribing contained within the guidance, the salary for Link Workers and how their effectiveness and much more. The guidance will be published in its final form in the summer.

Jun 2, 2019

In this podcast Clare Allcock outlines the four main areas on which nascent networks should be focussing if they want to accelerate their development. Clare works for Kaleidoscope Health and Care, an organisation devoted to facilitating collaborations that improve health and care. Prior to this she had a distinguished career in the NHS at local and national level; most recently heading up the primary care and community development team for three CCGs in Surrey and Sussex.

May 26, 2019

Minesh Patel is the Chair of the National Association for Primary Care and he joins us this week to explain what lessons the NAPC’s Primary Care Home programme has for emerging Primary Care Networks (PCNs). He focuses on wide engagement, the multi-disciplinary team and leadership. He looks at the different challenges of voluntary and mandated networks and has some sound advice for the new Clinical Directors of PCNs.

May 19, 2019

This week sees the return to the General Practice Podcast of Tara Humphrey, Managing Director of THC, a group of project managers who aim to influence and support positive change in primary care. With the introduction of new roles into Primary Care Networks many are asking detailed questions about how to guarantee successful implementation and ensure the people in the new roles are happy, effective and want to stay. In this episode Tara answers those questions.

May 12, 2019

The state-backed clinical negligence scheme for general practice launched on the 1st April this year. In this podcast Ben talks to Riaz Jetha, a GP and consultant with an interest in at-scale general practice. Riaz explains how the new scheme differs from the traditional indemnity providers, how claims can be made and what and who is covered by the scheme.

May 5, 2019

In this podcast Ben Gowland, Director and Principal Consultant of Ockham Healthcare, launches a new publication from Ockham; “Ten Steps for Developing a Powerful Voice for General Practice”. With the development of Primary Care Networks and the greater integration of care come huge opportunities for at-scale general practice. However, if they are to partner with often larger and more established organisations it is essential that they develop a more powerful voice. In the Ten Step Guide and in this podcast Ben explains why it is important, how it can be done and the pitfalls to avoid.

Apr 28, 2019

Record numbers are signing up for GP training and in this episode Ben talks to Dipesh Gopal and Ebrahim Mulla, two GP trainees, about why they chose to become GPs. He asks them about their expectations versus the reality of the role, how (and if) they see the partnership model figuring in their careers and why they think so many GPs are leaving the profession. They consider what can be done to “solve the problems of general practice” and give a view on whether the future for general practice is a bright one

Apr 14, 2019

In the third in our series of podcasts on social prescribing, GP and social prescribing champion Marie Anne Essam returns to tell us three powerful real-life patient stories in which a social prescription has changed a patient’s life; a carer who got his purpose back, a man with a housing problem who turned his life around and an anxious, reluctant patient who found the support she needed. Plus: guidance on the new link workers will shortly be issued to all primary care networks and Marie Anne gives us a sneak preview of what it will contain.

Apr 8, 2019

The specification and guidance for the new network DES runs to over 100 pages. In the days following its publication Ben and special guest Dr Riaz Jetha digested the content of the DES and, in this episode, they talk through the key differences they identified. They look at the nature of the network agreement, the role of federations, how clinical leaders will be recruited, population size, funding and much more. You might also be interested in Ben’s latest Blog which covers similar material.

Mar 31, 2019

We have three guests this episode to talk about the unique Salaried Trainee Practice Manager programme developed by the City and Hackney GP Confederation. Dr Mary Clarke CBE the Confederation’s Director of Workforce, Grace Neil, the Programme Co-ordinator for the scheme and trainee Practice Manager Kerry Reynolds join Ben to variously explain how and why the programme was developed, the format and content of the programme and what it felt like to be a participant.

Mar 25, 2019

Tom Howseman is a GP Partner in a large urban practice in Northampton. When their number of GP partners fell from twelve to six due to retirements and they couldn’t recruit they decided to adopt a more multi-disciplinary approach. Over the last two years they have introduced and refined a system of pre-triage protocols which enable reception staff to collect information from patients presenting on the day which is then helpful to the pre-triage clinicians in directing those patients to the appropriate member of the emergency care team. 20,000 additional appointments have been created through this system and in this episode Tom explains how they have done it.

Mar 18, 2019

Last Thursday (14th March) was International Social Prescribing Day and we brought you a short series of podcasts to recognise this. Last week we gave you social prescribing ambassador Marie-Anne Essam. This week it is the turn of Christiana Melam who is Chief Executive of the National Association of Link Workers; the national professional network for link workers. In this episode Christiana describes what the National Association does, outlines the roles and responsibilities of the link worker and suggests what primary care networks should be doing now to prepare for this role.

Mar 11, 2019

This Thursday (14th March) is International Social Prescribing Day. To recognise this and to focus on the new GP Contract commitment to provide link workers in all primary care networks, we begin a short series of two podcasts. In the first, this week, Ben talks to Marie-Anne Essam a GP in Herts Valley and an enthusiastic ambassador for social prescribing. She explains what it is and tells a powerful story about a patient of hers which amply illustrates the value of social prescription. She also talks about the role of link workers including their salary, their competences and their likely backgrounds

Mar 4, 2019

Ben’s special guest for the second week is Dr Nikki Kanani, Director of Primary Care for NHS England. You can listen to the first episode here. In this second part she addresses the concerns of podcast listeners about primary care networks including population size, hosting of the networks and the role of federations. She looks at how clinical leaders should be identified and focuses in detail on the timetable from March 2019 onwards and what practices should be doing now to guarantee success.

Feb 25, 2019

Ben’s special guest this week is Dr Nikki Kanani, one of the chief architects of the new GP contract. Nikki is a GP in south-east London and is currently Director of Primary Care for NHS England. This is the first of two discussions with Nikki and in this part, she explains the role of primary care networks in general practice and looks in detail at the funding behind the new contract. She explains how the money will be delivered and what it will be made available for including 20,000 new staff, support for clinical leadership and investment in innovation. The second part of the discussion will be published next week.

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