5
jun
0

Episode 66: Tracey Vell – Progress with integration in Manchester

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Last August we spoke to Tracey Vell, Manchester GP and LMC Lead about the integration of services in Manchester as they piloted the draft contract for Multi-speciality Community Providers. Nine months on Ben catches up with Tracey to talk about their continuing progress; about the philosophy and the model they are adopting, about the impact felt by individual practices and about some of the key lessons they are learning.

Show Notes

What’s happened in the last nine months since the previous podcast? (2min 11secs)

The Local Care Organisations in Manchester (3min 03secs)

Each LCO is around 250,000 patients (4mins)

Manchester is out to procurement – how? (4mins 25secs)

How did you achieve the level of sign-up (5mins 45secs)

Enhanced services ring-fenced within the LCO – a hub based structure (6mins 51secs)

What to do with QOF? (8mins 01secs)

Mechanisms for gain-share? (8mins 50secs)

The High Impact Centre – managing intensive patients (10mins 17secs)

The difficulties of procurement (11mins 18secs)

The impact on individual practices (11mins 50secs)

Successful bid for £42m for general practice (12mins 47secs)

Everything is aligned through one strategy (13mins 37secs)

The confidence of the practices (15mins 19secs)

Resilience in the long term (16mins 10secs)

Getting 90 practices to sign up – the key drivers (17mins 01secs)

Engaging with the practices (18mins 47secs)

The role of the federations (20mins 36secs)

The ownership of the MCP – avoiding provider control (22mins 36secs)

Do integrated care organisations provide a secure future? (24mins 43secs)

The radical difference that drives integration: population based outcomes rather than service specifications (25mins 48secs)

Getting more information (27mins 03secs)

The resources that Tracey describes are available here http://www.gmhsc.org.uk/

Remember – if you want to take part in the live event on becoming a GP partner on July 4th between 7pm and 8.30pm contact Ben ben@ockham.healthcare

30
may
0

Episode 65: Dillon Sykes – Predicting demand with “Doctor First”

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Dillon Sykes is the Managing Director of Productive Primary Care Ltd, a GP-led consultancy most famous for its Doctor First product. Doctor First is a demand-led appointment system where clinicians talk to all patients before the decision to offer an appointment is made. In this podcast Dillon tells Ben how the system works, the practices for whom it might work best and the ways in which it can be adapted.

Show Notes
Dillon describes the formation of Productive Primary Care Ltd (1min 11secs)
Predicting demand through Doctor First (1min 41secs)
A telephone call with the patient to make the decision (2mins 20secs)
Doesn’t this system increase the overall workload? (3mins 02secs)
The system allows GPs to build their own day (3mins 51secs)
How is demand predicted? (4mins 17secs)
Demand is predictable but organising supply is hard (4mins 47secs)
Does the size of the practice make a difference to its success? (5mins 59secs)
Does it have to be GP-led? (6mins 28secs)
Variances between GPs and nurse practitioners (6mins 46secs)
GP reaction to the system (7mins 21secs)
Does the model help with the crisis in GP recruitment? (7mins 51secs)
What is the reaction of patients? (8mins 29secs)
The role of receptionists (9mins 16secs)
Can a hybrid model exist (10mins 02secs)
Working this system with a hot/cold split (10mins 59secs)
Making the system work – conversion rates (12mins 06secs)
Improving conversion rates (13mins 27secs)
Is telephone based system the future? What about web based systems? (13mins 58secs)
The journey of one practice in implementing Doctor First (14mins 57secs)
Other resources (15mins 52secs)
Contacting Dillon (16mins 41secs)
You can access the Doctor First Case Studies here
Dillon’s email address is Dillon.sykes@productiveprimarycare.co.uk
The Blog that Ben and Dillon refer to can be found at https://hcwetherell.wordpress.com/
22
may
0

Episode 64: Helen Parker – General practice lessons from New Zealand – Part 1

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Could the way general practice operates on the other side of the world teach us anything about general practice in Britain? In this podcast (the first in a pair) Ben talks to Helen Parker who was an experienced nurse, manager and academic in England but who has, for the past four years, worked in New Zealand for the Pinnacle network of GP practices. In this podcast Helen discusses how the non-statutory nature of the network influences the way it works, how co-payments in NZ operate and what of this, if anything, might work in the UK.

