This week Ben is joined by Neha Shah, a Legal Director from Capsticks and Accountant Colin Haw from BHP Chartered Accountants. In this episode they discuss some of the legal, financial and governance issues facing general practice as it begins to establish Primary Care Networks. Specifically they consider how networks will be hosted and the implications for liability, choices around the organisational form, employment contracts, pensions and VAT.
Ross Dyer Smith is a GP Partner with the Hurley Group, a former Darzi Fellow, an expert in online consultations and developer of the GP eHub. He is also an NHS Digital Academy Fellow. In this podcast he talks about how online consultations work, how potential problems can be avoided and the benefits they deliver to GPs and patients. He also explains how the GP eHub operates and how it facilitates online consultations at-scale.
Something different this week; the tables are turned with Ben Gowland in the hot seat explaining the importance of the new GP contract. Ben, presenter of the General Practice Podcast and Principal Consultant for Ockham Healthcare, explains why the new GP contract is a huge opportunity and gives him optimism for the future. He describes the way that the additional £2.8bn attached to the contract will flow, how primary care networks will be developed and how they will be staffed. He also gives practical advice to practices about what they should be doing now, in preparation for the year ahead.
Matt Aiello is the national programme lead at Health Education England for Urgent and Emergency Care and for Physician Associates. In this episode we focus on the continuing introduction of the Physician Associate role into primary care. Matt explains how the profession is expanding supported by Health Education England, how the role supports general practice, how the recognition and regulation of the profession is being approached and offers some advice for practices wishing to appoint a PA.
Robin Miller is a Senior Fellow at the Health Services Management Centre of the University of Birmingham. Robin is heavily involved in research into the transformation of primary care. In this episode he shares some of the lessons that have emerged from this research including a study of the Aspiring for Clinical Excellence programme developed by a CCG in Birmingham. He looks at what transformation means, how innovation can be encouraged, how practical is the expectation that transformation will save money and how GPs and CCGs need to change their mind-sets if transformation is going to work.
In this episode Ben talks to two people behind an innovative initiative to develop the next generation of primary care leaders. The NHS@2030 programme was developed under the auspices of NHS England, the Thames Valley Strategic Clinical Network and the Thames Valley and Wessex Leadership Academy with the intention “…to grow individual confidence, courage and the conviction to transform care, and establish a system of continuous quality improvement for patients and primary care teams alike” In fact, the content of the programme was a co-production with its participants. To hear all about the programme and how this co-production process works, Ben talks to Marion Lynch from NHS England South and former CCG Chief Executive Alan Webb.
John Tacchi is the Programme Director for Integration at North Staffordshire Combined Healthcare NHS Trust, a provider of mental health, social care and learning disability services in the West Midlands. In this episode John talks about his role leading the Trust’s Primary Care Integration Strategy which offers GP practices a range of benefits from full integration into the Trust to the provision of back office functions. John explains how the integration is working and the benefits that the new service driven model and locality working is delivering for GP teams and for the Trust.
Terry Kemple was a past president of the RCGP and is now the RCGP’s representative for Sustainability and Climate Change. In this episode he talks to Ben about the Green Impact for Health Toolkit. The Toolkit enables general practices to plan and implement actions they can take to become more sustainable and covers areas such as health and well-being, water use, recycling and procurement. Terry describes the uses of the toolkit, the associated awards scheme and how practices can become involved.
Andy Sixsmith is a GP in West Yorkshire and is involved in workforce development through NHS England and the West Yorkshire and Harrogate Health and Care Partnership (WYHP). In this episode Andy also talks to Ben about his recent decision to join a practice in the Modality super-partnership. In terms of workforce development he talks about the challenges currently being faced and the plan put in place by WYHP (including the formation of four Primary Care Training Hubs) and about the early impact that this new approach is having.
Jake Lee is GP Medical Director of One Care, a federation of 82 practices in Bristol, North Somerset and South Gloucestershire. Formed in 2014 on the back of a bid for the Prime Minister’s Challenge Fund they have grown to serve 1 million patients. In this podcast Jake tells Ben the story of that growth, the relationship that has been developed with and across practices, how the federation works and about the many projects they have successfully delivered.
Andrew Boyd is the RCGP’s Clinical Champion for Physical Activity and Lifestyle. The RCGP has formed a partnership with Park Run UK and has already signed up over 400 practices to the park run initiative. Park Runs are free, weekly 5 kilometre runs (or walks) open to anyone over the age of 4 of any ability. They run in over 750 locations in the UK and have proven a hugely successful way of encouraging physical activity and wellbeing. Andrew explains how the partnership came about, and how practices can become involved. He describes two case-studies of patients who have benefited and explains some of the other initiatives covered by his champion role.
In this episode we hear about Northumbria Primary Care (NPC), a network of seven GP practices formed in 2015 across Northumberland and North Tyneside. The “twist” is that NPC is a wholly-owned subsidiary of Northumbria NHS Foundation Trust, the local acute trust, and that all the GPs are salaried. Ben is joined by NPC’s Medical Director Dr Nigel Twelves and Dr Lily Lamb, a GP and their Education Lead. Nigel and Lily explain how the model works, how it benefits patients and GPs and how the relationship with the acute trust has developed and is developing.
