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The GP Update March 2023 continued... What was discussed at the Best Practice Conference?
Updated: Mar 14, 2023
For those of you who missed day 1 of the Best Practice Conference in London this March, I thought I would share some of my key event takeaways.
The conference, which took place on 8th March 2023, was very timely as the new GP update was released on the 6th of March and will help me in making sense of the document and what it means for our networks (which we also cover in this blog).
The keynote session, titled 'Supporting the Vision of the Fuller Stocktake', for obvious reasons, focused on the GP update, and here's a high-level summary of what was covered (and my thoughts).
The keynote panel featured:
Genevieve Small, GP & Medical Director for Primary Care - North West London ICB
Amanda Doyle, National Director for Primary Care and Community Services - NHS England
Farzana Hussain, GP Partner - The Project Surgery
Claire Fuller, Chief Executive Officer - Surrey Heartlands ICS
Michael Lennox, NPA Integration Lead - National Pharmacy Association
Let's jump in!
Access
The update states that practices cannot request that patients contact them at a later date. Instead, patients should be offered an assessment of need, or sign-posted to an appropriate service at first contact.
Why?
Dr Claire Fuller said that the majority of patient complaints received are based on issues related to access.
Amanda Doyle, said; ”We simply can’t keep telling patients to call back tomorrow". The needs assessment is not about clinical triage; it's about giving patients other options.
There are self-care options
Support can be provided by community pharmacy colleagues
First contact practitioners are available via the ARRS workforce
Consider opportunities to create service hubs
Our PCNs also offer an enhanced access service which includes:
GP services providing appointments until 8pm on weekdays and from 9am - 5pm.
Appointments which are bookable in advance and available on the same day (and able to be cancelled remotely by the patient).
A mix of services to be available within these additional hours, with access to a range of health professionals working within the primary care team.
A choice in how patients can access appointments (dependent on clinical need), such as; telephone, video appointment, online consultation, or face-to-face.
There is also NHS 111 and the NHS website.
It's not perfect. It will likely never be, but a great example of effective triage and improvement in patient access can be found here on the General Practice Podcast. Featuring Central Worthing PCN, the team discuss the process of implementation and the impact of the new system on the surgery, the GPs, and the patients. They also share their findings and their advice for other surgeries thinking of embedding the same triage pathway.
Impact and Investment Fund (IIF) Targets
A big change communicated via the GP update is the reduction in IIF targets from 36 to 5.
Amanda Doyle said that IIF targets have been reduced based on feedback from networks, and recognition that it's hard to invest in resources when the IIF payment is not paid at the start of the financial year.
The panel also shared that, as we move to more integrated care, networks will be entrusted to make the right decisions and to utilise the services available to them.
75% of the funding attached to the impact and investment will be paid upfront.
The benefits of cloud-based telephony
As shared in the GP Update, one benefit of using cloud-based telephony is the increased functionality the tool brings, which is call queueing or call back.
This feature will provide a better patient experience when lines are busy, and better management information and data to support improvements as we move forward.
Cloud-based telephony is important as it can be used to support and protect our reception staff, who manage the highest volume of patient contact and who unfortunately, experience the most abuse.
How can we protect our staff and meet demand?
My thoughts on this were shaped by the panel discussion, conversations with peers throughout the day, and the work we are already doing.
The following list of ideas is the reality for many, and would both support our workforce and enable us to better manage patient demand:
Hub-based models
Group consultations
MDT working
Co-design of services
Sharing data
Better communication with our communities to better manage patient expectations
Enabling and investing in staff to operate at the top of their skill set
Sharing best practice
Allocating resources based on need versus equity
To agree locally on what is better delivered at:
- Practice level
- PCN level
- Place level
- System level
Michael Lennox, NPA Integration Lead, National Pharmacy Association, suggested that some of us may want to focus on micro-led changes underpinned by quality improvement frameworks which can, in fact, make a huge difference whilst we strive for system-level transformation.
🎯 As a network leader, can you look at the list above and consider if there is any merit in pursuing or reviewing any of these?
Managing patient expectations
I think we would all agree that the press has a lot to answer for when it comes to the perception of general practice however, Dr Farazana Hussian (former PCN Clinical Director and the sole GP partner at her practice), feels that we, as general practice and primary care network leaders, need to educate our patients as to what they can expect:
How do we communicate with patients?
What channels are available to us?
What key messages can we share?
🎯 As a network leader, can you look at the list above and consider if there is any merit in reviewing any of these?
The role of the PCN Manager
Lastly, in the session entitled 'Embedding Multi-Disciplinary Team Working in Primary Care', I asked whether all PCN Managers should be rebadged as the digital and transformation lead.
The simple answer is yes, if you can demonstrate that the requirements of the role are being performed.
Does this mean this is the end of the PCN Manager?
Absolutely not. The digital and transformation lead provides the funding mechanism to aid the leadership and management of your team.
Depending on the size, maturity and vision for your network, you need to assess what you need and staff it to the best of your abilities
When we conducted our PCN Management Survey, 50% of managers said they felt that there weren’t any opportunities for career progression in their role.
The digital and transformation lead remit may now provide that career progression along with the move to developing integrated neighbourhood teams.
I hope this information helps.
More Resources
About the Author
I'm Tara; I am the founder of THC Primary Care, an award-winning healthcare consultancy specialising in Primary Care Network Management and the host of the Business of Healthcare Podcast, where we have now published over 200 episodes.
I have over 20 years of project management and business development experience across the private and public sectors, and I have supported over 50 PCNs by providing interim management, training and consultancy.
I have managed teams across multiple sites and countries; I have an MBA in Leadership and Management in Healthcare,
I'm published in the London Journal of Primary Care, and I am the author of over 250 blogs. I have 3 children. My eldest has Asthma, my middle child has a kidney condition called Nephrotic Syndrome, and my youngest daughter has Type 1 Diabetes, so outside of work, healthcare plays a huge role in my life.
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