Podcast regulars and Practice Manager extraordinaires Robyn Clark and Nicola Davies return for the next instalment of our joint Practice Index / Ockham Healthcare podcast series. This week, the panel reflect on what the world of general practice might look like after the so-called ‘freedom day’ on 19th July. What will the initial changes be to their practices and practice locally (if any)? What are the longer-term impacts likely to be on staff, workload and on patients? What have we learned as a result of the pandemic that we can carry forward to the next, critical phase of working in primary care? And importantly, how can the IGPM support the practice management community with the demands of the upcoming winter months ahead?
Introductions (32 secs)
Robyn and Nicola’s initial thoughts about the change in Covid guidelines (38 secs)
Face mask policy approach (1 min 40 secs)
The call from the new Health Secretary to “embrace risk” (2 mins 17 secs)
Current level of demand in general practice (3 mins 43 secs)
Preparing for the winter months (5 mins 23 secs)
Looking ahead to the next phase of the enhanced service (6 mins 37 secs)
Is it possible for general practice to deliver the Covid vaccination boosters and meet the QOF targets? (9 mins 41 secs)
Does meeting the additional workload come at a cost to core general practice output? (11 mins 36 secs)
Enhanced service impact on flu vaccinations (13 mins 15 secs)
What are the barriers to network working? (15 mins 51 secs)
Are GP practices increasingly collaborative and less competitive as a result of the pandemic? (17 mins 5 secs)
IGPM update and how the IGPM will be supporting general practice through the next critical phase (17 mins 56 secs)
For more information and to sign up to become a member of the IGPM, please find the website here
Practice Index’s website can be found here
For all enquiries, please contact James Dillon here
Following on from our recent episode about the difference Health and Wellbeing Coaches can make in supporting patients with a non-medical approach (and continuing with our podcast series following the progression of those working within the additional roles), we introduce you to Newcastle GP Services’ and the north east’s original Health and Wellbeing Coach Frazer Solomon. With a long history of related care within the private sector, Frazer explains why his services are the perfect fit in primary care and how, despite his newness to public health, he has already been able to transform the lives of the patients he treats.
Introduction (46 secs)
What is a Health and Wellbeing Coach? (57 secs)
Linking with the wider team (1 min 58 secs)
Shaping the role (2 mins 24 secs)
Patient support groups (3 mins 52 secs)
Expansion of Frazer’s remit (4 mins 47 secs)
Team working (6 mins 5 secs)
Referral pathway (6 mins 45 secs)
PCN construct (7 mins 48 secs)
A disparity in practice referral numbers (8 mins 6 secs)
The importance of promotion and exposure of the role (9 mins 17 secs)
Work base (10 mins 19 secs)
Positive feedback and results (11 mins 2 secs)
What’s the most rewarding part of the job? (12 mins 8 secs)
Caseload numbers and patient management (12 mins 57 secs)
Support networks (13 mins 33 secs)
Establishment of a health and wellbeing team (14 mins 16 secs)
Service development (15 mins 17 secs)
The key components of a Health and Wellbeing person spec. (16 mins 30 secs)
Supporting Health and Wellbeing Coaches to succeed (17 mins 30 secs)
Another reminder that If you are interested in joining the PCN Clinical Director mastermind group programme which Rachel Morris and Ben have setup, or have any questions, please email ben@ockham.healthcare or rachel@shapestoolkit.com – or please check out our dedicated page here.
Social prescribing is already proving its worth in many practices up and down the country. It is traditionally embedded and under the control of the PCN or health authority but what about when provision of the service is by way of a third-party organisation? Edberts House is a charitable, community-based project in Gateshead who have long been involved in supporting the health and well-being needs of their local populations. It is a testament to their success that they are now responsible for the provision of social prescribing link workers to the health authorities in their area and it is a model that they believe is undoubtedly the most effective in giving the most vulnerable access to fully holistic care. Jackie Jamieson is the Community Linking Project Manager at Edberts House and speaks to Ben about how the third-party model works in practice, the benefits of the model and the impact they are making on the practices they work with - and their patients.
Introductions (33 secs)
What is Edberts House? (43 secs)
How social prescribing at Edberts House was born (1 min 24 secs)
The population and PCNs Edberts House cover (2 mins 41 secs)
How the service works in practice (3 mins 19 secs)
Staffing bases (4 mins 24 secs)
Referral process (5 mins 6 secs)
The role of the social prescriber (5 mins 42 secs)
Caseload numbers (7 mins 7 secs)
Relationships with the PCNs (7 mins 46 secs)
Funding and finance structure (9 mins 17 secs)
Partnership recruitment (9 mins 17 secs)
Meeting referral benchmarks (10 mins 31 secs)
Referral numbers (11 mins 40 secs)
How are the team at Edberts House making a difference? (12 mins 59 secs)
Feedback from practices (14 mins 39 secs)
Linking with other additional roles (15 mins 27 secs)
Planning for the future (16 mins 38 secs)
Are partnership models more likely to succeed? (18 mins 30 secs)
Getting in touch (19 mins 6 secs)
For more information, the Edberts House website is here
Another reminder that If you are interested in joining the PCN Clinical Director mastermind group programme which Rachel Morris and Ben have setup, or have any questions, please email ben@ockham.healthcare or rachel@shapestoolkit.com – or please check out our dedicated page here.
It’s the next episode in our series of podcasts dedicated to the new roles in primary care. This week, our spotlight is on the relatively newly formed Selby Town PCN care coordination team. Ben is joined by Clinical Director Dr Nick Jackson, Fiona Bell-Morritt, Lead Officer at NHS Vale of York CCG, Dementia Care Coordinator Helen Brazil and Frailty Care Coordinator Alice Houlden to explore the overwhelmingly positive impact the care coordinators are making on the wider team and in particular on the vulnerable members of their patient community. From the beginning of their journey, and the adoption of a population health management strategy, to recruitment and development of the care coordination team, an overview of the role itself and the work that’s encompassed, the benefits on offer to both the internal teams and externally, and the lessons learned; our episode today is testament to the powerful influence that the new roles can make.
