6
mar
0

Episode 53: Sarah Deeny – hospital admissions and continuity of care

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Sarah Deeny is one of the authors of a briefing by the Health Foundation called “Reducing hospital admissions by improving continuity of care in general practice”. In this podcast she tells Ben about how the research was conducted, what it reveals about continuity of care in general practice and what it means for patients and practices.

Show Notes

How did the research come about? (1min 01secs)

Higher continuity of care leads to fewer hospital admissions (2min 06secs)

Measuring continuity of care (2min 38secs)

Explaining the link (3mins 10secs)

Is continuity of care necessary for everyone? (3mins 49secs)

Identifying the cohort (4mins 15secs)

The impact of the Accountable GP (4mins 38secs)

Why did the policy not have an affect (5mins 12secs)

Continuity getting worse because of recruitment crisis (6mins)

Practice size and its impact on continuity (7mins 05secs)

Other clinical roles and continuity (7mins 55secs)

Focussing on the cohort for whom continuity matters (8mins 49secs)

Elderly patients with complex needs and other cohorts of patients (10mins 38secs)

Continuity against access (12mins 05secs)

Continuity reduced by increased access (12mins 58secs)

Practices improving continuity of care (13mins 24secs)

Practices measuring their own continuity (14mins 16secs)

Change at a commissioner level (15mins 23secs)

National policy (16mins)

Finding the briefing paper (16mins 24secs)

You can find the briefing paper here on the Health Foundation website

27
feb
1

Episode 52: Joanna Munden – a GP advocate for physician associates

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Joanna Munden is a GP Partner at a practice in Wallington, Surrey. In this, the final episode of our short series on Physician Associates, Joanna outlines why her practice chose to train and appoint a PA, the value that the PA role brings to her practice and offers advice to other practices thinking of doing the same.

Show Notes

Joanna explains the reasons for appointing a PA (1min 05secs)

The choice to appoint a PA (2min 18secs)

A training practice for PAs (3min 19secs)

How the training works (3mins 48secs)

Not necessary to be a trainer to employ a PA (4mins 24secs)

PAs – a valuable aid (5mins 07secs)

What can a PA do and not do? (5mins 25secs)

Trusting the PA (6mins 33secs)

Perspectives of the role (6mins 57secs)

Overcoming patient concerns (7mins 37secs)

An evolving role (7mins 59secs)

Part of the telephone triage rota (8mins 39secs)

Learning needs assessment and building the role (9mins 06secs)

Continuing support for the role (9mins 56secs)

Supervision and mentoring (11mins 11secs)

The impact of the role (11mins 41secs)

Does size matter? (12mins 21secs)

Skill mix for the future (12mins 40secs)

Recruiting PAs into general practice (13mins 23secs)

The right time to recruit (14mins 18secs)

Lessons learnt – getting the right person and creating the right role (14mins 46secs)

The value a PA brings (15mins 55secs)

Overcoming GP resistance – a missed opportunity (17mins)

The previous two episodes on PAs can be found below:

Episode 40 – Ben talks to two PAs about their experience

Episode 43 – Ben talks to Jeannie Watkins about the national picture

20
feb
0

Episode 51: Three Lead Nurses in Lambeth – recruiting and retaining practice nurses

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Louise Ashwood, Anne Macrae and Paula Marsden are practice nurses who are also part-time lead nurses for NHS Lambeth CCG. They have been part of a programme in the Borough to increase the recruitment and retention of practice nurses, expanding the number of practices who offer placements and increasing the number of nurse mentors. They explain to Ben how this works in practice and the impact their efforts have had. They look to the future of general practice nursing and offer advice for other areas.

