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Solving doctors

 

Blog headlines

  • ‘There is nothing so practical as a good theory’
    16 September 2021

    The Networks blog this week comes from the Staff College: Leadership in Healthcare (Staff College) is a national charity dedicated to promoting great leadership for the public good.

  • Reflections on a ‘new’ NHS and its impact on general practice
    10 September 2021

    This week’s blog we are sharing reflections by William Greenwood on the direction for the health service and potential impact on general practice.

  • When facilitation could turn into mediation
    3 September 2021

    Requests to attend a meeting, to help find a way forward, to help with planning, to redesign a care pathway, and numerous other reasons are not always what they seem. Sometimes you will be asked to facilitate, or just asked to attend. What then happens in the room may not be the meeting that you are expecting. Other situations, such as tensions between practices, departments or teams may give a more obvious sign that what is needed goes beyond just attending or facilitating a little.

  • Population Health Management?
    26 August 2021

    One of the frequently heard phrases of the moment is population health management – but what is it and does it work. The blog is from a longer article by Monica Duncan exploring the topic.

  • The future must be primary care
    19 August 2021

    The blog this week is by Professor David Colin-Thomé, chair of PCC.

  • Preparing for winter 2021/22
    13 August 2021

    One of the hottest days of the year saw people from practices, primary care networks (PCNs) and federations gather to start to think creatively about managing their winter pressures in this session hosted by PCC and the NHS Confederation PCN Network.

  • Building the collaboration
    5 August 2021

    Prior to COVID-19 primary care network (PCN) community pharmacy leads (representing a group of pharmacy contractors in their locality) were starting to contact the clinical director for their allocated PCN to discuss how pharmacy services could develop and adapt to help address community health needs.

  • Audit into action… with a pandemic thrown into the mix!
    29 July 2021

    A blog from the Clinical Leads for the National Audit of Care at the End of Life (NACEL).

  • GP partnership uses new video to highlight benefits of its merger-led transformation
    23 July 2021

    An East Cheshire-based GP practice, the Middlewood Partnership, which formally merged in order to successfully transform its clinical and business models, is sharing insights, via a new video, with colleagues across the health and social care sector.

  • Early evaluation of the Children and Young People’s Mental Health Trailblazer
    15 July 2021

    The Birmingham, RAND and Cambridge Evaluation Centre (BRACE) is funded by the National Institute for Health Research to conduct rapid evaluation of promising new services and innovations in health and social care. The BRACE Rapid Evaluation Centre and Policy Innovation and Evaluation Research Unit have published findings from the early evaluation of the Children and Young People’s Mental Health Trailblazer programme.

  • Learn from reflection
    8 July 2021

    We are sharing an article by Helen Northall, chief executive, PCC this week on learning from reflection.

  • Link of the week: National Thank You Day
    1 July 2021

    This week we are featuring National Thank You Day.

  • North East Essex integrated discharge single point of access - implementing the Coronavirus Act 2020 and Covid-19 hospital discharge service requirements
    24 June 2021

    The blog this week is from Frank Sims, chief executive of Anglian Community Enterprise and shares learning on collaboration and redesign to support hospital discharge.

  • Helping your patients making an informed choice: Medical or Surgical abortion?
    17 June 2021

    This week the blog has been submitted by MSI Reproductive Choices UK and is about supporting patients to make an informed choice based on NICE guidance.

  • The potential for case finding patients with cardiovascular disease in a dental setting
    10 June 2021

    The blog this week is by Wendy Crew, PCC adviser, considering the opportunity to case find patients with cardiovascular disease in a dental setting.

  • Using population health data to inform ARRS recruitment
    3 June 2021

    Funding for the additional role reimbursement scheme (ARRS) has increased nationally from £430m (2020-21) to £746m max. (2021-22) with an allocation available for each primary care network (PCN) depending on the size of the population it covers. Clinical commissioning groups (CCGs) draw down the funds but only as new roles are recruited within PCNs. PCNs are therefore being strongly encouraged to make use of their ARRS allocation to ensure people in their neighbourhoods benefit from the funding available.

  • SHAPE Atlas mapping tool
    27 May 2021

    As the themes of the NHS Long Term Plan start to become reality through plans for legislation to support integration, we need to work out where the best place is to deliver services.

  • Cancer Care Map
    20 May 2021

    The blog this week has been submitted by Robin Pritchard, co-director of Cancer Care Map. Cancer Care Map is a stand-alone, comprehensive, independent, free to use online directory of cancer support services in the UK providing verified and trusted information, regularly checked and updated and accessible to all.

  • Understanding and aligning link worker and community capacity building activity: A place-based approach in York and Wakefield
    13 May 2021

    The blog this week is by Sian Lockwood, chief executive officer of Community Catalysts.

  • Virtual group consultations and Why skip/send it to landfill?
    6 May 2021

    An article on group consultations that celebrates the patient perspective and experiences of receiving care this way from Alison Manson. Blog on reusing/recycling and saving money for a NHS Trust from Alex Ford.

