In this week's episode, brought to you in partnership with Practice Index, we welcome back podcast regulars Claire Houston & Robyn Clark to explore why appraisals are a vital part of staff development in general practice, and how to make them meaningful rather than just a tick-box exercise. They discuss whether 'appraisal season' is helpful or whether reviews should be spread throughout the year, how to structure objectives so they align with wider practice goals, and why appraisals should never contain surprises. The conversation covers practical tips on preparation, 360° feedback, handling difficult conversations, and setting SMART objectives that genuinely support both individual growth and organisational strategy. The episode also explores the unique challenge of appraising practice managers, the benefits of a four point scoring system, and how digital tools like the Appraisals Manager within the Practice Index Hub can streamline the entire appraisal cycle, from scheduling and documentation to tracking objectives and progress.

Introduction (0:09)

Practice Index Appraisals Manager: what it offers (00:35)

Is there such a thing as 'appraisal season'? (01:25)

Why appraisals should never contain surprises (02:15)

Formal appraisals (03:10)

Aligning individual objectives with practice strategy (04:00)

Setting meaningful objectives (and how many to set) (06:30)

Using SMART objectives effectively (08:30)

The importance of preparation and pre-appraisal questionnaires (10:30)

360° feedback and gathering wider perspectives (11:30)

Avoiding difficult conversations, and why you shouldn't (13:45)

A practical structure for giving constructive feedback (14:45)

Rethinking scoring: why move from five points to four? (16:50)

Documenting objectives and tracking progress digitally (18:20)

Who appraises the practice manager? (19:15)

Using the IGPM appraisal toolkit (20:30)

Accessing the HR package and Appraisals Manager in the Hub (23:30)

Episode summary and close (24:30)

To visit the Practice Index website, click here or contact James Dillon here.

For all enquiries about the Ockham podcast, please contact Ben Gowland here.

In this episode, Ben is joined by Catherine Pope, Professor of Medical Sociology at Nuffield Department of Primary Care Health Sciences, to explore how access to general practice really works in practice and what happens to appointment systems over time. Drawing on over 30 years of research and findings from a recent study, the discussion examines the sustainability of different access models, the legacy of initiatives such as Advanced Access, and why practices continually adapt systems to manage demand. The episode explores the limitations of top-down, standardised and digital first solutions, the impact of access systems on patients, reception teams and clinicians, and why variation is often necessary to meet the needs of local populations. The conversation also highlights patient experiences of navigating access, the risks of diversion and looping between services, creative approaches such as the 'Phones and Ladders' game to illustrate access challenges, and the case for more patient-centred, locally adaptable models that prioritise need, continuity and sustainable general practice.

Introduction (00:08)

Your recent study on access to general practice (01:00)

Did you find that practices were able to sustain the benefits of new access systems? (04:04)

Have practices managed to stick with the changes they made over time? (09:41)

Does this impact sustainability, because eventually people stop doing it? (13:39)

'Phones and Ladders' (15:30)

Should access start with local population needs? (19:28)

Are current access outcome measures too crude if they focus only on waiting times? (22:05)

If people want to access the research or learn more, where can they find it? (24:33)

Visit the 'General Practice: Innovation, impact and sustainable change' research here.

For all enquiries about the Ockham podcast, please contact Ben Gowland here.

In the first episode of 2026, Ben is joined by Dr Zalan Alam, General Practitioner, Director of Medical Education and GP Partner, to explore Rochdale's selection as a site for the National Neighbourhood Health Implementation Programme (NNHIP) and what this means in practice for general practice and PCNs. The discussion focuses on improving patient journeys, particularly for frail patients and those in the last year or 1,000 days of life, by strengthening connectivity between primary care, community services, hospices, ambulance services and acute trusts, using standardised frailty assessments, shared care plans and tools such as the Greater Manchester Care Record. The episode also covers targeted neighbourhood working in Rochdale South, the importance of peer leadership and measurable impact for frontline practices, and what comes next as the programme moves from planning into delivery, with an emphasis on locally adaptable models rather than a one-size-fits-all approach.

Introduction (00:08)

Why Rochdale was selected for NHIP (00:29)

Population, PCNs and deprivation (01:22)

How the programme is structured (02:42)

Early priorities and patient journey focus (03:35)

Targeting Rochdale South as a proof of concept (05:33)

Connectivity gaps and 'lightbulb moments' (06:25)

How neighbourhood working operates in practice (07:03)

Standardising care plans and frailty pathways (08:40)

Using data to identify priority cohorts (10:07)

Shared tools, shared vision (12:01)

Impact on PCNs and general practice (14:09)

System-level integration and why it works in Rochdale (16:12)

Moving from planning to delivery (17:42)

Measuring impact and managing expectations (18:40)

Learning from other NHIP sites (19:13)

Reflections & next steps (20:26)

Listen to Zalan's previous podcasts 'Innovative intermediate care' here and 'Integration working in practice' here.

