Tips on managing
demand in
general practice
Patient demand is increasing and there aren’t
enough GPs and nurses to go round but there
is a lot you can do to manage the pressure,
says practice manager Jo Wadey
Jo, who is the NAPC
representative on
Jo Wadey, NAPC
the National Practice
Representative, National
Practice Manager Network, Manger Network, will
be sharing with Best
will be speaking
Practice delegates
at Best Practice
some of the innovative
initiatives around skill mix and patient education
that have been introduced to relieve the pressure on
clinicians at the St Lawrence Surgery in Worthing.
for an appointment that they are directed to the right
healthcare professional which could be a nurse
practitioner who can prescribe, a paramedic or a GP.
After reviewing their skill mix, the practice has
taken on a paramedic who now does 80 per cent of
home visits, freeing up GPs to spend more time with
patients with complex needs. They have also set up
a triage system to ensure that when patients phone
The practice is also very focused on educating
patients about self-care, as a way of reducing
demand. They run evening education talks for
patients on how to prevent and manage a range of
conditions and have made a bank of self-care leaflets
The practice can also refer patients to four minor
injury and minor injury assessment MIAMI (minor
injury assessment and minor injury) clinics set up
with money from the Prime Minister’s Challenge
fund. The clinics are run by Innovations in Primary
Care, a GP provider company, the practice has joined.
available at the reception desk to inform patients how
they can manage their symptoms at home. Parents
with young children are given the RCGP leaflet When
to Worry, a guide to coughs, colds, earache and sore
throat, to help them understand when their child
needs to see a doctor and when they can be looked
after at home.
The practice further supports patients by linking in
to a range of community services such as singing,
walking, exercise, diet and smoking cessation groups
and run an annual community open day. An advocacy
service based in the practice relieves pressure on
staff by providing support for people with social
problems that might be affecting their health.
In October the practice will start working with Guild
Care, a charity in their area that runs nursing homes
which target patients with dementia, the housebound
and other socially isolated people to bring them in to
the surgery for coffee mornings.
“We have been trying out lots of different projects
over the years to see which ones will work. We just
keep adding more and more initiatives and are helped
by our very enthusiastic patient participation group
which supports us with fund raising and new ideas,”
says Jo.
Her talk is aimed at practice managers and primary
care clinicians who want some ideas on how they can
reduce demand in their surgeries.
“Every time I go to the Best Practice
conference I come away with new ideas
to implement in my practice when I get
back. It’s a great opportunity to network
and for practice managers to get out
and have some headspace be inspired
by things other people are doing. Best
Practice is a great conference for that”
NEW LEADERSHIP AND BUSINESS SKILLS
SUPPORT IS IN THE OFFING FOR PRIMARY
CARE PROVIDER ORGANISATIONS
The NAPC’s National Association of Provider Organisations (NAPO)
and the NHS Alliance’s Accelerate programme have begun to
jointly develop a new programme of leadership and business skills
development for the new vanguard sites and GP federations
They have put in a bid for funds from NHS England
to enable a combined programme to be rolled out
across the vanguards and NAPO’s extensive network
of over100 member federations covering a population
of around 15 million people. NAPO is a network
of primary care provider companies focused on
delivering more ‘out of hospital’ care and formed by
the National Association of Primary Care (NAPC).
NAPC President Dr James Kingsland said NHS
England had asked them to collaborate with the
NHS Alliance on providing this support and has
signalled that funding would be available to launch
this new initiative. Vanguard sites would be able to
choose whether or not they used this new service.
NHS market and develop attractive services, help
them to understand the business environment
they are operating in, the current policy direction
and the aims of the Five Year Forward View.
The courses will help people in these
organisations understand how to create an
inclusive and collective approach and will
focus on purposeful leadership rather than
positional leadership. There is also a real need
for succession planning – to bring on the next
generation of leaders, said Dr Kingsland.
“The programme will be developed initially for the
vanguard sites because they are already piloting the
NHS 5 Year Forward View, but we are also looking at
developing a wider programme for GP federations and
other primary care provider organisations,” he said.
He added that there was a growing recognition
that the NHS was a provider of care, not buying
organisation. “There are more clinicians now
interested and involved in getting together to plan
the provision of care rather than the strategic
commissioning of care. The NAPO/Alliance
programme will be designed to develop that
clinical thinking and thought leadership.
The training programmes will be designed to help
primary care providers stay competitive in the
“We’ve now got a tough internal market in
the NHS where secondary care is sometimes
www.bestpracticeshow.co.uk
James Kingsland, President, NAPC,
will be speaking at Best Practice
competing with primary care to deliver services.
People in the vanguards and federations now
need a skill