Show Notes

The nurses introduce themselves (48secs)

The recruitment and retention challenge for practice nurses (1min 18secs)

Addressing the challenges (2min 22secs)

Allocating a lead nurse to each locality (2mins 51secs)

Allocating a lead nurse to a specialist interest (3mins 20secs)

A few hours each for the CCG (4mins 06secs)

Increasing the number of practices who take student nurses (4mins 41secs)

Spreading the enthusiasm – and remuneration (5mins 11secs)

Encouraging mentorship (5mins 51secs)

Mentors gaining confidence (6mins 40secs)

The impact of having more students (7mins 36secs)

Supporting new practice nurses (8mins 10secs)

No problem in releasing nurses to train (8mins 35secs)

Funding from the Community Education Provider Network (9mins 34secs)

A programme of skills training (10mins 19secs)

The role of practice nurses in the borough (10mins 51secs)

Supporting the quality of practice nursing (11mins 41secs)

Healthcare Assistants – an untapped resource (12mins 50secs)

Fulfilling nurses’ potential (14mins 33secs)

The future of general practice nursing (15mins 26secs)

New clinical roles and their impact on nursing (17mins 05secs)

The team approach (18mins 08secs)

The lessons and advice for others (18mins 39secs)

 

 

13
feb
0

Episode 50: Rachel Tyler – A “hot” and “cold” split

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Rachel Tyler is a GP at Ocean Healthcare in Plymouth. Faced with their own GP recruitment crisis Rachel’s practice decided to merge and, at the same time, drastically alter the way they provided care to their patients; by splitting general practice into acute and chronic on different sites. In this podcast Rachel tells Ben how this worked in practice, how it impacted on GPs and about the introduction of new roles to support general practice.

Show Notes

Rachel describes the spiralling GP recruitment problems (1min 07secs)

The crisis comes to a head, despite their best efforts (2min 24secs)

Considering the decision to merge (3min 06secs)

Merging on its own may not be enough (4mins 13secs)

Merging plus radical change; the hot and cold split (5mins 04secs)

The split helps recruitment by making the workload more attractive (6mins 12secs)

The practicalities of the split and the introduction of new roles (6mins 57secs)

How the GPs work (8mins 30secs)

The skills of the nurse practitioners (9mins 32secs)

The skills and roles of the paramedics (10mins 12secs)

Training on the job – triage and support (11mins 10secs)

Introducing pharmacists and a pharmacy technician (12mins 02secs)

Pharmacists working across the hot and cold divide (13mins 03secs)

The impact on GP workload and stress levels (15mins 09secs)

Looking at admin pressures (15mins 58secs)

Innovative technology (16mins 25secs)

Patient and staff reaction (17mins 11secs)

Patient reaction to the non-GP roles (18mins 29secs)

The costs of the change (19mins 24secs)

One cost of the merger was on GP time… (20mins 31secs)

…and time to reassure staff (21mins 14secs)

The advisability of simultaneous merger and major change (21mins 32secs)

6
feb
0

Episode 49: Robert McCartney – Making practice mergers work

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Robert McCartney is Managing Director of McCartney Healthcare Associates Ltd and an expert on what it takes to make practice mergers work. A solicitor by background Robert has been involved in a large number of successful mergers and, in this podcast, he explores with Ben the challenges, benefits and costs of two practices merging and looks at the enhanced governance requirements of merged practices.

Show Notes

Robert moves from being a solicitor into the NHS (36secs)

Robert becomes an independent advisor on commercial issues to GP practices (1min 25secs)

He develops a broad focus to support practices in mergers (1min 48secs)

The key considerations if a practice is looking to merge (2mins 49secs)

The benefits of operating at scale depends on change (3mins 43secs)

Why merge? What will be different? (4mins 41secs)

The benefits of being bigger (5mins 21secs)

The introduction of new roles (5mins 51secs)

Reducing the risks of mergers failing (6mins 44secs)

Tackling cultural differences head-on (7mins 41secs)

The costs of two practices merging (8mins 36secs)

External support or using your practice manager (10mins 24secs)

The hidden cost of time for partners and practice managers (10mins 43secs)

Wider mergers (12mins 23secs)

Culture clashes across a number of practices (13mins 47secs)

Full merger or closer collaboration? (14mins 38secs)

Tiers of partnership (17mins 47secs)

You can contact Robert via e-mail at rm@mccartneyhealth.co.uk

Or call him on 0203 287 9336.

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