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This is the second conversation between Ben and Paul Deffley, Hove GP and clinical director of Practice Unbound; a not-for-profit organisation devoted to “helping general practice work smarter”. In this episode Paul uses the example of a pathology delegation pilot to look at how practices can effectively work together across networks, how they can better manage change and, working at scale, deliver network solutions to collective problems.

Show Notes

Paul outlines his background and his positive view of PCNs (0:48)

An example of working together – a pilot for pathology delegation (2:55)

Tests not needing a clinical context (5:00)

Understanding the pathology activity – what’s safe to delegate (6:07)

Clinical variation in pathology requests – and reducing requesting patterns (7:20)

Managing the delegated requests – a non-clinical team approach (8:37)

Group consultations? Testing different ways of managing patients (9:16)

Overcoming the concerns about risk (9:47)

Understanding the fears (10:59)

Grouping routine tests (11:17)

Auditing the administrators (12:54)

The impact on GP workload – 90% of routine bloods are handled by the admin team (13:27)

Working smarter (14:05)

Clinical variation down (15:02)

Is this a legitimate use of PCN time and energy? (15:33)

PCNs looking at individual GP practice (16:49)

Establishing and maintaining trust (18:37)

The impact of networks on shared problems (19:47)

Making the most of development funding (20:47)

An end-to-end flow exercise (22:49)

Positive relationships (23:33)

Further information (24:20)

Practice Unbound’s web address is www.practiceunbound.org.uk

And Paul can be emailed directly at Pauldeffley@nhs.net

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The tables are turned again and in this week’s episode Ben is interviewed about the lessons we are learning about Primary Care Networks after two months of their existence. He discusses the role of PCNs and how they are perceived, the challenges they are facing and the issues they are focussing on, their approaches to the new roles, the weight of expectations and the lessons they might learn from the establishment of CCGs.

Show Notes

Is the role of PCNs any clearer? (0:33)

The problem of mismatched expectations (2:07)

The rapid rise of PCNs – a tough start (3:30)

The Clinical Directors role as inspiring leaders – quick wins (5:06)

Unforeseen challenges – backwards to move forwards (6:27)

The role of federations with PCNs (7:09)

How can ensure the roles of federations and PCNs are clear and distinct (7:48)

The perceptions of the wider NHS (9:28)

Two roles for the clinical leaders (10:57)

Too many expectations placed on PCNs too soon (11:19)

Supporting a potentially fragile system (12:27)

Building the support on firm foundations (13:26)

Approaches to the appointment of new roles (14:54)

Addressing the 30% funding gap (15:45)

The challenge of the 30% funding gap (19:42)

Lessons from setting up the CCGs (17:33)

Prioritising building relationships and trust (18:36)

Ben’s advice – control your own agenda, focus on relationships and don’t reinvent the wheel (19:53)