Show Notes

Helen describes how her career in the NHS led to her move to New Zealand (50secs)

The key differences (and similarities) between general practice in the UK and NZ (2min 25secs)

Could co-payments work in this country? (3mins 32secs)

The impact that co-payments have on patients and practices (4mins 25secs)

The negatives of co-payment (4mins 55secs)

Co-payment makes it difficult to introduce new ways of working (5mins 26secs)

Networks – non-statutory Primary Health Organisations (6mins 41secs)

Merging the functions of the CQC, the support of a federation and part of the commissioning role of the CCG (8mins 02secs)

Governance and conflict of interests (9mins 45secs)

The networks assure quality (11mins 30secs)

The benefits to a practice of being in a network (12mins 39secs)

The size of a network (14mins)

Could the non-statutory network model work in the UK? (14mins 53secs)

Organisational structure should not be the focus (16mins 21secs)

Inviting Helen for Part Two… (17mins 57secs)

15
may
0

Episode 63: Nish Manek – General practice through the eyes of a GP trainee

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Nish Manek is a GP trainee. She is also, for this year, on the prestigious National Medical Director’s Clinical Fellow scheme – which is designed to fast track doctors in training “…who present with the clearest potential to develop as medical leaders of the future”. In this role she is spending 12 months working alongside Dr Arvind Madan, NHS England’s Director of Primary Care. In this podcast Nish eloquently and enthusiastically advocates for general practice as a career and outlines her hopes and expectations for the future. She explains the benefits of being on the Clinical Fellow scheme and talks about Next Generation GP, the programme she has co-developed for aspiring leaders in general practice.

Show Notes

What is the Medical Director’s Clinical Fellow Scheme? (54secs)

Working alongside Arvind Madan and Sir Bruce Keogh (1min 48secs)

National decision making is more complex than expected (2mins 41secs)

Experiencing the new models of care (4mins 11secs)

Choosing general practice – “…feels like real medicine” (4mins 40secs)

The crisis in general practice – “…pain in the system” (5mins 56secs)

Expectations of a career in general practice (6mins 39secs)

Training to become a GP partner (7mins 27secs)

Concerns for the future of general practice (8mins 06secs)

What does the future of general practice look like? (9mins 25secs)

Will the partnership model exist in the future? (10mins 24secs)

An attractive career in the future? (10mins 52secs)

Freedom to innovate and influence may wain (11mins 49secs)

Is general practice still an attractive career option? (12mins 23secs)

Let’s be positive about general practice (13mins 13secs)

All doctors in training should do a GP placement (13mins 37secs)

A four year training programme? (14mins 22secs)

Next Generation GP – a programme for aspiring leaders in general practice (14mins 52secs)

Watch this space for the future of the programme (16mins 35secs)

Follow Nish on Twitter @nishmanek or, @nextggp for information about the Next Generation GP programme

8
may
0

Episode 62: Nick Sharples – Active Signposting – non-medical telephone triage

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Implementing active signposting into a practice can divert up to 25% of GP appointments away from GPs and on to other appropriate health services. This is the claim made by Nick Sharples of DNA Insight, the company that runs the “Reception Plus” training programme for care navigators. In this podcast Nick explains how active signposting works and how it can be implemented into a practice. He also touches on reducing DNAs, another strand of his company’s work.

Show Notes

What is active signposting? (54secs)

25% of GP appointments are “avoidable” (1min 25secs)

What appointments are avoidable? (1mins 46secs)

Alternatives to GP appointments (2mins 29secs)

Developing a directory of alternative services (3mins 04secs)

The most frequently used alternatives (4mins 02secs)

Will patients share personal information? (4mins 55secs)

GP receptionists are not bound by an ethical code (6mins 20secs)

Close to quarter of all GP appointments could be diverted (7mins 11secs)

Is this achievable? (8mins 08secs)

What does a practice need to make signposting a success? (9mins)

Leadership in the practice (9mins 53secs)

Training for receptionists (10mins 26secs)

Follow-up support (11mins 39secs)

Patient records and data analysis (12mins 35secs)

Advice for practices who want to implement active signposting (13mins 31secs)

Accessing the funding for training (14mins 13secs)

DNA Insight’s role (15mins 22secs)

Contacting DNA Insight (15mins 57secs)

What practices can do to reduce DNA rates (16mins 22secs)

One simple trick to cut DNAs by 15% (18mins 14secs)

The website is www.dnainsight.co.uk

The Freephone number Nick mentions is: 0800 978 8323

Email: info@dnainsight.co.uk

Twitter: @dnainsight

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