It has been arguably some of the toughest few weeks general practice has ever known. The pressure of the delivery of the vaccination programme has been felt by teams up and down the country and our joint Ockham / Practice Index podcast regulars are no different. In this sixth instalment of our hugely popular practice manager panel posts, Nicola Davies, Robyn Clark and Ben are joined by Business Manager Amita Gokani to discuss their experiences of working at the forefront of the vaccination programme, so far. Each have faced their own challenges locally and are at different stages in the immunisation campaign and we have been fortunate to get their insights on how the first six weeks have gone for each of them; the highs, the lows and then what comes next.
Introductions (35 secs)
Robyn in the headlines (1 min)
The Institute of General Practice Management (IGPM) update (2 mins 47 secs)
The last 6 weeks in Nicola’s patch (3 mins 1 sec)
Dealing with local frustrations (3 mins 57 secs)
Amita’s recent experiences in Redbridge (5 mins 9 secs)
The impact of short notice, unannounced and cancelled deliveries (6 mins 49 secs)
Working through the cohorts versus potential for wastage (7 mins 30 secs)
Progress in Robyn’s area (8 mins 15 secs)
The potential for increased flexibility and where this has been limited (9 mins 3 secs)
What happened when the guidelines for administering the second dosage changed? (10 mins 57 secs)
The challenges presented by continually changing guidance and regulation (11 mins 42 secs)
Nicola’s view on these continuous changes (12 mins)
Managing staffing and rotas (14 mins 19 secs)
The limitations of running services on staffing good will (15 mins 45 secs)
The approach to care homes and housebound patients in Robyn’s area (17 mins 15 secs)
Anticipating the weeks ahead: Robyn and Amita (18 mins 9 secs)
All systems go for Nicola (19 mins 31 secs)
The Practice Index website can be found here
For all enquiries, please contact James Dillon here
Recruiting from the Additional Roles Reimbursement Scheme (ARRS) pot isn’t simply a case of picking out which services and posts you think would best suit your network or practice. As many are discovering, it requires a bit of a step back and some critical thinking as to what might work now versus in the future, what the needs of the local population are, how much capacity there might be to support new, additional team members and how they can best function across large networks and / or multiple practices. In this week’s podcast, we welcome back Dr Riaz Jetha, GP and Director of Health Integration Partners, whose team have adopted a novel approach to managing the process of applying for, funding and integrating new clinical posts into existing teams. Can there really be a magic formula which supports us in identifying the right roles, which can ensure we better meet the needs of the PCN and stay within the funding budget?
Introduction (40 secs)
How did the adoption of the process mapping methodology come about? (1 min)
How would we use a role instead of what role should we get (an alternative mindset) (3 mins 3 secs)
Where to begin (4 mins 26 secs)
Some surprising outcomes (7 mins 47 secs)
The value of the non-clinical functions (9 mins 33 secs)
Summing up a phased approach to the ARRS process (12 mins 28 secs)
Blending clinical and leadership skills (13 mins 30 secs)
Plugging the gaps in developmental and holistic support for newly recruited ARRS staff (13 mins 52 secs)
Alleviating the burden on PCNs and practices (15 mins 11 secs)
Riaz’s view on ARRS funding models (15 mins 51 secs)
Applying the funding more flexibly (17 mins 43 secs)
Being more creative when it comes to recruitment (18 mins 44 secs)
Key lessons learned (19 mins 45 secs)
Measuring the benefits of process mapping (20 mins 38 secs)
Getting in touch (21 mins 37 secs)
The link to the Health Integration Partners website can be found here
Contact email for Riaz here
A sample presentation showing the analysis of staffing a new service can be found here
With the recent inclusion of pharmacists within the Additional Roles Reimbursement Scheme offer, many practices and networks are seriously considering utilising the skills and services a pharmacist can bring to their table. However, many are equally uncertain as to what the pharmacists can cover, how to integrate them best within their teams and more practically, what the best model of employment might be to benefit both the new post holder and the PCN, amongst other things. Luckily, Mahmud Yusupov and Runa Salim, both Senior Clinical Pharmacists and joint founders of the innovative Clinical Pharmacist Solutions join Ben this week to talk us through all of the key practical aspects that PCNs must consider during the recruitment process and beyond – and from a third-party perspective, how they can support primary care in getting the best out of the new roles.
Introductions (36 secs)
Mahmud’s background and an introduction to Clinical Pharmacist Solutions’ mission (55 secs)
All about Runa (1 min 26 secs)
Attracting pharmacists to primary care and ensuring they can practice effectively (1 min 57 secs)
What are pharmacists looking for specifically when it comes to a career in general practice? (3 mins 23 secs)
The importance of the interview (5 mins 19 secs)
What support can Clinical Pharmacist Solutions for PCNs during the recruitment process? (6 mins 12 secs)
Matching the requirements of a practice to the skillset of a pharmacist (7 mins 44 secs)
Assessments of skills / training needs analysis (8 mins 14 secs)
How long does it take to upskill a pharmacist? (10 mins 15 secs)
Blending externally provided learning with CPPE training (11 mins 49 secs)
Reducing staff turnover (13 mins 1 sec)
Mahmud and Runa’s thoughts on potential employment models (14 mins 23 secs)
Funding challenges (16 mins 9 secs)
Getting in touch (18 mins 5 secs)
The link to the Clinical Pharmacist Solutions website can be found here
Their LinkedIn page is here
At the end of last year Ben recorded a review of 2020 with Dr Hussain Gandhi and Dr Andrew Foster from the eGPlearning podblast. We cover the impact of Covid on general practice, how that changed over the course of the year, and reflect on what the lasting implications of this might be for the service. It is a slightly longer listen than our normal podcast episodes at 45 minutes – primarily because there is so much to cover!