Contact Zalan via email here.

For all enquiries about the Ockham podcast, please contact Ben Gowland here.

In this episode, Ben is joined by Judy Oliver from Oliver & Company to discuss the role of the voluntary, community and social enterprise (VCSE) sector in healthcare and general practice. Judy explains why the voluntary sector is essential yet often misunderstood. She explores how social prescribing and asset mapping can better connect patients with non-clinical support, highlights successful collaborative models such as the Bromley by Bow Centre, and discusses the challenges VCSE organisations face around funding and visibility. The conversation focuses on practical ways PCNs and practices can work more effectively with local voluntary groups, move towards neighbourhood-based care, and take simple next steps to build meaningful partnerships that improve patient outcomes.

Introduction (00:08)

The Voluntary Sector in General Practice (00:22)

What does VCSE mean? (02:23)

Does it deliver real benefit? (03:21)

How have PCNs worked with the voluntary sector? (05:22)

How to find what's available in your area (07:40)

Finding the right people (10:22)

From PCNs to neighbourhood working (15:01)

Next steps (18:18)

Getting in touch (19:47)

Visit the Oliver & Company website here, or contact Judy via email here, or Charlotte here.

For all enquiries about the Ockham podcast, please contact Ben Gowland here.

In this week's episode, brought to you in partnership with Practice Index, we're joined by Claire Houston from Practice Index, Paul Gordon from Atomos, and ​James Gransby from Azets to break down what the latest budget really means for general practice. We explore how tools like the salary calculator and benchmarking manager can support smarter decision making as practices respond to rising costs.

They also look closely at how these budget changes affect personal finances, from the withdrawal of personal allowances for high earners to the long term impact of frozen tax thresholds. With insights on NHS pensions, future tax considerations, and the importance of revisiting financial plans, this episode offers straightforward guidance to help practice teams and individuals stay confident, informed, and financially resilient.

The Budget (00:08)

Benchmarking Manager (02:28)

Reactions to the budget (03:30)

What should people be doing differently now? (07:55)

NHS Pension (09:09)

What will be different? (10:58)

Increase in the National Living Wage (14:27)

The Carr-Hill formula (16:31)

The timeframe (19:25)

Other changes.. (20:34)

ISA changes.. (21:37)

Final thoughts.. (24:16)

To book your free Benchmarking Manager demo, click here or to access the Salary Calculator, login here.

To visit the Practice Index website, click here or contact James Dillon here.

For all enquiries about the Ockham podcast, please contact Ben Gowland here.

In this solo episode, Ben explores how PCNs can transform their role within the local healthcare system by taking the lead in organising neighborhood meetings. Moving beyond the limits of bilateral conversations, Ben explains how these gatherings can unite stakeholders, such as ambulance trusts and mental health services, to drive collaboration, set shared priorities, and influence the direction of neighborhood healthcare planning before formal mandates take shape.

With practical advice on starting small, building trust, and fostering genuine partnership, this episode offers tips for PCNs ready to step up as proactive leaders shaping the future of their communities.

Introduction (00:09)

Neighbourhood meetings (00:30)

Convening the neighbourhood meeting.. (02:24)

Why does Ben think it's a good idea? (03:14)

Argument against.. (10:00)

How do I convene a neighbourhood? (14:00)

Key takeaways (20:20)

For all enquiries about the Ockham podcast, please contact Ben Gowland here.

Can AI truly transform how patients access healthcare? In this episode, Ben is joined by Dr Hannan Chaudery, Chief Technology Officer of GP Triage, to explore how autonomous AI is reshaping patient care across the NHS. Hannan explains how GP Triage's innovative system prioritises appointments based on clinical urgency, easing the pressure on receptionists and clinicians while improving patient outcomes. With the NHS now requiring online consultations, GP Triage's AI powered triage is leading the way in managing surging demand efficiently and effectively, and adapting seamlessly to the needs of each individual practice.

Introduction (00:08)

Autonomous AI triage (00:18)

Are requirements increasing demand? (01:08)

More about Dr Hannan Chaudery.. (02:02)

More about GP Triage Ltd.. (02:58)

The tools learning (05:42)

The risks.. (06:35)

Your tool doesn't make mistakes? (07:59)

Giving patients the choice (08:53)

Evolving your tool over time (12:29)

The accuracy of the tool (13:26)

Coverage in England and beyond.. (14:48)

Implementing change.. (15:40)

How do you define success? (17:34)

Online vs telephone (20:22)

How it all works and what it costs.. (22:00)

What's next? (24:31)

Visit the GP Triage website here.

