Thank You For Inviting Us

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Thank You For Inviting Us
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GP Conference, Almaty, Kazakhstan (17 to 18
November 2014)

• GP Changes and Developments in England
• Presentation to Introduce the
• Discussion Paper
• Dr Steve Collins (Learning and Change Consultant)
• Botagaz Hopkinson (Public Health Adviser)

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Outline of Presentation and Paper

• NHS Historical Introduction (Steve)
• The Changing NHS today (Bota)
• Useful Management Models to understand changes
  (Steve)
• Changing Role of GPs (Bota)
• Outline for GP Training Programme Steve)

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A Good Place To Start
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NHS History One 1914-18The Need for State
Intervention

• Limited Healthcare Sector
• Fee for Service Doctors
• Endowed Hospitals
• Charities
• Voluntarism
• Growth of 'Homes for Heroes' Concept

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NHS History 2 Post 1945 Introduction of
Welfare State

• Beveridge - Tackling the 'Five Giants' of Social
  Deprivation
• 1946 NHS Created - Combining Existing Health
  Provision for a 'State Service Free at the Point
  of Entry'
• GPs become 'point of entry
• Also gradual Introduction of Social Security,
  State Education System Council Housing, Keynesian
  Economics - Create 'State Welfare Net

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NHS History 3 'Thatcherism'
Purchaser-Provider Model

• Welfare State an efficient burden on the economy
  need to 'roll back the welfare state'
• NHS an expensive, unchanging, 'ill-health
  institution
• Market Principles and Business Practices
  introduced
• Accountability Introduced
• NHS Split into Contractors and Providers
• 'Explicit Quality'
• Move from 'Institution to Community'
• GP Fundholding Created

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NHS History 4 'Blairist Third Way' and
'Cameron's Coalition Compromise'

• Responsible Citizenship
• Greater Equality and Respect
• Patient-Centred Focus
• Inclusion and Integration
• Seamlessness in Operations
• Transparency in all Activities
• A Need for Ongoing Change
• Improved Services
• Positive NHS Image

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• NHS Executive -
• Now NHS England
• Strategic
• Requirements

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NHS 'Brand' Objectives Include

• Raise Awareness
• Change Perceptions
• Work Towards Behaviour Change
• Enhance Service
• Share Experience, Skills and Expertise
• Access Consumer Insight
• Promote Campaign Message
• Increase Credibility and Extend Reach of 'A
  Message'
• Raise Event Profiles
• Raise Revenue

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Interactive Models Online
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NHS England
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Primary and Secondary Healthcare Functions
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Old and Proposed Primary System
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Commissioning Cycle
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Commissioning Structure
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Previous NHS Before Reforms
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BMA View NHS Structure 2013
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NHS Regulators and Watchdogs

• Care Quality Commission (CQC)
• Healthwatch England
• Human Fertilisation and Embryonic Authority
  (HFFA)
• Human Tissue Authority (HTA)
• Medicines and Healthcare Products Regulatory
  Agency (MHRA)
• Medical Research Council
• Monitor
• National Institute for Health and Care Excellence
  (NICE)
• Professional Standards Authority
• Public Health England
• National Institute for Health Research (NIHR)

• British Medical Association (BMA)
• Nursing and Midwifery Council
• Royal College of GPS and other Professional
  Bodies
• Educational Regulators
• Occupational Health and Safety Commission
• Civil Rights Commission
• Equal Opportunities Commission
• Other Statutory Bodies
• Media and Press

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'The Times' - Current Headlines and Commentary

• 'Patients told to go online in radical NHS
  Reforms' (Thursday 13 November 2014)
• 'Doctors' surgeries must become treatment
  centres, says NHS Chief'
• 'Your medical data has loaded...the doctors will
  skype you now'
• 'Smaller hospitals told to share their doctors on
  skype'
• Family doctors told to see patients seven days a
  week'
• 'Surgeries need 20,000 new staff for seven-day
  opening' (Friday 14 November 2014)

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'Online NHS' Reaction from BMA

• Virtual NHS consultations were insecure and
  risked wastig doctors' time on 'IT savvy' rather
  than those who were actually sick'
• '..it is too 'simplistic' to expect big savings
  through technology'
• 'Mr Hunt has arued that the NHS needs a digital
  revolution to follow those in banking and budget
  airlines but Dr Nagpaul dismissed that
  comparison...'
• (Friday 14 November 2014)

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Enfield's Joint Health and Wellbeing Forum

• Click to add text

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Health and Wellbeing Forum Information Sheets
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Management Thinking Learning Organisation
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Management Thinking Multi-Disciplimary Team
Building
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Management Theory Vision Building
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Royal College of GPs Euston Square
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Royal College of GPs 2022 Vision
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RCGPs - Developing Community Based Practice for
2022

• Promote greater understanding of generalist Care
  and its Value
• Develop new generalist-led, integrated services
  to deliver personalised, effective care
• Expand the capacity of the GP workforce to meet
  population and service needs
• Expand he skills and flexibility of GP workforce
  to provide complex care
• Support the organisational development of
  community based practices, teams and networks
• Increase Community-based academic activity to
  improve effectiveness, research and quality

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RCGPs Enhanced Training
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Growth of General Practice Management

• Most GP practices today employ a suitably
  qualified GP Manager
• Series of National Vocational Qualifications
  (NVQs) have been developed by AMSPAR and City and
  Guilds covering all support roles including
• Practice Managers
• Medical Secretaries
• General Admin Staff
• Receptionists

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Enfield's GP Practices
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White Lodge Medical Practice, Enfield
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White Lodge Dr Neil Amin
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NHS History 5 Greater Role for GPs

• Increasing and enlarging clinical services
  previously in hospitals
• Closer Patient Interaction
• Business and Service Development
• Public Marketing Role
• Learning and Change Management Agency
• Information Provision to Wider Public
• Increased reporting back to new bodies
• GPs made Central to all Systems with wider role
  in the management of the new systems Clinical
  Care Commissioning and Health and Wellbeing
  Forums
• Leadership and Organisation Development

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Learning Thinking - Approach
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Learning Thinking Proposed Learning Programme
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Proposed Topics Areas

• The Importance of Feedback
• Teambuilding
• Marketing Management
• Online Service Development
• Communications and Interaction
• Training and Developing Others
• Organisation Thinking
• Corporate Social Responsibility
• Project Management
• Knowledge Management
• Cultural Difference
• Negotiation and Conflict Handling

• Changing Clinical Practice
• Building a GP Practice Business
• Understanding the UK health and social care
  system
• Developing Quality Services
• Change Management
• Leadership
• Visioning, Strategy and Planning
• The Role and Function of Management
• Self Awareness and Development

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Possible Programme Outline
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Summary

• NHS has devolved eclectically and remains
  bureaucratic
• New reforms look to provide improved, local
  services in the
• wider context
• GPs are central to recent reform implementation
• New NHS developments reflect current management
  thinking
• and can be applied locally at least
• GP development in management skills is invaluable
• GP practices need to develop their full resources
  

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Thank You

• Do please contact Steve or Bota during the
  conference if there is any issue you wish to
  discuss or develop