Introductions (29 secs)
Selby Town PCN (49 secs)
Why did the PCN team decide to recruit their care coordinators? (1 min 29 secs)
First impressions (1 min 54 secs)
Introducing Fiona (2 mins 15 secs)
Fiona’s role in supporting the introduction of the care coordinators (3 mins 1 sec)
Identifying vulnerable patient groups (3 mins 32 secs)
Hearing from Helen (3 mins 54 secs)
Helen’s previous work experience and why the care coordination role was so appealing (4 mins 14 secs)
The evolution of Helen’s role (4 mins 59 secs)
What is care coordination? From Helen’s point of view (7 mins 56 secs)
Alice’s perspective (9 mins 27 secs)
Alice’s background and why she was attracted to the care coordination role (9 mins 45 secs)
The reality of being a care coordinator (10 mins 15 secs)
Responsibility for Selby Town’s frail population (11 mins 29 secs)
Describing the nature of Alice’s work (12 mins 5 secs)
Practice versus PCN? (12 mins 59 secs)
Measuring success (13 mins 44 secs)
Internal and external benefits (14 mins 47 secs)
The difference that can be made to patients’ lives (15 mins 53 secs)
Impact on other practice staff (19 mins 10 secs)
Developing the service (20 mins 10 secs)
Reflections and lessons learned…starting with Fiona (20 mins 53 secs)
Advice from Nick (22 mins 19 secs)
Helen’s top tips (22 mins 48 secs)
A final word from Alice (24 mins 24 secs)
Another reminder that If you are interested in joining the PCN Clinical Director mastermind group programme which Rachel Morris and Ben have setup, or have any questions, please email ben@ockham.healthcare or rachel@shapestoolkit.com – or please check out our dedicated page here.
Life as a PCN leader can be a little lonely at the top. When you’re in charge of your organisation, who do you turn to when you need to download, offload, get a general sense of perspective and / or perhaps just some good old-fashioned advice? This is increasingly becoming an issue for many of our most senior staff in general practice and with demand and stress levels at an all-time high, access to great peer support has never been more important. So, enter GP and executive coach Dr Rachel Morris and our very own General Practice Podcast host Ben. With a wealth of hands-on experience as both clinical and executive leaders, they discuss what great peer support looks like, the ingredients required for successful mentorship and coaching, who you should approach and most importantly, what’s on offer with the all-new mastermind group programme they have recently set up.
Introduction (33 secs)
Rachel’s thoughts on peer support and why it is so important (52 secs)
How do you identify the best sources of support? (2 mins 13 secs)
Can talking to peers outside of your PCN really help? (4 mins 26 secs)
Different methods of peer support (6 mins 45 secs)
Optimising a mastermind experience (9 mins 54 secs)
Why accountability matters (11 mins 38 secs)
The ideal demographic of a mastermind group (13 mins 14 secs)
How Rachel and Ben can help with peer support (14 mins 53 secs)
What’s on offer when you join Rachel and Ben’s mastermind programme and who should apply (16 mins 40 secs)
Group rules (17 mins 9 secs)
Finding out more and signup (17 mins 48 secs)
Establishing a mastermind group of your own (!8 mins 12 secs)
If you’re interested in joining the PCN Clinical Director mastermind group programme which Rachel and Ben have setup, or have any questions, please email ben@ockham.healthcare or rachel@shapestoolkit.com
For more information, please check out our dedicated page here
Just six short months ago, a super group of determined Practice Managers set out on a mission to ensure those in management roles within general practice would have their voices heard – and to recognise the invaluable contribution these roles make in keeping practices and networks running every day. Borne out of collective frustration and dismay at the lack of support and the numbers of highly experienced managers leaving the sector, a not for profit, professional body representing practice managers and those in management roles, the Institute of General Practice Management (IGPM), was founded. In this month’s joint Practice Index and Ockham podcast, we pick up the conversation where we left off November 2020, and hear from the four, formidable founders of the institute about the great strides (and indeed, waves) they have been making since joining forces; from hard-hitting campaigns, recruitment of regional IGPM champions, a proposed accreditation process and the impact they are already making.
Introductions (36 secs)
How has the IGPM taken off? (1 min 2 secs)
Who is on board? (2 mins 57 secs)
Finding the time to nurture and grow the IGPM (4 mins 46 secs)
Professional recognition (5 mins 16 secs)
Support from the LMCs (6 mins 30 secs)
IGPM membership (8 mind 34 secs)
Is the formation of an accreditation process the main goal of the IGPM? (9 mins 31 secs)
Does professional accreditation confine practice management to a particular role? (10 mins 40 secs)
New to partnership scheme (12 mins 38 secs)
‘If I die, it’ll be your fault” (13 mins 5 secs)
Campaign launch (15 mins 15 secs)
Kay gives a key example of why the campaign is much needed (16 mins 10 secs)
What next for the IGPM? (17 mins 14 secs)
Finding out more (18 mins 43 secs)
For more information and to sign up to become a member of the IGPM, please find the website here
Practice Index’s website can be found here
For all enquiries, please contact James Dillon here
It’s the third in our series of podcasts covering the experiences of those working in the new Primary Care additional roles. This week’s episode features Lisa Barnes, a Health and Wellbeing Coach based within SEOxHA PCN, Oxfordshire. Appointed in September 2020, Lisa is very possibly one of the most experienced health coaches in Primary Care so we invited her to the Ockham couch to talk us through her experiences so far; what exactly a health coach can offer in terms of services, who is most likely to benefit, why linking with community support hubs is key, how health and wellbeing coaches can relieve some of the burden on the medical teams and most importantly, how they can have a positive impact on their patients both directly and indirectly.
