30
jan
1

Episode 48: Mia Skelly – The truth about general practice nursing

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As well as being a practice nurse in south London, Mia Skelly has a Darzi Fellowship and is part of a project to boost the numbers of nurses choosing general practice nursing. In this podcast she strongly advocates for general practice nursing as a career, overturning some of the myths about the profession along the way and suggests some ways of how the crisis in GPN recruitment and retention might be overcome.

Show Notes

Mia “falls into” Practice Nursing (44secs)

Mia takes the plunge with little or no experience in primary care (1min 39secs)

The challenges of moving from hospital to practice nursing – and the benefits (2min 01secs)

General Practice Nursing is a specialism in itself (2mins 58secs)

Developing a new range of skills (4mins 18secs)

GPNs find it a challenge to access training and development – but it is getting better (5mins 05secs)

“Distracted by the opportunities…” and boosting GPN numbers (6mins 31secs)

Recruitment and retention difficulties – student nurse placements in primary care (7mins 40secs)

The truth about General Practice Nursing (9mins 21secs)

Not enough nurse training practices (9mins 55secs)

Encouraging practice nurse tutors and mentors (10mins 32secs)

Advice for practices reluctant to receive student nurses (11mins 09secs)

Potential for a portfolio career and supporting nurses in their professional interests (13mins)

A career structure for GPNs – a career framework (see below) (14mins 10secs)

Practices working at scale and in new models of care creates greater opportunities for nurses (14mins 59secs)

Practice Nursing and District Nursing (16mins 12secs)

The introduction of new roles into general practice (17mins 22secs)

The crisis in practice nursing – what can be done? (18mins 03secs)

You can follow Mia on Twitter @miaskelly

The education and career framework Mia refers to in this podcast can be found here

23
jan
0

Episode 47: Zalan Alam – Integration working in practice

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Dr Zal Alam is a Director & Intermediate Tier Lead for GP Care Services in Rochdale. The GP provider organisation has been instrumental in developing a care collaborative (with acute care, the local authority, the out-of-hours service and third party partners) that has established an Intermediate Care Service in Heywood, Middleton and Rochdale. In this podcast Zal tells Ben that the scheme demonstrates how integration can work in practice, how clinical leadership drives the collaboration and the impact of the scheme in reducing admissions.

Show Notes

The new Intermediate Care Service in Rochdale – managing patients in the community (49secs)

GP Care Services – provider arm (2min 05secs)

GPs leading the model (2min 32secs)

How does the model work? (3mins 07secs)

The team (3mins 48secs)

Assessment at home (4mins 01secs)

Alternative to acute admission (4mins 36secs)

Community beds for the collaborative (5mins 04secs)

Not just for the frail and elderly and strong clinical leadership (5mins 34secs)

How does the clinical leadership work? (6mins 28secs)

GPs with background in acute medicine and A&E (7mins 16secs)

Recruiting separate GPs (7mins 55secs)

8.7% reduction in all admissions (8mins 32secs)

Great example of collaboration – the Future is Rochdale! (9mins 20secs)

The impact on local GPs (10mins 08secs)

From dementia to falls to over-medicalisation… (10mins 55secs)

The impact on home visits (11mins 56secs)

Attracting GPs to Rochdale (13mins 05secs)

The collaborative and long term plans for the Manchester area (14mins 07secs)

If you do it well – it makes work easier (15mins 17secs)

A dedicated team makes it more likely to succeed (16mins 06secs)

Finding out more (17mins 18secs)

GP Care Services website can be found here

And they can be contacted via email: gpcare.services@nhs.net

 

16
jan
0

Episode 46: Jonathan Serjeant – Workflow optimisation. Or how to save an hour a day…

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Jonathan Serjeant is a GP and founder of an organisation called Here based in Brighton whose aim is to “…help people to live well”. Here have developed a system of workflow optimisation for GP practices which is “…a system by which practice administration staff are trained, and supported to read, code, and action incoming clinical correspondence safely and accurately” In this podcast Jonathan tells Ben everything you need to know about the system and it’s phenomenal impact on GP administrative time.

