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Episode 105: Amer Sheikh – redesigning musculo-skeletal services

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Amer Sheikh is the musculo-skeletal clinical lead for North West Surrey CCG and Surrey Heartlands STP. He also runs a musculo-skeletal and chronic pain course for Red Whale (of GP-Update fame). In this podcast he describes how, in North West Surrey, they were able to introduce a new model of musculo-skeletal care by putting more resources into the start of the patient journey and so reduce delays and the need for surgery.

Show Notes

Amer’s involvement in musculo-skeletal care (50secs)

The big challenge of musculo-skeletal care – the Right Care data gives Surrey pause for thought (1min 46secs)

Sharing the data with the local Acute Trust who challenge the data (2min 35secs)

Chances of surgery were high but outcomes were marginal (3mins 31secs)

Resistance to change (4mins 24secs)

Going to procurement delivers confrontation (4mins 52secs)

Acknowledging there was a better clinical model (5mins 23secs)

The service is threatened, or is it? (6mins 29secs)

Protecting the trauma service (7mins 02secs)

Developing a new model collaboratively (7mins 18secs)

The new model – a common point of entry and paper triage by an inter-disciplinary team (8mins 26secs)

Reducing the length of the process (9mins 12secs)

Forestalling chronic pain (10mins 03secs)

An unacceptable year-long process causes physical and psychological changes (11mins 02secs)

More resource up front pays dividends down the line (11mins 41secs)

Straining the Trust’s finances (13mins 05secs)

Can this change be achieved through an integrated care model? (14mins 19secs)

Further developing the model (15mins 20secs)

Advice for other areas thinking of changing their model (16mins 32secs)

Finding out more and contacting Amer (17mins 25secs)

Musculo-skeletal and chronic pain training course for GPs (17mins 48secs)

E-mail Amer: Amer.sheikh@nhs.net

The NHS England report on this work is available here

Details of the MSK course with Red Whale are available here

26
mar
0

Episode 104: How technology is shaping the future of general practice – Part Two

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We follow up Episode 102 with the second part of our panel discussion on technology. Five nationally renowned practitioners with an interest in new technology look at how technology is shaping the future of general practice. In this final part of the discussion they focus their discussions on virtual and augmented reality, some of the ethical issues and how practices should be preparing now for the digital future.

Joining Ben Gowland on the panel are (in order of appearance):

Atul Kumar-Beurg – for three days a week Atul works for eConsult WebGP (an online consultation platform providing on-line triage for general practice) and spends two days a week doing clinical work. We spoke to Mark Harmon from eConsult in Episode 83 of the General Practice Podcast. https://econsult.net/

Maneesh Juneja – Maneesh is a digital health futurist exploring emerging technologies in healthcare. We spoke to Maneesh in Episode 10 of the General Practice Podcast. www.maneeshjuneja.com

Keith Grimes – a GP, Digital Health consultant and founder of VR Doctors (a Facebook group). As a clinical GP Keith works two days a week at a walk-in centre, one day a week in a visiting service caring for more complex patients and the rest of the time as The VR Doctor looking at immersive technology in healthcare. http://www.drgrimes.co.uk/

Jim Forrer – Jim is an Exmouth GP who leads a programme within his federation (as part of NHS England’s Estates and Technology Fund) looking to introduce more technology into general practice. We spoke to Jim in Episode 74 of the General Practice Podcast. jimforrer@nhs.net

Sandeep Kapur – a GP who works part-time in the NHS and also as Chief Medical Officer for Qured, a private medical organisation, helping to develop their home visiting service in London. We spoke to Sandeep in Episode 96 of the General Practice Podcast. sandeep@qured.com

Show Notes

Will virtual reality and augmented reality impact on general practice? (1min 19secs)

Keith responds – five possible uses (1min 32secs)

Jim’s perspective (4min 04secs)

How far away are prescriptions for virtual reality? (5mins 33secs)

Keith responds (5mins 41secs)

Atul responds – assistance in consultations (7mins 20secs)

Jim responds – the use of YouTube in consultations (9mins 45secs)

Keith continues – Google glass and beyond in augmented reality (11mins 43secs)

Sandeep responds – Virtual reality as a GP education tool (13mins 39secs)

