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Releasing time in general practice (Robert Varnam)

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Information about Releasing time in general practice (Robert Varnam)
Health & Medicine

Published on March 3, 2014

Author: rvarnam

Source: slideshare.net

Description

Presentation at NHS Expo 2014. A review of the need to release capacity in general practice, the impact of the Productive General Practice programme so far, and top tips about deploying the programme for maximum benefit.

RECORDING is here: http://www.screencast.com/t/ySvkzxftg
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Releasing time in general practice Dr Robert Varnam PhD MRCGP Clinical lead for CCG & primary care delivery, NHS Improving Quality Head of general practice development, NHS England GP, Robert Darbishire Practice, Manchester robert.varnam@nhs.net slidesha.re/1cyDzWS @robertvarnam #GPdev @NHSIQ

Releasing time in general practice      The issue The Productive General Practice Examples Deployment Top tips @robertvarnam #GPdev @NHSIQ

Releasing time in general practice      The issue The Productive General Practice Examples Deployment Top tips @robertvarnam #GPdev @NHSIQ

The issue @robertvarnam #GPdev @NHSIQ

Quality • safety • effectiveness • experience Care & support Secondary / specialist care Access Diagnostics Community services Proactivity Coordination Pharmacy Self care @robertvarnam #GPdev @NHSIQ CCG AT LA

@robertvarnam #GPdev @NHSIQ

Releasing time in general practice      The issue The Productive General Practice Examples Deployment Top tips @robertvarnam #GPdev @NHSIQ

The Productive General Practice @robertvarnam #GPdev @NHSIQ

The Productive General Practice Visual Management @robertvarnam #GPdev @NHSIQ

The Productive General Practice @robertvarnam #GPdev @NHSIQ

The Productive General Practice Comprehensive lean-based redesign for busy general practices Practical, guided, supported @robertvarnam #GPdev @NHSIQ

The Productive General Practice @robertvarnam #GPdev @NHSIQ

The Productive General Practice @robertvarnam #GPdev @NHSIQ

The Productive General Practice • 12 modules packaged in a box set • Manageable, easy to follow, self-directed modules • A large range of supporting resources – spreadsheets, documents, eLearning and guidance films @robertvarnam #GPdev @NHSIQ

The Productive General Practice • Support packages from expert teams • Options for sharing & collaboration between practices • Aligned with strategic commissioning priorities @robertvarnam #GPdev @NHSIQ

Typical results • Extra nursing capacity identified, providing extra capacity worth £11k • More accurate staff planning resulted in the cancellation of planned appointment of staff – avoiding £15k of staff expenditure year on year • Time taken to retrieve prescriptions requests reduced by 82%, releasing 12.5hrs of staff time per week • Turnaround time for medical reports reduced by 43% • 14% reduction in stationary costs • 57% reduction in blood test resource costs • 82% reduction in nurse sickness and absence @robertvarnam #GPdev @NHSIQ

„I seem to manage to get home on time much more often than I used to … It makes a big difference to my work-life balance.‟ Dr Knut Schroeder, Bristol “Led to changes that were really life changing for me. Improvements mean I do not stay late evenings and this means I am not making mistakes because I am tired.” Dr Angela Bradley, Leamington Spa Our list size has started to grow for the first time in a good while … the practice is more efficient, friendly, flexible and productive. Dr Paul Cook, Bolsover @robertvarnam #GPdev @NHSIQ

Releasing time in general practice      The issue The Productive General Practice Examples Deployment Top tips @robertvarnam #GPdev @NHSIQ

