With stress levels continuing to soar within all areas of the healthcare system, we felt it was time to tackle things head on and really get to grips with how conflict occurs specifically within primary care, what options are available to those involved in a breakdown in relations and why a mediator can be instrumental in moving things forward. This week, Ben talks to experienced GP and mediator Dr Clare Sieber about some of the situations she has been involved with, how mediation works in practice, when it is most likely to achieve success and why communication is again so crucial to avoiding the culture of a stressful and unhealthy workplace.

Introducing Clare (56 secs)

Becoming an accredited mediator (1 min 42 secs)

The most common types of disputes (3 mins 12 secs)

The principles of mediation and the legal parameters (3 mins 54 secs)

A mediation agreement (5 mins 53 secs)

How does the process work? (6 mins 28 secs)

Reaching an agreement (8 mins 6 secs)

What does a good outcome look like? (10 mins 10 secs)

What factors determine whether a mediation is likely to be successful (or unsuccessful)? (11 mins 27 secs)

Within a situation of conflict, what other options are available, as well as mediation? (13 mins 52 secs)

Avoiding conflict in the first place (15 mins 52 secs)

Managing PCN disputes (19 mins 12 secs)

Changes to PCN leadership (21 mins 55 secs)

Finding out more / getting in touch (23 mins)

To learn more about what Clare can offer as a mediator, check out her LinkedIn profile here

The General Practice Mediation website is also here

To get in touch, Clare is contactable here

To find out more information about our PCN Plus training programme, focused on supporting and skilling PCN Clinical Directors to be successful in their roles, check out our dedicated webpage or get in touch with Ben here

In what is a dose of pure positivity for a Monday, Alvanley Family Practice’s award-winning Nursing Director and Practice Nurse Katherine Parker joins Ben on this week’s Ockham podcast to give us an insight into the work of Primary Care nurses and how they can make a difference when stepping into leadership roles. Katherine details her own journey; where she sits within the wider practice team, the empowerment she has been given oversee the clinical workload and the innovation that she and her team continue to champion in their area. She also reflects on the impact of PCNs, the pandemic and how other practices and networks can better attract, retain, recognise, and champion their own nursing workforce, so that there is greater confidence in promoting general practice nursing across the board.

Introduction (10 secs)

Katherine’s role within the practice (24 secs)

The remit of a Nursing Director (1 min 10 secs)

Alignment with Practice Manager, Kay (1 min 56 secs)

Celebrating and championing innovation (2 mins 42 secs)

Group Consultations (3 mins 33 secs)

Why group consultations work (5 mins 5 secs)

A more efficient use of time? (5 mins 53 secs)

Social prescribing and the Alvanley Health Champions (6 mins 47 secs)

What are Alvanley’s key objectives when it comes to social presciribing? (8 mins 19 secs)

Wellness Navigators (9 mins 4 secs)

The benefits of a non-medical approach (11 mins 5 secs)

Katherine’s view of PCNs, from a nursing perspective (11 mins 37 secs)

Valuing Primary Care nurses (12 mins 33 secs)

Recruitment and retention (13 mins 25 secs)

Advocacy and empowerment of nurses (14 mins 54 secs)

The impact of Covid (16 mins 28 secs)

Ninja nursing! (18 mins 38 secs)

Advice for GPs and practices (19 mins 19 secs)

Finding out more & getting in touch (20 mins 34 secs)

The Alvanley Family Practice Facebook page can be found here

A wealth of resources can be found when searching for Katherine Parker and / or Kay Keane online (other search engines are available!)

More about Katherine the Ninja Nurse here

Finally, you can make direct contact with Katherine here

In the first of our new podcast series focused on the introduction of Integrated Care Systems (ICSs) and the transition to yet wider scale working, we speak to distinguished GP Dr Jaweeda Idoo based at Alvanley Family Practice in Stockport. As Chair of her local GP federation, Jaweeda has played an active part in preparing for this brave new world and knows first-hand of the challenges which lie ahead. Here, she fills Ben in on the Greater Manchester journey so far, navigating the system and ensuring each element can move at the same pace, the continuing importance of the CCGs, maintaining the voices of individual practices in strengthening primary care’s wider influence, managing relationships and why continuous communication is, as always, key at this pivotal moment for general practice.