Introduction (29 secs)
Lisa’s journey to becoming a health and wellbeing coach (42 secs)
PCN makeup (1 min 33 secs)
What is a health coach? (1 min 57 secs)
Patient demographic (3 mins 11 secs)
Appointment structure (4 mins 27 secs)
The impact a health and wellbeing coach can make (6 mins 22 secs)
Support for GPs (8 mins 17 secs)
Developing the service (9 mins 34 secs)
Where does Lisa’s role fit within the network team? (11 mins 4 secs)
Population health management programme (13 mins 6 secs)
Has there been any internal resistance to Lisa’s appointment? (14 mins 9 secs)
Advice for others thinking of applying to be or starting out as a health and wellbeing coach (15 mins 8 secs)
Advice for GPs, practices and networks considering the appointment of a health and wellbeing coach (16 mins 26 secs)
Why community resources and support matter (17 mins 44 secs)
Getting in touch (18 mins 45 secs)
If you’re inspired to appoint or be appointed as a Health and Wellbeing Coach, you can reach Lisa here
If you have an ARRS success story and / or you are working within one of the additional roles and have a story to share, we would love to feature you on the podcast! Do email Ben at ben@ockham.healthcare or get in touch via Twitter
In the second of our series of podcasts covering the experiences of those working in the new Primary Care additional roles, we meet the team from East Merton PCN. GPs Dr Annie Murphy and Dr Mohan Sekeram, talk to Ben about their approach to the employment of the new roles and how they have empowered and enabled their new team members to better support the needs of the patient population, whilst relieving pressure on existing practice staff. They are also joined by Health and Wellbeing Coach Caroline Haines and Paramedic Patricia Murphy who share their experiences of their respective roles so far. How they fit in alongside existing staff across practices and the wider network, how easily they have found the transition into primary care and most importantly, the impact and where they are seeing benefits when it comes to improving health outcomes for their patients.
Introductions (35 secs)
East Merton PCN demographic and their approach to the recruitment of new roles (57 secs)
Why population health management is key (3 mins 12 secs)
Integrating the roles at practice level (4 mins 46 secs)
Caroline tells us what attracted her to health and wellbeing coaching (6 mins 34 secs)
Caroline’s previous experiences and coming into Primary Care as a ‘newbie’ (7 mins 13 secs)
Where does Caroline feel she fits (practice versus PCN)? (8 mins 3 secs)
How the health and wellbeing coaching referral pathway works in practice (8 mins 18 secs)
Positive patient feedback (9 mins 14 secs)
Educating existing staff on health and wellbeing coaching (10 mins 58 secs)
Introducing Patricia, East Merton PCN paramedic (12 mins 5 secs)
Paramedic referral management (12 mins 53 secs)
Linking with other new roles (13 mins 17 secs)
Impact of additional roles on practice, network, and patients (13 mins 55 secs)
Support with overall workload (15 mins 25 secs)
Relieving pressure on GPs (16 mins 23 secs)
Planning for the future (18 mins 15 secs)
Measuring outcomes and patient outreach work (19 mins 22 secs)
Advice to others on embedding additional roles and getting the best from your new workforce (20 mins 46 secs)
If you have an ARRS success story and / or you are working within one of the additional roles and have a story to share, we’d love to feature you on the podcast! Do email Ben at ben@ockham.healthcare or get in touch via Twitter
It’s a podcast with a difference this week! Ben joins forces with Tara Humphrey of THC Primary Care to share the highlights of their recent webinar focusing on the Impact and Investment Fund, introduced very recently as part of the GP and Primary Care Network Contract Settlement. Within the session, Ben and Tara attempt to unpick what the funding means in practice, what value it can add and where the pitfalls may lie alongside how to incorporate the funding into existing financial models and PCN plans, and where the IIF fits within the wider primary care framework. Are the additional monies going to be of benefit or is it simply another burden to manage at a time when general practice is already stretched to the limit?
Welcome and intro from Tara (27 secs)
Why a webinar on the impact and investment fund? (48 secs)
Hello from Ben (1 min 55 secs)
Lessons learned from round 1 (1 min 37 secs)
Network versus practice approach (3 mins 59 secs)
Leveraging social prescribing referrals and the contribution of the ARRS teams (5 mins 52 secs)
Advice to managers and clinical leaders on leading the IIF approach (6 mins 55 secs)
Can the IIF play a useful part in realising the network vision? (9 mins 37 secs)
Ben’s initial thoughts on the updated guidance (10 mins 28 secs)
Opting out (11 mins 14 secs)
Summing up the session so far (12 mins 54 secs)
How might ICSs influence the IIF? (13 mins 54 secs)
The importance of robust financial planning (15 mins 43 secs)
What can the IIF achieve within the 5-year GP contract settlement period? (16 mins 34 secs)
Balancing workforce issues alongside workload pressures (18 mins)
Budgeting for moving QOF targets (19 mins 8 secs)
Good, better, and best financial modelling (20 mins 18 secs)
Conclusions (21 mins 46 secs)
To connect with Tara and to access all the resources available on offer from THC Primary Care check out:
THC Primary Care’s wealth of information on PCN Managers starts here
Listen to The Business of Healthcare Podcast to get the latest insights into business and management behind the scenes in primary care.
Follow Tara on Twitter and on Linkedin
After the accompaniment of “that” letter from NHS England alongside the most recent Standard Operating Procedure, general practice has reacted. Anger, frustration, sadness, shock, and depression are all words permeating through the primary care world at the moment. With workload and demand at an all-time high and staffing numbers stagnating or in decline across many areas, and a (so far, highly successful) vaccination programme to deliver, the general feeling is that this is a slap in the face from central government and the mainstream media alike. There has also been a direct (and much darker) impact on the ground with cases of abuse from patients directed at staff on the rise. Against this depressing backdrop, our joint Practice Index, Practice Manager panel return and are joined by GP and Clinical Director Dr Hussain Gandhi, to reflect on the detail of the letter, the implications of it, the impact on digital evolution in primary care, workload, capacity, patient education and most importantly, how we move forward from here.