Examples  Improvement & transformation  Better care & reduced costs  Reduced hassle & time @robertvarnam #GPdev @NHSIQ

eg Improvement & transformation Improving today’s practice Process redesign • “given us a structured approach to making improvements”  reduced the number of calls GPs have to make by 80% and released time for an extra 2 patients to be seen each day @robertvarnam #GPdev @NHSIQ

eg Improvement & transformation @robertvarnam #GPdev @NHSIQ

eg Improvement & transformation @robertvarnam #GPdev @NHSIQ

eg Improvement & transformation Shaping our future practice Radically re-thinking & transforming • focus on self-care, group consultations, technology  patient-led design approach  segmentation of high profile patient groups  proactive multiple LTC review clinics @robertvarnam #GPdev @NHSIQ

eg Better care & reduced costs Handling of repeat prescriptions • source of “near-constant frustration for staff” • already looked at several times  small, short-lived improvements @robertvarnam #GPdev @NHSIQ

eg Better care & reduced costs PGP Prescribing Module  saved 12 hours of receptionist time per week • „script hunt‟ reduced from 118 to 21 seconds • less time waiting for GPs • happier staff, less stressed  75% reduction in interruptions for GPs • happier GPs, feeling safer  50% drop in „urgent‟ requests • less sense we‟re working „on the brink‟ all the time @robertvarnam #GPdev @NHSIQ

eg Reduced hassle & time Sort Remove non-essential things Set Organise necessary things Assign each object a place Shine Standardise Regularly clean & maintain the area Develop procedures, arrange similar areas in similar ways, use colour codes Use regular audits and embed 5S in the everyday Sustain @robertvarnam #GPdev @NHSIQ routine

eg Reduced hassle & time Sort Set Shine Standardise Sustain @robertvarnam #GPdev @NHSIQ

eg Reduced hassle & time Sort Set Shine Standardise Sustain @robertvarnam #GPdev @NHSIQ

eg Reduced hassle & time Sort Set Shine Standardise Sustain @robertvarnam #GPdev @NHSIQ

eg Reduced hassle & time Sort Set Shine Standardise Sustain @robertvarnam #GPdev @NHSIQ

eg Reduced hassle & time Sort Set Shine Standardise Sustain @robertvarnam #GPdev @NHSIQ

eg Reduced hassle & time @robertvarnam #GPdev @NHSIQ

Releasing time in general practice      The issue The Productive General Practice Examples Deployment Top tips @robertvarnam #GPdev @NHSIQ

Deployment • Appealing & relevant to wide variety of practices • Most are doing PGP in collaboration with others • Attractive in supporting CCGs‟ system transformation strategies • Time & commitment are essential • Support is highly valued • Additional training in improvement tools is helpful @robertvarnam #GPdev @NHSIQ

NHS England‟s strategic framework @robertvarnam #GPdev @NHSIQ

Aug 13 • Call to action on general practice. • Strategic framework for commissioning general practice. • 9 workstreams. Mar 14 • Emerging Findings Apr 14 • Phase Two

General practice development programme 1. Innovation spread Learning networks Peer networking Innovation hub Bureaucracy 2. Release capacity Clinical ‘clutter’ Internal productivity 3. Capability-building 4. Business development Development advisers Service improvement Leadership Legal Financial Management National Coordinating Centre Strategic Development leadership advisers National guidance PMO support Evaluation

Release capacity Bureaucracy Administrative pressures on practices originating within the NHS, particularly through contracting. Clinical ‘clutter’ Potentially avoidable demand for consultations created outside the practice. The Productive General Practice Improving efficiency in practice systems and processes.

Releasing time in general practice      The issue The Productive General Practice Examples Deployment Top tips @robertvarnam #GPdev @NHSIQ

Top tips Prepare, engage, explain, collaborate, support @robertvarnam #GPdev @NHSIQ

@robertvarnam #GPdev @NHSIQ

Top tips  Create strategic alignment  Create a values-based shared purpose  Do it collaboratively  Engage, engage, engage  Be realistic about time commitment  Build local support resource  Use it as it is meant to be used @robertvarnam #GPdev @NHSIQ bit.ly/1hD0GCD

www.nhsiq.nhs.uk/capacity-capability/productive-gp.aspx enquiries@nhsiq.nhs.uk robert.varnam@nhs.net slidesha.re/1cyDzWS @robertvarnam #GPdev @NHSIQ bit.ly/1hD0GCD

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