With the nights now beginning to draw in, the reality of the cost-of-living crisis is looming large over general practice. With charges for heating, lighting, and overall maintenance of our premises going up, coupled with the impact of inflation on pay, the promised staff pay rises and the difficulty of balancing the books ever more challenging, and with all the usual winter pressures now around the corner…something has got to give. Our ever-popular Practice Index panel members, and Institute of General Practice Management (IGPM) directors, Robyn, and Nicola, return to discuss their own concerns, the approaches they are taking in their own practice areas, and share their thoughts about the key considerations for primary care, as a whole.

Introduction (9 secs)

What has Nicola been up to since our last conversation? (22 secs)

And what’s keeping Robyn busy right now? (43 secs)

What are the challenges of the cost-of-living crisis at practice level? (59 secs)

Balancing staff pay rises (2 mins 35 secs)

Maintenance of buildings and services and rising utilities costs (4 mins 37 secs)

Travelling, home visits, and fuel charges (5 mins 25 secs)

Staff turnover (6 mins 39 secs)

Patient health and wellbeing and the potential for a further increase in demand (8 mins 3 secs)

Implications for GP Partners (9 mins 47 secs)

Sustainability of the practice as a business (11 mins 43 secs)

Is there any support available? (13 mins 4 secs)

Action from the Institute of General Practice Management (14 mins 2 secs)

Making the primary care voice heard (15 mins 14 secs)

For all enquiries about the Practice Index / Ockham podcast, please contact James Dillon here or Ben Gowland here

Integrated Care Systems are here and with them, the advent of new ways of working and yet more healthcare terminology! Integrated Neighbourhood Teams (INTs) may be an original concept to many of us in general practice but in Suffolk and North East Essex, they have been in existence for a little bit longer. In this week’s podcast episode, sponsored by Livi, we are privileged to be joined by Maddie Baker-Woods, Director of Ipswich and East Suffolk Alliance at Suffolk and North East Essex Integrated Care Board, and Paul Little, Director for Integrated Health and Care at Suffolk County Council and East Suffolk and North Essex Foundation Trust, who explain how their own, established network of INTs work, how the teams interact with PCNs and primary care more widely, the challenges, and rewards, they have encountered on their own journey – and why localised care is key to meeting the needs of individual population areas, rather than a more widespread approach.

Introduction (9 secs)

Meeting Maddie and Paul (1 min 6 secs)

Maddie’s role (1 min 16 secs)

All about Paul (2 mins 9 secs)

Building Integrated Neighbourhood Teams (3 mins)

Organising services and a locality-based model (4 mins 33 secs)

Balancing relationships between integrated neighbourhoods and primary care networks (6 mins 53 secs)

Overcoming barriers (7 mins 24 secs)

Working with constraints and challenges (8 mins 30 secs)

How does general practice feed into the integrated neighbourhood teams? (9 mins 8 secs)

Accountability (10 mins 48 secs)

A place-based versus organisational (top down) approach (12 mins 55 secs)

The influence of local demographic (14 mins 28 secs)

Positive outcomes (15 mins 42 secs)

Helping people to be as independently functioning as possible (17 mins 44 secs)

Advice from Paul for others embarking on the same journey (18 mins 51 secs)

Maddie’s top tips (20 mins 45 secs)

Estates and co-location (21 mins 6 secs)

Where general practice should be prioritising their efforts (21 mins 30 secs)

Finding out more (24 mins 14 secs)

To learn more about the work of NHS Suffolk and North East Essex Integrated Care Board, check out their website here.

This podcast episode is sponsored by Livi, the first digital healthcare provider to be rated Outstanding by the CQC. Further information about Livi and what’s on offer can be found here.

This week heralds the start of the new term and a return to weekly podcasts, and we are incredibly privileged to be joined by Dr Naj Seedat; GP Principal and Partner at a large practice in Ilford, northeast London, LMC Board member, GP appraiser and one of the founding fathers of his local GP federation. In this episode, Naj and Ben discuss the challenges faced by those new to GP partnership; the key considerations for those debating whether or not to make the leap into partnership, the experiences of both old hands and those who are just starting out, partnership in the context of the ever evolving primary care landscape, the rewards of partnership and why the New to General Practice Partnership Programme Naj and Ben are launching can be instrumental in shaping and supporting the journey to partnership, and beyond.

Introduction (9 secs)

A bit about Naj (17 secs)

What’s life in partnership like right now? (38 secs)

Is partnership still an attractive prospect whilst nationalism of general practice is being mooted? (2 mins 24 secs)

Working autonomously (4 mins 23 secs)

Transition to partnership and how the programme can help (6 mins 15 secs)

Navigating the Human Resources minefield (9 mins 3 secs)

Managing finance (10 mins 31 secs)

Monitoring practice performance and local KPIs (13 mins 34 secs)

Understanding how to best manage your business and benchmarking progress (15 mins 51 secs)

The external environment / Integrated Care Systems (16 mins 35 secs)

Signing up to cohort three of the New to Partnership Programme (17 mins 57 secs)

It’s not just for GPs! (18 mins 30 secs)

Access to resources and knowledge (19 mins 25 secs)

The next cohort of the New to General Practice Partnership training programme begins on Tuesday 11 October. To find out more and to grab one of the remaining spaces, please follow this link.

Our Practice Index Practice Manager panel return and this week, Robyn and Nicola are joined by two special guests, Brigadier Robin Simpson, RCGP Veterans Champion and the Professor of Military Primary Healthcare and Veterans Health at the University of Chester, and by Darren Davies, former Royal Military Police Staff Sergeant to highlight the issues faced by military veterans in accessing healthcare and how we in primary care can ensure there is better support for our veterans, post service, who frequently suffer in silence with seemingly invisible and escalating health conditions and concerns. With this in mind, the RCGP have launched their veterans’ healthcare toolkit and the GP practice veteran friendly accreditation, which offer insight and much needed guidance on making healthcare more accessible for those in our society who have sacrificed the most, but whose needs are all too often overlooked.  