There are generally more failures than success stories when it comes to launching and maintaining community based urgent care services across the country so what have the team in Rochdale done differently? To kick off the new year, Ben is joined by GP Dr Zalan Alam, Clinical Director for the hugely successful and pioneering Heywood, Middleton and Rochdale Urgent Community Care Team who gives an inspiring insight into their five-year journey to date; from establishing a business case, to taking a more flexible approach to their service specification, where they have grown and continually adapted, the lessons learned and their future aspirations.
Introduction (34 secs)
Zalan’s role and an overview of the service model (51 secs)
Establishment of the service and some key factors in its success to date (1 min 56 secs)
The business case (3 mins 7 secs)
A typical patient journey (4 mins 58 secs)
Capacity challenges? (6 mins 29 secs)
Impact of Covid (7 mins 11 secs)
Integrating social prescribers (8 mins 50 secs)
The five-year evolution of the service (9 mins 50 secs)
Lessons learned (11 mins 30 secs)
Zalan’s thoughts on integrated care (13 mins 4 secs)
Cultivating a shared vision (14 mins 57 secs)
An alternative approach to the service specification (15 mins 33 secs)
What’s next? (16 mins 36 secs)
Finding out more (18 mins 14 secs)
Heywood, Middleton & Rochdale’s Intermediate Care Team website
Contact points for the service as follows:
Dr Zalan Alam Clinical Director for Intermediate Tier Services
Wendy Antil Service Manager
Ruth Chamberlain Directorate Manager
The link to Zalan’s first podcast episode is here
The publication of the enhanced service landed at the beginning of December and with it comes further, additional challenges for general practice and places us firmly in the spotlight of the current healthcare agenda. Our ever-popular Practice Index panel return and as well as providing an update following their last episode, they are this week joined by podcast favourite Dr Hussain Gandhi (Dr Gandalf) to consider the implications of and considerations required for the delivery of the Covid vaccination programme locally and nationally. How do we engage with a partially sceptical public? How will we fare balancing immunisations alongside business as usual? How delivery will be managed in practice? Whilst also not forgetting the management of finances and workforce planning…
Introductions (35 secs)
An update on the establishment of a nationally recognised organisation for Practice Managers (46 secs)
The Institute of General Practice Management contact points (2 mins 22 secs)
The panel’s reaction to the Enhanced Service publication (2 mins 53 secs)
Moving from practice to network wide delivery (3 mins 56 secs)
Robyn’s perspective (5 mins 23 secs)
Identification of a designated site for Nicola’s network area (6 mins 31 secs)
The plans for Nottingham City East (7 mins 6 secs)
What differences are there between the Enhanced Service and the original, local plan in Gandhi’s area? (7 mins 55 secs)
The challenges in summary (8 mins 59 secs)
Workforce organisation (10 mins 28 secs)
Nicola’s thoughts on staffing the enhanced service (11 mins 59 secs)
Managing a vaccination programme alongside business as usual (13 mins 8 secs)
Financial reimbursement in South Gloucestershire (13 mins 46 secs)
How Gandhi is handling the financial flow in his network (14 mins 41 secs)
Comms / engagement with the public – and managing concerns (15 mins 47 secs)
Recording appointments and immunisation numbers (18 mins 10 secs)
The process for vaccination clinics in practice (20 mins 27 secs)
eGP Learning and Practice Index resources (21 mins 57 secs)
For more information on The Institute of General Practice Management:
YouTube channel for Dr Gandalf’s eGP Learning podblast
Amongst the host of new roles available to PCNs are First Contact Physiotherapists (FCPs); a service designed to signpost patients directly into a physiotherapy service and therefore saving valuable GP and GP referral to treatment times. As this is a relatively new concept for most, we speak this week to Larry Koyama, Head of FCP Implementation at the Chartered Society of Physiotherapy to get the lowdown on what an FCP actually is, what the role can offer in terms of supporting practice efficiency, the suggested models for successfully embedding FCPs in both an employment sense and in terms of integration within the wider network, the lessons learned so far and more.
Introduction (35 secs)
The background to Larry’s role (46 secs)
Making the case for First Contact Physiotherapists (1 min 34 secs)
What is an FCP? (2 mins 34 secs)
What is the difference between a Physiotherapist and an FCP? (3 mins 38 secs)
Patient pathway and service access (4 mins 28 secs)
Crunching the numbers; caseload and appointment sizes (5 mins 11 secs)
FCPs per population size (5 mins 52 secs)
Lessons learned so far (6 mins 51 secs)
FCPs within the wider practice and network teams (8 mins 19 secs)
Optimising working experience within a network environment (10 mins 3 secs)
3 suggested employment models (12 mins 37 secs)
Exploring the implications of direct and indirect employment (14 mins 21 secs)
Current availability of FCPs (15 mins 45 secs)
Larry’s final thoughts on making the most of your FCP (16 mins 46 secs)
Finding out more (18 mins 27 secs)
Please visit the Chartered Society of Physiotherapy’s website for a range of resources from making the business case for employment of an FCP to supporting implementation and tools for evaluating the effectiveness of the role.
