1
aug
0

Episode 25: Rebecca Rosen – Lessons from large-scale general practice

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Ben talks to Rebecca Rosen, a GP and author of a new report from the Nuffield Trust called “Is Bigger Better? Lessons for large-scale general practice”. They discuss the benefits of working at scale including the impact on staff and patients and the surprisingly limited impact on quality. Rebecca also has advice for practices thinking of working at greater scale and for CCGs who are supporting the development of General Practice.

Show Notes

Rebecca explains how the report grew out of research undertaken by the Nuffield Trust (1min 23secs)

One of the headlines is that larger scale has little impact on quality (2mins 08secs)

The four quality measures used in the report (3mins 03secs)

The research organisations weren’t necessarily established as quality improving organisations (4mins 35secs)

What benefits did they find of operating at scale? (5mins 39secs)

Positive impact on staff – apart from salaried doctors (8mins 06secs)

Operating at scale as a response to the crisis in General Practice (9mins 21secs)

Continuity of care for patients (10mins 48secs)

Advice for at-scale General Practice organisations (12mins 16secs)

Where should at-scale organisations start? (13mins 13secs)

Working at scale versus complete merger (14mins 43secs)

The role of CCGs in supporting at-scale General Practice (16mins 44secs)

Is bigger actually better? (18mins 50secs)

Finding the report (20mins 14secs)

The report is available here http://www.nuffieldtrust.org.uk/publications/bigger-better-lessons-large-scale-general-practice

 

25
jul
0

Episode 24: Caroline Chill – from GP partner to a locum in a GP chambers

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Caroline Chill was a GP partner for 24 years before leaving in 2012 to pursue a portfolio career. Intending to locum only as a “stop gap” she discovered and joined her local locum GP chambers and has now worked through the chambers for four years. She tells Ben about how the chambers works for her and how it has allowed her to regain her enthusiasm for medicine.

Show Notes

Carrie explains how her GP career began (38secs)

Carrie becomes a partner in Wimbledon (56secs)

In 2012 Carrie leaves the partnership to pursue a portfolio career (1min 21secs)

Carrie becomes a locum as a “stop gap” (2mins 13secs)

She discovers locum chambers (2mins 48secs)

Local chambers for local people (3mins 14secs)

Carrie describes the chambers (3mins 49secs)

How does the chambers work for Carrie? (4mins 37secs)

Being in a chambers creates time for discussing clinical issues (6mins 35secs)

Carrie’s portfolio career (6mins 59secs)

Becoming a locum as a career (7mins 33secs)

Chambers has kept Carrie in mainstream clinical practice (8mins 34secs)

Is chambers for everyone? (9mins 32secs)

A chambers model beyond GPs? (10mins 18secs)

Pensionable work and the costs of chambers (10mins 43secs)

Continuity of care (12mins 10secs)

Advice for other GPs (13mins 08secs)

Regaining your enthusiasm for medicine (14mins 09secs)

Advice for practices (14mins 39secs)

20
jul
0

Bonus Episode: King’s Fund Report on GPs and Clinical Commissioning

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Ben talks to Ruth Robertson one of the authors of a new King’s Fund report on GP involvement in clinical commissioning and the roles of CCGs. The report is the culmination of four years’ research working with six CCGs. They discuss relationships between GPs and CCGs, avoiding conflicts of interest and the likely future for clinical commissioning.

Show Notes

Ruth explains the purpose of the report (42secs)

Are GPs really in charge of clinical commissioning? (1min 50secs)

The importance of GP engagement in commissioning (2mins 35secs)

Fragile relationships between GPs and CCGs (3mins 16secs)

Will more power be devolved to local areas? (4mins 22secs)

How easy is it to engage GPs in commissioning? (5secs 12secs)

A view of the future for commissioning – CCGs get bigger and more strategic (6mins 12secs)

Could this mean GP engagement gets harder? (7mins 15secs)

Has co-commissioning been a positive thing? (7mins 37secs)

The General Practice role – commissioning or influencing delivery? (9mins 12secs)

Where should GP leadership sit? (10mins 24secs)

Succession planning for GP leadership (12mins)

Models of encouraging GP leadership in commissioning (12mins 33secs)

Innovative work coming out of CCGs- e.g. avoiding conflicts of interest, engaging the GP community (13mins 34secs)

CCG role in developing GP provider models (14mins 52secs)

The line between supporting transformation and anti-competitive behaviour (15mins 42secs)

Are CCGs being nervous or over-zealous? (16mins 32secs)

The GP role in commissioning is vital (17mins 25secs)

Finding the King’s Fund Report – four years’ worth of research (17mins 57secs)

The report is available at http://www.kingsfund.org.uk/publications/clinical-commissioning

 

 

18
jul
1

Episode 23: Charmi Rogers – Paramedic Practitioner in General Practice

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Episode 23: Charmi Rogers – Paramedic Practitioner working in General Practice

Charmi Rogers is a Paramedic Practitioner working in a GP Practice in Haywards Heath. In this podcast she tells Ben how her role in dealing with on-the-day demand has grown and the consequent impact on the practice and its GPs. Also, in a first for the Ben Gowland Podcast, she answers four questions posed by you, the listeners, via Twitter.

Show Notes

Charmi becomes a paramedic (39secs)

The difference between a paramedic and a paramedic practitioner (1min)

Charmi’s route into General Practice (1min 28secs)

Induction into General Practice (2mins 02secs)

Charmi’s initial role in General Practice (2mins 32secs)

The Practitioner’s own clinic (2mins 49secs)

Charmi establishes the role (3mins 04secs)

Triaging on-the-day demand (3mins 43secs)

The team of paramedics expands (4mins 46secs)

Teamwork in General Practice (5mins 42secs)

Can the paramedic practitioner model only work at scale? (6mins 26secs)

The impact of the paramedic on the practice (7mins 09secs)

Four Questions from Listeners to the Ben Gowland Podcast (7mins 44secs)

1: Considering the shortage of paramedics in the ambulance service what prompted you to leave? (8mins 26secs)

2: Does the GP practice work enable you to develop your role as an autonomous practitioner? (9mins 39secs)

3: What role can the skilled paramedic play in keeping frail people in their homes as part of an extended primary care team? (10mins 18secs)

4: How have you dealt with issues around indemnity? (12mins 08secs)

What would Charmi do differently if she could start over? (12mins 52secs)

Advice for paramedics interested in the role (13mins 34secs)

Advice for practices considering the role (14mins 13secs)

Charmi can be contacted via e-mail at charmi.rogers@nhs.net

14
jul
0

Audioblog: Three steps to CCGs supporting the development of local locum GP chambers

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Ockham Healthcare is running a series of podcasts and blogs on local locum GP chambers because of the impact they can have on an area struggling with GP recruitment. In this second audioblog in our series Ben Gowland calls on CCGs to do what they can to support their development – but warns against trying to control them.

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