Introduction (9 secs)

Congratulations to our Nicola! (22 secs)

Meeting our guest panel members (41 secs)

The advent of the veteran friendly practice programme (1 min 12 secs)

What are the differences between recognised veteran friendly practice and those who aren’t yet accredited? (2 mins 50 secs)

Darren’s take on the initiative and the impact on veterans (4 mins 8 secs)

The struggle of those returning from tour and access to healthcare (5 mins 37 secs)

Comparison with the more established support systems in the US (6 mins 38 secs)

Promoting practice sign up within a landscape of competing demands (8 mins 38 secs)

The accreditation process (10 mins 11 secs)

Nicola and Robyn’s experiences of sign up (11 mins 12 secs)

PCN accreditation (13 mins 30 secs)

Meeting the health inequalities agenda (14 mins)

Identification of a clinical lead (15 mins 19 secs)

What would it mean for veterans if every practice became accredited? – Robin’s perspective (15 mins 52 secs)

Darren’s view (18 mins 14 secs)

Finding out more and signing up (19 mins 16 secs)

If you’d like to find out more, or even better, spend 15 minutes signing up for the RCGP veteran friendly GP practice accreditation, we strongly encourage you to follow the link here.

For all enquiries about the Practice Index / Ockham podcast, please contact James Dillon or Ben Gowland.

Here at Ockham, we are always keen to explore how we deliver high quality content to our audiences and this week Ben is trialling something new. In a change to our usual format, Ben has recorded a solo, “bite size” episode offering his thoughts and advice for practices about the implications of the changing healthcare landscape. Starting from the top, with what Integrated Care Systems (ICSs) actually are, how they are comprised and how resources and funding are likely to be organised, onto what the new systems mean for practices and staff on the ground, the influence of the Fuller Report, how we could and should react and where the priorities and challenges lie, we hope you find our latest podcast offering as insightful and informative as ever!

All by myself…. (9 secs)

What are Integrated Care Systems (ICSs) and why is the recent transition so fundamental? (36 secs)

The history and lead up to integrated care (1 min 11 secs)

Why size matters (2 mins 32 secs)

Priorities, challenges, and funding implications (2 mins 57 secs)

Partnership working with other providers (4 mins 8 secs)

Policy direction and the Fuller Report (5 mins 6 secs)

What do all the changes and proposals mean for individual practices? (7 mins 58 secs)

Local priorities; two approaches (9 mins 2 secs)

Maintaining independence whilst creating unity (10 mins 39 secs)

Why cohesive working and collaboration is key (12 mins 7 secs)

Working out how to best align to the strategic directives set out in the Fuller Report (12 mins 52 secs)

Integrated Neighbourhood Teams (14 mins 17 secs)

In Summary (16 mins 16 secs)

We need your feedback! (16 mins 58 secs)

We’d love to hear your views about Ben’s first solo podcast and whether you’ve found this shorter, summary edition helpful! Please do get in touch via email, via our website comment area, or via Twitter, Instagram or Facebook….

It has not escaped our notice that the regularity of our (now almost resident) pensions expert Paul Gordon’s appearances on the podcast is increasing as further changes to the NHS pension (and our wider entitlements) are introduced. Thankfully, with the wisdom of Paul, now Sanlam Wealth’s Head of Medical Specialist Wealth Planners, leading on the NHS pensions proposition, we can keep our listeners abreast of the changes. What are the headlines? How do we ensure we avoid any potential financial landmines? Where can we access further information about our own pension position and get further support? It’s all covered in this week’s podcast episode…

Introduction (9 secs)

A change of circumstance for Paul (20 secs)

What’s the latest on GP pensions? (1 min 26 secs)

Standard annual allowance (2 mins 52 secs)

Exceeding the allowance (3 mins 51 secs)

The financial impact of going above the annual allowance (5 mins 17 secs)

Payment of tax charges (6 mins 58 secs)

Annual allowance calculations (8 mins 42 secs)

Working out how much to pay (10 mins 22 secs)

Annual allowance compensation scheme (12 mins 11 secs)

Understanding my own pension status and key contact points (14 mins 15 secs)

What are the options for those with potentially significant tax liabilities and implications of opting out (15 mins 33 secs)

https://www.totalrewardstatements.nhs.uk/ (18 mins 39 secs)

BMA response to the government’s handling of the NHS pension (19 mins 7 secs)

When a pension is not index linked (22 mins 2 secs)

Finding out more and further support (23 mins 11 secs)

What to be aware of and what’s coming next (25 mins 36 secs)

If you haven’t done so already, you should speak to NHS Business Services Authority (NHSBSA) to request at least seven years of annual allowance growth figures. Their telephone number is 0300 330 1346.

You should also visit https://www.totalrewardstatements.nhs.uk/ to access your personal pension benefit statement. Your Total Reward Statement additionally offers personalised information about the value of your employment package and includes details about remuneration and the benefits on offer from your employer at a more local level.

If you’d like to get in touch with Paul directly, you can email him here.

Episode 311 - Podcast – Practice Index – Credit where accreditation is due…

We at Ockham Healthcare have closely followed the journey of the Institute of General Practice Management (IGPM) since its inception at the beginning of 2021. Its four founding Directors, Robyn Clark, Nicola Davies, Kay Keane, and Jo Wadey have worked hard to establish the IGPM presence and ensure the voices of those working in general practice management are represented and heard. This week in a return to our joint Ockham / Practice Index Practice Manager panel podcast, Robyn, Nicola, and Kay talk to us about a major new development in the IGPM world, that of their recently launched accreditation framework which is now on offer to all managers in primary care with a minimum of two years’ experience. It is something the Directors and their regional representatives have put in tireless effort to pull together and in this episode, they explain the process from top to bottom, and why it is beneficial not only for those in Primary Care management roles, but also what the positive knock-on effect will be for wider practice teams and GP partners.

Introduction (9 secs)

An important announcement… (31 secs)

Why accreditation? (1 min 19 secs)

Putting the framework together (2 mins 2 secs)

What does the accreditation process look like and what competencies do you need to demonstrate as a Practice Manager? (3 mins 47 secs)

Improvement in standards (6 mins 3 secs)

Benefits of accreditation to practices and partners (7 mins 5 secs)

MIGPM explained (8 mins 1 sec)

The application process (8 mins 8 secs)

Support in preparing for accreditation assessment (9 mins 37 secs)

Active involvement from the IGPM regional representatives (10 mins 12 secs)

Empowerment and a celebration of skills of achievement (10 mins 59 secs)

Reaction from Practice Managers (11 mins 25 secs)

Establishing Practice Management as a recognised and respected profession (12 mins 48 secs)

Minimum experience criteria (14 mins 21 secs)

Moving from ‘nice to have’ to widespread recognition of skill (15 mins 16 secs)

The New to Partnership Scheme and Practice Managers (16 mins)

Expansion of influence (18 mins 6 secs)

What’s next for the IGPM? (18 mins 51 secs)

More representatives required! (21 mins)

Finding out more (21 min 46 secs)

All the information you need about accreditation, membership, and the work of the IGPM is available on their website here.