What have we missed that might impact on the future? (14mins 45secs)

Atul responds – sensitive information – who owns it? (15mins 04secs)

What should practices be doing now to get ready? (16mins 47secs)

Atul responds – getting use to the idea of shared responsibility (16mins 56secs)

Jim responds – the power of shared digital communities (17mins 45secs)

Jim continues – a digital space to enhance general practice (18mins 31secs)

Jim continues – getting ready for the future (20mins 05secs)

Keith responds – artificial intelligence – augmenting clinical and patient intelligence – genomics (21mins 29secs)

Keith continues – driving a greater skill mix (22mins 45secs)

Keith continues – get competent in popular media platforms (23mins 24secs)

Maneesh responds – maintaining and growing trust in the new era (23mins 34secs)

Maneesh continues – maintaining humanity (25mins 45secs)

Sandeep responds – the four steps to adopting new technology (27mins 09secs)

Future panel discussions (28mins 25secs)

19
mar
0

Episode 103: William Bird – Physical activity as a route to greater wellbeing

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William Bird is a GP from Reading and is the CEO and founder of Intelligent Health (“…dedicated to increasing physical activity and improving the health of communities around the world”). In this podcast he explains to Ben how his career has been focussed on encouraging physical activity as a means of improving health and happiness. He talks Ben through a number of schemes including Health Walks, the Green Gym and Beat the Street. He finishes by eloquently summarising how he believes we could, as a race of hunter-gatherers, shift the focus from illness to wellbeing.

Show Notes

William has his own Wikipedia entry (54secs)

William becomes a GP as the result of a tragedy (1min 15secs)

The beginning of his interest in wellness (1min 57secs)

Health walks (2mins 36secs)

The origin and development of health walks (2mins 59secs)

Volunteers lead the walks (4mins 37secs)

The walks go national (5mins 10secs)

The ideal community size (5mins 48secs)

Setting up the Green Gym (6mins 58secs)

Combining conservation work with wellbeing (8mins 18secs)

The roll of Intelligent Health (9mins 26secs)

Beat the Street (10mins 03secs)

Points mean prizes (and wellbeing) (11mins 03secs)

Successful increases in activity (11mins 58secs)

Coverage of Beat the Street (12mins 56secs)

The process of establishing a Beat the Street game (13mins 54secs)

Funding the games (15mins 06secs)

Making the shift to wellness – wrong to solely focus on the frequent flyers (16mins 21secs)

Early diagnosis is more important (18mins)

William plugs his book! The Oxford Textbook of Nature and Public Health (18mins 23secs)

A summary of where we should be going… avoiding stress becoming ill health (18mins 50secs)

Impulsive behaviour of hunter-gatherers (19mins 58secs)

The social determinants (20mins 38secs)

The big three causes of disease (21mins 35secs)

Focussing much earlier on wellbeing (22mins 28secs)

Finding out more (23mins 02secs)

The Intelligent Health website is www.intelligenthealth.co.uk

Contact William: William.bird@intelligenthealth.co.uk

William’s Book is available on Amazon here

12
mar
0

Episode 102: How technology is shaping the future of general practice – an expert panel discussion

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In this, the first in a series of expert panel discussions, five nationally renowned practitioners with an interest in new technology look at how technology is shaping the future of general practice. In Part One of the discussion the panel considers virtual consultations and the impact of digital technologies. Part Two will follow in a few weeks.

Joining Ben Gowland on the panel are (in order of appearance):

Atul Kumar-Beurg – for three days a week Atul works for eConsult WebGP (an online consultation platform providing on-line triage for general practice) and spends two days a week doing clinical work. We spoke to Atul’s colleague Mark Harmon from eConsult in Episode 83 of the General Practice Podcast. https://econsult.net/

Maneesh Juneja – Maneesh is a digital health futurist exploring emerging technologies in healthcare. We spoke to Maneesh in Episode 10 of the General Practice Podcast. www.maneeshjuneja.com

Keith Grimes – a GP, Digital Health consultant and founder of VR Doctors (a Facebook group). As a clinical GP Keith works two days a week at a walk-in centre, one day a week in a visiting service caring for more complex patients and the rest of the time as The VR Doctor looking at immersive technology in healthcare. http://www.drgrimes.co.uk/