Introduction (33 secs)

Jaweeda’s role and remit (39 secs)

The relationship between federation, PCN and practices (1 mins 39 secs)

Managing tensions and maintaining authority (4 mins 44 secs)

The transition from Viaduct Federation Board to Stockport GP Board (7 mins 50 secs)

CCG involvement (10 mins 8 secs)

Building relationships across provider organisations whilst sustaining locality expertise (11 mins 25 secs)

The interface between Stockport and the Greater Manchester ICS (12 mins 32 secs)

How does an individual practice maintain a voice within a much wider system? (15 mins 26 secs)

Driving forward the general practice agenda (17 mins 4 secs)

Jaweeda’s advice for other areas when preparing for ICS go-live (18 mins 29 secs)

Finding out more (20 mins 10 secs)

Further information can be found via the medium of Twitter!

Greater Manchester Health & Social Care Partnership

Viaduct Care

Or you can make contact directly with Jaweeda here

Our Practice Index panel return and this week, podcast regulars Robyn Clark and Nicola Davies reflect on the workforce challenges in the year ahead (and beyond) both in their own, immediate areas of influence and across primary care in general. From assessing the situation right now, to recruitment and retention planning for the future, getting the best out of staff and supporting others in the networks – and the effect of the Additional Roles Reimbursement Scheme (ARRS), our pro Practice Managers share their experiences (and their expertise) and tell us why their aim is to focus on the positive in 2022.

Introductions (40 secs)

Staffing levels right now (46 secs)

The challenges ahead (1 min 16 secs)

Robyn’s strategy for 2022 (2 mins 43 secs)

Has Covid had an impact on the expectations of existing and prospective staff? (4 mins 15 secs)

Reflecting on the positive effects of the pandemic (6 mins 30 secs)

Attracting new staff (7 mins 8 secs)

A focus on the rewarding aspects of general practice employment (8 mins 59 secs)

Do workforce pressures = poor network relations? (11 mins 14 secs)

What happens when another practice is struggling? (13 mins 52 secs)

Turning the “PCN problem” on its head (16 mins 22 secs)

Workforce planning in the time of ARRS (17 mins 28 secs)

Building resilience for the future (20 mins 17 secs)

The Practice Index website is here

For all enquiries, please contact James Dillon here or Ben Gowland here

After a short hiatus for the festive break, the Ockham podcast is back, and kicking off 2022 with a focus on those considering and/ or beginning life as a new GP Partner. Ben, along with senior GP and podcast veteran Dr Naj Seedat, discuss the key factors when considering signing up to GP partnership, what you can expect from partnership (and dealing with the unexpected), the demands and the rewards - and what Naj has learned in his own 21-year journey. And for those feeling that they may need more formal learning, and the option to tap into a peer network of support? Ben and Naj also share their insights into our very own New to General Practice Partnership training programme which is open for enquiries and sign up now.

Introduction – and all about Naj (9 secs)

Making the decision to move into partnership (45 secs)

Early experiences (2 mins 17 secs)

The pressure of responsibility (3 mins 13 secs)

Lessons learned so far (3 mins 59 secs)

Building relationships (4 mins 55 secs)

Reflections on what might have been helpful to a new GP Partner when starting out (5 mins 30 secs)

What are the essential components for a successful partnership team? (6 mins 56 secs)

Maintaining successful communication within a practice (7 mins 44 secs)

The role of the Practice Manager in relation to the Partnership (9 mins 56 secs)

Then and now (11 mins 31 secs)

Where do new GP Partners feel support is most needed? (12 mins 29 secs)

The New to General Practice Partnership training programme; how we can help (14 mins 38 secs)

The challenges faced in both smaller and larger partnership teams (15 mins 48 secs)

Balancing leadership and management (17 mins 3 secs)

Naj’s top tips (18 mins 3 secs)

The importance of doing your due diligence (19 mins 9 secs)

To find out more about the New to General Practice Partnership training programme, our dedicated webpage is here. Alternatively, both Ben and Naj are happy to receive email queries directly.

Frailty and the introduction of a targeted service to better meet the needs of those living locally with frailty issues was high on the agenda of Townships 1 PCN Clinical Director and GP Dr Tom Holdsworth. Once CCG funding had been successfully secured, the challenge to recruit a clinical project lead was proving tricky and Tom was eventually convinced by a colleague that an Occupational Therapist, in the form of Julia Clifford, might be the answer. One year on from Julia’s appointment and following a formal evaluation of the service, both Tom and Julia join Ben to discuss all aspects of the transformative approach they are taking in Sheffield to support their frail populations. From Tom’s initial concerns about whether an OT could provide what was needed, to the service specification and what Julia can offer, working collaboratively with the other additional roles team, and the service evaluation findings, this week’s episode is another truly inspirational offering to round off the 2021 podcast series.