For all enquiries about the Practice Index / Ockham podcast, please contact James Dillon here or Ben Gowland here

Many practices and networks up and down the country are already aware of the benefits that pharmacists and pharmacy technicians can offer however in Suffolk Primary Care, they have taken this to a whole new level with the establishment not only of a centralised Pharmacy team, but in also embedding a standardised pathway across a so-called super PCN area. On this week’s podcast, Ben is joined by Henri Cresswell, East Suffolk PCN’s Head of Pharmacy, and Dr Neil Macey, Medical Director at Suffolk Primary Care, to talk about their journey from the beginning of the Additional Roles Reimbursement Scheme (ARRS) journey and the birth of the Pharmacy team, to where they are now, the lessons they have learned, how they managed to successfully embed a centralised team and processes, within the backdrop of the pandemic and where they are aiming next.

Introductions (9 secs)

Suffolk Primary Care and the relationship with East Suffolk PCN (22 secs)

ARRS and the birth of the Pharmacy team (1 min 19 secs)

All about Henri (2 mins 51 secs)

Getting buy in for a single, standardised process from multiple practices (4 mins 7 secs)

Supporting the change process (5 mins 32 secs)

What were the major challenges? (6 mins 14 secs)

Management of a centrally based team (6 mins 53 secs)

What happens within a pharmacy clinic? (8 mins)

How the temporary shift to remote working helped to embed the service (8 mins 35 secs)

Neil’s role in promoting the team (9 mins 11 secs)

Measuring impact (10 mins 34 secs)

What has the experience been like from the pharmacists’ perspective? (11 mins 40 secs)

Training and supervision (13 mins 49 secs)

Development and progression of the staff (14 mins 33 secs)

Challenges of recruitment (15 mins 44 secs)

What does the future look like? (16 mins 4 secs)

Support from the Care Coordinators (16 mins 45 secs)

Neil’s thoughts on what comes next for the Pharmacy, and wider ARRS team (17 mins 22 secs)

Lesson learned – Neil’s view (18 mins 32 secs)

Henri’s reflections (20 mins 19 secs)

To find out more about the evolution of the Suffolk Primary Care Pharmacy Team, Henri and Neil are both happy to be contacted via their respective emails.

The Suffolk Primary Care website is here.

Here on the Ockham podcast, we are proud to have been able to feature many inspiring success stories where utilisation of the Additional Roles Reimbursement Scheme funding and the introduction of new roles into Primary Care. This week’s is no less thought-provoking. Our guests, GP, and Clinical Director Dr John Stevenson, PCN Development Manager Anna Straker and most importantly, Safeguarding Coordinator Sam Beaumont, talk to Ben about the incredible impact Sam’s role has made on relieving GP workload pressures, establishing and maintaining strong connections with other local systems and providers, and most importantly, ensuring that safeguarding concerns are proactively flagged and managed, to promote safer and more responsive patient care whilst building PCN and wider workforce resilience.

Introduction (9 secs)

PCN make-up (25 secs)

The inception of the Safeguarding Coordinator (51 secs)

How was the Safeguarding process managed previously? (1 min 53 secs)

Anna’s approach to implementation (2 mins 50 secs)

Working out the skills and experienced required (4 mins 37 secs)

Sam’s background and what attracted her to the role (5 mins 45 secs)

Establishment of the role and Sam’s day to day practice (7 mins 27 secs)

Linking back with the clinicians (10 mins 22 secs)

How has the role evolved since Sam started in August / September 2021? (12 mins 18 secs)

Impact on PCN and practices – from John’s perspective (13 mins 34 secs)

Anna’s endorsement (14 mins 51 secs)

Lessons learned (16 mins 17 secs)

The importance of early critical thinking (18 mins 44 secs)

Getting in touch (20 mins 31 secs)

To find out more about the Safeguarding Coordinator, and WBC’s wider approach to embedding their ARRS team members, you can contact John here, or check out the WBC website here.

We are all aware that the practice workload balance is already, or about to, tip over and with this in mind, it is more important than ever to regularly take stock, check in on our colleagues, proactively plan ahead, take our leave (even if it’s not necessarily when we want to!), and if need be, reach out to others for support. With this in mind, our ever-popular Practice Index Practice Manager panel return to the podcast this week and are joined by GP, executive coach, and resilience expert Dr Rachel Morris to dissect and discuss a situation of which unfortunately many of us are more and more likely to identify with, where a GP partner has been forced to cancel leave due to a mixture of demand and a lack of locum availability. How can we avoid the same fate and how do we start to build resilience whilst most of us are feeling very much like we are close to the same level of vulnerability?

Introduction (33 secs)

Sourcing locums from a practice manager’s perspective (1 min 14 secs)

The situation in Kay’s area in Manchester (1 min 55 secs)

How have we got to a situation where locums are in such high demand? (2 mins 25 secs)

Facing the reality of having to cancel annual leave (3 mins 26 secs)

Working out what you’re in control of and what you’re not (4 mins 29 secs)

Planning leave, proactive rota management and the role of the practice manager (6 mins 21 secs)

Sustainability in a smaller practice (7 mins 31 secs)

Building resilience in larger practices (8 mins 21 secs)

Acknowledging our vulnerabilities and planning for them (9 mins 7 secs)

Added pressure as a GP partner (10 mins 8 secs)

Protecting the workload (10 mins 37 secs)

Support for the wider workforce (11 mins 9 secs)

Collaboration and co-dependence (12 mins 7 secs)

Working out where you can influence and what you can change (13 mins 58 secs)

Why asking for help is not a sign of weakness (15 mins 8 secs)

Buddy practices and increased reliance on others (16 mins 15 secs)

Managing the dearth of GPs and developing practice skill mix (17 mins 26 secs)

Effective communications (18 mins 50 secs)

An analogy of managing patient demand (19 mins 40 secs)

Making the most of the ARRS funding (20 mins 50 secs)

Time management and maximising impact (21 mins 50 secs)

Staff wellbeing is paramount (23 mins 8 secs)

Final thoughts from Robyn and Kay (23 mins 33 secs)