Introductions (45 secs)
Nicola’s reaction the letter (1 min 19 secs)
From Robyn’s perspective (2 mins 2 secs)
Gandhi’s view (2 mins 46 secs)
Why was the letter issued? (3 mins 53 secs)
Long term issues with access (4 mins 59 secs)
Diverting attention from the bigger, more long-term challenges (5 mins 38 secs)
The impact on staffing capacity (and turnover) (5 mins 56 secs)
Crunching the staffing numbers (6 mins 36 secs)
Effect on Whole Time Equivalents (WTE) and clinical sessions (7 mins 29 secs)
Can the additional roles make a positive difference? (8 mins 36 secs)
Patient education is key (9 mins 29 secs)
Digital evolution (10 mins 13 secs)
Signposting patients to the most appropriate care provider (11 mins 20 secs)
What happens now re. remote consultations? (12 mins 35 secs)
Online consultations; help or hindrance when considering total demand (14 mins 29 secs)
Balancing telephone, online and face to face consults (16 mins 20 secs)
Why is demand at an all-time high? (17 mins 16 secs)
Patient appreciation and understanding (19 mins 19 secs)
The impact of the NHSE letter for practices on the ground (19 mins 57 secs)
How do we respond? (22 mins 12 secs)
The Institute of General Practice Management (IGPM) view (22 mins 45 secs)
Final thoughts from Gandhi (23 mins 26 secs)
The IGPM are currently running a campaign to raise awareness of the abuse suffered by general practice staff right now. View and promote here: (short clip) and (long clip)
In the first of a series of podcasts shining a spotlight on the ARRS new roles and those working in them, Ben is joined by Kosiwa Lokosu, an experienced Senior Occupational Therapist who has recently taken up her first post in primary care. Here, Kosiwa shares a fascinating and inspirational insight into her life as an OT before general practice, the recruitment process from her perspective, the integration of her team within the wider PCN, her work and her patients, and her advice for those considering setting up an OT service in their own areas (and the key considerations for this).
Introduction (43 secs)
What led Kosiwa towards becoming an OT? (53 secs)
Kosiwa’s experiences to date (1 min 38 secs)
Starting in general practice (3 mins 7 secs)
PCN demographic (4 mins 37 secs)
Team structure (5 mins 34 secs)
Base and space (6 mins 26 secs)
Working across practices and referrals in (7 mins 17 secs)
Creation of a referral criteria (8 mins 40 secs)
Conclusion of treatment (9 mins 14 secs)
Referral quality and appropriateness (10 mins 1 sec)
OT caseload and division of time (11 mins 18 secs)
Clinical supervision budget (13 mins 3 secs)
Progressing the service (13 mins 27 secs)
Patient feedback (15 mins 3 secs)
A positive impact on general practice (16 mins 9 secs)
Linking with community mental health services (17 mins)
Advice for those who are considering employing an OT (17 mins 18 secs)
The pros of a multi-disciplinary model (18 mins 41 secs)
Getting in touch (19 mins 37 secs)
To get in touch with Kosiwa, you can email her here or follow her on Twitter
Catch up with Kosiwa’s blog here
Episode 255 - Podcast – Tara Humphrey – What makes a perfect PCN Manager?
Although the role of PCN Manager is growing in importance, alongside the evolution of PCNs, there is still confusion and misconception about where a manager fits and what they can bring to the primary care table. Ben is joined this week by podcast veteran and management guru Tara Humphrey of THC Primary Care to dispel the myths and to explain precisely how and why a manager can be of benefit. What they can do to support the work of the Clinical Director and the wider management team in facing down some of the challenges, how they can remove pressure from existing staff, what makes a perfect PCN Manager, how to find them - and if you’re lucky enough to already have a manager in post, where resources and information can be found to support them in continuing to thrive.
Introduction (39 secs)
What first sparked Tara’s interest in PCN management? (55 secs)
What’s the general practice perception of PCN Managers right now? (1 min 49 secs)
Tackling the workload (3 mins 9 secs)
What should the person spec for a PCN Manager look like? (4 mins 6 secs)
Is an NHS background necessarily required? (4 mins 36 secs)
How about experience in primary care specifically? (5 mins 49 secs)
Practice Managers for PCN Manager (6 mins 39 secs)
Combining practice management with network management (7 mins 17 secs)
Where should we target recruitment of PCN Managers? (7 mins 41 secs)
The key challenges right now (8 mins 36 secs)
Learning the role and the remit it encompasses (9 mins 22 secs)
Understanding of PCN vision and objectives (10 mins 34 secs)
What’s on offer to a PCN Manager when the network is still developing? (11 mins 41 secs)
Dealing with disparate practices (12 mins 3 secs)
Why the Practice Manager and PCN Manager relationship is key (13 mins 53 secs)
Where a PCN Manager sits within the network hierarchy (14 mins 30 secs)
Supporting new ARRS team members (15 mins 24 secs)
A summary of the key challenges a PCN Manager might face when it comes to the ARRS (17 mins 8 secs)
How Tara and her team can help (18 mins 55 secs)
What’s available on THC Primary Care and signing up for the PCN Manager Masterclass (19 mins 57 secs)
To connect with Tara and to access all the resources available on offer from THC Primary Care check out:
THC Primary Care’s wealth of information on PCN Managers, starting here
Sign up to the THC Primary Care PCN Manager Masterclass here
Listen to The Business of Healthcare Podcast to get the latest insights into business and management behind the scenes in primary care.
Dem Dx is a CE certified artificial intelligence clinical reasoning platform which has been designed and set up to support frontline healthcare professionals diagnose, investigate, and make care recommendations at the first point of contact. What makes it a little different though is that the aim is to provide an information resource which aids and empowers staff in supporting roles to triage and diagnose, relieving some of the burden on medics. How does it work in practice though? And can it really alleviate pressure on GPs, particularly when it comes to supporting the new, additional roles workforce? Today’s podcast features Dr Lorin Gresser, Dem Dx’s CEO and founder, who takes us on the Dem Dx journey from the beginning; from setup and capture of certified pathways (and approved guidance) to preserve safe clinical decision making, why it is a tool which focuses on diagnosis rather than ongoing management, where they have a presence currently (and where primary care comes in) - and how staff in primary care access and benefit from this multi-award-winning platform.
