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 [email protected]