How to ensure effective GP services at a time of swine flu, funding cuts and low resources? In many ways, this question formed a thematic undercurrent to the Management in Practice Event on Wednesday (6 October) at the Birmingham NEC.
This was the last of our three annual events and, while speaker presentations and the afternoon panel session drove home the point that NHS finances are anything but healthy, which will no doubt have a significant impact on how general practice operates, it was reassuring to see that delivering high-quality GP patient services remained the foremost concern.
Nowhere was this more apparent that at the MiP Awards Ceremony, which took place in the early afternoon. Once again it was a privilege to take part in this presentation and meet practice teams who are going above and beyond a baseline level of service to deliver excellent patient care in all areas of modern general practice – click on the news stories below to read about the winners. I'm just sorry that we can't include mention of the runners-up too, who, it needn't be said, also delivered superb patient care, but who just missed out because the standard was so very high.
As Philippa White, Practice Manager of the Upton Surgery, which won the Practice of the Year Award, said, there are hundreds of unsung practice managers across the country doing great work. It's my belief that the winners do not stand outside the general trend of UK primary care, but rather reflect the typical high standard to be found in UK GP surgeries, but which sadly goes unnoticed among negative headlines.
We'll be hearing more from our winners in Management in Practice – in addition to the stories below, several features are planned for the magazine and winners will also be given the opportunity to speak at MiP Events in 2010.
The theme of quality kicked off early on at Birmingham, when keynote speaker Dr Maureen Baker congratulated practice teams for doing a "brilliant job" earlier this year when faced with the influx of concern over swine flu.
As expected, Dr Baker, the RCGP's flu pandemic lead, gave an authoritative overview of the swine flu threat, explaining how the government arrived at the "worst-case scenario" of a possible 750,000 excess deaths from pandemic flu, and concluding that, sadly, there is still scope for a significant increase in swine-flu cases.
Following this, specialist medical accountant Rosemary Smith outlined her "financial dos and don't this year", looking at the preparatory steps a practice can take to maximise its profits. Like every financial talk at MiP Events this year, the session was filled to capacity; clearly, and regrettably, the threat of income losses and keeping costs to a minimum are particularly topical concerns now.
In a concurrent talk on world class commissioning (WCC), Carolyn Robertson from the NHS Institute for Innovation and Improvement noted NHS Chief Executive David Nicholson's quote from September this year: "In financially difficult times, clinical empowerment is a necessity." With the NHS needing to close a funding gap of between £10-20bn, the need for robust and effective services could be a severe challenge.
Could WCC hold a solution? Carolyn outlined the need to "create a compact" between PBC and PCTs, but it's clear this is no mean feat. As one manager commented during this session, "PBC and patient choice are totally different things" – if that's true, will PCTs support PBC initiatives if they are not on their immediate agenda? Perhaps a solution, supported by the Conservatives, is to allocate real budgets to PBC? It seems this is a difficult area, and one that may well shift if there is a change in government between now and next year.
The political dimension of general practice dominated the afternoon's panel session. The first topic was the impact of Lord Darzi on primary care. Following his resignation, would he be missed?
Not by healthcare writer and broadcaster Roy Lilley, who said: "I'm pleased he's gone. If you want to reform primary care, why go to a surgeon?" He said he opposed the construction of polyclinics, or "Darzi domes", as this moved away from the fundamentally local community service of general practice.
The panel session went on to discuss practice boundaries, Connecting for Health (which Wendy Garcarz described as a financial "black hole" to applause from some delegates – yet Roy Lilley argued the case that investing in good IT was necessary to improve poor – and costly – administration, such as chasing after patients' paper records), the Care Quality Commission and primary care organisation.
On the latter point, Roy Lilley argued that PCTs should be abolished and practices given the money in a return to fundholding. Dr Grant Ingrams, the West Midlands GPC Secretary, rejected this idea but contended that there are too many PCTs, which should be reduced in number. Both interesting propositions – what are your views?
One of the highlights of the day was Roy Lilley's afternoon speaker presentation, entitled "It ain't what you do …", in which he discussed the NHS and the delivery of a good healthcare service. As Roy argued, the delivery of quality patient care often lies in the extra effort and the details – the nurse who phones her patient up to find out how they are, the GP who knows his patient's history and takes the time to listen, and the manager who understands and facilitates all of this.
Preserving good patient care at a time of funding cuts: another new challenge for primary care!
MiP Awards news: