accuRx have been on an interesting journey and one that they may not always be given credit for, given the overnight and overwhelming success of the simple, yet game changing software they have introduced to general practice over the last four months. From modest beginnings, working out of small numbers of practices on process improvement measures, to the inception of the messaging service and video consultations, super rapid rollouts, continuous reinvention and pioneering tech in scope for the future, co-founder Jacob Haddad takes Ben through, arguably, one of tech's biggest triumphs in healthcare and what accuRx means for primary care and beyond.
Introductions (45 secs)
Where accuRx began (1min 8 secs)
A turning point (1 min 36 secs)
The messaging service (2 mins 5 secs)
The cause for the change in direction (2 mins 45 secs)
Communication, communication, communication (4 mins 25 secs)
A new approach to rollout (5 mins 16 secs)
Video consultations and Covid triage (6 mins 15 secs)
Feature design with patients and practice in mind (8 mins 9 secs)
Rollout timeline (8 mins 24 secs)
Identifying the need for more effective patient communication tools (9 mins)
The surge in demand (9 mins 50 secs)
Filling a gap in the market (10 mins 17 secs)
Has the messaging service been the key enabler of change and improvement in healthcare? (11 mins 31 secs)
Security, governance and information sharing (12 mins 1 sec)
How long will the service continue to be free to use? (14 mins 17 secs)
The "plus" tier (15 mins 50 secs)
accuRx ethos (16 mins 6 secs)
Working alongside health to build great tech (17 mins 54 secs)
What's next for accuRx? (18 mins 55 secs)
Staying up to date / more information (21 mins 49 secs)
For updates on what's next on the accuRx horizon:
Twitter @accuRx
The accuRx Facebook user group is here
accuRx have been hailed as the overwhelming success story of the Covid crisis, with a rapid deployment of much needed virtual tech into practices up and down the country and enabling primary teams to maintain high quality care for their patients. Ben is joined on this week’s podcast by GP and IT champion Dustyn Saint of Primary Care Pathways, to discuss the accuRx journey, what their breakout success has meant for general practice and how their influence is likely to extend beyond the pandemic.
Introductions (35 secs)
Primary Care Pathways (44 secs)
When did Dustyn first hear about accuRx? (1 min 33 secs)
Text messaging (1 min 58 secs)
How does the accuRx messaging service work alongside existing clinical systems? (3 mins 28 secs)
What other features does the messaging tool offer? (4 mins 6 secs)
A “game changing” video consultation service and its effect on general practice during the pandemic (4 mins 49 secs)
A comparison with previous video consultation applications (5 mins 54 secs)
How easy was it for colleagues and staff to adapt to using the accuRx systems? (6 mins 56 secs)
Widespread adoption across general practice (7 mins 41 secs)
Working with other providers and additional functionality (8 mins 8 secs)
Are virtual consults here to stay? (8 mins 35 secs)
The effect of tech on managing care going forwards (9 mins 21 secs)
Remote monitoring (10 mins 38 secs)
A turning point for primary care? (11 mins 30 secs)
The accuRx journey (12 mins 10 secs)
accuRx financial model and the procurement process (12 mins 53 secs)
A comparison against other business models; past and present (14 mins 8 secs)
The impact on working practices and benefits to patients (14 mins 4 secs)
Security and governance (15 mins 37 secs)
GP testimonial (16 mins 38 secs)
What’s next for Primary Care Pathways? (16 mins 58 secs)
Getting in touch (18 mins 11 secs)
For more information on Primary Care Pathways and making direct contact with Dustyn:
Primary Care Pathways website here
Primary Care Pathways first Ockham podcast episode is available here
Contact @PrimaryCareIT / @DustynSaint
Resilience in primary care has been truly tested by recent events but we are going back to basics on this week’s podcast as we talk to former midwife turned executive coach Janice Steed about why the resilience of a practice and its people is key to its success overall. What are the indicators of a resilient practice, where are the red flags and what are the clear elements that we must consider if we are to make improvements? Janice offers advice, gives her thoughts and shines a light on the Beds and Herts journey, following the introduction of their resilience programme there.
Introductions (44 secs)
What inspired Janice to become involved in resilience improvement? (1 min 16 secs)
The general practice resilience programme in Bedfordshire and Hertfordshire (1 min 50 secs)
Why the programme was introduced (2 mins 21 secs)
How the programme began (2 mins 41 secs)
Resilience: key indicators that a practice may be struggling (4 mins 3 secs)
Practice versus personal resilience (5 mins 47 secs)
Engaging the whole practice through its individuals (7 mins 30 secs)
The LMC’s role in improving resilience (8 mins 29 secs)
Practical elements for consideration (9 mins 16 secs)
The Beds and Herts resilience programme outline (10 mins 32 secs)
An overview of the programme’s six modules (12 mins 5 secs_
The impact of Covid on general practice resilience (15 mins 28 secs)
PCNs and their influence (15 mins 41 secs)
Getting in touch / further information (17 mins 49 secs)
For more information about Janice, her website is here
Details on the Beds and Herts resilience journey can be found on their LMC website here
Covid-19 has presented many challenges for GPs, not least the changes they have had to enact to ensure they are able to continue safe and effective management of patients with long terms health conditions. This week’s podcast features GP Dr Andrew Whittamore, Clinical Lead at the Asthma UK and British Lung Foundation Partnership and fellow GP Dr Minal Bakhai, National Clinical Director for Digital First Primary Care, who discuss the impact that the rapid introduction of tech and a more tech based approach in primary care has meant overall but also more crucially, how the opportunities presented by Covid have enabled them to offer increased flexibility and adaptability to meet patients’ needs - and to reach previously untapped patient populations.
Introductions (35 secs)
Which of the changes has had the most beneficial effect? (1 min 1 sec)
A total triage model of care (1 min 31 secs)
Remote consultations in numbers (2 mins 12 secs)
Using the wider workforce and rapid progress in other areas (3 mins 17 secs)
Remote monitoring and the impact on management of long-term conditions (4 mins 10 secs)
Andy’s experience from Portsdown Group Practice
The opportunities presented by Covid (5 mins 54 secs)
Was Covid the enabler for change or was this already the direction of travel? (6 mins 37 secs)
The power of shared purpose and streamlining services (8 mins 24 secs)
How has the shift to digital changed the management of patients with long term conditions? (8 mins 41 secs)
The risks new ways of working may present to patients with asthma and other lung conditions (10 mins 32 secs)
Asthma: the facts (and the ways digital transformation can improve outcomes) (11 mina 44 secs)
What happens next? (14 mins 38 secs)
Continuing the momentum at PCN level (17 mins 45 secs)
The importance of being able to align primary care services to patient lifestyle and preference (18 mins 38 secs)
Getting in touch and further information (19 mins 18 secs)
Links for guidance and support in setting up a digital model:
Advice on how to establish a 'total triage' model in general practice using online consultations
Health Education England e-learning on remote total triage model in general practice
Principles for safe video consulting during Covid-19
Digital First Primary Care home page: https://www.england.nhs.uk/gp/digital-first-primary-care/
Contact Digital First Primary Care: england.digitalfirstprimarycare@nhs.net
Specific links related to management of asthma:
Here is the link to all of the asthma uk publications
Specifically digital asthma: reimagining primary care
Minal mentioned this report looking at data sharing and technology exploring the attitudes of people with asthma
With the focus shifting back towards the normality of day to day working, primary care now has scope to reconsider the opportunities presented by the Additional Roles Reimbursement Scheme in building workforce capacity and to establish further transformative working practices. This week’s spotlight is on the role of the pharmacist and we are fortunate to be joined by the experienced and progressive Steve Williams, who is a Clinical Pharmacist and network lead in his area of expertise based at Westbourne Medical Centre in Dorset. Here, Steve explains how his role fits both at practice and at network level - and gives his advice on making the best use of pharmacy professionals, and the additional roles more broadly, in general practice.
Introductions (36 secs)
Steve’s journey to becoming a PCN pharmacist (1 min 3 secs)
Why a move into general practice? (2 mins 33 secs)
Steve describes the transition from secondary to primary care (3 mins 15 secs)
The key differences (3 mins 44 secs)
What was the practice’s initial reaction to taking on a pharmacist? (4 mins 53 secs)
Embedding new roles; advice on induction and adapting your structures (6 mins 23 secs)
Maximising the impact from a network perspective (7 mins 18 secs)
An opportunity for innovation (9 mins 59 secs)
The role of a pharmacy technician and the skills they can offer (10 mins 50 secs)
Future plans and further expansion (12 mins 17 secs)
The influence of the DES on utilising new roles (13 mins 50 secs)
How will the role of the pharmacist develop further? (15 mins 28 secs)
Getting in touch (16 mins 42 secs)
Steve is contactable via email, Twitter and through Westbourne Medical Centre:
stevethechemist@onelesspill.com
@stevechemist
https://www.westbournemedical.com/
@BayPcn
The links for the supporting documents Steve references:
Link re "Practice to PCN role – A Pharmacist’s journey" presentation for Dorset CCG PCN Development Event on Understanding and establishing Clinical Pharmacy in PCNs 15th January 2020
Structured medication reviews research at WMC
Steve Williams, Lawrence D Brad. Impact of practice based clinical pharmacist led medication reviews on ambulatory patients with hyper polypharmacy. Br J Gen Pract 2018; 68 (suppl 1) https://doi.org/10.3399/bjgp18X697097
Viewpoints on pharmacists in primary care published with GP Prescribing lead Dr Lawrence Brad
Williams SD, Hayes JM, Brad LD. Clinical pharmacists in general practice: a necessity not a luxury? British Journal of General Practice. Br J Gen Pract 2018; 68 (667): 85. DOI: https://doi.org/10.3399/bjgp18X694697
Useful documents / websites re pharmacy professionals working in primary care RPS Wales Multidisciplinary Teams (MDT) in General Practice
PRESQIPP
NHS funded not-for-profit organisation that supports quality, optimized prescribing for patients Virtual Professional Network for pharmacy starting April 2020 (membership required)
https://www.prescqipp.info/news/prescqipp-practice-plus/
Primary Care Pharmacy Association (PCPA)
https://www.pcpa.org.uk/ (membership required)
https://pcpa.org.uk/assets/documents/Guide-for-GPs-considering-employing-pharmacist.pdf
We have been fortunate to have been able to share a number of best practice stories throughout the Covid-19 crisis and this week’s podcast is no exception. Ben is joined by Dr Lorenz Kemper, a GP who co-founded MedLink Solutions, a unique online platform which allows practices to remotely manage reviews of patients with long term conditions and chronic disease. Lorenz explains how the system was launched, how it works, and the impact it is having - allowing clinical teams to reach previously inactive patients, creating greater flexibility in management of clinical time and crucially, enabling practices to continue vital routine care for their patients safely.
Introductions (36 secs)
The challenge of remotely monitoring primary care’s ‘routine’ workload (47 secs)
Who was involved in setting up MedLink? (1 min 27 secs)
How the MedLink solution was designed (1 min 55 secs)
The first patient cohort and system rollout (2 mins 35 secs)
Reaching previously inactive patients (3 mins 8 secs)
The mechanics of the solution and establishing patient contact (3 mins 47 secs)
What about the patients who can’t be reached via MedLink? (4 mins 48 secs)
Impact on practice workload and how the process is managed (5 min 30 secs)
Capacity creation (6 mins 58 secs)
What are the key benefits of MedLink? (7 mins 22 secs)
How has MedLink been grown and extended beyond Lorenz’s practice? (8 mins 17 secs)
The Covid effect (8 mins 55 secs)
How flexible is the system? (9 mins 15 secs)
The process for designing the review questionnaires (10 mins 5 secs)
Patient and practice feedback (11 mins 26 secs)
A gateway to safer and more flexible care in the current climate? (12 mins 25 secs)
Future plans and further development (13 mins 41 secs)
Getting in touch (15 mins)
This week’s podcast has been sponsored by MedLink Solutions
Medlink solutions are offering a 3-month free trial to help practices during COVID. To find out more simply visit their website or email Lorenz at info@medlinksolutions.co.uk
Covid has presented many challenges for practices and networks but many have risen to the challenge and found that, as a result, they have been able to accelerate many existing projects and are seeing hugely positive outcomes. Sovereign Health, made up of three practices based in Hampshire, are one example of a network who have enacted rapid change as a result of the crisis and are now at the point of considering what to keep, how to rebalance network versus local priorities and how to maintain momentum going forwards. Clinical Director Dr Tom Bertram, Network lead Amanda Gray and Nursing lead Laura Miller share their story of what they did, what they achieved and where they are now. .
Introductions (39 secs)
The first year as a primary care network (1 min 45 secs)
Creation of a same day service (2 mins 1 sec)
Amanda’s transition from practice manager to practice manager and network lead (3 mins 6 secs)
When Covid happened (4 mins 17 secs)
A ‘command and control’ approach (5 mins 1 sec)
Mixing up the workforce; working by risk profile (5 mins 35 secs)
The challenge of losing a practice’s identity (6 mins 53 secs)
Staff reaction (admin and management) (7 mins 59 secs)
Support for the wider teams, both clinical and non-clinical (8 mins 52 secs)
What was the impact on the nursing teams and how did Laura manage this? (9 mins 43 secs)
How do the nurses feel now? (11 mins 5 secs)
Results from the staff survey (11 mins 31 secs)
What other changes have been made? (12 mins 4 secs)
A shared pharmacy service (12 mins 31 secs)
The telephone hub (13 mins 25 secs)
Single route access to the network (13 mins 41 secs)
Patient feedback (14 mins 33 secs)
Rebalancing network and practice priorities post Covid (15 mins 5 secs)
Population health management (15 mins 54 secs)
Juggling practice and network priorities as a local manager and network lead (16 mins 58 secs)
Summarising the overall effect of Covid on the network (17 mins 54 secs)
Getting in touch (19 mins 9 secs)
Amanda Gray, Sovereign Health Network lead: amanda.gray2@nhs.net
Dr Tom Bertram, Clinical Director, Sovereign Health Network: tom.bertram@nhs.net
The challenges presented by the Covid crisis have seen an acceleration of many existing transformation projects in general practice, particularly where use of tech and a move to a digital infrastructure is concerned. This week’s podcast features a panel of experts from the London region who bring a clinical, project and programme perspective on the hugely successful transition to online and video consultations and an insight into the brand-new NHS app. From triage and the creation of a digital front door to managing an incredibly rapid deployment, the importance of effective communication and the public response, here is how, in a few short weeks, they have enabled 91% of London practices to offer online consultations and 100% who now have the ability to deliver video consultations to support their patients.
Introductions (36 secs)
The challenge presented by Covid (2 mins 11 secs)
How was the transition to online and video consultations enabled? (3 mins 17 secs)
The deployment from a clinical perspective (5 mins 8 secs)
Patient response (7 mins 30 secs)
The NHS app (9 mins 19 secs)
Rollout across the STP area (10 mins 57 secs)
Why each London borough was managed differently (13 mins 44 secs)
What has been the impact of both online and video consults? Has one proved more successful than the other? (14 mins 54 secs)
Was hardware a critical success factor? (16 mins 33 secs)
Future plans (18 mins 22 secs)
Life after Covid? (19 mins 55 secs)
What happens next from a practice point of view? (20 mins 48 secs)
Getting in touch (22 mins 51 secs)
If you would like to know more, you can contact the London Digital First Programme team and / or Emily, Sustainability and Transformation Partnership (STP) project lead for North Central London:
Digital First Programme (London): england.londondtt@nhs.net
STP lead: Emily.mitchell9@nhs.net
Robert McCartney and Stephen Kemp specialise in supporting and developing innovative and sustainable primary care services. Here, they take us through their experiences of setting up Covid ‘hot’ sites in the south Kent area, in response to the global pandemic; how the projects were mobilised, what were the key consideration factors and what they learned along the way.
Introductions (9 secs)
The network set up (1 min 54 secs)
When did the planning for a ‘hot’ hub begin? (3 mins 1 sec)
Overcoming the logistical challenges (4 mins 56 secs)
From idea to go-live (6 mins 12 secs)
Staffing a ‘hot’ site (6 mins 42 secs)
The cost implications for a practice or network (8 mins 23 secs)
Activity levels so far (9 mins 6 secs)
Boosting the numbers (9 mins 54 secs)
Lessons learned (11 mins 24 secs)
Internal versus external spaces (12 mins 24 secs)
Can there be a centralised model? (14 mins 20 secs)
Planning for the future of Covid (15 mins 39 secs)
Getting in touch (17 mins 19 secs)
Robert’s email: rm@mccartneyhealth.co.uk
Stephen’s email: skemp@mccartneyhealth.co.uk
McCartney Healthcare Associates website here
Twitter: @McCartneyHealth
With PCNs and practices facing the impending deadline for their decision on the Network Contract Directed Enhanced Service (DES) Contract Specification for2020/21, Ben talks to Justin Cumberlege, who specialises in providing legal advice to the primary care healthcare sector as a partner at Hempsons Solicitors. From the contract specifics, to the key considerations and the legal and practical implications in between, this week’s podcast offers a bitesize overview of what primary care should be mindful of before 31 May 2020.
Introductions (14 secs)
How is this year’s network DES different? (38 secs)
The challenges so far (1 min 41 secs)
Publication timing (2 mins 53 secs)
What does sign up mean for practices and networks? What are the timescales? (4 mins 26 secs)
What if a practice does not want to be part of their PCN going forwards? (5 mins 49 secs)
Can the PCN configuration be changed at this point? (7 mins 15 secs)
The thorny issue of ‘expelling’ a practice from a network (7 mins 46 secs)
Justin’s highlights the key considerations for practices and networks, ahead of the sign-up deadline (8 mins 15 secs)
Reviewing the network agreement (9 mins 35 secs)
Requirements of collaboration (11 mins 39 secs)
The repercussions of breaching the contract (14 mins 15 secs)
Defining the difference between the PCN DES and the PMS agreement and GMS contract (17 mins 23 secs)
Focusing on the small print and implications of worst-case scenarios (18 mins 18 secs)
If practices sign up this year, what are the implications for opt out next year? (19 mins 9 secs)
Getting in touch (20 mins 6 secs)
Justin is contactable via email: j.cumberlege@hempsons.co.uk
Tara Humphrey, our 'almost' resident Project Management expert supporting the development of Primary Care Networks and GP Federations, returns for a third episode in a series of podcasts covering the pandemic from a management and support perspective. This week Tara and Ben reflect on where they are up to in their own roles, within their own areas, with their focus shifting towards life after Covid and more traditional priorities – but with the added benefit and experience of the best practice that has taken place during recent times.
Introductions (14 secs)
Drive through immunisations (1 min 14 secs)
What has been happening in Tara’s world? (2 mins 35 secs)
Planning for life after Covid? (3 mins 6 secs)
Considering new priorities in a GP Federation schedule (4 mins 6 secs)
The Care Home challenge (4 mins 56 secs)
Modelling a new Care Home scheme (5 mins 47 secs)
Ben’s experiences of aligning care homes to practices and PCNs (6 mins 46 secs)
The network mindset (8 mins 19 secs)
Tara and Ben discuss the PCN DES more broadly (9 mins 14 secs)
Positive impacts as a result of the pandemic? (9 mins 57 secs)
Building on the positives; opportunities for further partnership working (11 mins 1 sec)
The theory of change and maintaining momentum (13 mins 16 secs)
Th effect of crisis working (14 mins 43 secs)
Learning lessons (15 mins 27 secs)
What’s next for Tara? (16 mins 6 secs)
…and for Ben? (16 mins 58 secs)
Find out more about Tara Humphrey:
During a time when many GP surgeries across the nation are managing near total transformation of their working practices, James Davies, a Practice Manager at Amicus Health, features on this week’s podcast to tell their story. From the highs to the not so highs, to the tech they’ve employed, the valuable lessons they have learned and the bits of their new processes they would like to retain for the future, this week’s podcast is a one stop shop for all things remote working during the era of Covid-19.
Introductions (26 secs)
Amicus Health – the stats (41 secs)
The ‘GP heavy’ model (58 secs)
When did their transformation journey begin? (1 min 51 secs)
How to embed a system of remote working and enabling staff to work from home (2 mins 34 secs)
Away From My Desk (4 mins)
Access to full clinical software (4 mins 44 secs)
Explaining the ‘soft phones’ system (5 mins 18 secs)
What does a typical day look like in the new world? (6 mins 11 secs)
Staff reactions (7 mins 59 secs)
Striking the balance of staffing cover (9 mins 1 sec)
Which roles fit remote working best? (10 mins 7 secs)
Continuing effective staff management (11 mins)
Is dedicated IT support required? (12 mins 24 secs)
What happens next? (13 mins 8 secs)
Opportunities for further transformation and planning for the future (14 mins 47 secs)
What will Amicus Health retain going forwards? (15 mins 41 secs)
Lessons learned (16 mins 41 secs)
Getting in touch (18 mins 41 secs)
James is contactable at: jamesw.davies@nhs.net
Is now the right time to making the most of the funded social prescribing link worker roles? Christiana Melam, Chief Executive at the National Association of Link Workers and Nicola Gitsham, Head of Social Prescribing at NHS England think so. Here, they talk to Ben about the history of the role, how practices and PCNs can maximise holistic patient care through the employment of the link workers and why they are a crucial element in managing the impact and the effects of the Covid-19 crisis.
Introductions (14 secs)
The evolution of the link worker role (1 min 21 secs)
What has been the impact of the pandemic on social prescribing link workers? (2 mins 50 secs)
How has the role changed in recent weeks? (7 mins 56 secs)
Why the link workers are the key to maintaining joined up patient care during the pandemic (9 mins 16 secs)
Recruitment of a social prescribing link worker (11 mins 21 secs)
Maximising the effectiveness of a social prescribing link worker in practice (12 min 53 secs)
NHS England and NALW resources (14 mins 42 secs)
NHS England links, contacts and resources:
Guidance on the role social prescribing link workers in supporting the response to COVID 19
GP Preparedness Letter: 27 March and Covid/GP Standard Operating Procedure (SOP) updated 6 April set out the role of the SPLW in supporting the response to COVID19
“Social prescribing link workers form part of the multidisciplinary teams in primary care networks (PCNs) and are uniquely placed to work closely with GPs, local authorities, health and care professionals and voluntary sector partners to coordinate support for these people whilst they are self-isolating.”
Network Contract Directed Enhanced Service (DES) Specification 2020/21:
Key sections for social prescribing link workers:
Learning and development (Annex B/B3.2)
Referrals to social prescribing link workers must be recorded using the SNOMED codes (Annex B/B3.6)
All the additional roles employed by a PCN or engaged via a sub-contract (including social prescribing link workers) must have access to other healthcare professionals, electronic ‘live’ and paper based record systems of the PCN’s Core Network Practices (section 6.4.1.)
Details on the NHSE delivery support offer
Social prescribing collaborative platform – with active discussion forum. To sign up to the collaborative platform, email england.socialprescribing@nhs.net
Weekly webinars for SP link workers specific to the COVID-19 response. More information is on the collaborative platform.
Regional learning coordinators facilitate virtual peer support for link workers and providing additional support and information. Contact details available from england.socialprescribing@nhs.net
Existing resources and support for social prescribing link workers (such as ) : https://www.england.nhs.uk/personalisedcare/social-prescribing/support-and-resources/
Regional facilitators and regional delivery teams available to support recruitment of link workers
Nicola has also included a blog she did for the National Academy of Social Prescribing: http://www.socialprescribingacademy.org.uk/time-to-come-together/
National Association of Link Workers resources and contacts:
Ben is joined this week by Katherine Saunders, Chief Executive, and Pramit Patel, Medical Director, from Alliance for Better Care; a GP federation covering 49 practices, within 10 primary care networks, across East Surrey and West Sussex. Together, they explain how the federation is meeting the challenges presented by the Covid-19 crisis in their local area by setting up multi-disciplinary clinical decision units within the community, redesigning the home visiting process, identifying clear roles and responsibilities within their existing staffing models - and working to put general practice at the heart of their response.
Introductions (22 secs)
The role of Alliance for Better Care (ABC) and the Covid-19 response (1 min 18 secs)
The relationship with primary care (2 mins 6 secs)
Setting up a Clinical Decision Unit (CDU) within a community setting (2 mins 45 secs)
Managing patient exposure within the CDU (4 mins 23 secs)
Multi-disciplinary team working during a pandemic (5 mins 18 secs)
Integrating primary care into the wider system (6 mins 29 secs)
Sharing learning, materials and experiences (8 mins 12 secs)
How are local practices coping? (9 mins 3 secs)
Home Visiting (10 mins 26 secs)
Access to data and its importance (12 mins 4 secs)
How to manage demand and agree priorities with local partners (12 mins 59 secs)
Procurement of new systems and software (14 mins 39 secs)
The capacity to cope: roles, responsibilities and managing staffing levels (15 mins 44 secs)
Communication and engagement (17 ins 45 secs)
Getting in touch (19 mins 2 secs)
Katherine is contactable via email: katherine.saunders2@nhs.net
The Alliance for Better Care website
Tara Humphrey, Project Management expert supporting the development of Primary Care Networks and GP Federations, returns for the second in a series of podcasts focused on practical demands and planning in primary care, during the pandemic. This week, Tara and Ben discuss the differences and challenges in the approaches from practices, networks and federations, getting the staffing balance right and maintaining business continuity and personal resilience within a crisis.
Introductions (12 secs)
What's happening in Tara's world right now? (35 secs)
Financial management and planning (1 min 23 secs)
Redistribution of an underspend and the development fund (2 mins)
Supporting vulnerable patients (3 mins 7 secs)
Introduction of new roles / recruitment options within a network (3 mins 42 secs)
A federation's approach to incorporating new roles (5 mins 15 secs)
How does a practice buddy system work? (5 mins 48 secs)
Introducing and implementing new SOPs across networks and practices (6 mins 39 secs)
Joint working from a top down perspective... (8 mins 49 secs)
… versus expectation at practice level (9 mins 53 secs)
The pace of change and anticipating new demands (10 mins 30 secs)
How are practices coping overall? (11 mins 44 secs)
Putting emotional support in place for GPs (13 mins 14 secs)
The importance of practice managers and protecting the well-being of wider practice staff (14 mins)
Working from home and sustainability (14 mins 54 secs)
What's next for Tara? (15 mins 17 secs)
…and for Ben? (16 mins 10 secs)
Find out more about Tara Humphrey:
Specialist Medical Accountant James Gransby returns to the Ockham podcast to give his invaluable advice and assessment of the effect of the coronavirus pandemic on primary care finances. What is currently being offered by the government by way of support for individuals, practices and networks, where are the landmines and what should we be mindful of now and going forwards?
Introductions (9 secs)
What is in place to support practices right now? (19 secs)
The Coronavirus Act 2020: Implications for general practice explained (1 min 15 secs)
‘Furloughing’ of staff (3 mins 14 secs)
The overall picture for primary care in summary (5 mins 16 secs)
How are PCNs affected? (5 mins 56 secs)
How to reflect a pandemic within a balance sheet (8 mins)
The national return to work scheme (8 mins 51 secs)
Death in service (11 mins 50 secs)
How worried should we be about the financial impact? (12 mins 36 secs)
Relaxation of pension rules (13 mins 35 secs)
Getting in touch (15 min 35 secs)
James is contactable via email: James.Gransby@rsmuk.com
Cassandra Baiano and Ron McDonald are both medical students within the Scottish Graduate Entry Medicine (ScotGEM) programme at the University of St Andrews. Inspired by the quality improvement and agents of change portion of their curriculum, they have created an innovative application, HealthSHIP, which can offer support to health and social care workers in balancing the practical aspects of their home lives alongside the demands of working on the frontline of the coronavirus crisis. Here, they talk to Ben about the inception of the app, the value of voluntary support during the pandemic and why healthcare students, in particular, can be a crucial source of assistance during these difficult times.
Introductions (10 secs)
The ScotGEM Programme update (23 secs)
How HealthSHIP began (1 min 30 secs)
Why healthcare students? (2 mins 25 secs)
Where did the idea come from? (3 mins 7 secs)
HealthSHIP right now (3 mins 33 secs)
How does it work in practice? (4 mins 49 secs)
What areas are covered and where does HealthSHIP fit alongside the national voluntary schemes? (5 mins 36 secs)
When was HealthSHIP launched and which tasks are being filled? (6 mins 44 secs)
Access and signup information (7 mins 45 secs)
Requesting support and types of support on offer for general practice (9 mins 29 secs)
Getting in touch and contact information (11 mins 42 secs)
email: hello@healthship.org
Twitter: @HealthSHIP_UK
In the wake of the global coronavirus crisis, GP surgeries across the UK are facing the challenge of transforming working practice within a short space of time and reducing in-person consultations with their patients, whilst protecting their staff and maximising their capacity to deal with everyday demands alongside those presented by the pandemic. Dr Ravi Tomar was part of the transition at Portland Medical ahead of time and gives his advice for managing the changes and reflects on the key outcomes that they have experienced as a result.
Introductions (38 secs)
The move towards telephone and ‘virtual’ triage (48 secs)
Portland Medical: the stats (2 mins 32 secs)
Decreasing locum use (3 mins 3 secs)
Impact on face to face consultations (4 mins 23 secs)
Reducing face to face appointments as a result of Covid-19 (5 mins 5 secs)
Video consultation (6 mins 9 secs)
What tech is required? (6 mins 58 secs)
Telephone versus video consultations (7 mins 36 secs)
Video consults: lessons learned and practical advice (8 mins 18 secs)
Telephone to video consultation: managing an in-consult switch (10 mins 37 secs)
Covid-19 effect on day-to-day practice (11 mins 20 secs)
The system for managing Covid-19 at Portland Medical (12 mins 6 secs)
The ‘hot and cold’ model (13 mins 16 secs)
The role of other healthcare professionals and upskilling the workforce (14 mins 50 secs)
What are the significant outcomes as a result of the changes? (16 mins 47 secs)
Transition from old to new processes (18 mins 18 secs)
Patient feedback (19 mins 51 secs)
Final thoughts (20 mins 17 secs)
Getting in touch (20 mins 17 secs)
Preparedness update letter for general practice: 27 March 2020 here
Portland Medical website: https://www.portlandmedicalcentre.co.uk/
Dr Ravi Tomar is contactable via email: ravi.tomar@nhs.net
How do you prepare for an upcoming crisis which is anticipated, yet unpredictable? What steps should a practice and a network be taking to manage its response and resources whilst safeguarding its people? Which issues should be tackled now and what workstreams should be put in place? Project management expert, Tara Humphrey, who supports the development of Primary Care Networks and GP Federations, chats to Ben Gowland about her experiences so far and offers practical advice for maximising efficiency ahead of time.
Introductions (22 secs)
The state of play locally (56 secs)
What support is available now for practices? (1 min 30 secs)
Practical considerations (2 mins 17 secs)
The importance of communication (3 mins 46 secs)
Site/s management (5 mins 8 secs)
What are the biggest challenges for practices and networks? (5 mins 53 secs)
Co-ordinating skills and expertise (8 mins 35 secs)
Managing communication effectively and supporting staff (8 mins 59 secs)
Crisis leadership (10 mins 59 secs)
The mood in general practice right now (14 mins 26 secs)
Next steps (16 mins 37 secs)
Supporting well-being (17 mins 50 secs)
NHS Confederation document (How CCGs can support PCNs and practices during the Covid-19 crisis) https://www.nhsconfed.org/-/media/Confederation/Files/Publications/Documents/How-CCGs-can-support-PCN_COVID_19.pdf
Find out more about Tara Humphrey:
This week’s podcast features Tim Sacks, Chief Operating Officer at East Leicestershire and Rutland CCG, who guides Ben through the prevalence-based contract they employ for funding general practice in his area. Does it work better than the more traditional, weighted capitation-based models, where are the challenges and can it be employed within a PCN?
Introductions (48 secs)
Delegated commissioning (1 min 33 secs)
GP contracts: weighted capitation versus prevalence (1 min 48 secs)
How do you implement a new type of contract? (3 mins 16 secs)
Measuring the impact on investment (4 mins 7 secs)
The response from general practice so far (5 mins 31 secs)
How effectively can general practice respond to financial risk? (6 mins 29 secs)
Practice involvement in shaping new contracts (8 mins 8 secs)
PCNs and funding distribution (9 mins 46 secs)
Identifying the fairest and most appropriate funding model (11 mins 38 secs)
‘Proportionate universalism’ (12 mins 38 secs)
Do hybrid models work? (13 mins 58 secs)
Plans for the future (15 mins 17 secs)
Opportunities within a PCN framework (16 mins 27 secs)
Primary care commissioning in the future? (17 mins 33 secs)
The potential for PCNs to own their funding (19 mins 36 secs)
Getting in touch & further information (22 mins 13 secs)
https://eastleicestershireandrutlandccg.nhs.uk/
Tim is contactable via email: tim.sacks@eastleicestershireandrutlandccg.nhs.uk
The spotlight is on Practice Managers and their crucial role in shaping and influencing new ways of working in a network-based world. Gary Hughes has a wealth of experience in this area and here shares his insights on the impact of the PCNs on practice managers, where the role evolves and fits within a wider network community and how practice managers really feel about the changes.
Introductions (42 secs)
Gary’s own PCN and his involvement so far (54 secs)
Bracknell mental health project pilot (1 min 42 secs)
Embedding new processes; expectation versus reality (2 mins 27 secs)
What is the network impact on individual practices? (3 mins 8 secs)
Does the introduction of new roles herald a new era in general practice? (3 mins 50 secs)
Practice Managers and collaborative working (6 mins 6 secs)
Organisational leadership within a practice management role (7 mins 19 secs)
What do Practice Managers see that maybe GPs don’t? (9 mins 2 secs)
The Practice Management view of the PCNs (9 mins 52 secs)
The evolution of the Practice Manager role within networks (10 mins 41 secs)
What support might Practice Managers’ need to drive change? (11 mins 46 secs)
How does joint working really begin? (13 mins 7 secs)
The case for dedicated management support (14 mins 53 secs)
Advice on joined up working (15 mins 30 secs)
Keeping in touch (16 mins 51 secs)
You can contact Gary and keep up to date with his weekly blog via his LinkedIn profile here
How have PCNs impacted on local medical councils (LMCs)? What should the relationship be between LMCs and PCNs? Does the role of LMCs have to change following the introduction of PCNs? Listen as William Greenwood, Chief Executive of Cheshire LMC, shares his thoughts and experiences on this week’s podcast.
Introductions (45 secs)
PCNs: First impressions (1 min 40 secs)
Have LMCs been largely supportive of PCNs since their formation? (2 mins 40 secs)
The role of LMCs in relation to PCNs (3 mins 28 secs)
What have been the main concerns for Cheshire local members? (4 mins 37 secs)
Reaction to the original draft primary care specification (5 mins 51 secs)
…and the updated version? (6 mins 43 secs)
Are the LMCs generally happy with he updates & what are the chances of sign off? (8 mins 3 secs)
Are PCNs a “fad”? (8 mins 33 secs)
Practice based contracts versus a network specification (9 mins 32 secs)
Supporting the voice of a practice within a network (10 mins 49 secs)
The expectation of and from the LMC and its members (a two-way process) (14 mins 43 secs)
LMC skills and expertise and what they can offer as a result (15 mins 48 secs)
Are LMCs always constructive and helpful? (16 mins 29 secs)
LMC future role (18 mins 15 secs)
Getting in touch (19 mins 30 secs)
https://www.cheshirelmcs.org.uk/
Cheshire LMC office: 01244 313483
James Gransby, Partner at RSM UK and medical financial expert, summarises the key considerations and implications for practices and new networks of their financial arrangements, particularly within the context of the new - and the since updated - draft primary care contract service specification.