Jim Forrer – Jim is an Exmouth GP who leads a programme within his federation (as part of NHS England’s Estates and Technology Fund) looking to introduce more technology into general practice. We spoke to Jim in Episode 74 of the General Practice Podcast. jimforrer@nhs.net

Sandeep Kapur – a GP who works part-time in the NHS and also as Chief Medical Officer for Qured, a private medical organisation, helping to develop their home visiting service in London. We spoke to Sandeep in Episode 96 of the General Practice Podcast. sandeep@qured.com

Show Notes

Are the days of face-to-face consultations over? (1min 54secs)

Atul responds (2min 16secs)

What’s the impact on workload? (3min 41secs)

Maneesh responds (3mins 50secs)

What about the lack of evidence? (4mins 41secs)

Keith responds (5mins 04secs)

Will it just add to workload? (6mins 28secs)

Jim responds (6mins 35secs)

Could patient demand for new interventions reshape general practice if GPs don’t offer them? (7mins 51secs)

Atul responds (8mins 39secs)

Online consultations to manage chronic disease (10mins 43secs)

Keith responds (10mins 56secs)

Sandeep responds (13mins 33secs)

Will virtual appointments adversely impact on the relationship with patients? (14mins 41secs)

Jim responds (14mins 50secs)

Where will a patient go if there is poor access and virtual consultations aren’t offered? (16mins 12secs)

Maneesh responds (16mins 22secs)

Moving on to digital technology – what are the opportunities (18mins 12secs)

Keith responds (18mins 36secs)

Could new technology change the power dynamic between patient and doctor? (20mins 15secs)

Maneesh responds (20mins 26secs)

Shift to wellness (22mins 48secs)

Sandeep suggests the physician will always retain a degree of power (23mins 09secs)

Jim suggests the aim should be to shift the power to the patient (24mins 10secs)

Keith doesn’t a healthcare professional will always be necessary (26mins 04secs)

What kind of technology is now available to GPs? (27mins 37secs)

Sandeep responds with an example (28mins 03secs)

Jim continues with further examples (28mins 51secs)

Keith continues with an example of a portable ECG (30mins 41secs)

What’s likely to be the impact of these technologies? (32mins 49secs)

Keith responds (33mins 14secs)

Atul responds – the GP record (34mins 23secs)

Who owns the records? (37mins 14secs)

Maneesh responds (37 mins 28secs)

Who owns the records? (37mins 14secs)

Maneesh responds (37 mins 28secs)

What might this mean for the role of the GP? (39mins 32secs)

Jim responds (39mins 37secs)

Part Two, which will follow in a few weeks, will include discussion around virtual and augmented reality, artificial intelligence and the power of digital communities. If you’d like to be alerted when we publish Part Two and indeed to be told about all of our new episodes and our general practice blog, then why not sign up to our weekly newsletter here.

5
mar
0

Episode 101: Surina Chibber – perspectives of a millennial GP

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Although she has been a GP for less than four years, Surina Chibber has developed an enviable portfolio career including the formation of a successful business: My Locum Manager. In this episode she describes how she developed her business and what it does. She also gives her perspectives on what new GPs are looking for, on how the general practice model might need to change to meet these needs and what she would like to see from general practice in five years’ time.

Show Notes

One of the country’s “rising stars” (46secs)

Surina’s story begins – aiming for a varied career – businesswoman, educator, writer (1min 08secs)

Rationale for her portfolio career (2min 39secs)

Chasing the ideal rather than running away (3mins 51secs)

Setting up My Locum Manager – practical experience of being a locum (4mins 59secs)

Keeping a book of challenges (6mins 17secs)

A call from the accountant sparks an idea (6mins 53secs)

Who uses My Locum Manager? (7mins 52secs)

Surprises about the users (8mins 27secs)

A growth in the use of the site (9mins 43secs)

What do new GPs want? (11mins 06secs)

Changing mind-set of new GPs (12mins 16secs)

How will the practice model have to change? (13mins 12secs)

The existing structure can work well (14mins 26secs)

Aspirations for general practice in five years’ time (15mins 27secs)

Finding out more (16mins 59secs)

The resources Surina mentions can be found here

Their Facebook page can be found here

And Surina is on Twitter @dr_surina

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