Introduction (40 secs)
All about Lorin (53 secs)
When was Dem Dx born? (1 min 54 secs)
Where is Dem Dx operational now? (3 mins 3 secs)
How the platform works in practice (4 mins 28 secs)
What are the challenges for Dem Dx? (5 mins 42 secs)
A tool with a focus on supporting staff, rather than patients, in the first instance (6 mins 14 secs)
Helping primary care staff in supporting roles to free up GP time (7 mins 40 secs)
The benefits when it comes to the additional roles (9 mins 1 sec)
Focusing on diagnosis, rather than ongoing management (9 mins 19 secs)
Remote working (10 mins 3 secs)
Ongoing decision support or simply upskilling staff as they go? (10 mins 56 secs)
Funding and procurement (12 mins 5 secs)
Dem Dx’s Rwanda project (14 mins 25 secs)
Finding out more and getting in touch (16 mins 13 secs)
The Dem Dx website can be found here
For all enquiries, please contact Lorin Gresser via email or via LinkedIn
It’s also the last chance to sign up for The Resilient Team Academy offer! Head over to the Resilient Team Academy website which contains information on the current, discounted offer and how to apply.
A brand-new year for the Quality and Outcomes Framework (QOF) has already begun so what do practices, and networks, need to be aware of, to ensure they are informed and ahead of the game, almost one month in? Our monthly Practice Index Practice Manager panel return and Nicola, Robyn and Ben are this time joined by Claire Houston, Practice Index’s expert on all things QOF, to highlight where there are major changes, what the changes mean in real terms, what general practice should be on top of now, the impact on patients (and primary care teams) – and most importantly, how to ensure you stand the best chance of meeting the targets set for 2021 / 22.
Introductions (29 secs)
More about Claire (51 secs)
QOF for next year, the headlines (1 min 19 secs)
Moving flu vaccs from QOF into the Investment and Impact Fund (IIF), what does mean in real terms for practices? (1 min 50 secs)
Discussing the thresholds (3 mins 21 secs)
Network versus practice targets (3 mins 53 secs)
IIF funding distribution (4 mins 37 secs)
Significant changes to vaccs and imms more widely (5 mins 9 secs)
The effect on patient choice (6 mins 53 secs)
Clarity on vaccine targets (network and practice) (8 mins 38 secs)
What happens if you don’t meet your QOF target/s? (8 mins 59 secs)
Getting a head start (11 mins 29 secs)
The importance of coding correctly (12 mins 2 secs)
What else is new? (12 mins 41 secs)
The difficulty of onward referral/s (13 mins 52 secs)
Management of serious mental illness (15 mins 20 secs)
Patients in remission (15 mins 59 secs)
Nicola and Robyn reflect on the changes (16 mins 45 secs)
Core standards related to vaccs and imms (18 mins 10 secs)
Claire’s advice, in summary (18 mins 51 secs)
Final thoughts (20 mins 3 secs)
Getting in touch (20 mins 21 secs)
The Practice Index website can be found here
For all enquiries, please contact James Dillon here
Here is the link to the Resilient Team Academy website which contains information on the current, discounted offer and how to apply.
Up and coming, The Physician Associate Podcast, is a brand-new resource for Physician Associates both newly qualified and established, to access a wealth of information, opinion and all the latest news relevant to the PA world. Host James Catton is this week joined by our very own Ben Gowland, who has taken time out from recording The General Practice podcast, to give new listeners a much-needed overview of and insight into general practice right now. How general practice works within the wider healthcare ecosystem, when and why Primary Care Networks were born, the financial model, partnerships and the New to Partnership Scheme, and most importantly, all the need to knows for a PA considering a career in general practice.
Introduction (59 secs)
Setting the scene (1 min 15 secs)
Where general practice sits within the wider NHS (2 mins 9 secs)
Recent changes and the birth of PCNs (3 mins 1 sec)
The Additional Roles Reimbursement Scheme (3 mins 58 secs)
Challenges facing PCNs (4 mins 50 secs)
James’ view of practice versus PCN placement (6 mins 26 secs)
The importance of knowing where you stand before applying for a role (6 mins 52 secs)
Getting the most out of having a PA and being a PA in a PCN (7 mins 34 secs)
What is GP partnership and the business model explained (10 mins 18 secs)
Financial challenges (11 mins 34 secs)
The New to Partnership Scheme (12 mins 26 secs)
Why have numbers of partnerships fallen in recent years? (13 mins 32 secs)
Out of hours services in general practice (15 mins 38 secs)
Quality and Outcomes Framework (QOF) explained (17 mins 58 secs)
Predicting the future (19 mins 6 secs)
Further information and getting in touch (23 mins 4 secs)
Staff across general practice are currently feeling the impact of the enormous increase in workload as a result of the pandemic and business as usual spectacularly colliding but what is life like at the top of a PCN right now? How are the Clinical Directors bearing the additional burden, managing the demands from their own workloads, and finding adequate time to support and grow new, integrated teams across their network? In this week’s podcast, we welcome back GP and executive coach Rachel Morris who offers her usual brand of practical, innovative, and accessible solutions for managing team stress and individual pressure. Rachel is joined by Dr Nicky Turner, Clinical Director for The Chalfont PCN in Buckinghamshire, who shares her experiences in the role and where her own support systems exist. Together, our panel explore where the challenges lie right now, what can be done to preserve and promote team and personal resilience – and finally how and why listeners to the podcast should access further support of their own and resources from Rachel’s Resilient Team Academy
Introductions (39 secs)
Nicky’s PCN demographic (55 secs)
What are the main challenges Nicky faces in her role right now? (1 min 16 secs)
Is the issue of workload the main factor or is it wider than that? (1 min 43 secs)
Working across practices within a PCN (2 mins 9 secs)
Managing people and change (3 mins 12 secs)
The impact of the Additional Roles Reimbursement Scheme (ARRS) (4 mins 13 secs)
Rachel’s view on the pressure Clinical Directors are under (4 mins 42 secs)
What is helpful in terms of support? (5 mins 21 secs)
Nicky’s perspective on reducing stress and being more effective (6 mins 16 secs)
Actively seeking support (7 mins 1 sec)
The Drama Triangle (7 mins 43 secs)
Are softer skills really beneficial? (9 mins 36 secs)
Tailoring resilience training for different leaders (10 mins 19 secs)
Finding support in difference places (11 mins 41 secs)
The Resilient Team Academy (12 mins 5 secs)
Building a stronger team (13 mins 39 secs)
Planning for team engagement, post Covid (14 mins 30 secs)
Embedding ARRS staff (15 mins 29 secs)
Lessons learned from others’ experiences…what will get from joining The Resilient Team Academy? (17 mins 27 secs)
Constructive conflict (18 mins 53 secs)
The issues of virtual meetings and the impact on building great team relations (19 mins 48 secs)
Final words from Rachel (19 mins 59 secs)
Here is the link to the Resilient Team Academy website which contains information on the resources available, the current discounted offer– and how to join up.
As the new financial year and all its uncertainties looms, our joint Practice Index / Ockham Healthcare panel return to discuss their predictions and the preparations they have in place. Podcast regulars Robyn Clark and Nicola Davies are this week joined by RSM Partner and our resident finance expert James Gransby to talk all things QOF, enhanced services and the contractual requirements for 2021/22. Where are the pressure points? Can we continue to manage business as usual alongside the Covid vaccination drive? Will our core service once again expand to include the vaccinations year on year? How do we juggle this and what can we expect to receive by way of funding? Are we simply going to break even or can primary care profit from the increased workload? Life after Covid potentially starts here…
Introductions (33 secs)
How does life in general practice right now compare to that of a ‘normal’ March? (49 secs)
Planning for QOF next year (1 min 47 secs)
Is it possible for networks to manage business as usual alongside the enhanced service? (2 mins 59 secs)
What networks should be considering when it comes to finance in the new year (4 mins 44 secs)
Covid vaccinations to become core practice? (6 mins 8 secs)
The implications of a year-round vaccine drive (7 mins 42 secs)
Budget 2021 in summary and what it means for primary care (8 mins 38 secs)
Contract considerations, outside of QOF (10 mins 48 secs)
Implementing the Additional Roles Reimbursement Scheme in practice (11 mins 55 secs)
Mitigating the risk of high staff turnover (14 mins 43 secs)
Are PCN structures fit for future? (16 mins 35 secs)
Utilising the £1.50 (17 mins 33 secs)
An alternative way of thinking (18 mins 40 secs)
Embedding mental health workers (19 mins 39 secs)
James’s final thoughts (20 mins 53 secs)
The Practice Index website can be found here
For all enquiries, please contact James Dillon here
We are all aware of the pressure on general practice which has ramped up considerably since the vaccine drive began back in December but with no let up in sight and in fact, with pressure increasing across primary care going forwards, how do we maintain our current resilience and productivity levels whilst succumbing to the stress and even worse, the very real threat of burn out? Luckily GP and Executive Coach turned trainer Dr Rachel Morris is our featured guest this week and offers her thoughts, and some really practical advice, to ensure the burden of responsibility can be shared and managed more constructively, to preserve and promote the wellbeing of a team (and its individuals) during what many are finding to be the most stressful period of their working lives to date.
Introduction (29 secs)
Where are we at right now? (1 min 5 secs)
How do we maintain current momentum? (2 mins 19 secs)
Why you should be taking time off despite increasing pressure (4 mins 18 secs)
Taking a leap of faith (5 mins 54 secs)
Assuming the role of the rescuer (6 mins 46 secs)
Managing tensions and moving forwards (7 mins 45 secs)
Communication is key (9 mins 33 secs)
Building trust (10 mins 8 secs)
Where some PCNs have become disjointed (10 mins 54 secs)
Network challenges (11 mins 39 secs)
The Five Dysfunctions of a Team – Patrick Lencioni (12 mins 17 secs)
The importance of constructive conflict (12 mins 50 secs)
The transition of good working relationships to business as usual (15 mins 21 secs)
Mining for conflict to enable teams to function well (16 mins 22 secs)
The impact of the virtual environment (17 mins 39 secs)
Finding out more (19 mins 9 secs)
The Resilient Team Academy (20 mins 24 secs)
A list of the resources Rachel has mentioned:
The evolution of technology in general practice has been accelerated over the last 12 months but how ready were we, and are we, for further digital transformation? What are the factors that influence our willingness to embrace new ways of working and what are the barriers to progression? This was the focus of GP and Digital Fellow Dr Matt Hammerton’s recent report on digital readiness within his local integrated health partnership, a report conducted in conjunction with Wessex Academic Health Science Network (AHSN), with the support of WAHSN’s Associate Director Rachel Dominey. This week’s podcast offers a fascinating overview of the report’s findings and outcomes and includes practical advice and recommendations on readying practices and networks for the next stage of the digital journey.