The link to the Phase 3 FCP evaluation data Larry refers to is here
Has there ever been a year which has been more tough in terms of demand and output in general practice? Covid landed and with it a whole host of immediate and long-term issues which have all had a direct impact on practice and network cashflow. Our resident finance guru James Gransby of RSM UK is back this week to give his thoughts and his advice on available funding now, what may be up for grabs in future, where savings could be identified, whether general practice overall is thriving in spite of the pressure and most importantly, what to do if your financial position is already precarious.
Introduction (33 secs)
Is it harder for practices to stay on top of finances now? (43 secs)
What support is available from NHS England? (1 min 12 secs)
The influence of individual CCGs (2 mins 18 secs)
Income protection (2 mins 47 secs)
Where is income being lost? (4 mins)
Has the £150m Covid expansion funding really made a difference? (4 mins 46 secs)
Practical and financial implications of taking on additional roles (6 mins 2 secs)
The pressure from two, large-scale immunisations programmes in one financial year (6 mins 53 secs)
Direct support from government (8 mins 21 secs)
James’s take on the overall financial impact of Covid (10 mins 8 secs)
What actions should we be taking right now? (11 mins 31 secs)
Advice for those who are struggling (12 mins 52 secs)
Utilising a PCN surplus (14 mins 3 secs)
How the additional roles can help from a network perspective (14 mins 34 secs)
Will there be any further opportunities to boost income at any point? (15 mins 8 secs)
Transformation of working process = savings? (16 mins 14 secs)
James’s final thoughts (17 mins 29 secs)
Further information, resources and getting in touch (17 mins 56 secs)
The COVID article can be found here and the Autumn version which also contains COVID tips (including Christmas gifts) can be requested from your local AISMA accountant or by emailing James at james.gransby@rsmuk.com
Following our recent podcast featuring Dr Farzana Hussain, we catch up this week with Dr Hussain Gandhi, aka Dr Gandalf to his own eGPlearning Podblast listeners, to hear about how his year in post as Clinical Director for Nottingham City East PCN has gone, in the backdrop of all the challenges presented by Covid, the flu vaccination programme and the new PCN DES specs (to name but a few). Gandhi talks to Ben about his own reflections within his role, how his teams have fared, how they are dealing with increased pressure and their plans for the future which include expansion of the team and the services they can offer.
Introduction (31 secs)
Sustaining the initial excitement of being Clinical Director despite a particularly gruelling year (45 secs)
Relationship development within the network area (1 min 23 secs)
Sink or swim? (2 mins 49 secs)
The explosion of tech in general practice (3 mins 31 secs)
Adoption of digital process and the impact on multi-disciplinary working and setting up new services (4 mins 36 secs)
How are Nottingham City East using the additional roles scheme? (6 mins 17 secs)
Gandhi’s thoughts on the network manager post and recognising the efforts of Practice Managers over the last 12 months (8 mins 16 secs)
The practicalities of employing a network manager / designing the role (9 mins 42 secs)
Progress on the additional clinical roles (10 mins 27 secs)
Time management (11 mins 56 secs)
Short and long-term strategies for employment of additional roles (12 mins 26 secs)
PCN DES specs (13 mins 42 secs)
Coping with an escalating workload (15 mins 12 secs)
The importance of saying “no” (16 mins 4 secs)
Main reflections and highlights from the last 12 months (16 mins 41 secs)
What happens next? (17 mins 45 secs)
The eGPlearning Podblast (19 mins 8 secs)
Finding out more (19 mins 57 secs)
The link to the eGPlearning YouTube channel is here
With a whopping 55% of Practice Managers intending to leave their posts in the next 12 months, this is a clear sign that there is growing discontent and therefore, a potentially huge problem for general practice that needs to be tackled sooner, rather than later. In the latest of our series of Practice Manager panels, Nicola Davies and Robyn Clark return and are this week joined by Jo Wadey, fellow Practice Manager and Chair of the West Sussex Practice Managers Association and by Carole Cusack, Director of Primary Care at Wessex LMCS to discuss the issue of continuing disregard and lack of recognition nationally for Practice Management as a profession. Where and how do Practice Managers get their concerns heard? How effective are LMCs in addressing their needs? Should there be national accreditation of Practice Managers? And the million-dollar question; is there a role for collectivism and the establishment of a union?
Introductions (28 secs)
What is the reason for low morale amongst Practice Managers right now? (1 min 5 secs)
Robyn’s views (2 mins 55 secs)
Jo shares her experiences (3 mins 45 secs)
Carole’s sense from an LMC perspective (4 mins 47 secs)
The exclusion of Practice Managers from the New to Partnership Payment Scheme (5 mins 57 secs)
Clinical versus non-clinical (6 mins 29 secs)
The Practice Management Network (7 mins 18 secs)
Percentages of Practice Managers leaving post in the next 12 months and the implications for general practice (7 mins 57 secs)
Why there is a need for a nationally recognised professional body for Practice Managers (9 mins 6 secs)
Membership and / or accreditation (10 mins 48 secs)
The complexities and variation in becoming a Practice Manager (13 mins 41 secs)
Which existing organisations could be a model for a national body of Practice Management? (16 mins 11 secs)
How it feels to be disregarded by existing, recognised bodies (18 mins 14 secs)
Where do we go from here? (19 mins 48 secs)
Ben’s closing remarks / summary (20mins 56 secs)
This time last year we caught up with Clinical Director and now GP of the Year Dr Farzana Hussain to get her early thoughts about her (then) new role as a PCN lead. Fast forward 12 months and Farzana is back to share an update on the challenges she and her network team have faced and where they have achieved success, in spite of the pressures of meeting the demands of the primary care contract and the small matter of a global pandemic. From developing and managing relationships, to understanding and embedding additional roles and identifying where further support is required across the board, this week’s podcast is a fascinating insight into the world of a Clinical Director during the early life of a PCN.
