24
jul
0

Episode 73: Nav Chana – The Primary Care Home

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Dr Nav Chana is a GP and Chair of the National Association of Primary Care and, in this episode, he describes the Primary Care Home initiative from its origins and the drivers for its development, through its rapid growth to the impact being made on patient care and team morale. Nav outlines the four essential characteristics of a Primary Care Home and summarises the lessons learned so far.

Show Notes

The origins of the Primary Care Home (1min 19secs)

What drove the creation of the Primary Care Home? (2mins 19secs)

The growth of the model (3mins 37secs)

What is a Primary Care Home site? (4mins 31secs)

The elements of a Primary Care Home (5mins 07secs)

The four essential characteristics Number 1: Population health management (6mins 01secs)

What drives the enthusiasm of GPs to join? (6mins 47secs)

The four essential characteristics Number 2: Integrated systems (7mins 36secs)

The multi-professional “squad” (8mins 07secs)

Benefits to morale (8mins 57secs)

Finding the capacity to integrate (9mins 22secs)

Workload increased by poor communication (10mins 36secs)

Not just about scaling up (11mins 32secs)

Developing wider teams to support the Primary Care Home (11mins 54secs)

Does this require a single organisational “home” (13mins 12secs)

The four essential characteristics Number 3: Responsibility for the resources (14mins 02secs)

Taking on capitated budgets (15mins 27secs)

The four essential characteristics Number 4: Size (16mins 50secs)

The right population size; 30-50,000 (17mins 30secs)

The importance of engagement (18mins 46secs)

Access to data (19mins 14secs)

The impact of the model (20mins 12secs)

Finding out more (21mins 02secs)

More information from the NAPC on the Primary Care Home is available here

The three other episodes of the General Practice Podcast about the Primary Care Home are available here: Stewart Smith in Cornwall; Steve Kell in Notts and Jonathan Cope in Devon.

17
jul
0

Episode 72: Edwina Farrell – Leases – should you sign them?

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This week we have the second episode in our short season on GP premises. Ben is talking to Edwina
Farrell, a partner at Weightmans legal firm where she is a specialist in GP property and partnership
business matters. Our focus is on leases and landlords; why the current increase in lease disputes
and how to go about resolving them without necessarily taking legal action.

Show Notes

Why the rise in lease disputes? The birth of NHS Property Services (30 secs)

The different kinds of lease (1 mins 54 secs)

4,000 undocumented tenancies (2 mins 56 secs)

The inconsistent legacy of PCTs (3 mins 11 secs)

The source of disputes – confusion in the changeover (3 mins 47 secs)

Does rent reimbursement cover the service charge? (5 mins 55 secs)

What should a practice do if they have a problem? (6 mins 29 secs)

Approaching NHSPS (7 mins 56 secs)

Who is responsible for resolving the issues? (9 mins 39 secs)

Carefully analyse your historical position (11 mins 48 secs)

Involving the LMC (12 mins 26 secs)

Considering legal action (13 mins 30 secs)

Considerations prior to legal action (14 mins 06 secs)

The situation for those in LIFT buildings (15 mins 29 secs)

Can you do anything once you’ve signed your lease? (16 mins 50 secs)

Contacting Edwina (17 mins 37 secs)

Weightmans website is www.weightmans.com and Edwina’s email address is Edwina.farrell@weightmans.com

 

10
jul
0

Episode 71: Paul Conlan – Should GPs own premises? …and other questions

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This week we launch a short series for the summer on GP premises. In this first episode Ben is joined by surveyor Paul Conlan who has a wealth of experience in primary care and is Operations Director at GP Surveyors. Are GP premises still a good investment? What happens to the “last man standing”? What are leases? And should you challenge the District Valuer? These questions and more are answered by this illuminating discussion.