Introductions (45 secs)
The reasons for undertaking the study (57 secs)
The reality of the tech available versus what is being used (1 min 42 secs)
Defining digital readiness (2 mins 8 secs)
Which areas of general practice does the report cover? (3 mins 6 secs)
Rachel describes her role at the AHSN (3 mins 34 secs)
How did the study work in practice? (5 mins 3 secs)
Recording the acceleration of tech use during the pandemic (5 mins 45 secs)
The difference in results, pre and post Covid-19 (6 mins 48 secs)
Does digital readiness depend on the tech we are using? (7 mins 17 secs)
Is the ability to embrace new technology more important than how the tech itself works? (8 mins 33 secs)
The AccuRx effect (9 mins 17 secs)
Does a more bespoke technology increase our willingness to use it? (9 mins 57 secs)
Other key factors impacting digital readiness (12 mins 53 secs)
Some recommendations (14 mins 6 secs)
The non-clinical profile (16 mins)
Patient age impact and influence (16 mins 38 secs)
The risk of practices and networks falling behind (17 mins 28 secs)
Further outcomes, recommendations, and advice (18 mins 33 secs)
Taking forward the recommendations from the AHSN’s perspective (19 mins 58 secs)
The link to the digital readiness report is here
Telehealth is a tool which can be used in a variety of ways; to support and enhance existing systems or to introduce a completely new way of working. Whilst telehealth is a relatively new concept in many areas, in others it is a more long-term feature of the health ecosystem. In West Yorkshire, Immedicare offer a 24/7 digital care service to support primary care providers with the management of care home patients. Having been established for over 10 years, they know only too well what works, what does not and crucially how to realise the benefits of telehealth; enabling rapid triage and response around the clock, reducing secondary care admissions and relieving pressure on care home staff, local practices and PCNs. Rachel Binks, Nurse Practitioner for Digital and Acute Care at Airedale NHS Foundation Trust, joins Ben this week to fill us in on the Immedicare journey and why they have been instrumental in improving health outcomes for their care home patients.
Introduction (34 secs)
How did the concept first come about? (46 secs)
The Immedicare journey (1 min 26 secs)
Enabling a 24/7 service (2 mins 11 secs)
800 care homes and counting (3 mins 43 secs)
How does the service work in practice? (4 mins 32 secs)
What is the contractual basis of the service and where does it fit with local providers? (5 mins 12 secs)
Managing a broad spectrum of conditions and health concerns (7 mins 13 secs)
The importance of building and maintaining relationships (7 mins 56 secs)
The Immedicare clinical workforce (9 mins 27 secs)
Making the service viable (10 mins 15 secs)
Balancing relationships with local PCNs and practices (11 mins 16 secs)
Multi-disciplinary team meetings (12 mins 59 secs)
What has been the impact of the service? (13 mins 36 secs)
Technical limitations? (14 mins 16 secs)
Reducing community care visits and admissions (14 mins 50 secs)
Aligning with new PCN services and staff teams (15 mins 51 secs)
Feedback from the care homes (16 mins 42 secs)
Financial and contractual setup (17 mins 14 secs)
What’s next as far as developing the service is concerned? (18 mins 23 secs)
Finding out more (19 mins 17 secs)
Immedicare website is here
Rachel is happy to discuss any aspect of the service on offer from Immedicare or telehealth more broadly. Her email address is here
It is undeniable that the success of the Covid vaccination programme so far is due to the efficiency and the herculean efforts of general practice staff across the board; from volunteers, to drivers, Practice Managers, doctors, nursing, and administration teams who all continue to go the extra mile to try to get the country back on its feet. On our dedicated monthly Practice Index / Ockham podcast, we have closely followed the progress of our Practice Managers (and their teams) from the beginning in December and January - and this week we revisit their journeys at a pivotal point as they smash their initial target of vaccinating the most vulnerable patient groups with their first doses. On this month’s panel, podcast regular Nicola Davies is joined by her colleagues Kay Keane of Alvanley Family Practice (and network manager for Werneth PCN) and Andrew Athale, Practice Manager for Eastmoor and Alverthorpe GP practices, to discuss their largely positive experiences so far but also the additional pressure they and their wider colleagues are feeling, their views on ensuring full and accurate financial reimbursement across their networks and what comes next as far as core general practice demand and delivery of second doses are concerned.
Introductions (34 secs)
Progress on the vaccination programme in each area; starting with Nicola’s (1 min 30 secs)
Kay tells us about her experiences in Stockport so far (2 mins 26 secs)
Kay’s role in the process (3 mins 1 secs)
Patient inspiration (3 mins 29 secs)
How has it gone so far in Andrew’s network? (4 mins 5 secs)
Meeting the challenge of vaccinating care home residents and house bound patients (5 mins 3 secs)
Processing payment (7 mins 51 secs)
The problem with Pinnacle (9 mins 20 secs)
Ensuring accurate and timely distribution of funds (10 mins 5 secs)
The pressure of working at scale when it comes to financial reimbursement (10 mins 58 secs)
Wider network impacts (12 mins 22 secs)
Could this be the making of PCNs? (13 mins 13 secs)
How has the set up of the mass vaccination sites affected local practices? (14 mins 14 secs)
Are PCNs really in competition with the mass vaccinations sites? (15 mins 55 secs)
Delivery of vaccines at a more local level (17 mins 30 secs)
Preparations for second doses (18 mins 56 secs)
Why delivery notifications need to be right (19 mins 30 secs)
Managing core general practice demand alongside the vaccine drive (20 mins 2 secs)
Pressure on Practice Managers (20 mins 49 secs)
Ben’s closing remarks (22 mins 25 secs)
The Practice Index website can be found here
For all enquiries, please contact James Dillon here
With demand on general practice already at an all-time high, many practices and networks require a smarter solution to manage staffing and rotas, to ensure the pressure of core primary care work, alongside the mass vaccination drive, can be effectively delivered. Dr Ishani Patel, GP and co-founder of the digital staff bank solution Lantum is back on the podcast and joined by colleague, Lantum account manager, Tom Herbert-Maynard, to update us on the progress that Lantum has made, how their solution is supporting ICSs up and down the country to create a fully flexible workforce across the NHS eco-system, their influence on staffing the vaccination sites and most importantly, to provide information on the NHSEI funding available now for ICSs to enable procurement of and access to a digital staff bank.