Introduction (33 secs)
Becoming GP of the Year (47 secs)
Stand out moments in the last year, in summary (1 min 34 secs)
Evolving relationships between practices and the network more broadly (2 mins 38 secs)
Working on shared purpose (4 mins 14 secs)
How has Covid impacted on PCN relationships and the development of the network itself (5 mins 45 secs)
Recruitment of additional roles (6 mins 52 secs)
Meeting the challenge of embedding new roles in practice (10 mins 7 secs)
When will the positive impact of the new roles be felt? (12 mins 33 secs)
Is there adequate support in place for managing the establishment of new teams? (14 mins 12 secs)
Managing the demands for time and meetings (15 mins 29 secs)
What support is available for clinical directors themselves? (16 mins 46 secs)
The £1.50 challenge (19 mins 7 secs)
What’s next for Farzana? (20 mins 44 secs)
The Primary Care Home programme is an innovative approach to strengthening and redesigning primary care, which was founded by the National Association of Primary Care (NAPC) in 2017. Since that time, there has been the emergence of primary care networks so how have the radical differences which have swept across the general practice system affected the programme and its development? This week’s podcast features Dr Minesh Patel, current NAPC Chair, who talks to Ben about the progress of the Primary Care Home movement, the impact of PCNs and their influence broadly and what is next in terms of both models.
Introductions (10 secs)
The role of the NAPC (21 secs)
Primary Care Home (PCH) initiative and the relationship with PCNs (1 min 2 secs)
How is the work of the Primary Care Home being carried out now? (2 mins 2 secs)
Are PCNs a risk to the Primary Care Home movement? (3 mins 24 secs)
PCN new roles (5 mins 13 secs)
The key differences of Primary Care Home and PCN – and the resulting impacts (6 mins 40 secs)
Are networks operating differently in different areas when it comes to recruitment of the new roles? (8 mins 11 secs)
The timeline for embedding new staff (9 mins 34 secs)
Where PCNs fit as far as integrated care is concerned (10 mins 8 secs)
Lessons in engagement from the Primary Care Home programme (13 mins 4 secs)
Relationship development (14 mins 33 secs)
How has Covid affected the development of PCNs? (15 mins 32 secs)
NAPC forward view and how they can help practices and networks right now (16 mins 49 secs)
Getting in touch (18 mins 26 secs)
The NAPC website is here
To get in touch via Twitter
Or you can call: 020 7636 7228
There has been an explosion of digital innovation within primary care over recent months, particularly where maintaining contact between practices and their patient populations is concerned. But what about joining up practices with other practices, within Primary Care Networks (PCNs) and GP Federations, as well as other cross-sector organisations, to enable secure information sharing across care providers? This week’s podcast features GPs Dr Susannah Thompson and Dr Eleanor Holmes from TyneHealth GP Federation who, together with Nigel Walker, CDO and Co-Founder of leading data security provider CyVolve, share a fascinating insight into the transformative approach they are taking in North Tyneside to truly put patients at the heart of integrated care pathways; how they are able to safeguard security around the sharing of information and ultimately, finally, break down the barriers of silo working.
Introductions (44 secs)
All about TyneHealth GP Federation (1 min)
The extended access service (1 min 47 secs)
The birth of CyVolve and their mission (2 mins 22 secs)
CyVolve’s role in supporting safe information sharing (3 mins 7 secs)
Sharing the right information, at the right time, with the right people (6 mins 5 secs)
Motivating multiple practices to trust in the technology (7 mins 30 secs)
The challenges faced by CyVolve (8 mins 4 secs)
Bringing benefit to business continuity during the pandemic (8 mins 50 secs)
What are the key differences of the CyVolve technology? (9 mins 20 secs)
How is information stored? (10 mins 34 secs)
What types of data are being managed? (11 mins 20 secs)
Handling pushback (12 mins 12 secs)
The TyneHealth Covid-19 resource hub (14 mins 11 secs)
What has been the impact of the new system being in place? (15 mins 7 secs)
Lessons learned from CyVolve’s perspective (16 mins 3 secs)
Finding out more (17 mins 16 secs)
To find out more and to get in touch with Susannah and Eleanor at TyneHealth:
The TyneHealth website is here
Dr Eleanor Holmes (GP / QI & Communications Manager)
A case study published by CyVolve on their work with TyneHealth (n.b. same title as the podcast: 'Patient Data: Who Holds The Key?')
The CyVolve website for more info about NHS secure collaboration can be found here
This time of year is ordinarily an extraordinarily busy period for practices with the onset of ‘business as usual’ winter pressures but what is the effect of the additional impact Covid presents, while business is not running as normal? In the third of our Practice Index Practice Manager panels, now seasoned podcast professional Nicola Davies joins Ben, along with fellow Practice Manager Michele Petrie and GP, executive coach and speaker, Dr Rachel Morris, to discuss the challenges leadership teams face right now, what low morale means in practice day to day and critically, what can be done to maintain staff resilience during this period of long term uncertainty.