Rachel’s incredibly popular ‘You are not a frog’ podcast can be found here

For all enquiries about the Practice Index / Ockham podcast, please contact James Dillon here or Ben Gowland here

In another episode documenting general practice preparations for integrated care, we welcome back Dr Jon Griffiths, GP Advisor for Cheshire and Merseyside Health and Care Partnership, NHS North West Leadership Academy board member, RCGP Mersey Faculty Board deputy council rep and Cheshire LMC member. As part of his GP Advisor role, Jon has worked with colleagues across Cheshire and Merseyside to produce a consensus document focused on the Primary and Secondary Care Interface and improving cohesion and clinical pathways between these two key areas of healthcare. Based on a set of guiding principles and with the aim of establishing a common architecture of good quality, patient-centred communication within the new integrated care systems, Jon talks to Ben about the input from both primary and secondary care, striking a balance between meeting the needs of the wider system and more local requirements, and the key milestones for both sectors when embedding a truly successful system of integrated care.

What is Jonathan’s role and remit right now? (23 secs)

Responsibilities of the ICS GP Advisor (59 secs)

Myth-busting (3 mins 41 secs)

Primary Care views of secondary care (5 mins 25 secs)

Reaction from the secondary care consultants (8 mins 30 secs)

…and the secondary care ask of general practice (10 mins 45 secs)

Establishing mutual benefit (13 mins 14 secs)

Building consistency across primary care (14 mins 41 secs)

Where does the real opportunity for truly integrated care lie and how do we strike a balance between real-time need and the PCN DES requirements? (15 mins 31 secs)

What is needed to enable a strong and united primary and secondary care interface? (17 mins 7 secs)

Life after CCGs (19 mins 37 secs)

Strengthening GP representation (21 min 12 secs)

Accessing the consensus (22 mins 7 secs)

The Consensus document is available within the Cheshire and Merseyside Health and Care Partnership website here.

As ever, here at Ockham, we are fortunate to have been able to have taken some time out from business as usual to put our feet up and properly digest, review, and summarise the recent Fuller report publication on integrated Primary Care (and what this might look like in the context of the wider Integrated Care world). As with everything, our conclusions are our own and having spoken to our allies over at THC Primary Care, it’s clear that the report can be interpreted in many different ways, depending on who you are, where you sit, what your remit is and how prepared you may (or may not) be feeling ahead of the upcoming transition. In this week’s episode, Ben and THC Primary Care founder and MD, and PCN Management expert Tara Humphrey discuss their key takeaways from the stocktake and what they both feel general practice should be doing right now to ready themselves for integrated primary care, and ICSs beyond.

Introduction (9 secs)

Setting the scene…. our differing perspectives (19 secs)

Tara and Ben’s initial thoughts (29 secs)

What’s missing? (45 secs)

Ben’s concerns (1 min 17 secs)

What would Ben liked to have seen within the report? (2 mins 54 secs)

Shaping the debate (4 mins 46 secs)

A threat to the PCN model as we know it? (5 mins 52 secs)

Tara’s views and getting the most out of a larger network infrastructure (8 mins 3 secs)

Readying general practice, as it stands (9 mins 21 secs)

Acknowledgement of existing constraints and what this means going into an ICS environment (9 mins 58 secs)

Do the recommendations within the report pose a risk to the PCN management structure? (11 mins 6 secs)

General Practice influence at an ICS level (12 mins 44 secs)

The importance of a united primary care voice (14 mins 27 secs)

Time pressures and maintaining influence as a GP leader (15 mins 15 secs)

What should we be doing right now in preparation? (16 mins 55 secs)

Tara’s predictions ahead of the transition (17 mins 47 secs)

Recommendations from Ben (18 mins 53 secs)

Tara advises (19 mins 53 secs)

Navigation of bureaucracy versus responsive decision-making (20 mins 43 secs)

We need you! (21 mins 45 secs)

Next steps for integrating primary care: Fuller stocktake report (final report) is available here.

There is still plenty to discuss where the report is concerned and absolutely no way to cover it all this 22-minute podcast instalment. We are keen to hear views and even better, feature representatives from across general practice on the podcast to discuss the transition into the integrated care, what this feels like from your part of the world and your own take on the Fuller Report. So if you (or your team) are interested in taking part, please contact Ben at ben@ockham.healthcare or get in touch via Twitter.

We are in full countdown to ICS mode here on the podcast and in recognition of the existing issues of workload, pressures, and targets - and of the upcoming challenges General Practice is facing as we transition into the new, larger scale networks, we felt it was about time we welcomed back Dr Rachel Morris, GP, executive trainer, coach and all-round leadership and resilience expert. This week’s podcast offers a wealth of practical advice and insight into how and why we should be saying no, how to stick to your guns (and not fall victim to external pressures and pushback), why a long-term approach will always win out and how to stop, take stock and adopt a more strategic forward view during this period of high stress, unpredictability and unprecedented levels of patient demand.

Introduction (9 secs)

Why has the importance of saying “no” become so relevant recently? (19 secs)

Working out what and where your boundaries are (2 mins 6 secs)

Engagement and decision making when setting boundaries (2 mins 41 secs)

Should we benchmark the PCN DES?  (3 mins 12 secs)

A case in point: Investment and Impact Fund (3 mins 50 secs)

Identifying our top priorities? (4 mins 27 secs)

What is achievable and what’s not? Managing system pressures (5 mins 42 secs)

Practical measures for dealing with pushback (7 mins 11 secs)

Pressures of conformity in the new world? (8 mins 53 secs)

The importance of taking a long-term approach (10 mins 59 secs)

Moving from firefighting to forward view (11 mins 54 secs)

Applying the same principles for the Additional Roles Reimbursement Scheme (12 mins 56 secs)

When ARRS strategies fail and why (14 mins 6 secs)

“I’m choosing to…..so that…..” (15 mins 12 secs)

Maintaining a strong narrative (15 mins 34 secs)

Do the same strategies work from an individual perspective? (16 mins 9 secs)

The concept of ‘air cover’ and truly having each other’s backs (17 mins 45 secs)

Why proactive engagement matters (19 mins 1 secs)

….and ensuring there is accountability (20 mins 13 secs)

Finding out more / access to resources (21 mins 32 secs)

You can access the free mini video series on helping your team to set boundaries, say “no” powerfully and prioritise time and energy here

Rachel’s incredibly popular ‘You are not a frog’ podcast can be found here

Going into partnership and realising success as a GP Partner can be a difficult enough landscape to navigate but when you are from a black, Asian, or other minority ethnic background, simply finding the opportunity to apply and establish yourself within a partnership can be a challenge in itself, for a variety of reasons. In this week’s episode, Ben welcomes Drs Onyi Okonkwo and Mo Sattar, who provide insight into the barriers and issues both they, and colleagues within the black, Asian and minority ethnic (BAME) GP network have faced (and continue to face) - and share their personal reflections from their respective journeys into senior partnership whilst offering practical advice for those considering taking on partnership on what to expect, how best to prepare and why a difference in culture shouldn’t be a hinderance to achieving success.

