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Following on from last week’s theme, Ben asks Dr Nav Chana and Dr Tracey Vell for their views on the problems and the progress of PCNs. What are their experiences of PCNs? What are the perceptions of the new models of care across general practice? Where do the threats and opportunities lie?

Introductions (46 secs0:46)

Tracey and Nav’s personal experiences of PCNs summed up (1:15)

Working together; impact on structure and investment opportunities (2:45)

What’s happening in Nav’s PCN (3:47)

Are PCNs too inward looking from a general practice perspective? (5:45)

The impact of change and using change as a mechanism for improvement (7:00)

The PCN paradox (8:14)

Tracey: where practices can use PCNs to focus on their priorities (9:20)

The challenges of linear development (10:15)

The Maturity Matrix (11:34)

How do we support enable innovative working in PCNs from the start? (12:14)

Plug in now to integrated care systems and why not to wait (13:24)

Benefits at practice level from working within a network (15:16)

…and the challenges (16:33)

The current perception of PCNs (16:54)

A threat to command and control? (18:47)

Working at scale = larger resources (21:00)

Integration of PCNs within the wider healthcare system (22:04)

Population Health Management as a tool for building a successful PCN (23:01)

NAPC resources and case studies (24:07)

Greater Manchester GP Excellence Programme (25:09)

The links for both the NAPC’s material and the Greater Manchester GP Excellence programme:

https://napc.co.uk

https://gpexcellencegm.org.uk

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In our first podcast of the new decade, Ben chats to PCN guru Becky Malby, Professor of Health Systems Innovation at London South Bank University, about the introduction and progress of network-based working. Listen for her take on their establishment, on the critical success factors and navigating the minefield of structural challenges versus meeting local health needs.

Introductions (0:31)

Becky’s take on the first few months since PCN formation (0:47)

Difficulty of contracting versus meeting complex needs (1:18)

Importance of collaboration (2:02)

A crystal-clear purpose is key to a successful PCN (3:02)

Change should happen at practice (as well as at network) level (3:45)

How to reach agreement on purpose (4:29)

Data analysis and the gateway to collaboration and collaborative working (4:55)

What is the relationship between the network and its practices? (6:05)

PCN priorities: three main aims (7:11)

How setting network priorities can achieve local goals (8:29)

Defining PCN membership (9:30)

How do individual practices hurdle barriers to reciprocal working? (10:08)

“Strategy is measured by the speed of trust” and why talking matters (11:28)

Contractual requirements and where these fit with a holistic vision (12:38)

Introduction of new roles into new network models (13:29)

Management of time, capacity and funding; striking a balance (15:15)

Just say “no” (17:23)

Further information (19:35)

For Becky’s podcast and access to the resources she mentions, head to:

www.beckymalby.wordpress.com

www.source4networks.org.uk

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Dr Paul Bennett is back on the Ockham sofa for a second week to discuss his practice’s revolutionary new approach to home visiting. Borne partly from a a technical constraint, Paul describes how the project was started, who has been involved and how it has evolved into more than an atypical Skype consultation.

Welcome and introduction (0:40)

The constraints enabling change (0:58)

The role of nurses within the new model (2:45)

Keeping the technology simple (3:20)

The difference between moving to Skype consulting and a fully transformative approach (4:00)

GP consultations in the new world and the logistical setup (4:45)

A whole team approach (6:26)

The role of tech: challenges and benefits (7:07)

Crunching the numbers (8:22)

What has been the impact on the practice and its GPs? (9:47)

What’s stopped the rollout progressing further? (10:23)

Patient feedback and a case in point (10:38)

Could this work across a wider Primary Care Network? (12:25)

Paramedic involvement (13:30)

Virtual consulting with nursing homes? (14:19)

Just do it! (16:58)

Getting in touch (17:45)

The importance of sharing best practice and learning (18:19)

Paul is contactable at: paul.bennett5@nhs.net

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Joining Ben this week is Dr Paul Bennett, a GP Partner in Portchester, who describes the revolutionary new approach to managing the duty system within his practice; how it works, how the system has been implemented, the impact on managing demand and most importantly, the benefits felt by both staff and patients alike.

Show Notes

Welcome and introduction (0:38)

What triggered the changes? (0:57)

Could a triage system work? What was the appetite for change? (1:26)

Kick-off and implementation (2:34)

The role of the Healthcare Support Worker (3:10)

GP involvement and “stress-testing” the new system (4:30)

How is the new working day structured? (5:24)

Room setup and crunching the (patient) numbers (6:07)

What’s happening right now? The positive effects (7:25)

More decisions + more patients = reduced fatigue? (8:19)

Perceived drawbacks versus positive reality (9:46)

Impact, experiences & training for Healthcare Support Workers (11:14)

Patient feedback (12:30)

Where does they go from here? Plans for the future (14:23)

What does the rota look like? (15:05)

Could the system work at PCN level? (16:00)

Getting in touch (18:04)

The importance of shared experiences and learning (18:48)

Paul is contactable at: paul.bennett5@nhs.net