Cassandra Baiano is a medical student in the first cohort of the innovative Scottish Graduate Entry Medicine (ScotGEM) MBChB at the University of St Andrews in Fife, Scotland. ScotGEM is “designed to develop doctors interested in a career as a generalist practitioner within NHS Scotland….(and) offers a unique and innovative four-year graduate entry medical programme…and focuses on rural medicine and healthcare improvement” In this podcast Cassandra describes the course and explains how the programme is different to traditional medical training.
Rachel Morris is a GP, an executive coach and presenter with Red Whale; producers of the famous GP Update. In Episode 108 of the General Practice Podcast Rachel described two courses that Red Whale run to develop primary care leaders. In this episode she looks at GP resilience; what it is and how can you acquire it. She considers the causes of stress and burnout and points to a range of useful resources GPs can use to develop their personal resilience.
The Neighbourhood Development Programme in City and Hackney in London is a primary care network based around eight neighbourhoods with populations of between 30-50,000. The neighbourhoods are structured round GP practices with a bottom-up, clinically-led support network bringing together all local partners engaged in integrated health and social care. In this podcast Ben talks to Clinical Lead and local GP Dr Steph Coughlin and Nina Griffith who is the work stream director for Neighbourhoods. They describe how the network functions and how it is bringing together all constituent organisations to improve access, reduce duplication, improve integration and, in the medium term, change outcomes for patients.
Alison Halliwell is a mental health practitioner leading a team in general practice in Fleetwood. The service Alison leads began in 2004 when 42% of patients were presenting to GPs with a mental health component to their illness. Fourteen years on and now only 8% of her GPs’ time is spent dealing with mental health issues. The service has won six national awards and Alison explains how it began, how it developed, how it runs and offers advice to other practices thinking of doing the same.
Farzana Hussain is a GP in the London Borough of Newham and a great advocate for quality improvement. For Farzana it is less a task and more like a way of life. In this podcast she explains why. She describes the three tools she has utilised in her own practice (The Change Model, Process Mapping and the PDSA Cycle) with some practical examples. She also explains the impact that building quality improvement into her day-to-day activities has had on the practice and on her.
This is the concluding part of our discussion with Andy Wilkins, the co-author of a report called Beyond The Fog: A future for public healthcare. In the first part published last week (find it here) Andy described the trends that will influence the future of healthcare. In this episode he looks at the likely impact that the developments described in the first episode might have on the role of general practice and the wider community of health. He looks at areas already taking the first steps and explains more about how he hopes the final report will be used in shaping health policy and describing an inspiring vision for the future.
Andy Wilkins is co-author of a new report called Beyond The Fog: A future for public healthcare which sets out to provide a provocative, ambitious vision for what healthcare might look like in 10 to 15 years’ time. In this fascinating and challenging episode (the first of two) Andy presents the six biggest trends (including technology, future society and systems biology) which he believes will influence changes in healthcare. He looks at the idea of “Always On” healthcare, based on a real-time view of patients and he explains the concept of a Digital Health Coach, effectively an Alexa for the future offering 24 hour advice and support to maintain an individual’s health. Part Two follows next week.
In the third of our series of podcasts looking at pharmacists in general practice Ben talks to Ceinwen Mannall who is the national lead for Clinical Pharmacists in General Practice education at the Centre for Postgraduate Pharmacy Education (CPPE). In this episode she tells Ben about the training available to pharmacists moving into general practice, the impact and value that pharmacists have and tips for practices thinking of employing a clinical pharmacist.
James Morrow is the Chief Exec and Managing Partner of Granta Medical Practices in Sawston, Cambridge. In this episode James tells Ben how the benefits of increased scale have led to a new model for delivering core general practice which has improved access, eased recruitment and developed new and constructive dialogues with secondary care. He touches on the way the practices are involving staff in innovation and working with the local community. Looking to the future he describes a vision where the staff will share ownership of the practice through a Board of Trustees whilst also maintaining the independence of general practice.
Imagine a world where a patient’s first contact with primary care is through a robot. Digital Health Futurist Maneesh Juneja believes that this is a likely scenario for general practice in the near future, if not an inevitable consequence of staff shortages and shifts in public expectation. In this episode he describes how near we are to developing and using “caring robots” and discusses some of the ethical issues as well as the barriers and benefits to digital health.
Regular listeners will remember Paula Wright from Episode 117 when she talked to Ben about GP learning groups. In this episode Paula (who is a GP in the North East of England and GP tutor for Newcastle, Health Education England – North East team) highlights the retained GP scheme, designed to keep GPs who are at risk of leaving, in the workforce. Paula explains how the scheme works, the financial support for both GPs and practices, the application process and much more.
Social prescribing is one of the Ten High Impact Changes from the GP Forward View. But what is it? How does it work and who can benefit? In this week’s podcast Ben speaks with Nick Sharples from training consultancy DNA Insight. Nick explains how his involvement in social prescribing evolved from his company’s focus on active signposting (listen to our previous podcast with Nick here). He also explains the three factors which will enable social prescribing to work best, how it is likely to evolve and much more.
Here is the second part of our expert panel discussion considering the impact of millennials on general practice. In this part the panel considers the impact of the differing needs of millennial patients, how disruption and innovation will continue to influence and whether, ultimately, millennials pose an opportunity or a threat.
If you missed Part One you can find it here.
The panel consists of:
Surina Chibber: a GP and founder of My Locum Manager
Aisha Malik: a GP, social media strategist and founder of Doctors in Business
Mayur Vibhuti: a GP and Visiting Reader in Medical Leadership at Canterbury and Christchurch University