26
sep
0

Episode 33: Operating at Scale

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This is the second in a short series of podcasts looking at the highest impact changes practices can make to help them manage the current crises in general practice and prepare for the future. In this episode Ben Gowland talks about operating at scale; what is it? What are the benefits? And, practically, how can you do it?

Ben’s analysis is based in part on the various case studies that Ockham Healthcare has developed from across the country. This podcast links in to our new book “The Future of General Practice: Real Life Case Studies of Innovation and New Ways of Working” which is available to pre-order from our website here. If you order before October 10th you’ll get 20% off the recommended retail price.

Show Notes

What we mean by operating at scale (40secs)

How big should a practice be? (1mins 36secs)

The Four Benefits of Operating at Scale –

  • One: Increased income (2mins 18secs)
  • Two: Reduced costs (4mins 30secs)
  • Three: Ability to better manage demand (5mins 41secs)
  • Four: Preparing for the future (7secs 18secs)

Should all practices aim to get bigger? (8mins 52secs)

Practical Advice – start with a shared motivation (10mins 02secs)

Clarity about the problem you’re trying to solve (11mins 09secs)

Don’t get lost in the governance and the technical issues (12mins 01secs)

Identify a good leader or leaders (12mins 50secs)

Great leaders then create a clear vision (13mins 45secs)

The importance of effective communication (14mins 16secs)

Don’t underestimate the commitment… (15mins 12 secs)

…and be realistic about the returns (16mins 08secs)

…but establish some quick wins (16mins 58secs)

Get help where you can (17mins 31secs)

If you don’t want to miss an episode of this podcast then why not subscribe to our weekly newsletter and receive notification about the podcast and our weekly blog on innovation in general practice. You can subscribe here.

20
sep
0

Episode 32: Introducing New Roles into General Practice

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This is the first in a short series of podcasts looking at the highest impact changes practices can make to help them manage the current crises in general practice and prepare for the future. In this episode Ben Gowland talks about the introduction of new clinical roles into general practice, based in part on the various case studies that Ockham Healthcare has developed from across the country. The series links in to our new book “The Future of General Practice: Real Life Case Studies of Innovation and New Ways of Working” which will shortly be available from our website www.ockham.healthcare

Show Notes

Why is the introduction of new roles necessary? (42secs)

Aren’t these new roles a way of cheaply replacing GPs? (1mins 52secs)

The variety of roles that are available (3mins 36secs)

The impact of new clinical roles on GPs and general practice (4mins 10secs)

Is there an ideal role for your practice? Where do you begin? (5mins 44secs)

The business plan for new roles (7secs 14secs)

How a practice may have to change to accommodate new roles (8mins 41secs)

Care when introducing too many new roles (10mins 59secs)

Advice for the risk averse practice (13mins 06secs)

Don’t reinvent the wheel – useful advice is abundant (15mins 04secs)

New roles are not about replacing GPs (16mins 23secs)

The resources Ben mentioned in the podcast are available here:

 

12
sep
0

Episode 31: General practice on the edge – a GP tells all

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This week Ben is in conversation with a GP whose story epitomises the stark and seemingly insurmountable challenges facing many GPs across the country. He is beset with recruitment difficulties, relentless patient demand, a serious fall in income and challenges to the very viability of his business. His story became one of the reasons that Ben formed Ockham Healthcare – to help practices create the head-room to find different ways of working.

Show Notes

The problems of a small practice are described (51secs)
Five adverts in search of a doctor (1mins 13secs)
Locum costs threaten the viability of the surgery (1mins 31secs)
Using head-hunters as a last resort (2mins 46secs)
The business suffers – a £15,000 drop in profits (3mins 14secs)
Unable to earn non-NHS income (3secs 44secs)
GPs recruited but problems with the bank increase (4mins 01secs)
The practice must change to survive (4mins 49secs)
150 telephone appointments a day to maintain access (5mins 23secs)
A working day that stretches from 6.30am to 9.30pm (6mins 19secs)
Partners are hard to find (6mins 48secs)
Considering scale as a way of making the business viable (8mins 10secs)
The practice’s role in a federation (9mins 10secs)
Investing in a federation (10mins 02secs)
Expectations of being in a federation (10mins 45secs)
The challenge of creating head room to turn things around (11mins 24secs)
Ockham Healthcare’s Practical Steps programme has been designed to support practices facing
similar problems (11mins 44secs)
If you’d like more information about Ockham Healthcare’s Practical Steps programme visit our
website here.  If you’d like to talk to someone about how the Practical Steps programme might help your practice please e-mail Ben Gowland at ben@ockham.healthcare
5
sep
0

Episode 30: Robin Miller – the relationship between general practice and social work

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Dr Robin Miller is a Senior Fellow at the Health Services Management Centre of the University of Birmingham. He has been researching the relationships between general practice and social workers and has gained interesting insights into how this relationship has struggled in the past and how it might develop in the future. In our thirtieth podcast he explains all to Ben.

Show Notes

Robin explains his background prior to joining the university (46secs)

It’s a key relationship but little researched (1min 39secs)

Not as good a relationship as it should be (2mins 11secs)

Researching why the relationship was not necessarily working well (2mins 23secs)

Unearthing the stereotypes (4mins 44secs)

The impact of current pressures on the relationship and communication between the two professions (5mins 26secs)

Overcoming the challenges (7mins 04secs)

The impact of the interventions (8mins 35secs)

The importance (and difficulty) of developing the vital relationship (10mins 21secs)

The impact of changes in general practice teams – could social workers become part of the team? (11mins 42secs)

Understanding the professional sensitivities (14mins 32secs)

Social prescribing – mind your language (15mins 32secs)

The impact that new models of care might have on the relationship (18mins 10secs)

The Better Care Fund – did integrating the budgets work? (19mins 23secs)

High hopes for the devolution agenda (20mins 42secs)

Finding out more and contacting Robin (22mins 18secs)

Dr Robin Miller works at the Health Services Management Centre of the University of Birmingham and can be e-mailed at r.s.miller@bham.ac.uk

30
aug
0

Episode 29: Tracey Vell – trialling the new MCP contract in Manchester

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A fascinating episode this week with Dr Tracey Vell, LMC lead in Greater Manchester. Greater Manchester is one of six areas working on a draft of the MCP contract and Tracey tells Ben about the progress being made, about the incentives for local GPs to get involved and about the surprising levels of engagement amongst GPs across the area.

Show Notes

Tracey explains how she became involved in the LMC (1min)

LMC involvement in the devolution process in Manchester (1min 49secs)

Representing general practice as providers (2mins 42secs)

Development of the MCP contract (4mins 13secs)

A flexible contract that allows many options for general practice (5mins 09secs)

General practice gets to choose the level at which they get involved (6mins 29secs)

How does size influence the care organisations (8mins 04secs)

The size of a hub (9mins 06secs)

The size of a “neighbourhood” (9mins 27secs)

Practices within a neighbourhood can choose how involved they are (9mins 44secs)

What are the incentives to get involved? (10mins 33secs)

How estates are dealt with (12mins 08secs)

Corporate indemnity for a hub – rather than an individual (14mins 21secs)

Is the funding dependent on the new contractual arrangements? (15mins 43secs)

The difficult issues (16mins 39secs)

Where are the agreements at now? (18mins 56secs)

What level of sign up has been achieved? (20mins 04secs)

What advice for other areas considering the contract (21mins 42secs)

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