Welcome to the panel (38 secs)
An introduction to Michele (49 secs)
All about Rachel (1 min 24 secs)
Morale right now in general practice (2 mins 10 secs)
Why is morale so low? (3 mins 24 secs)
Pressure from the top and the influence of the media (3 mins 46 secs)
Summarising the contributing factors (4 mins 18 secs)
What does a stressful working environment look and feel like in reality? (5 mins 20 secs)
The power of social media (7 mins 5 secs)
What can practices do to find a way through? (8 mins 21 secs)
The zone of power (10 mins 36 secs)
Recognition, reward, and the importance of saying “thank you” (11 mins 24 secs)
Long term impacts of low morale and maintaining wellbeing (13 mins 4 secs)
Pulling together as a team (14 mins 38 secs)
Standing in the shoes of a practice leadership team (15 mins 24 secs)
Coping strategies (17 mins 13 secs)
Rachel’s advice for self-care and sustaining resilience (19 mins 31 secs)
The link to Rachel’s I am not a frog podcast is here
The Covid-19 team wellbeing toolkit Rachel refers to can be found here
Episode 228 - Podcast – Jessica Hollingsworth & Nick Sharples – Digital group consultations
Group consultations are a relatively new concept in primary care, but one GP has taken this a step further and in the wake of the pandemic, has introduced digital group consultations at her practice. Dr Jess Hollingsworth of Linthorpe Surgery in Middlesbrough, in partnership with podcast favourite Nick Sharples of DNA Insight, saw that there was a need to better support patients recovering from Covid. Together, they decided that giving patients access to an online consultation, in the company of other individuals also struggling with the long term impact of the virus, might offer some much needed insight into its effects, whilst giving them a safe route of access to an individual consultation and to a potential network of support going forwards. Here, they talk to Ben about how the idea came about, the preparation that is required, how the consultation works in practice and what the impact has been overall on the patients that have taken part.
Introductions (34 secs)
Making the transition to virtual group consultations (55 secs)
The definition of a digital group consultation and its structure (1 min 29 secs)
Timings and patient consult allocation (2 mins 25 secs)
Which patient group/s were targeted and why? (2 mins 53 secs)
What preparation is required? (3 mins 21 secs)
The role of the facilitator (4 mins 7 secs)
Governance and consent (4 mins 46 secs)
Recommended group size and numbers (5 mins 56 secs)
A group consultation in practice (7 mins 21 secs)
After care (8 mins 26 secs)
How social prescribing link workers can help (9 mins 40 secs)
Patient feedback (10 mins 30 secs)
Reflections from a practice perspective (11 mins 40 secs)
Technical challenges (12 mins 34 secs)
Which online platform works best and why? (13 mins 19 secs)
Lessons learned (14 mins 36 secs)
Advice from Nick for practices who are in setting up a digital group consultation (15 mins 43 secs)
The Personalised Care Institute and the support and training on offer (17 mins 12 secs)
Where can I find out more about virtual group consultations? (18 mins 28 secs)
Further support for patients recovering from Covid-19 (19 mins 14 secs)
A link to the case study on Linthorpe Surgery’s digital group consultation pilot (which Nick references) can be found here
We are proud of the many inspirational stories that are shared and the fascinating people who feature on our podcast and none more so than this week’s guest, GP Rebecca Farrington. Rebecca works within an almost truly unique role as a GP with a special interest in asylum seeker mental health, within a specialist hub in Salford, Greater Manchester. The challenges faced by asylum seekers and refugees within the UK cannot be underestimated and the impact on mental health and wellbeing is significant. Here, Rebecca talks to Ben about these challenges in more detail, the dynamics of her role, the difficulties Covid has presented and how other providers can ensure the best care for this particularly vulnerable population, in their own areas of the country.
Introduction (29 secs)
Rebecca’s journey (41 secs)
How ‘typical’ is Rebecca’s role (2 mins 25 secs)
Life as a GP with a special interest and the model of care (2 mins 41 secs)
Are there other support frameworks for refugees and asylum seekers? (4 mins 12 secs)
The challenges faced by those seeking asylum in the UK (6 mins 5 secs)
How can GPs provide a better service? (7 mins 1 sec)
Why specialist health services make such a big difference (7 mins 50 secs)
The impact of Covid (10 mins 7 secs)
Doing things differently post Covid (12 mins 16 secs)
Advice and support on reaching out to the vulnerable populations in your area (13 mins 8 secs)
The importance of high-quality interpretation (15 mins 35 secs)
More information on the vital work and the services offered by Rebecca and her team (and Rebecca as a practitioner) can be found as follows:
It’s an exciting week because we are so pleased to have our first PCN Manager to feature on the Ockham podcast! Tara Dawson, PCN Manager for the Lytham St Annes network, takes us through her journey to becoming PCN Manager, her experiences, her achievements, the key relationships she has formed and then, what she hopes to achieve going forwards and more broadly, why having a manager is instrumental in establishing the setup of the network, driving the key commitments and priorities - and managing the wellbeing of the relationships between practice and PCN.