Introductions (26 secs)

The origins of ‘Townships 1’ PCN (38 secs)

How was the service first introduced? (58 secs)

Why a project focused on supporting frailty? (2 mins 57 secs)

The story behind recruiting an Occupational Therapist (OT) for the project role (3 mins 59 secs)

Preconceptions of what an OT could offer (4 mins 43 secs)

What attracted Julia to the role? (5 mins 8 secs)

Evaluating progress to date (5 mins 57 secs)

What are the most common scenarios and interventions? Where is Julia able to make the biggest impact? (8 mins 8 secs)

Alignment with the PCN’s ARRS strategy (9 mins 58 secs)

Making the most of the ARRS funding pot (10 mins 52 secs)

Formal service evaluation findings (12 mins 3 secs)

Are the practices feeling the impact? (13 mins 45 secs)

The risk of uncovering unmet need (14 mins 25 secs)

Continuing to progress amongst competing demands (14 mins 54 secs)

Working towards the anticipatory care specification (16 mins 46 secs)

Lessons learned from Julia’s perspective (18 mins 29 secs)

The full, published evaluation of the frailty project can be found here.

If you are interested in learning more, Tom and Julia are very happy to be contacted via their respective emails.

April 2022 marks a significant turning point in terms of finances for both employers and employees within primary care, as changes to the National Living Wage are made, the new Health and Social Care Levy comes into force and there are additional implications for those paying into the NHS Pensions Scheme. Regular podcast guest and primary care accountancy guru James Gransby returns to walk us through all the updates and what these could mean in real terms for practices and staff as individuals. James is joined by Practice Index panel members Nicola Davies and Claire Houston who reflect on the significance of the changes, how they can best prepare themselves (and their staff) as Practice Managers, and how they might mitigate the risks, and the knock on effect, on the ground.

Introductions (30 secs)

Changes to the National Living Wage (1 mins)

The Health and Social Care Levy (1 min 38 secs)

The knock-on effect on employers and employees (2 mins 32 secs)

Impact from a practice perspective (3 mins 7 secs)

Nicola’s reaction / pressure on staff (4 mins 12 secs)

Claire’s views / benchmarking performance in line with finance (6 mins 9 secs)

Implications for recruitment (7 mins 41 secs)

How can we make our vacancies more attractive to potential applicants? (8 mins 49 secs)

Pitting practice against practice (9 mins 41 secs)

Pensions changes in summary (10 mins 53 secs)

The effect of the McCloud Judgement (11 mins 40 secs)

Reviewing personal pensions choices (12 mins 13 secs)

How can we ensure everyone is aware of what’s coming? (16 mins 12 secs)

Where accountancy firms can help (18 mins 5 secs)

Will the additional costs be considered centrally? (19 mins 17 secs)

Contractual pressures (20 mins 21 secs)

Communication is key (21 mins 43 secs)

What else do we need to be aware of right now? (23 mins 17 secs)

The Practice Index benchmarking tool Claire mentioned can be found here

The Practice Index website is here

For all enquiries, please contact James Dillon here or Ben Gowland here

There have been some notable developments in the NHS pensions world since we last caught up with expert Paul Gordon in the spring of 2020. Luckily, Paul is back to bring us up to speed and to explain in simple terms where things have changed, the impact of a highly publicised age discrimination case, what the changes mean in practice for GPs and primary care staff on the ground, the key considerations for individuals based on their circumstances and most importantly, making sure those eligible are able to access the annual allowance related government endorsed compensation scheme, the deadline for this and how to determine eligibility. Listen now for a full overview of all the crucial pensions need to knows, and where to go to find out more.

Introduction (9 secs)

The main developments and changes, in summary (40 secs)

The McCloud judgement (1 min 46 secs)

Th resulting impact of the age discrimination case findings (2 mins 8 secs)

A choice of two sets of benefits (3 mins 46 secs)

Why would I opt into the newer scheme? (5 mins 30 secs)

Remaining in the ‘original’ scheme (6 mins 39 secs)

Determining retirement age and associated options at that time (9 mins 8 secs)

Retirement age and the McCloud judgement (10 mins 42 secs)

Transition to the new scheme and what this means in real terms (13 mins)

Being mindful of the annual allowance… (14 mins 28 secs)

Annual allowance tax charges (16 mins 6 secs)

Claiming compensation for annual allowance excess tax charges (17 mins 22 secs)

Who is eligible for compensation? (18 mins 31 secs)

‘The remedy period’ and what this means for individual contributions, allowances & benefits (19 mins 19 secs)

Outlining the key differences between old and new pension schemes (20 mins 16 secs)

What employers should be aware of (21 mins 18 secs)

Finding out more (22 mins 54 secs)

To request the last 7 years’ worth of annual allowance growth figures, please ring NHS Business Services Authority (NHSBA) on 0300 330 1346.