For all enquiries about the Ockham podcast, please contact Ben Gowland here.

In this week's episode, brought to you in partnership with Practice Index, we welcome back podcast regular Claire Houston and returning guest Kay Keane from Urban Village Medical Practice, a practice that recently achieved an Outstanding CQC rating. Together, they share practical advice and real experiences from the CQC inspection process, from innovative community services to managing the pressures of staff questionnaires and documentation. Kay offers a candid look at how preparation, teamwork, and a strong practice culture can make all the difference.

Claire highlights how practices can use tools and resources from Practice Index to streamline compliance, boost confidence, and maintain readiness all year round. They also discuss how to turn inspection challenges into opportunities for growth, the importance of clear communication, and practical tips for approaching appeals calmly and effectively. Whether you're preparing for your first inspection or aiming to strengthen your next rating, this episode is full of valuable insight and encouragement for every practice team.

Introduction (00:09)

From good to outstanding.. CQC visits (01:36)

Preparing in advance.. (04:44)

Specifics of a CQC inspection (07:25)

The inspection (08:39)

Reaching for 'Outstanding' (14:06)

Changes in the regime (14:29)

Making inspectors feel welcome (16:19)

The pressures.. (21:41)

The feedback (22:20)

The 'correct' way to appeal (28:02)

Final thoughts and advice (30:19)

Listen back to our episodes with the Urban Village Medical Practice;

About Urban Village

Urban Village Strategies to Support Homelessness

To visit the Practice Index website, click here or contact James Dillon here.

For all enquiries about the Ockham podcast, please contact Ben Gowland here.

This week, Dr. Debbie Hipps, a pioneering GP and primary care lead, joins Ben to explore how genomic medicine is transforming general practice. From enhancing risk assessments, family history evaluations, and cancer treatments to driving the NHS's shift from reactive to preventative care, Debbie highlights the urgent need for GPs and pharmacists to upskill in this fast-evolving field. We discuss practical tools like the Genomics Education Programme, real-world examples such as managing Lynch syndrome, and the broader challenges of integrating genomics into primary care, while looking ahead to a future of more precise, personalised treatments.

Introduction (00:10)

Genomic medicine (01:43)

Genomics in the 10 year plan (02:28)

How is genomic medicine being used in general practice now? (03:21)

What makes something genomic medicine? (07:02)

What genetic tests are available for patients? (07:53)

Examples of practices who regularly use the testing.. (11:45)

The near future.. (13:10)

Staying up to date.. (16:13)

Services across the UK.. (17:19)

Resources (19:01)

Can it make the shift from treatment to prevention.. (19:31)

Access the RCGP Genomic Toolkit and Curriculum Guidance here.

Access the Genomics Education Programme: Genomics in Primary Care here.

Access the Genetic Test Ordering in Primary Care Resources here.

Access the Genomic notes for clinicians here.

Visit the Gateway C Course: The role of Genomics in Primary Care here.

Visit the Futurelearn: the Future of Genetics in Medicine Online Course here.

Download the Genomics information on an App here (Please note - only currently available for SE, NThames and East regions)

North Thames GMSA Educational Resources can be accessed here.

eLearning for Health Genomics in Healthcare is found here.

For all enquiries about the Ockham podcast, please contact Ben Gowland here.

In this episode, Dr. Jonathan Griffiths and Dr. Bryony Kendall open up about one of the most sensitive challenges in general practice, supporting families through the loss of a child. They share the journey of creating a new framework for GPs, co-produced with bereaved parents and the Alder Centre, to help doctors provide compassionate and consistent care. The discussion highlights why child bereavement is often avoided in society, and how GPs can play a vital role in offering empathy, continuity, and support at such difficult times. They also explore the national child bereavement support document, its UK-wide relevance, and the importance of preparedness in general practice. They emphasise the privilege and responsibility of walking alongside grieving families, and the lessons this work brings to healthcare. A powerful and practical conversation for all healthcare providers seeking to offer comfort when it's needed most.

Introduction (00:09)

When a Child Dies Framework (00:48)

Lack of support available.. (02:47)

Discussions with practices (06:36)

Three main areas (07:35)

Tailoring the approach (12:24)

Reactions to the framework so far.. (18:49)

Where to access the document (21:40)

Next steps.. (22:14)

When a Child Dies: An NHS Cheshire and Merseyside Framework can be found here.

For all enquiries about the Ockham podcast, please contact Ben Gowland here.