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Episode 11: John Tacchi – a BIG practice in Birmingham

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When 87 practices get together to work at a truly mammoth scale, what benefits can accrue? How does communication work and what problems can occur? Ben talks to John Tacchi, CEO of Birmingham Integrated General Practice (BIG Practice) and finds out whether BIG is beautiful.

Show Notes

John describes what BIG Practice is (49secs)

The difference between BIG and a federation (1min 16secs)

Super partnerships and how they form (2mins 10secs)

Single entity within a joined entity (2mins 57secs)

BIG is a company limited by shares (3mins 14secs)

One entity for your clinical business and one entity for the provider business (4mins)

How big is BIG? (5mins 36secs)

The relationship between BIG and Our Health Partnership, the “clinical business” in Birmingham (6mins 11secs)

How does the funding work? (6mins 46secs)

What is BIG taking on? (7mins 06secs)

Forming a buyer’s club (7mins 40secs)

Setting up a locum service (8mins 04secs)

Retaining GPs (9mins 15secs)

Links with commercial companies (9mins 41secs)

Savings from operating at scale (10mins 35secs)

Support for practices with challenges (11mins 19secs)

The end of the “single-hander”? (12mins 35secs)

How BIG focus on education and learning (13mins 14secs)

Building partnerships or supporting competition? (14mins 02secs)

The early lessons (14mins 56secs)

How do you engage 87 practices? (15mins 32secs)

More information and the videos mentioned in the podcast are available at www.bigpractice.co.uk

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Bonus Episode – The Reform Report on the Future of General Practice

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Can fundamental change in General Practice be achieved by changing the contracting model? Will the use of other professionals achieve major efficiencies? Reform the public sector think tank believe so and have published “Who Cares; The Future of General Practice” to set out their “blue print for best practice”. In this bonus edition of our podcast, Ben Gowland talks to Alex Hitchcock, one of the report’s authors.

Show Notes

Alex explains the aims of the Reform report (44secs)

The report aims to set out a blue print for best practice (1min 06secs)

Reforms view of the problems in General Practice (1mins 40secs)

Do GPs feel the problems differently? (2mins 07secs)

Fundamentally changing the model (3mins 01secs)

Abandoning the target for 5000 new GPs (3mins 30secs)

Using other professions to plug the gap and make efficiencies (4mins 19secs)

How do you preserve continuity of care? (5mins 35secs)

How do you deliver the efficiencies? (7min 16secs)

Other professionals delivering appointments will achieve efficiencies (8mins 17 secs)

Creating new contracts to emphasise prevention (8mins 52 secs)

The Valencia model of integrated care (9mins 59secs)

The example of Lakeside in Corby delivering wider care (11mins 12secs)

Can change be delivered via contracting? (12mins 01secs)

A new role for commissioners? (12mins 37secs)

Are federations “old wine in new bottles”? (13mins 38secs)

How best can we deliver change? (15mins 16secs)

Private investment in primary care (16mins 06secs)

Does general practice have the capacity for change? (16mins 30secs)

Practice leadership from individuals with a business background (17mins 07secs)

The report is available from www.reform.co.uk (17mins 48secs)

 

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Episode 10: Maneesh Juneja – digital health

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Digital health technologies could dramatically change the relationships between clinicians and patients and support the shift towards prevention. Ben interviews Maneesh Juneja, internationally lauded expert in digital health to determine whether the advent of this brave new world is a promise or a threat.

Show Notes

Maneesh explains the spread of digital is likely to come from patients and the public rather than health organisations (57 secs)

The data gathered by patients themselves could allow them to hold the NHS accountable (2mins 04secs)

Information is (patient) power (3mins 13secs)

Digital technology will allow patients to take greater control of their health (4mins 29secs)

Could wearable tech become mandatory? (5mins 51secs)

Becoming the “CEO” of your own body – the future for digital in the NHS (7mins 23secs)

Is owning our own care record the future? (10mins 07secs)

The concept of health data unions (11mins 24secs)

What will be the impact on General Practice? (12mins 52secs)

The fear of “information obesity” (14mins 42secs)

A radically different model of General Practice (15mins 27secs)

What can the NHS be doing now? (16mins 07secs)

More information? Maneesh has his own website and blog at www.maneeshjuneja.com

 

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Episode 9: Harry Longman – technology for managing demand

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Can technology help GPs better manage on-the-day demand? Ben talks to Harry Longman, founder and Chief Executive of GP Access, about how telephone consulting and online algorithms can dramatically support practices in reducing the pressures of seemingly uncontrollable demand.

Show Notes

Harry explains how his approach developed from an understanding of practice variances in A&E attendances (56secs)

Harry discovers that practices with less attendances are the ones that telephone their patients (2mins 15secs)

The idea originates in Leicestershire… (2mins 32secs)

…and has a long term effect (3mins 11secs)

Harry’s engineering background uncovers the detail (3mins 28secs)

He begins to test his theories across the country (4mins 29secs)

Dramatic results on access and attendances (5mins 23secs)

But isn’t it harder work? (5mins 40secs)

Successful practices thrive and transform finances (6mins 23secs)

How long does it take? (6mins 51secs)

Demand is predictable (7mins 32secs)

A whole system change is necessary (8mins 49 secs)

Even better – an online system (10mins 13 secs)

The online system generates a detailed patient history (10mins 34secs)

The doctor triages the patient (11mins 26secs)

Will patients use an online system? (12mins 11secs)

Creating an “expert patient” (13mins 18secs)

Developing a 24/7 service (14mins 03secs)

Accelerating the pace of the roll-out (14mins 38secs)

Leadership needed (15mins 30secs)

Contact Harry at harry@gpaccess.uk

 

 

 

 

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Episode 8: Dr Isabel Hodkinson – commissioners supporting general practice

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How can commissioners support the development of General Practice? Ben talks to Dr Isobel Hodkinson the principal clinical lead at Tower Hamlets CCG about their 15 year journey of transformation through network working to a borough-wide GP provider group.

Show Notes

Isobel describes how the care of people with type 2 diabetes became the “strong collective burning platform” to bring practices together (1 min)

The PCT supports practice engagement and performance manages the struggling practices (2mins 06secs)

The practices decide they should be uniformly “good enough” to provide quality care for diabetic patients (3mins 19secs)

Tackling poor performance is a pre-requisite for networking (4mins 03secs)

The CCG leads the networking decisions and imposes the geographical groupings (5mins 17secs)

A focus on population health creates the glue (6mins 55secs)

The CCG invests in General Practice (7 mins 20secs)

The model for diabetes becomes the model for other services (8mins 36secs)

The benefits (9mins)

How the network helps (9mins 23secs)

The networks control the money (10mins 09secs)

Using shared data to learn (10mins 45secs)

For long term conditions, don’t expect a quick return on investment (11mins 21secs)

But interim proxy measures begin to prove the benefits (12mins 23secs)

How did the collective vision come about (12mins 43secs)

The next stage – a GP provider body (13mins 24secs)

CCG commitment to provider development (14mins 02secs)

Developing the provider group – the future (14mins 52secs)

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