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Robin Miller is a Senior Fellow at the Health Services Management Centre of the University of Birmingham. Robin is heavily involved in research into the transformation of primary care. In this episode he shares some of the lessons that have emerged from this research including a study of the Aspiring for Clinical Excellence programme developed by a CCG in Birmingham. He looks at what transformation means, how innovation can be encouraged, how practical is the expectation that transformation will save money and how GPs and CCGs need to change their mind-sets if transformation is going to work.

Show Notes

What do we mean by the “transformation of primary care”? (0:39)

The Aspiring to Clinical Excellence programme (1:17)

Trust model versus traditional “pay for performance” (2:31)

Freedom for local primary care to come up with answers (3:51)

£10 per patient and a competitive process for groups of practices (4:21)

Flexibility to innovate (5:51)

Resentment from those missing out (6:42)

Action learning sets of pioneers and the CCG (7:29)

Lessons learnt from the process (9:00)

Was this programme a success? (9:50)

Did it save money for investment into primary care? (10:46)

Transformation has to be sustained (12:08)

Wider lessons – changing the perception of the role of the GP (12:55)

Shift to multi-disciplinary teams with a leading practitioner (14:51)

Changing the GPs’ perceptions of themselves (15:55)

Funders also need to change their mind-set (17:08)

Local ownership is essential (18:50)

Motivation general practice to change – evidence with data (19:54)

Structured programmes with methodologies (21:22)

Accessing Robin’s research (23:53)

Robin can be emailed at r.s.miller@bham.ac.uk

The two papers Robin refers to in his podcast can be found here:

https://www.ijic.org/article/10.5334/ijic.3044/

https://www.emeraldinsight.com/doi/full/10.1108/JICA-03-2018-0023#_i7