Show Notes

What is Here? (1min 22secs)

Here is a collective who want to make a difference (2min 38secs)

Developing workflow optimisation (3min 47secs)

Non-clinicians learning to Reed code (5mins 28secs)

A system of assurance (6mins 32secs)

75%-80% letters closed-off by administration staff (7mins 20secs)

The more complicated letters (8mins 44secs)

Identifying new diagnoses, picking up metrics, focusing on prescribing… (9mins 08secs)

Booking follow-ups, booking blood tests, contacting patients… (10mins 03secs)

Saving GP time…40 mins per GP per day (11mins 11secs)

What dictates the amount of time saved? (12mins 10secs)

Making the change sustainable – governance and leadership (14mins 27secs)

Developing the “right” administrator (17mins)

Skills, templates and supporting manual (18mins 56secs)

Safeguards against things getting missed (19mins 42secs)

The cost impact on practices (21mins 18secs)

The programmes in the GPFV and £45m commitment from NHS England (23mins 35secs)

Money via the CCG (24mins 48secs)

Finding out more (25mins 16secs)

Better delivered at network or federation level (25mins 56secs)

Here want to develop a network of change agents and systems with similar impact (27mins 03secs)

Here’s website: www.hereweare.org.uk

The Workflow Optimisation website: www.workflowoptimisation.co.uk

Further information via e-mail info@hereweare.org.uk

9
jan
0

Episode 45: Jon Griffiths – Promoting general practice

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Jon Griffiths is the GP Chair of Vale Royal CCG in Cheshire and the presenter of a recent TEDx talk on why he chose generalism over a specialist medical career. In this podcast he explains to Ben his passion for being a generalist and how he developed the talk. He also talks about the reaction to his views on this and other subjects from fellow clinicians and others.

Show Notes

How did the TEDx talk come about? (1min 11secs)

The audition process (2min 05secs)

Acceptance by TED (2min 30secs)

Detailed preparation – learning in full (2mins 59secs)

Practice makes perfect (4mins 31secs)

The whole process takes six months (5mins 28secs)

Is specialisation the cause of some patients’ problems? (6mins 45secs)

Do we give a higher status to specialists? (7mins 51secs)

Specialisation creates a clearer career destination (9mins 33secs)

Celebrating general practice (11mins)

The impact of working at scale on generalism (12mins 05secs)

GPs are good at collaboration (13mins 15secs)

Reaction from around the world to the talk (13mins 53secs)

Reaction from local GPs (15mins 22secs)

Speaking out honestly – leads to nervous reaction from the CCG (15mins 58secs)

Jon starts his own website to allow some independence from the CCG (17mins)

Negative reaction to Jon’s blogs (18mins 21secs)

Jon’s honesty can set the tone and advocate for general practice (18mins 21secs)

If you’d like to watch Jon’s TEDx talk you can find it on YouTube here https://www.youtube.com/watch?v=-BfcvI49GCw

Jon’s Blog can be found on his own website here https://drjongriffiths.wordpress.com/

19
dec
0

Episode 44: Penny Pereira – Whole System Flow

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The Health Foundation (an independent charity aiming to improve healthcare) has recently published a report entitled “The Challenge and Potential of Whole System Flow” which is about the coordination of all systems and resources, across a health and social care economy. This week Ben talks to Penny Pereira, one of the report’s authors, about why flow is important and, particularly, why it is relevant to general practice.

Show Notes

Whole system flow described (57secs)

Why is whole system flow important (1min 11secs)

The role of general practice in whole system flow (1min 46secs)

“Failure demand” – demand created by not meeting the needs of patients (2mins 35secs)

Flow at a practice level (3mins 34secs)

Delivering change, scale and expertise (4mins 43secs)

GPs delivering change – scale shouldn’t be a barrier (6mins 17secs)

Freedom in general practice (7mins 32secs)

The challenge of GPs working with acute hospitals – good examples from Sheffield (7mins 52secs)

Collaboration between organisations to improve flow (10mins 16secs)

Relationships and processes are key (11mins 32secs)

Focus on individuals collaborating, not big organisations; the concept of “Big Room” (12mins 32secs)

Finding out more about “Big Room” (14mins 36secs)

Resources available to support change (14mins 56secs)

Finding the report (15mins 26secs)

The Health Foundation website is at www.health.org.uk and the whole report is on that site here

 

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