 
 
Thursday, 2 November 2017

Solving doctors

It’s been a week of helpful interventions. NHS England has told sustainability and transformation partnerships (STPs) to sort out the GP recruitment crisis. NHS Improvement has taken high-impact steps to enrich the lives of junior doctors. Two different initiatives, two different sets of doctors, two national bodies determined to make the world more doctor-based and success-centric.

Magic Kingdom

We have the HSJ to thank for the story that NHS England has set STPs targets for GP recruitment. Only lack of statutory powers, resources and candidates stand in their way.

Otherwise it’s a great idea. Devolution has been focused for too long on the vulgar business of funding and not enough on finding really practical solutions to problems that Big Government is too sausage-fingered to solve.

STP unorganisations already have secondary care deficits, hospital performance and decaying social care on their plates. Added to which they have the job of plotting the route to the Magic Kingdom, the fairytale world of accountable care organisations and new care models featured in Walt Disney’s Forward View. Sorting out the primary care workforce is a breeze by comparison. 

Local GP training initiatives could obviate the need for Health Education England, local education and training boards, royal colleges and other expensive bureaucratic paraphernalia. We could even finish the job started by Lord Lansley, and get rid of the Department of Health altogether. Think of the money we’d save.

Relax

It’s no coincidence that this news comes in the same week that the department announced a consultation on relaxing medical regulation. The current rules requiring years of training and learning on the job were designed for an age where doctors were compelled to practise medicine before they were allowed to practise medicine.

But there is little to be gained by harking back to the 1950s. We need to redefine “GP” for the new world. You wouldn’t dream of training someone for ten years to flip burgers, paint your home or drive an Uber taxi, so what makes doctors so special?

GP training could open up in a variety of innovative ways. They could include opportunities for stay-at-home mums planning a return to work, retraining for eastern European plumbers and builders seeking post-Brexit job security, and courses at local colleges enabling medicine to be combined with media studies, sociology and modern dance. E-learning would allow doctors to upskill at their own pace and still leave time for evening bar work.

We don’t need stuffy old colleges and mentoring schemes. There are thousands of qualified docs on social media who trainee community doctors and wellbeing assistants could turn to for advice and support.

Quacks

In other news, junior doctors responded with gratitude to a guide from NHS Improvement to making their working lives better. It turns out that traditional forms of stress-relief - alcohol, drugs, sex and contract disputes - do not work. Eight High Impact Actions to Improve the Working Environment for Junior Doctors advises, among other top tips, that they should be given access to fresh water – leading one medic to wonder if the authors were confusing junior doctors with ducks.

Animal husbandry is a recurring theme. We also learn that hospitals could employ a “dedicated pastoral lead”, who would presumably ensure that busy doctors get a break for fresh air, exercise and grazing.

Other suggestions include “promoting rest”, “rewarding excellence”, and “better engagement with the board”. The authors may be on to something here. A couple of hours in a board meeting could be just the thing to make a long shift in an understaffed emergency department suddenly seem appealing.   

Impactfulness

Concerned that NHS Improvement may have missed some even higher impact actions, we canvased doctors. Here are some of their ideas for enhancing the working environment.

  1. Take turns to have a go on the ride-on floor cleaners
  2. Do ward rounds/surgery outside if it’s nice
  3. Customise your pager’s ring-tone or choose your own call-sign, eg Iceman, Maverick
  4. A non-smoking room with retro nicotine décor and faux ashtrays
  5. Biscuits/stickers to reward excellence and celebrate success
  6. Allotments for growing vegetables
  7. Workshops on proactive chatting, compassionate breathing and mindful positivity led by NHS Horizons
  8. Complementary sanitising hand gel.

Hospitals that adopt these innovations can expect to see an up to 1000% improvement in the morale of junior doctors, albeit from a lowish base. Don’t forget to choose a suitably high-impact way to mark each achievement along the way. The Dam Busters theme played at high volume goes down particularly well on geriatric wards. Staff in other departments will have their own ideas.

Improvement editor: NHS Networks 

@NHSnetworks
websupport@networks.nhs.uk

 
Dee Gray
Dee Gray says:
Nov 03, 2017 07:59 AM

Motivational talks from Chief Execs have been overlooked. They are really good at getting doctors to deliver on targets, especially those that make money for NHS.

Anonymous says:
Nov 03, 2017 03:23 PM

Thanks JP. Glad to see Top Gun directly referenced in this week’s dispatches.

With reference to doctors training - I think the NHS should be looking to harmonise its approach around shared life experiences. This would help reduce the natural anxiety most feel when first encountering clinical environments. I am of course referring to the happy days spent by most flipping burgers, pulling pints and de-constructing lattes.

Suggest a bell at the nurse base would help promote an overall feeling of familiarity. For example, this could dinged every time a patient is discharged with an added incentive of two dings if the patient makes it onto transport before 1000am (Refer 2017 Top 10 high impact changes affecting discharge ).

Possibly for balance we should also look at a similar approach to re-admissions? The jury would need to decide whether introducing a Two Ronnie’s sound effect from the Phantom Raspberry Blower of Old
London Town would be an effective deterrent?

b/rgs ‘Goosed’