Introductions (48 secs)
James’ initial thoughts on the formation of PCNs and their impact (1 min 22 secs)
Workforce implications (2 mins 15 secs)
How is the PCN’s money best held? Is there an ‘ideal’ financial model? (3 mins 51 secs)
The lead practice model (5 mins 21 secs)
Lessons learned so far, advice on setting up a new financial model - and all things VAT (6 mins 27 secs)
Let’s talk about pensions (7 mins 41 secs)
Clinical Director pay (9 mins 18 secs)
Check employment status for tax / HMRC (10 mins 4 secs)
Year End accounts (13 mins)
Showing a ‘surplus’ and how to manage a PCN ‘surplus’ (14 mins 21 secs)
Impact on practice finances as a result of PCNs (16 mins 15 secs)
Reflecting on the draft service specifications (the December 2019 version) (17 mins 37 secs)
General Practice sustainability in today’s world? (20 mins 10 secs)
James’ top tips for practices and networks (21 mins 55 secs)
Getting in touch (23 mins 10 secs)
The draft GP contract update – new reflections (23 mins 31 secs)
What differences do the changes in the draft contract make? (24 mins 19 secs)
Tax implications for contract incentives? (24 mins 55 secs)
HMRC updates discussed (26 mins 25 secs)
James is contactable at: james.gransby@rsmuk.com
Dr Riaz Jetha, GP Organisational and Leadership Development Consultant with Health Integration Partners, joins Ben on this week’s podcast to dissect and discuss the updates to the current GP contract agreement. Listen here for their analysis and interpretation of some of the key amendments and what they mean for primary care and primary care networks on a wider scale.
Introductions (9 seconds)
First impressions (57 secs)
PCN focus (1 min 29 secs)
Changes to the Additional Roles Reimbursement Scheme (1 min 50 secs)
Removal of employment liability within the roles reimbursement scheme (3 mins)
Which roles will have the most influence? (3 mins 21 secs)
Structuring new roles according to local need (4 mins 48 secs)
Support for PCNs in forming their structures and the funding timetable (5 mins 53 secs)
The impact of the draft service specification updates (7 mins 30 secs)
Changes in the ability to earn (8 mins 40 secs)
Renewing the burden + wider reaction to the service spec changes (9 mins 51 secs)
The Impact & Investment Fund (13 mins 12 secs)
Is the impact and investment funding more lucrative? Could this be a benchmark for the future? (14 mins 46 secs)
Breaking down the investment payments; cost per patient? (16 mins 9 secs)
Changes to imms and vaccs / QOF (16 mins 55 secs)
Increasing GP numbers (17 mins 55 secs)
Access improvement (19 mins 40 secs)
The Time to Care Programme and maintaining positive initiatives (20 mins 39 secs)
Current status of the contract update & draft service specification and Riaz’s final thoughts (21 mins 12 secs)
Riaz is contactable at: raiz.jetha@healthintegrationpartners.co.uk
Ben is joined by Wessex GP and Physical Activity Clinical Champion Dr Sarah Kay who outlines why physical activity is a key component in the health agenda of all providers, how to motivate patients and practices in enhancing their own health and wellbeing, why prevention is always better than cure and what support is available to enable everyone to feel the benefits.
Introductions (36 secs)
Physical Activity Clinical Champions: the facts (1 min 17 secs)
What are the aims of the role? (2 mins 9 secs)
The Moving Medicine website (2 mins 54 secs)
National guidelines on physical activity; where to find them and the information provided (3 mins 53 secs)
New areas of focus in management of physical activity (4 mins 59 secs)
Is general practice doing enough to promote physical wellbeing? (5 mins 42 secs)
Finding time to talk about physical activity during a restricted GP consult (7 mins 21 secs)
The potential for wider impact (8 mins 16 secs)
#parkrunPractice @parkrunUK and #GPparkrunPledge (9 mins 11 secs)
Wellbeing champions & best practice (11 mins 29 secs)
“Active Practice” resources (12 mins 5 secs)
PCNs and the health wellbeing agenda (13 mins 29 secs)
Support from the link workers (14 mins 31 secs)
How do I start the ball rolling in my area? What support is available? (15 mins 25 secs)
Where can I find my local clinical champion? (17 mins 21 secs)
Final word from Sarah (17 mins 42 secs)
Moving Medicine website
Public Health England: National guidelines on physical activity
RCGP Guidance
parkrunpractice
https://r1.dotdigital-pages.com/p/49LX-52M/parkrunpractice
Physical Activity & Lifestyle Toolkit
GP On-Call Bike
https://www.gponline.com/gps-offered-subsidised-bikes-home-visits-rcgp-scheme/article/1661079
https://www.wessexfaculty.co.uk/product-page/gp-on-call-bike
Where to find your local Physical Activity Clinical Champion
email: physicalactivity@phe.gov.uk