Introductions (15 secs)

A meeting of minds (40 secs)

Going into GP Partnership – Onyi’s story (1 min 35 secs)

Mo’s journey to partnership (2 mins 43 secs)

Transitional challenges (3 mins 37 secs)

Making the jump from salaried GP into partnership (5 mins 17 secs)

Dealing with a steep learning curve – advice from Mo (5 mins 59 secs)

Mo’s lessons learned (7 mins 49 secs)

Being propelled into senior partnership (8 mins 30 secs)

Access to formal support (10 mins 25 secs)

The benefit of coaching and mentoring (11 mins 13 secs)

Clinical versus management (13 mins 25 secs)

Issues facing GPs from a BAME background – from Mo’s perspective (14 mins 47 secs)

Onyi’s view (17 mins 12 secs)

Advice from Onyi for BAME GPs considering going into partnership (20 mins 52 secs)

A final word from Mo (22 mins 14 secs)

With patient demand at an all-time high, coupled with a steady increase in relevant funding and the issue of estates, we are having to think ever more creatively when it comes to workforce planning. When Haywards Heath Villages PCN detected that additional support was needed in improving patient outcomes for cancer and the uptake of cancer screenings, the Cancer Nurse Assessor role was born. On this week’s podcast, we talk to Dr Katie Spensley, PCN Clinical Director, and Esther Walker, Cancer Nurse Assessor, about Esther’s approach to the role, her learnings so far, working alongside the ARRS staff, her aims for the future both short and long term, the positive outcomes she is seeing and why she is already a hugely well valued member of the Haywards Heath Villages PCN team.

Introduction (9 secs)

Haywards Heath Villages PCN (21 secs)

The creation of the Cancer Nurse Assessor role (31 secs)

Funding streams (1 min 28 secs)

Esther’s background (2 mins 22 secs)

How does the role work in practice? (3 mins 56 secs)

Auditing the existing service (6 mins 29 secs)

What are Esther’s key objectives? (8 mins 50 secs)

The impact of the role on the PCN- and individual practices (10 mins 25 secs)

Long term plans; for Esther, the service, and the wider workforce (12 mins 39 secs)

Balancing resources against patient needs (14 mins 3 secs)

Esther’s reflections on the PCN transition (14 mins 31 secs)

Interfacing with the ARRS teams (16 mins 43 secs)

Development of staffing going forwards (18 mins 37 secs)

Lessons learned (20 mins 4 secs)

Finding out more / getting in touch (22 mins 33 secs)

Katie is very happy to speak to anyone wanting to learn more about the Cancer Nurse Assessor role and is contactable here.

If you would like to know more about the innovation within Hayward’s Heath Villages PCN, you can also contact their local federation, Alliance for Better Care (who have also recently featured on the podcast). Their website (which contains all the relevant information and contact points) can be found here.

Up until now, there has been a disparate and distinct lack of easily accessible information available to the lesbian, gay, bisexual, trans and non-binary community on the practical processes and implications of changing title and gender marker. There have been many reports of misunderstanding and in some cases mistreatment, in the absence of clear guidance on entitlement and expectation; coupled with a widespread lack of knowledge and advice available to staff on the ground in general practice. Luckily, with the colliding of Pride in Practice, Indigo Gender Service, The Institute of General Practice Management and Practice Index worlds, a team of representatives from each have put their heads together, spent time gathering all the available information, experiences and knowledge, and together, Aimee, Luke, Kay, Ali and their colleagues have taken time out to talk us through what is already an invaluable resource; The Gender Identity Toolkit for General Practice.

Introduction (9 secs)

Our panel members (31 secs)

Meeting Aimee and the role of Pride in Practice (54 secs)

Dr Luke Wookey tells us more about Indigo Gender Service (1 min 58 secs)

Why was the toolkit created? (2 mins 51 secs)

The process of centralising knowledge and guidance (4 mins 11 secs)

The importance of information gathering and sharing, and a collective approach (4 mins 49 secs)

Confusion around records management and establishment of clear guidelines (5 mins 34 secs)

Existing barriers felt by the trans and non-binary community (6 mins 19 secs)

Bureaucracy, misunderstanding and a lack of knowledge on all sides (7 mins 23 secs)

How to get the most from the toolkit (8 mins 36 secs)

Summarising the process for changing title and gender marker (9 mins 14 secs)

The implications for screening and having access to a lead professional within the practice (12 mins 5 secs)

Bringing all the information together (13 mins 55 secs)

What difference will the toolkit make? (14 mins 14 secs)

A working example of the impact of Pride in Practice (14 mins 54 secs)

Ensuring the policy is adopted at a local level (16 mins 17 secs)

Applying the policy within daily practice (17 mins 47 secs)

Ensuring there isn’t a ‘one size fits all’ approach (18 mins 42 secs)

Implications of records migration (19 mins 22 secs)

The training on offer from Pride in Practice (20 mins 48 secs)

Accessing the toolkit – and other resources (22 mins 27 secs)

The Practice Index website link to the toolkit (and the relevant discussion forums) is here

You can also access the toolkit via the IGPM website here

Pride in Practice’s website can be found here. If you are interested in learning more about the training on offer, please get in touch here

The link to the Indigo Gender Service website is here

Indigo Gender Service also have a dedicated email for healthcare professionals to get in touch which is indigo.advice@nhs.net - or you can contact Luke directly at lukewookey@nhs.net  

Luke has recently featured on another podcast with Primary Care Knowledge Boost around trans health which may also provide some additional useful information for primary care teams.