The deadline for compensation claims relating to the 19/20 tax year and the annual allowance tax charge growth and excess payments is 11 February 2022. Claimants will need to complete a Scheme Pays Election form (available via Primary Care Support England) and a compensation form. Further information can be found here.

The times they are a-changin’ and as we enter the third year since the formation of primary care networks (PCNs), Ben is joined by podcast regular and primary care management guru Tara Humphrey to take stock of the current situation in general practice. Are we still surviving, rather than thriving? What gains have been made over the last 28 months? Where do the pressures lie and where are the incumbent Clinical Directors up to in their thinking of where to go next in taking their networks forward and/or handing on responsibility to a new leader? Have we made any progress in making sure the work of individual practices intertwines with network goals and our overall vision? Do we still have an overall vision? All this and more in this week’s fascinating episode…

Introduction (9 secs)

An update from Tara (26 secs)

What are the key challenges in the PCN world currently? (1 min 23 secs)

The pressure of the new delivery requirements (1 min 58 secs)

How a PCN Manager can help (4 mins)

The link between PCN Manager and ARRS staff (5 mins 3 secs)

Managing capacity and keeping up (5 mins 44 secs)

Recent BMA reaction and the impact of this on the ground (6 mins 51 secs)

Bridging the gap between practices and PCN (7 mins 43 secs)

Taking stock at this point in the PCN journey (9 mins 55 secs)

Face to face versus virtual working (11 mins 10 secs)

Next steps into the future (11 mins 49 secs)

Passing on the baton of Clinical Directorship (13 mins 4 secs)

Balancing hierarchical structure (13 mins 57 secs)

Re-establishment of the PCN purpose and why this is so important (15 mins 43 secs)

Getting in touch (17 mins 37 secs)

To connect with Tara and to access all the available resources on offer from THC Primary Care, do check out:

The THC Primary Care website

The Business of Healthcare Podcast to get the latest insights into business and management behind the scenes in primary care.

Tara’s Twitter and LinkedIn accounts

Applications for the second round of the incredibly popular New to General Practice Partnership training programme are open! If you are considering stepping into partnership, or are a newly appointed GP partner, the Ockham Health / THC Primary Care / McCartney Health Associates training course is scheduled to begin again in February 2022. If you would like to know more, or you would like to sign up, please get in touch with Ben at [email protected]

On her almost first anniversary of working in primary care, Nusrat Kausar joins Ben on the podcast this week to discuss the parameters of her role as a dietitian specialising in supporting pre-diabetic patients and those diagnosed with Type 2 diabetes within primary care. Based in a West Yorkshire PCN, Nusrat fills us in on her experiences so far; how her previous roles have influenced her journey into general practice, the value that dietitians can add in terms of supporting the PCN and her patients, her top tips for attracting, keeping and getting the most from a good dietitian, how dietitians can blend in seamlessly with existing staff (and the more newly established additional roles teams) and turning to the future, how she foresees the role developing even further.

Introduction (1 min 10 secs)

Designing a job description (1 min 56 secs)

Nusrat’s background as a dietitian (2 mins 40 secs)

Making the move into primary care (3 mins 29 secs)

What does a day in the life of a dietitian look like? (4 mins 6 secs)

The referral process and caseload (4 mins 37 secs)

PCN demographic and how each practice works within the system (5 mins 47 secs)

Maximising service engagement (6 mins 17 secs)

Monitoring the impact so far (7 mins 28 secs)

How is the service making a difference to patients? (8 mins 26 secs)

Working alongside other ARRS team members (9 mins 24 secs)

Encouraging a sense of belonging (10 mins 12 secs)

Line management and clinical supervision (11 mins 21 secs)

How can PCNs make the best use of their dietitian? (12 mins 3 secs)

Is a more flexible approach to role design better? (13 mins 28 secs)

Nusrat’s top tips for recruiting and retaining a dietitian (15 mins 9 secs)

Advice for dietitians who are considering working in general practice (16 mins 18 secs)

Looking ahead: How will the role develop going forwards? (17 mins 44 secs)

Recommended resources (19 mins 11 secs)

Applications for the second round of the incredibly popular New to General Practice Partnership training programme are now open! If you are considering stepping into partnership, or are a newly appointed GP partner, our training course scheduled to begin again in February 2022, in collaboration with McCartney Health Associates and THC Primary Care, might just be for you. If you’d like to know more, or if you’re already sold and keen to sign up, please get in touch with Ben at [email protected]