Introduction (30 secs)
All about Tara and how she became a PCN Manager (47 secs)
Has Tara’s prior experience helped? (2 mins 7 secs)
Organisational setup (2 mins 58 secs)
Incorporated status and NHS pensions implications (3 mins 54 secs)
Managing the incorporation process (4 mins 56 secs)
What does a typical working week look like for Tara? (6 mins 21 secs)
Recruitment and staffing (7 mins 28 secs)
The relationship between PCN Manager and Clinical Director (8 mins 38 secs)
Has having a PCN Manager in post allowed the Clinical Directors to drive the clinical priorities? (9 mins 43 secs)
The PCN demographic and practice engagement (10 mins 57 secs)
PCN Managers and Practice Managers (13 mins 5 secs)
The best things about being a PCN Manager (14 mins 55 secs)
Support network (15 mins 53 secs)
The forward view (17 mins 5 secs)
Lessons learned so far (17 mins 53 secs)
Following up in a year (19 mins 52 secs)
Getting in touch (20 mins 24 secs)
Tara is contactable at: tara.dawson1@nhs.net
It’s all about profitability on this week’s podcast. In the second of our Practice Index panels, Practice Managers Robyn Clark and Nicola Davies return and are this time joined by financial expert James Gransby to talk through the current pressures on practice income, particularly during this period of uncertainty. However they have also shared with us their practical advice for managing finances at a local level; how to maximise income, how to avoid commonly made mistakes, where to access the most up to date toolkits and resources to support good financial management and why some practices may operate differently but can be equally profitable.
Introduction (43 secs)
Is GP income down overall? (1 min 6 secs)
How do some practices maintain profitability whilst others are experiencing a drop in their income? (2 mins 43 secs)
Maximising income (Nicola’s approach) (3 mins 40 secs)
Robyn outlines the factors influencing profitability at her practice (5 mins 27 secs)
The importance of claiming income and checking you have been paid (6 mins 39 secs)
Common mistakes that practices are making (7 mins 2 secs)
The disparity in claim eligibility and the benefit of experience (8 mins 18 secs)
PCSE portal (10 mins 38 secs)
Dealing with the fallout of PCSE issues (10 mins 55 secs)
What is the decision-making process when presented with the opportunity of a new enhanced service? (11 mins 34 secs)
Why could an enhanced service prove profitable for one practice and not for another? (12 mins 44 secs)
What opportunities might practices be missing out on? (14 mins 24 secs)
The reasons why practices operate differently but can be equally profitable (16 mins 43 secs)
Final pay controls, pensions, and tax implications (19 mins 14 secs)
Robyn, Nicola, and James’ closing words of wisdom (20 mins 25 secs)
This is the blog James mentioned
Information about Practice’s Index’s PPA Toolkit can be found here
Another resource which has been really popular from AISMA and PI is here
Contact details for the panel are as follows:
So much has changed since the formation of PCNs at the beginning of last year in terms of availability of funding and staff and the governance of how we run our networks. As a result, many partnerships, practices, and networks are reconsidering their financial models and specifically, whether incorporation could prove more lucrative in the long run. This week’s podcast features our (almost) resident financial expert, James Gransby, Partner at RSM, who has waded through the reams of guidance and jargon to explain in simple terms what the pros and cons of PCN incorporation are likely to be; what are our options, what we need to watch out for and where the hidden benefits may be.
Introduction (36 secs)
What does incorporation mean and is this the direction of travel for PCNs? (55 secs)
Why PCNs may choose to change their financial model at this stage (1 min 38 secs)
VAT implications broadly (2 mins 11 secs)
Incorporation pros (3 mins 17 secs)
Setting up a PCN as a separate entity (4 mins 19 secs)
NHS pensions (5 mins 7 secs)
CQC registration (6 mins 38 secs)
What are the other governance obligations an incorporated body would have to meet? (7 mins 2 secs)
VAT and staffing setup (8 mins 11 secs)
Tax benefits? (9 mins 26 secs)
Impact and Investment Fund monies (10 mins 49 secs)
Should a PCN incorporate itself or use a local, already incorporated, federation? (11 mins 28 secs)
Will overall funding increases lead to a greater number of limited companies? (12 mins 33 secs)
A PCN in the open market… (14 mins 8 secs)
…versus as an NHS organisation (14 mins 55 secs)
GP practices and incorporation (15 mins 36 secs)
PMS agreements and GMS contracts (18 mins 12 secs)
Getting in touch (18 mins 58 secs)
James is contactable via email at: james.gransby@rsmuk.com
A patient’s wellbeing underpins their physical health so what can we do to complement our existing models of care and ensure their wellbeing needs are met? One of our most popular guests (and as it turns out, podcast regular) Dr Neil Modha of Thistlemoor Medical Centre in Peterborough, is back on our sofa this week and believes the key lies in the relatively new health and wellbeing coaching roles. What are they? How do they fit within existing staffing and service models? How can practices and PCNs take advantage of these roles, particularly in line with the reimbursement scheme? And most importantly, what value do they add to practices and their patient populations?