Show Notes

Why GPs might not want to own their own premises (53secs)

Building equity in premises (2mins 09secs)

GP premises – still a sound investment (3mins 03secs)

If you can afford it – buy in (3mins 49secs)

Succession – buying out the exiting partner (4mins 30secs)

Incoming and outgoing partners (5mins 33secs)

Leases – regulating the agreement (6mins 24secs)

Always have a lease in place (6mins 50secs)

Abiding by the partnership agreement (7mins 55secs)

Reviewing the partnership agreement – disputes over valuation (8mins 47secs)

Valuations – valuing different things – a real life example (9mins 34secs)

Thinking about sale and lease back (10mins 37secs)

Better to own premises? (12mins 29secs)

Operating at scale to spread risk and keep premises (15mins 21secs)

The Business vs the individuals in The Business (15mins 55secs)

The estate strategy of mergers (16mins 39secs)

Parity of partners in relation to the estate (18mins 04secs)

Challenging the District Valuer’s opinion (19mins 22secs)

The importance of the DV’s opinion (20mins 53secs)

Finding out more – the services offered by GP Surveyors (20mins 53secs)

GP Surveyors website is at www.gpsurveyors.co.uk

3
jul
0

Episode 70: Chris Ash – General practice in partnership with a community trust

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Two years ago we spoke to Chris Ash from Southern Health in Hampshire. Southern Health are a NHS Foundation Trust running community services and when we last spoke they were working with general practice in the county as a vanguard developing a Multi-Specialty Community Provider model. Two years on and nothing has quite proceeded as Chris predicted. In this fascinating episode Chris describes progress in the partnership – with all its highs and lows.

Show Notes

Two years since we last spoke to Chris he reflects on whether things have gone as he expected (1min 22secs)

The Willow Group – a partnership with four GP practices (2mins 35secs)

GPs are salaried and on a Southern Health contract (3mins 56secs)

Early days of the staffing model (4mins 43secs)

The same day access service explained (5mins 45secs)

Learning from introducing change across the county (7mins 27secs)

The opportunities for general practice and community trusts working together (8mins 14secs)

Do large institutions slow things down? (10mins 23secs)

Success dictated by presence of a local leader and the state of general practice (11mins 56secs)

An example of institutional processes getting in the way (12mins 43secs)

Making it work as flexible partners (13mins 48secs)

The Trust’s relationship with general practice and progress with the partnership (14mins 28secs)

The provider model is emerging differently than originally anticipated (16mins 07secs)

Decision to focus the Trust on mental health – and shed community services (18mins 19secs)

Clinician to clinician relationships drive the innovation (19mins 16secs)

Financial model and risk taking (21mins 12secs)

Will other practices join the model? (22mins 01secs)

The federations are working (22mins 59secs)

Advice for other areas (23mins 43secs)

In his introduction Ben mentions an event in central London focused on becoming a GP partner. This is aimed at GP trainees, salaried GPs or new GP partners and is being held on July 4th and more information can be found here.

26
jun
0

Episode 69: Helen Parker – General practice lessons from New Zealand – Part 2

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This week we return to Helen Parker and her fascinating insights into general practice half way round the world. Helen has, for the past four years, worked in New Zealand for the Pinnacle network of GP practices and this is the second part of an interview that we began in Episode 64. In this part Helen goes into more detail about the structured model of general practice they are introducing in New Zealand; how it is being implemented and what it means for patient and staff satisfaction.

Show Notes

Re-engineering the inside of general practice – the Healthcare Home model (1min 53secs)

Planning a model of best general practice (3mins 41secs)

Getting sign-up to the model (5mins 14secs)

Strengthening and preserving general practice (7mins 05secs)

Central resources from working at scale (8mins 05secs)

The new patient information system and the patient portal (8mins 41secs)

The call centre (9mins 36secs)

Getting involved in the business of the practices (11mins 08secs)

The “lean” programme for ensuring high quality general practice (11mins 56secs)

Supporting the implementation of the model into general practice (12mins 51secs)

Funding the support (14mins 27secs)

Financial incentives/disincentives (15mins)

Ensuring the changes happen – leadership (16mins 13secs)

The change team (17mins 21secs)

The outcomes of introducing the new model on patients and staff (18mins 05secs)

The wider impact (19mins 21secs)

The clarity of the process – lessons for the UK (20mins 46secs)

Further information available at www.Healthcarehome.co.nz (21mins 53secs)

If you are interested in either of the events Ben mentions in his introduction the details are as follows:

The webinar to find out more about the Collaboration in Primary Care programme is being held on 30th June at 12pm. Details of how to register and more info can be found at http://www.collaborationfunder.org/primarycollab

The event in central London about becoming a GP partner aimed at GP trainees, salaried GPs or new GP partners is being held on July 4th and more information can be found here.

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