Kay is contactable on Twitter, if you have any further queries

The Gender Identity Toolkit Launch webinar is available on the IGPM YouTube channel now

For all enquiries about the Practice Index / Ockham podcast, please contact James Dillon here or Ben Gowland here

In another of our series focused on Primary Care preparations for Integrated Care System (ICS) go-live in July and working alongside partners both old and new, we speak to Alliance for Better Care (ABC) Chair, Surrey Heartlands ICS Primary Care Leader and PCN Clinical Director Dr Pramit Patel, and ABC CEO Katherine Saunders, on the role of GP federations, and how they can both support and springboard practices and networks in making the most of the opportunities available in the new world. From establishment of meeting forums and well-balanced structures, to managing and maintaining effective communication across much wider remits, and the role of federations going forwards, ABC offer a best practice view of where we should be challenging our energies over the coming weeks and months, in the lead up to ICS launch.

Meeting Pramit (17 secs)

Introducing Katherine (44 secs)

The ICS / Primary Care Leader role (1 min 7 secs)

Executive Structure (2 mins 12 secs)

Reaching consensus across a large area; meetings and formal structures (2 mins 56 secs)

Summarising the existing setup (5 mins 28 secs)

How does engagement work, particularly at place level? (6 mins 14 secs)

A lone GP voice in the room? (7 mins 37 secs)

Getting a sense of how other parts of the system view general practice (8 mins 33 secs)

External perceptions of Primary Care (9 mins 41 secs)

How does the federation work to support general practice operations within the ICS? (10 mins 38 secs)

The role of the federations in the ‘new world’ (11 mins 56 secs)

Joint working between federations (12 mins 53 secs)

What should the objectives be for general practice, moving forwards? (14 mins 19 secs)

Communication of the positive possibilities (15 mins 49 secs)

What differences will we see and what impacts will we feel at ICS go-live? (17 mins 41 secs)

Readying practices, networks, and federations ahead of July (19 mins 23 secs)

Pramit’s top tips for others (20 mins 32 secs)

Advice from Katherine (21 mins 44 secs)

Further resources, support, and information, as advised by Pramit and Katherine, can be found within the dedicated Primary Care NHS Confederation webpage here

Katherine and Pramit are happy to speak to anyone who would like to learn more about the Surrey Heartlands / Alliance for Better Care journey towards integrated care. Please visit the ABC website for information and contact points.

There is no clear answer when it comes to the ‘ideal’ PCN setup, as it is all very much dependent on an individual spectrum of factors including (and not limited to) population size, numbers of employees, local health needs and priorities, financial setup, and more. With workload becoming ever more complex and demand continuing to grow for general practice services, is incorporation the answer when we are seeking to establish a safe and sustainable structures for the managing partners and their employees, going forwards? Luckily, DR Solicitors own Managing Partner Nils Christiansen features in this week’s podcast episode and guides us expertly through, not only the minefield of incorporation, but offers practical advice on safeguarding and streamlining the PCN as a business entity.

Introduction (9 secs)

The PCN issues which are on Nils’ radar at present (18 secs)

The Practice Agreement (59 secs)

Establishing a sustainable PCN model (2 mins 10 secs)

Discounting the lead practice model? (3 mins 38 secs)

Benefits of incorporation – risk management (4 mins 49 secs)

Other advantages of incorporation (5 mins 38 secs)

Addressing issues of parity (7 mins 31 secs)

When PCNs incorporate, does this affect the fabric of wider general practice? (8 mins 51 secs)

What’s the actual process for incorporation? (10 mins 46 secs)

Can we leverage our existing governance frameworks to make the process smoother? (12 mins 50 secs)

Additional admin burden (14 mins 10 secs)

Implications on the financial flows and resources (15 mins 27 secs)

Employment liabilities (17 mins 46 secs)

Transfer of employees into a new entity (20 mins 9 secs)

NHS Pensions (22 mins 1 sec)

Data on the numbers of PCNs who are incorporating (22 mins 36 secs)

Finding out more (24 mins 37 secs)

If you have more specific questions on any aspect of incorporation and your existing PCN setup, you can visit the DR Solicitors website here, telephone them on 01483 511555, or email Nils at n.christiansen@drsolicitors.com  

There are just a couple of spaces up for grabs on our new, online PCN Plus programme and the deadline for sign-ups is this week! Aimed at new PCN Clinical Directors, and experienced PCN Managers, and featuring a team of experts, we will be delivering training and advise on all the need to knows, including (and not limited to); establishment of a PCN vision, communications, managing finances and workforce, and preparations for integrated care systems. If you are interested in learning more, or you’re keen to confirm your space now, please visit our dedicated webpage or you can contact Ben for further information.

It’s the third in our series of podcasts focused on the preparations for Integrated Care Systems! This time, we meet with Adrian Loades, who is the Corporate Director of People at the London Borough of Redbridge, responsible for Adults and Children’s Social Care (and Education), and Public Health within his remit. Adrian chats to Ben about his thoughts on the preparations and the build up so far towards the new systems of working, the priorities on the local council agenda and how these already align with much of what primary care is aiming to achieve, how general practice and local authorities can come together to establish strong, multi-agency partnerships and ultimately, what we need to do in practice, across the board, to maximise health outcomes in an integrated world.

Introduction (9 secs)

Meeting Adrian (40 secs)

Adrian’s experiences of working within the local authority (1 min 5 secs)

Is there a council perspective on general practice? (2 mins 20 secs)

The barriers to establishing relationships with general practice, from the council’s point of view (3 mins 43 secs)

Collective working through the pandemic (4 mins 44 secs)

Examples of strong multi-agency initiatives (5 mins 59 secs)

The health inequalities agenda (7 mins 10 secs)

Moving into an ICS environment (8 mins 9 secs)

Neighbourhoods and place-based working (9 mins 28 secs)

Are councils and general practice natural allies when it comes to embedding a place-based approach within an ICS? (11 mins 7 secs)

How will working at place, actually work in practice? (11 mins 45 secs)

What are the key factors when it comes to embedding a place-based approach? (13 mins)

Adrian’s advice for general practice in making a success of working at place (14 mins 12 secs)

Focusing on the needs of the residents, instead of prioritising a political agenda (15 mins 23 secs)

Cultivating relationships with those who can influence council leaders (17 mins 3 secs)

Neighbourhoods and Primary Care Networks (18 mins 4 secs)

The local authority view of PCNs (20 mins 21 secs)

Leveraging PCNs as a means for establishing strong neighbourhoods (20 mins 58 secs)

Advice for PCNs on building relationships within the wider ICS network (21 mins 56 secs)

Support for general practice on sourcing additional space (23 mins 2 secs)

Who to contact at local authority level (23 mins 59 secs)

PCN Plus (24 mins 32 secs)

There are still a few spaces left on our PCN Plus online programme! Aimed at new PCN Clinical Directors, and experienced PCN Managers, and featuring a team of experts, we will be delivering training and advise on all the need to knows, including (and not limited to); establishment of a PCN vision, communications, managing finances and workforce, and preparations for integrated care systems. If you are interested in learning more, or you’re keen to sign up now, please visit our dedicated webpage or you can contact Ben for further information.