Introduction (53 secs)
How has Neil’s practice coped during the pandemic? (1 min 34 secs)
The triage model at Thistlemoor (2 mins 24 secs)
The impact of Covid on general practice locally – and more broadly (3 mins 7 secs)
Integrating health and wellbeing coaches within a practice structure (4 mins 53 secs)
What is a health and wellbeing coach? What can they bring to our table? (6 mins 23 secs)
Are new people required to take on this role or can we upskill existing staff? (7 mins 30 secs)
Where Neil’s PCN are up to in the training and recruitment process (8 mins 39 secs)
The patient journey (10 mins 23 secs)
Caseload (11 mins 43 secs)
What does success look like? (12 mins 20 secs)
Who is responsible for running the training? (13 mins 33 secs)
Proving the impact (14 mins 17 secs)
Utilising funding from the Additional Roles Reimbursement Scheme (ARRS) (15 mins 49 secs)
Breaking down the financial benefits of the ARRS (17 mins 2 secs)
Where do health and wellbeing coaches fit within the context of the PCN DES? (18 mins)
Lessons learned so far (19 mins 54 secs)
Following Thistlemoor’s journey and additional resources (20 mins 57 secs)
Further information regarding health coaching can be found on Thistlemoor’s website here
The WHO wellbeing as a measure for wellbeing is an additional tool Neil and his team are using which should be completed at the beginning and end of the patient journey, to measure the impact of their health and wellbeing intervention.
If you would like to join the discussion or get in touch, both Neil and Thistlemoor are active in all the usual places:
Twitter: https://twitter.com/ThistlemoorMC
Instagram: https://www.instagram.com/thistlemoorhealth/
Raw Horizons Academy are a recognised training provider for health and wellbeing coaches and their contact details are as follows:
Website: academy.rawhorizons.co.uk/
Twitter: https://twitter.com/RHA_Wellbeing
Facebook: https://www.facebook.com/rawhorizons
Instagram: https://www.instagram.com/rawhorizons/
Finally, the link to Neil’s podcast on his practice’s triage model (which Ben refers to) can be found here
The ability to be resilient, as an individual and as a team, has never been more important, particularly over the last 6 months and it is particularly difficult to maintain resilience during a period of such intense change and unpredictability. Luckily for us, executive coach Janice Steed has agreed to return to the podcast to dissect how resilience applies to Covid, how the changes faced by general practice have truly tested our ability to be resilient and offers a wealth of advice and practical tips on supporting primary care staff through the impacts of Covid - and the positive steps that can be taken to move forward from here.
Introduction (31 secs)
Janice’s initial thoughts (48 secs)
The impact of Covid on healthcare more broadly (1 min 35 secs)
….and on primary care staff (2 mins 37 secs)
Different phases of stress throughout the pandemic (3 mins 9 secs)
The ‘prepare’ phase (3 mins 56 secs)
The ‘active’ phase (4 mins 34 secs)
The implications of having low levels of resilience (5 mins 20 secs)
The ‘recovery’ phase and adjusting to life after the acute period of Covid (6 mins)
How do we take forward the positive solutions we have embedded and avoid reverting to old, more comfortable behaviours? (6 mins 50 secs)
Focus on communication, support for others and recognising that we may go backwards before we go forwards again (8 mins 5 secs)
Practical advice on establishing a support forum locally (10 mins 6 secs)
Who should be involved in a support forum? (12 mins 46 secs)
Can a support forum work virtually? (13 mins 4 secs)
The role of facilitator (14 mins 38 secs)
Getting in touch (15 mins 17 secs)
For further support and advice, please visit Janice’s website here
Janice is also contactable via janice@steedconsulting.co.uk
With the publication of a new Asthma UK report about how the use of data and technology can shape and transform the management of asthma in primary care, a wider discussion has now been prompted about how the same principles and recommendations within the report could shape chronic disease management in general practice overall. Dr Minal Bakhai and Dr Andy Whittamore have returned to the podcast to break down the specifics of the report, to share their experiences of implementing some of the recommendations, to discuss how we can better use data and tech to support innovation, how the improvement measures employed now could serve as a springboard for further success and the instant and long term impact on patients with asthma.
Introduction (35 secs)
Why has the report been published? (1 min 7 secs)
The current picture of asthma management in the UK and some stats (1 min 22 secs)
What has Asthma UK done so far? (3 mins 6 secs)
Asthma as a gateway condition for trial of tech in chronic disease management (3 mins 58 secs)
Has Covid been a contributing factor? (4 mins 14 secs)
Minal’s view; does asthma hold the key for successful implementation of tech in managing long term conditions? (5 mins 27 secs)
Total digital triage (6 mins 59 secs)
Digital First Primary Care accelerators and the work towards integrated care pathways (8 mins 11 secs)
The Portsdown experience (9 mins 32 secs)
Employing better analytics; what data skills are required? Which data samples should we be focused on? Who is responsible? (10 mins 58 secs)
Other improvement measures that Andy and Portsdown have employed (12 mins 30 secs)
The results of the changes at Portsdown (14 mins 36 secs)
The role of PCNs (15 mins 22 secs)
Minal’s view on the potential for influence and outcomes at PCN level (16 mins 37 secs)
A permanent change in the future of general practice? (18 mins 14 secs)
Resources, guidance, capacity support, accelerated procurement pathways and training – all available from Digital First Primary Care (19 mins 40 secs)
Accessing the report and support from Asthma UK (22 mins 48 secs)
Here is the link to the report
Asthma UK: https://www.asthma.org.uk/
Digital First Primary Care home page: https://www.england.nhs.uk/gp/digital-first-primary-care/
Networks and practices are planning in earnest for a more complex flu vaccination season involving all the normal the challenges of ensuring adequate staffing numbers, facilities and PPE are in place – and the right levels of vaccine are in stock. This year’s campaign is additionally complicated by the confusion about how the immunisation programme can be delivered practically in the era of Covid and the near constant changes in national guidance. This week’s podcast features a panel of experts in Practice Managers Robyn Clark and Nicola Davies who, together with Ben, try to unpick some of the issues and give an insight into their own preparations in order to support others in their planning for winter 2020.
