Releasing time in general practice (Robert Varnam)

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


The issue


Quality
• safety
• effectiveness
• experience
Care & support
Secondary /
specialist care

Access
Diagnostics

Community
services

Proactivity

Coordination

Pharmacy

Self care


CCG

AT

LA


Visual
Management



Comprehensive lean-based redesign
for busy general practices
Practical, guided, supported


• 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


• Support packages from expert teams
• Options for sharing & collaboration between practices
• Aligned with strategic commissioning priorities


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

„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


Examples
 Improvement & transformation
 Better care & reduced costs
 Reduced hassle & time


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


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


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


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

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

Sort

Set

Shine

Standardise

Sustain


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

NHS England‟s strategic framework


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.

Improving efficiency in practice systems and processes.

Top tips
Prepare, engage, explain, collaborate, support


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


bit.ly/1hD0GCD

www.nhsiq.nhs.uk/capacity-capability/productive-gp.aspx
enquiries@nhsiq.nhs.uk
robert.varnam@nhs.net

slidesha.re/1cyDzWS


bit.ly/1hD0GCD

Releasing time in general practice (Robert Varnam)

Recomendados

Recomendados

Más contenido relacionado

La actualidad más candente

La actualidad más candente (20)

Destacado

Destacado (20)

Similar a Releasing time in general practice (Robert Varnam)

Similar a Releasing time in general practice (Robert Varnam) (20)

Más de Robert Varnam Coaching

Más de Robert Varnam Coaching (18)

Último

Último (20)

Releasing time in general practice (Robert Varnam)

Notas del editor