Introductions (38 secs)
Who are Lantum and what role are they playing in supporting the vaccination rollout? (51 secs)
How does a digital staff bank work where the vaccination programme is concerned? (1 min 39 secs)
Lessons learned from the programme so far (3 mins 28 secs)
What advantages does a digital system offer versus traditional methods of rota management? (5 mins 38 secs)
How would a rota manager organise staffing using an online portal, in practice? (6 mins 8 secs)
Governance considerations (8 mins 14 secs)
Maintaining a good rate of vaccinations and how the system could support this (8 mins 26 secs)
The key differences between smaller vaccination hubs and larger scale vaccination sites (9 mins 28 secs)
NHSEI funding availability (11 mins 5 secs)
Putting a flexible staffing pool in place across an ICS (12 mins 46 secs)
Which roles can be managed within a digital staff bank? (14 mins 34 secs)
Enabling delivery of truly integrated care (15 mins 22 secs)
Breaking down organisational boundaries (16 mins 29 secs)
How do I access the NHSEI funding offer? (17 mins 29 secs)
I am a Clinical Director, and I would like to find out more (18 mins 29 secs)
Getting in touch (19 mins 20 secs)
The Lantum website is here
Ishani is contactable here
This page explains a little more about how Lantum can provide 'connected scheduling' between staff banks.
What should be the key considerations when sourcing a digital staff bank provider? Lantum’s blog post is here
With the right training and support in place, Physician Associates can play an important part in relieving a proportion of the clinical burden on GPs and their wider staff. As the role is now included in those available through the Additional Roles Reimbursement Scheme, we persuaded Ria Agarwal, herself an experienced Physician Associate (PA), to make a return to the podcast, to share her experiences and her tips for getting the best out of a newly recruited PA. Why she believes they can really make a difference to practice productivity, what PA preceptorships (such as the scheme currently on offer in Sheffield) can bring in the way of support and how to get the best out of your newest recruit.
Introduction (34 secs)
Four years in the life of a Physician Associate (PA) (48 secs)
Is the PA role now more widely accepted in general practice? (2 mins 5 secs)
The inclusion of PAs in the additional roles’ reimbursement scheme (2 mins 39 secs)
Preceptorship schemes (2 mins 58 secs)
What is involved in a preceptorship typically? (3 mins 46 secs)
Structuring PA consulting appointments in the first year (6 mins 24 secs)
Progression and training (7 mins 16 secs)
The influence of a practice in enhancing the potential of a PA (8 mins 26 secs)
Is there a benefit to newly qualified PAs having access to and mentorship from a more experienced PA? (11 mins 3 secs)
Tackling recruitment (12 mins 31 secs)
Expectation versus reality (15 mins 11 secs)
Why where you base your PA matters (16 mins 24 secs)
Preceptorship funding (17 mins 22 secs)
The key to success (18 mins 30 secs)
Final thoughts and advice (19 mins 44 secs)
A link to Ria’s paper on the preceptorship scheme available in Sheffield is here
When primary care networks were first launched, many believed this might spell the end for GP federations, but this is not necessarily the case. There are numerous examples of some innovative partnership models developing across the country to support PCNs in delivering the best quality care and whereby federations are providing the resources to absorb some of the key workstreams, thus removing the burden from practice and network staff. Alliance for Better Care, or ABC as they are commonly known, are a typical example of a GP federation who are achieving success by working collaboratively with their PCNs. This is due, in part, to the expertise of their two Network Development Managers, Caroline Upton and Lena Abdu, who join Ben on the podcast to give an insight into their roles, what they entail, where they have made a difference and why partnership working might be the way forward.
Introductions (38 secs)
ABC demographic and mission (57 secs)
Lena’s background (1 min 39 secs)
Caroline’s journey to becoming a Network Development Manager (2 mins 42 secs)
Sharing the management of networks from a federation perspective (3 mins 14 secs)
Ownership of dedicated work packages (4 mins 2 secs)
The importance of maintaining strong relationships with individual clinical directors (4 mins 48 secs)
Communication and engagement with wider teams (5 mins 34 secs)
Other available support for PCNs (6 mins 42 secs)
All about recruitment (7 mins 53 secs)
The additional roles scheme (10 mins 23 secs)
Managing workload and demand capacity (12 mins 4 secs)
Meeting the new general practice service specifications (13 mins 13 secs)
Meeting representation (15 mins 38 secs)
What are the main challenges? (17 mins 31 secs)
How are the Network Development Manager roles costed? (19 mins 43 secs)
Finding out more and getting in touch (21 mins 32 secs)
Alliance for Better Care’s website can be found here
Email: caroline.upton@nhs.net and / or lena.abdu@nhs.net
It has been arguably some of the toughest few weeks general practice has ever known. The pressure of the delivery of the vaccination programme has been felt by teams up and down the country and our joint Ockham / Practice Index podcast regulars are no different. In this sixth instalment of our hugely popular practice manager panel posts, Nicola Davies, Robyn Clark and Ben are joined by Business Manager Amita Gokani to discuss their experiences of working at the forefront of the vaccination programme, so far. Each have faced their own challenges locally and are at different stages in the immunisation campaign and we have been fortunate to get their insights on how the first six weeks have gone for each of them; the highs, the lows and then what comes next.
Introductions (35 secs)
Robyn in the headlines (1 min)
The Institute of General Practice Management (IGPM) update (2 mins 47 secs)
The last 6 weeks in Nicola’s patch (3 mins 1 sec)
Dealing with local frustrations (3 mins 57 secs)
Amita’s recent experiences in Redbridge (5 mins 9 secs)
The impact of short notice, unannounced and cancelled deliveries (6 mins 49 secs)
Working through the cohorts versus potential for wastage (7 mins 30 secs)
Progress in Robyn’s area (8 mins 15 secs)
The potential for increased flexibility and where this has been limited (9 mins 3 secs)
What happened when the guidelines for administering the second dosage changed? (10 mins 57 secs)
The challenges presented by continually changing guidance and regulation (11 mins 42 secs)
Nicola’s view on these continuous changes (12 mins)
Managing staffing and rotas (14 mins 19 secs)
The limitations of running services on staffing good will (15 mins 45 secs)
The approach to care homes and housebound patients in Robyn’s area (17 mins 15 secs)
Anticipating the weeks ahead: Robyn and Amita (18 mins 9 secs)
All systems go for Nicola (19 mins 31 secs)
The Practice Index website can be found here
For all enquiries, please contact James Dillon here