Releasing time in general practice (Robert Varnam)
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This document discusses the concept of 'releasing time in general practice' led by Dr. Robert Varnam, focusing on improving efficiency and reducing administrative burdens in GP practices through structured approaches and lean management techniques. It highlights successful cases of practices achieving significant improvements, including reduced costs and enhanced staff work-life balance. The document also includes deployment strategies, top tips for implementation, and the significance of collaborative efforts and support in achieving these goals.
Releasing time in general practice (Robert Varnam)
- 1. 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
- 2. Releasing time in general practice The issue The Productive General Practice Examples Deployment Top tips @robertvarnam #GPdev @NHSIQ
- 3. Releasing time in general practice The issue The Productive General Practice Examples Deployment Top tips @robertvarnam #GPdev @NHSIQ
- 4. The issue @robertvarnam #GPdev @NHSIQ
- 5. Quality • safety • effectiveness • experience Care & support Secondary / specialist care Access Diagnostics Community services Proactivity Coordination Pharmacy Self care @robertvarnam #GPdev @NHSIQ CCG AT LA
- 8. Releasing time in general practice The issue The Productive General Practice Examples Deployment Top tips @robertvarnam #GPdev @NHSIQ
- 9. The Productive General Practice @robertvarnam #GPdev @NHSIQ
- 10. The Productive General Practice Visual Management @robertvarnam #GPdev @NHSIQ
- 11. The Productive General Practice @robertvarnam #GPdev @NHSIQ
- 12. The Productive General Practice Comprehensive lean-based redesign for busy general practices Practical, guided, supported @robertvarnam #GPdev @NHSIQ
- 13. The Productive General Practice @robertvarnam #GPdev @NHSIQ
- 14. The Productive General Practice @robertvarnam #GPdev @NHSIQ
- 15. 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
- 16. The Productive General Practice • Support packages from expert teams • Options for sharing & collaboration between practices • Aligned with strategic commissioning priorities @robertvarnam #GPdev @NHSIQ
- 17. 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
- 18. „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
- 19. Releasing time in general practice The issue The Productive General Practice Examples Deployment Top tips @robertvarnam #GPdev @NHSIQ
- 20. Examples Improvement & transformation Better care & reduced costs Reduced hassle & time @robertvarnam #GPdev @NHSIQ
- 21. 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
- 22. eg Improvement & transformation @robertvarnam #GPdev @NHSIQ
- 23. eg Improvement & transformation @robertvarnam #GPdev @NHSIQ
- 24. 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
- 25. 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
- 26. 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
- 27. 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
- 28. eg Reduced hassle & time Sort Set Shine Standardise Sustain @robertvarnam #GPdev @NHSIQ
- 29. eg Reduced hassle & time Sort Set Shine Standardise Sustain @robertvarnam #GPdev @NHSIQ
- 30. eg Reduced hassle & time Sort Set Shine Standardise Sustain @robertvarnam #GPdev @NHSIQ
- 31. eg Reduced hassle & time Sort Set Shine Standardise Sustain @robertvarnam #GPdev @NHSIQ
- 32. eg Reduced hassle & time Sort Set Shine Standardise Sustain @robertvarnam #GPdev @NHSIQ
- 33. eg Reduced hassle & time @robertvarnam #GPdev @NHSIQ
- 34. Releasing time in general practice The issue The Productive General Practice Examples Deployment Top tips @robertvarnam #GPdev @NHSIQ
- 35. 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
- 36. NHS England‟s strategic framework @robertvarnam #GPdev @NHSIQ
- 37. Aug 13 • Call to action on general practice. • Strategic framework for commissioning general practice. • 9 workstreams. Mar 14 • Emerging Findings Apr 14 • Phase Two
- 38. 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
- 39. 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.
- 40. Releasing time in general practice The issue The Productive General Practice Examples Deployment Top tips @robertvarnam #GPdev @NHSIQ
- 41. Top tips Prepare, engage, explain, collaborate, support @robertvarnam #GPdev @NHSIQ
- 43. 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
Editor's Notes
- #2: Power options** RECORDING **CLICKERSPEAKER FOR VIDEOHandouts& pens
- #5: We need to simultaneously:improve outcomes for the population & patientshandle a growing number of people with multi-morbidity, whom we can’t cure and should stop sending into hospitalsave the health and care system from bankruptcy
- #7: What is happening here?What is the impact?Learning: waste == safety == quality == experience
- #8: Slide: The challenge and pressure for general practice is increasing in a number of ways.Duration: 5-10 minutes (this and the next 2 slides)Preparation:Materials:Script:Ask them what it feels like get their personal view of the pressures they are facing as practices at the moment. This is your opportunity to show that you understand the demands of general practice. Run through each graph on the page.
- #14: This is how PGP defines value. It’s about making the most of every opportunity, and reducing waste of human spirit
- #16: Slide: How does the programme work?Duration: 2 minutePreparation:Materials:Script:The modules are designed to be a step-by-step guide for the module lead (practice manager or GP or receptionist etc). Everything is laid out clearly. Each module explains how the module lead works with others in the practice to identify opportunities to make things work better for the benefit of you and your patients. There are a range of resources on line (that hopefully you have discovered). We have put these resources together so that you don’t have to spend time creating word documents, slide packs or spreadsheets!