In the second of our series (and on the occasion of our 300th podcast episode), we focus on the preparations for, and the journey towards, Integrated Care Systems (ICSs). We are delighted to feature Cambridgeshire Community Services Trust CEO (and NHS England lead for Community Health) Matthew Winn, to get his views on the existing relationship between community services and general practice, and what can be done to establish, enhance and improve existing partnerships locally, in readiness for the new models of care. It is a fascinating insight into how external partners perceive primary care both locally and centrally, and with the advent of new meeting forums, and new initiatives, how we can work together to meet the scale of demand from our patients, post Covid and beyond.

Introduction (9 secs)

Meeting Matthew (39 secs)

The scope of Matthew’s NHS England role (1 min 25 secs)

The future for Primary Care Networks (PCNs) (2 mins 36 secs)

The Community Services view of general practice right now (3 mins 51 secs)

Building relationships with general practice, an external perspective (6 mins 15 secs)

Big versus small? (8 mins)

Reaching out at a local level (10 mins 14 secs)

The remit of place-based Boards (12 mins 47 secs)

A new opportunity to re-establish local partnerships? (14 mins 4 secs)

A shift in strategic focus, where out of hospital is concerned (16 mins 23 secs)

Hospital at Home and virtual wards (18 mins 31 secs)

Thoughts about leadership for the future and upskilling our GPs (20 mins 18 secs)

Matthew’s advice about establishment of stronger relationships with Community Services teams (23 mins 1 sec)

Who should we reach out to? (25 mins 21 secs)

Further information and resources (26 mins 35 secs)

Here is the link to the NHS England and NHS Improvement workspace on futureNHS

Doctors of the World is a leading charitable organisation which aims to break down barriers to healthcare and prevent social injustice for millions, both globally and within the UK. Currently based in London, Doctors of the World provide medical care, information, and practical resources for minority groups who continue to struggle with access to basic healthcare. In this month’s episode of the Practice Manager podcast, Nicola, Robyn and Ben are joined by Dr Yusuf Ciftci, Policy and Advocacy Manager, and Janet Alfred, National Health Advisor, from Doctors of the World to discuss the issues of access in-depth. From the thorny issues of current bureaucracy, prejudice and misunderstanding to re-education and improvements via the medium of programmes such as the Surgeries Initiative, and a powerful personal account of Janet’s own experiences, today’s podcast is a must-listen for general practice in raising awareness of the importance of inclusion – and improving health outcomes for all.

Introduction (9 secs)

Doctors of the World; the charity, and its aims (25 secs)

All about Yusuf (1 min 47 secs)

Janet’s background and her role as a National Health Advisor (2 mins 40 secs)

Janet details her own experiences, including the disparities between England and Scotland in accessing healthcare (3 mins 32 secs)

Why registering with a GP surgery is not necessarily straightforward (4 mins 17 secs)

Prevalence of the registration and access issue (5 mins 21 secs)

Nicola’s view (6 mins 20 secs)

Robyn’s perspective and feedback from the IGPM (8 mins 10 secs)

Re-educating practice staff (9 mins 20 secs)

Improving access and support (10 mins 6 secs)

What changes can be made right now? (12 mins 11 secs)

Doctors of the World’s Safe Surgeries Initiative (13 mins 4 secs)

Signing up for Safe Surgeries (14 mins 24 secs)

Clarification on the resources available (15 mins 5 secs)

Addressing health inequalities as a practice and as a network (15 mins 46 secs)

Robyn’s thoughts about escalation of poor health outcomes and prevention of these locally (17 mins 13 secs)

Janet’s thoughts about how to positively effect change (17 mins 49 secs)

Finding out more (19 mins 26 secs)

The Doctors of the World webpage, which contains all of the resources discussed in this episode, including The Safe Surgeries toolkit, can be found here. You can sign up for the initiative here

The Practice Index website is here

For all enquiries about the Practice Index / Ockham podcast, please contact James Dillon here or Ben Gowland here

As we so frequently state, a new era is truly beginning in general practice, with so much on the horizon strategically and operationally. With more and more being demanded from our clinical and management leaders, and three years on since the birth of PCNs, we are seeing widespread changes in leadership teams and the styles required to support and motivate staff, meet the ever-growing demand in terms of patients’ needs, centrally driven targets and the push towards further integration. Thankfully, Tara Humphrey, Founder and Director of THC Primary Care, host of the Business of Healthcare podcast and one of the country’s leading experts in PCN Management, is back in the hot seat to share her own experiences of the transition within her area and to offer advice for those currently living through the same changes and challenges, as well as giving insight into two key programmes which are currently on offer to both seasoned managers and new leaders alike.

Introduction (33 secs)

A new dawn for PCN management (57 secs)

What’s the latest from Tara’s area? (1 min 32 secs)

Reaching the decision to step down (2 mins 11 secs)

When there is a complete change in operational and clinical leadership (2 mins 58 secs)

A reform in leadership style? (3 mins 54 secs)

Escalation of workload (4 mins 32 secs)

Handing over (5 mins 49 secs)

Transitional challenges (6 mins 53 secs)

Tara’s reflections and advice for other areas undergoing the same changes (7 mins 56 secs)

Preserving relationships (9 mins 21 secs)

Finding support as a new Clinical Director (10 mins 53 secs)

The PCN Plus Programme for more experienced leaders (12 mins 1 sec)

How Tara’s PCN Accelerator Programme works for new leaders (13 mins 17 secs)

Course dates and information about sign up (14 mins 53 secs)

Our PCN Plus online programme is now open for registrations! Aimed at seasoned PCN Clinical Directors, our team of experts will deliver training on all the need to knows, including (and not limited to); establishment of a PCN vision, communications, managing finances and workforce, and preparations for integrated care systems. If you are interested in learning more, or you’re keen to sign up, please see our dedicated webpage or you can contact Ben for further information.