A panel of experts (9 secs)
Introductions (45 secs)
Robyn practice and professional background (1 min 11 secs)
Nicola’s PCN, practice and career history (1 min 54 secs)
Changes to the flu vaccination programme for 2020 (2 mins 52 secs)
Issues with supply (3 mins 51 secs)
Staff anxieties (4 mins 11 secs)
Flu targets and the eligibility criteria (4 mins 32 secs)
Current guidance (5 mins 49 secs)
Vaccine demand (6 mins 13 secs)
Is there anything we can be doing now to boost our supply? (9 mins 12 secs)
Vaccination storage (9 mins 31 secs)
Mutual aid (10 mins 9 secs)
PPE (11 mins 6 secs)
Debating the use of PPE and advice on maintaining stock (13 mins 24 secs)
How will administration of the vaccines work in practice? (14 mins 53 secs)
Are there benefits to non-clinical staff being trained in vaccine administration? (18 mins 1 sec)
Medico-legal implications (18 mins 45 secs)
Car park clinics and drive throughs (20 mins 20 secs)
Practice versus PCN delivery models (21 mins 44 secs)
Data collection and recording information (23 mins 12 secs)
Final thoughts (25 mins 27 secs)
This episode of the podcast is a joint collaboration between Ockham Healthcare and Practice Index and we’d love to get your thoughts and feedback! To get in touch you can email Ben via ben@ockham.healthcare or James Dillon via james.dillon@practiceindex.co.uk
It can be tough at the top for many clinical directors but does being in the role as a nurse offer an alternative perspective? Do the challenges differ or are there additional benefits to coming to the role from a slightly different background? Ben Scott is an ANP and Clinical Director for Doncaster South PCN and has taken time out of his busy schedule to speak to us about his experiences from starting life as a professional footballer, to health professional and leader - and his journey to becoming a clinical director.
Introductions (33 secs)
An unlikely route into general practice (50 secs)
Ben’s journey as a health service professional (1 min 39 secs)
The transition to general practice (2 mins)
A clinical directorship post beckons (2 mins 34 secs)
Doncaster South PCN: the stats (3 mins 10 secs)
….and the culture (3 mins 47 secs)
Working amongst GPs as a nurse clinical director (4 mins 41 secs)
Does Ben feel he’s had to work harder to establish himself in the leadership role? (5 mins 36 secs)
The experience of other CDs and their influence on Ben (6 mins 25 secs)
Developing as a leader (7 mins 12 secs)
Establishing a support network (7 mins 37 secs)
What are the benefits to being a nurse clinical director? (8 mins 38 secs)
The effect on recruiting additional roles (9 mins 39 secs)
The first year as a CD; focusing on the good and learning from the not so good (11 mins 13 secs)
Lessons learned (12 mins 19 secs)
Overcoming mistrust (12 mins 57 secs)
Words of wisdom for those considering a clinical leadership position (13 mins 41 secs)
Getting in touch (14 mins 38 secs)
Ben is contactable via @ScottyANP35
If you want to hear more from Ben, he will be speaking at the Best Practice Show which is taking place in October and is free for all healthcare professionals to attend. You can reserve your place here.
What is population health management, and can it really make a difference? Does it really offer a holistic solution to meeting health needs, supporting better integrated care and relieving day to day pressure on practices and networks? Dr Dan Alton is a GP at the Wargrave Surgery in Berkshire and the Population Health Management (PHM) clinical lead for West Berkshire CCG. In addition, he is an NHS England PHM Champion and has a wealth of experience in applying the PHM principles and is on our sofa this week to shine a light on all things PHM; what it is, how it can be applied at scale yet tailored locally, the lessons he has learned and most importantly, how to realise the benefits.
Introductions (32 secs)
What is Population Health Management (PHM)? (1 min 4 secs)
Joining up data with local knowledge (1 min 25 secs)
Embedding proactive integrated care which meets individual and whole community health needs (2 mins 53 secs)
Dan explains how he became involved in PHM (4 mins)
Finding from the national NHS England wave 1 PHM Development Programme in Berkshire West (5 mins 28 secs)
Resulting interventions (7 mins 16 secs)
The conclusions (8 mins 17 secs)
What were the datasets that led to those interventions and how were they identified? (8 mins 41 secs)
How data can be used effectively regardless of its complexity (9 mins 45 secs)
10% PHM data 90% cultural change (10 mins 21 secs)
How do you convert data into patient conversations? (11 mins 51 secs)
Positive, measurable outcomes as a result of a PHM approach (13 mins 32 secs)
Applying PHM principles in response to Covid (14 mins 38 secs)
Accelerating the process to identify areas of need during the pandemic (17 mins 4 secs)
Can PHM support the development of the PCN? (18 mins 49 secs)
Access to further information and PHM resources (20 mins 16 secs)
The NHSE/I PHM Academy website contains a wealth of resources, contacts and materials to support practices and PCNs in engaging with the PHM agenda
The NHS England Population Health Management Development website is here
If you want to hear more from Dan, he will be speaking at the Best Practice Show which is taking place in October and is free for all healthcare professionals to attend – you can reserve your place here.