The landscape of primary care has altered significantly, and many of the changes practices have made to prioritise patients and protect their staff during the Covid crisis are here to stay. This week’s podcast features Practice Manager Kay Keane and QCS Head of Primary Care Tracy Green, who talk through their experiences of the pandemic, how they have worked together to support the implementation of Alvanley Family Practice’s new systems of working and their thoughts on where we go from here as life returns to the new normal.
Introductions (36 secs)
About Alvanley Family Practice and their practice manager, Kay (1 min 20 secs)
‘Feed the birds’ project (1 min 40 secs)
Further innovation: group consultations (2 mins 57 secs)
The advantages of Zoom (4 mins 2 secs)
Tracy’s background and experience (4 mins 15 secs)
What have been the biggest challenges for Alvanley? (5 mins 43 secs)
Increased volume of work versus the need to do things differently (6 mins 42 secs)
Changes to the operating model (7 mins 17 secs)
Which new processes would Kay keep? (8 mins 5 secs)
The effect of rapid changes on team dynamics (9 mins 22 secs)
The loss of in-person contact (9 mins 54 secs)
Has general practice changed for the long term? (10 mins 39 secs)
Partnership working with local providers (11 mins 4 secs)
Have we been boosted in some ways? (11 mins 37 secs)
Maintaining momentum during a crisis (12 mins 41 secs)
The QCS response to Covid (14 mins 5 secs)
Who are QCS and what do they do? (16 mins 4 secs)
Governance and general hints and tips (16 mins 59 secs)
The QCS impact on an individual practice (17 mins 33 secs)
Time for reflection (18 mins 6 secs)
Managing the after effects of such a rapid period of change (19 mins 28 secs)
Lessons learned from Tracy’s perspective (20 mins 34 secs)
Further information (21 mins 18 secs)
This week’s podcast has been sponsored by Quality Compliance Systems (QCS)
QCS are offering a free trial to help support practices in embedding their new procedures and processes following the Covid crisis. To find out more, you can visit their website here
Content can also be found via the QCS Facebook general practice discussion group:
www.facebook.com/Alvanleyfamilypractice
Additional support in relation to Covid-19 is here
With the focus shifting back towards the normality of day to day working, primary care now has scope to reconsider the opportunities presented by the Additional Roles Reimbursement Scheme in building workforce capacity and to establish further transformative working practices. This week’s spotlight is on the role of the pharmacist and we are fortunate to be joined by the experienced and progressive Steve Williams, who is a Clinical Pharmacist and network lead in his area of expertise based at Westbourne Medical Centre in Dorset. Here, Steve explains how his role fits both at practice and at network level - and gives his advice on making the best use of pharmacy professionals, and the additional roles more broadly, in general practice.
Introductions (36 secs)
Steve’s journey to becoming a PCN pharmacist (1 min 3 secs)
Why a move into general practice? (2 mins 33 secs)
Steve describes the transition from secondary to primary care (3 mins 15 secs)
The key differences (3 mins 44 secs)
What was the practice’s initial reaction to taking on a pharmacist? (4 mins 53 secs)
Embedding new roles; advice on induction and adapting your structures (6 mins 23 secs)
Maximising the impact from a network perspective (7 mins 18 secs)
An opportunity for innovation (9 mins 59 secs)
The role of a pharmacy technician and the skills they can offer (10 mins 50 secs)
Future plans and further expansion (12 mins 17 secs)
The influence of the DES on utilising new roles (13 mins 50 secs)
How will the role of the pharmacist develop further? (15 mins 28 secs)
Getting in touch (16 mins 42 secs)
Steve is contactable via email, Twitter and through Westbourne Medical Centre:
stevethechemist@onelesspill.com
@stevechemist
https://www.westbournemedical.com/
@BayPcn
The links for the supporting documents Steve references:
Link re "Practice to PCN role – A Pharmacist’s journey" presentation for Dorset CCG PCN Development Event on Understanding and establishing Clinical Pharmacy in PCNs 15th January 2020
Structured medication reviews research at WMC
Steve Williams, Lawrence D Brad. Impact of practice based clinical pharmacist led medication reviews on ambulatory patients with hyper polypharmacy. Br J Gen Pract 2018; 68 (suppl 1) https://doi.org/10.3399/bjgp18X697097
Viewpoints on pharmacists in primary care published with GP Prescribing lead Dr Lawrence Brad
Williams SD, Hayes JM, Brad LD. Clinical pharmacists in general practice: a necessity not a luxury? British Journal of General Practice. Br J Gen Pract 2018; 68 (667): 85. DOI: https://doi.org/10.3399/bjgp18X694697
Useful documents / websites re pharmacy professionals working in primary care RPS Wales Multidisciplinary Teams (MDT) in General Practice
PRESQIPP
NHS funded not-for-profit organisation that supports quality, optimized prescribing for patients Virtual Professional Network for pharmacy starting April 2020 (membership required)
https://www.prescqipp.info/news/prescqipp-practice-plus/
Primary Care Pharmacy Association (PCPA)
https://www.pcpa.org.uk/ (membership required)
https://pcpa.org.uk/assets/documents/Guide-for-GPs-considering-employing-pharmacist.pdf
We have been fortunate to have been able to share a number of best practice stories throughout the Covid-19 crisis and this week’s podcast is no exception. Ben is joined by Dr Lorenz Kemper, a GP who co-founded MedLink Solutions, a unique online platform which allows practices to remotely manage reviews of patients with long term conditions and chronic disease. Lorenz explains how the system was launched, how it works, and the impact it is having - allowing clinical teams to reach previously inactive patients, creating greater flexibility in management of clinical time and crucially, enabling practices to continue vital routine care for their patients safely.