If you’re brand new to PCN management, Tara's Online Accelerator Programme is perfect for you. All the details from course content to how to sign up and access the training are contained within the dedicated THC Primary Care page.

We’ve followed the journey of Dr Farzana Hussain, GP lead at The Project Surgery in East London, former 2019 GP of the Year closely over the last three years. Following her recent decision to step down as a Clinical Director, we wanted to revisit her story and find out the reason for her change in direction, particularly while the primary care landscape begins to shift and change once more. In this week’s episode, Farzana gives a typically open and honest account of her reasons for stepping away from Clinical Directorship, where she feels the challenges have been and where they lie ahead, what she has enjoyed most during the last three years, her hopes for the future on a personal level and for general practice, and what new (and seasoned) clinical leaders may need to be mindful of as we step into the brave new world of Integrated Care Systems (ICSs).

Introduction (9 secs)

Farzana’s decision to step down (32 secs)

Moving away from PCNs? (2 mins 15 secs)

Where does the problem lie with PCNs? (2 mins 39 secs)

The tension between central expectation and priorities on the ground (4 mins 21 secs)

What needs to change to enable PCNs to thrive, particularly within the ICS context? (6 mins 32 secs)

Getting the most from PCN investment (8 mins 51 secs)

Adoption of a place-based approach (10 mins 23 secs)

Is a change in mindset needed, where PCNs are concerned? (12 mins 2 secs)

Partnering with local agencies and an increased community-based focus (14 mins 19 secs)

Concern for the future (15 mins 34 secs)

Advice for new PCN Clinical Directors starting out now (16 mins 42 secs)

Farzana’s top three lessons learned (19 mins 8 secs)

What’s next? (20 mins 50 secs)

Our PCN Plus online programme is now open for registrations! Aimed at new PCN Clinical Directors, our team of experts will deliver training on all the need to knows, including (and not limited to); establishment of a PCN vision, communications, managing finances and workforce, and preparations for integrated care systems. If you are interested in learning more, or you’re keen to sign up, please see our dedicated webpage or you can contact Ben for further information.

The announcement of the changes in GP contract heralds a fresh set of challenges for already stretched PCN Clinical leaders, and the need for a bonus edition of our (usually weekly) podcast alongside the introduction of a targeted programme of training. Today’s episode features a seasoned panel of experts; PCN and management guru Tara Humphrey of THC Primary Care, Dr Hussain Gandhi, Clinical Leader, and co-presenter of the eGPlearning Podblast, Dr Andrew Foster, Gandhi’s eGPlearning counterpart, and fellow Nottinghamshire-based Clinical Director, and finally, our very own Ben Gowland. Together, the quartet dissect the announcement, reflect on the changes (and the change in the way the contract has been negotiated), how primary care could and should respond, and why Clinical Directors might feel that now is the right time to upskill further, ahead of the new integrated world and the additional pressures that this may present.

Introduction & Overview (30 secs)

Ben’s immediate reactions to the new GP contract (1 min 19 secs)

Initial thoughts from Tara (3 mins 27 secs)

Andy’s perceptions (5 mins 13 secs)

….and Gandhi’s views (8 mins 49 secs)

Tensions between NHS England and the General Practice Committee (10 mins 45 secs)

Ben discusses the shift in management of contract negotiations (and the fallout) (11 mins 29 secs)

Funding general practice recovery and the response (13 mins)

Tara: why we should focus on building stronger networks and take a more strategic view (14 mins 32 secs)

How the PCN Plus programme can help (15 mins 38 secs)

What might happen next (16 mins 35 secs)

Responding versus reacting (17 mins 42 secs)

A test of diplomacy and resilience in our Clinical Directors (18 mins 20 secs)

How to sign up for PCN Plus (19 mins 45 secs)

The PCN Plus online programme is now open for registrations! Aimed at new PCN Clinical Directors, the team of experts featured in today’s podcast will deliver training on all the need to knows, including (and not limited to); establishment of a PCN vision, communications, managing finances and workforce, and preparations for integrated care systems. If you are interested in learning more, or you’re keen to sign up now, please visit our dedicated webpage or you can contact Ben for further information.

We are shaping up for the new world of integrated care systems (ICSs) and as part of this, the Fuller national stocktake is a live initiative which has been commissioned to appraise how well existing systems work with primary care (and others) to improve integration of patient care. As a senior GP who is leading on the data, population health management, risk stratification and health inequalities workstream, Dr Neil Modha talks to Ben about the scope of the review, how it is being conducted in practice, the influence of the review outcomes on general practice’s place in the new world, and how others can also get involved.

Introduction (41 secs)

How Neil became involved in the review (47 secs)

The purpose of the review (1 min 21 secs)

Is the review focused on PCNs, or is it a more holistic appraisal of primary care as a whole? (2 mins 11 secs)

How is the review being undertaken? (3 mins 15 secs)

Organisation of workstreams and input (3 mins 44 secs)

What are the likely outcomes and how are these measured? (5 mins)

Examples of best practice (6 mins 8 secs)

A focus on improving the interaction between the wider system and primary care (7 mins 18 secs)

PCN & ICS; getting off to the right start (8 mins 5 secs)

Report timeline (8 mins 56 secs)

What happens when the report it released? (9 mins 44 secs)

Maintaining the voice of general practice within a larger healthcare ecosystem (10 mins 25 secs)

The role of PCNs in the new world (11 mins 52 secs)

Shaping the future GP contract (13 mins 38 secs)

Talking sustainability (14 mins 24 secs)

A wider ownership of PCNs? (16 mins 40 secs)

Commissioning and funding deployment going forwards (17 mins 23 secs)

Advice for general practice staff on the PCN effort in light of the upcoming changes (18 mins 18 secs)

Finding out more (20 mins 10 secs)

Responses and input (21 mins 8 secs)

Deadline for feedback (22 mins 18 secs)

If you are interested in getting involved, would like to learn more and / or participate in providing input into The Fuller Review, please email here.

The Fuller Review engagement platform is additionally accessible here.

Our PCN Plus online programme is now open for registrations! Aimed at new PCN Clinical Directors, our team of experts will deliver training on all the need to knows, including (and not limited to); establishment of a PCN vision, communications, managing finances and workforce, and preparations for integrated care systems. If you are interested in learning more, or you’re keen to sign up, please see our dedicated webpage or you can contact Ben for further information.