Introductions (36 secs)
The challenge of remotely monitoring primary care’s ‘routine’ workload (47 secs)
Who was involved in setting up MedLink? (1 min 27 secs)
How the MedLink solution was designed (1 min 55 secs)
The first patient cohort and system rollout (2 mins 35 secs)
Reaching previously inactive patients (3 mins 8 secs)
The mechanics of the solution and establishing patient contact (3 mins 47 secs)
What about the patients who can’t be reached via MedLink? (4 mins 48 secs)
Impact on practice workload and how the process is managed (5 min 30 secs)
Capacity creation (6 mins 58 secs)
What are the key benefits of MedLink? (7 mins 22 secs)
How has MedLink been grown and extended beyond Lorenz’s practice? (8 mins 17 secs)
The Covid effect (8 mins 55 secs)
How flexible is the system? (9 mins 15 secs)
The process for designing the review questionnaires (10 mins 5 secs)
Patient and practice feedback (11 mins 26 secs)
A gateway to safer and more flexible care in the current climate? (12 mins 25 secs)
Future plans and further development (13 mins 41 secs)
Getting in touch (15 mins)
This week’s podcast has been sponsored by MedLink Solutions
Medlink solutions are offering a 3-month free trial to help practices during COVID. To find out more simply visit their website or email Lorenz at info@medlinksolutions.co.uk
Covid has presented many challenges for practices and networks but many have risen to the challenge and found that, as a result, they have been able to accelerate many existing projects and are seeing hugely positive outcomes. Sovereign Health, made up of three practices based in Hampshire, are one example of a network who have enacted rapid change as a result of the crisis and are now at the point of considering what to keep, how to rebalance network versus local priorities and how to maintain momentum going forwards. Clinical Director Dr Tom Bertram, Network lead Amanda Gray and Nursing lead Laura Miller share their story of what they did, what they achieved and where they are now. .
Introductions (39 secs)
The first year as a primary care network (1 min 45 secs)
Creation of a same day service (2 mins 1 sec)
Amanda’s transition from practice manager to practice manager and network lead (3 mins 6 secs)
When Covid happened (4 mins 17 secs)
A ‘command and control’ approach (5 mins 1 sec)
Mixing up the workforce; working by risk profile (5 mins 35 secs)
The challenge of losing a practice’s identity (6 mins 53 secs)
Staff reaction (admin and management) (7 mins 59 secs)
Support for the wider teams, both clinical and non-clinical (8 mins 52 secs)
What was the impact on the nursing teams and how did Laura manage this? (9 mins 43 secs)
How do the nurses feel now? (11 mins 5 secs)
Results from the staff survey (11 mins 31 secs)
What other changes have been made? (12 mins 4 secs)
A shared pharmacy service (12 mins 31 secs)
The telephone hub (13 mins 25 secs)
Single route access to the network (13 mins 41 secs)
Patient feedback (14 mins 33 secs)
Rebalancing network and practice priorities post Covid (15 mins 5 secs)
Population health management (15 mins 54 secs)
Juggling practice and network priorities as a local manager and network lead (16 mins 58 secs)
Summarising the overall effect of Covid on the network (17 mins 54 secs)
Getting in touch (19 mins 9 secs)
Amanda Gray, Sovereign Health Network lead: amanda.gray2@nhs.net
Dr Tom Bertram, Clinical Director, Sovereign Health Network: tom.bertram@nhs.net