Practice Business Media Pack

Practice INSPIRING BUSINESS SOLUTIONS FOR PRACTICE MANAGERS

MEDIA INFORMATION

www.practicebusiness.co.uk

The changing health sector Patients are living longer; there are more and better treatments available; but the health budget is finite. The solution: DELIVER MORE CARE WITHIN PRIMARY CARE Services delivered close to home, by the people patients know and trust:  delivers better patient experience and better health outcomes  and it’s much better value for taxpayers – the two key drivers of government policy.

For the practice, delivering more services is financially rewarding, but it all needs to be managed, and practise managers are the people in place to do this.

GP COMMISSIONING The Government is committed to establishing radical changes to the NHS to ensure it better meets the needs of patients at a local level.

In July 2010, it published the whitepaper ‘Equity and Excellence: Liberating the NHS’, concluding that GPs were best suited to make decisions on behalf of their patients and paving the way to GP-led commissioning.

Pathfinder CCGs formed, and quickly covered nearly 90% of the patient population in England. Their boards included GPs, practice managers practice nurses and latterly, secondary clinicians.

It is becoming increasingly clear that practice managers are stepping up to take on the management support role in these groups.

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The evolving role

Practice managers are the professionals to influence when it comes to selecting, specifying or purchasing decisions in the practice.

The Government has publicly linked the success of its own health agenda to the development of a successful primary care sector and for primary care to really prosper, a tier of great practice managers is essential.

of the practice manager

In recent years, the practice manager’s role has extended way beyond its traditional responsibilities.

Going forward, the scope of the role is set to increase further and it is vital they receive focused attention.

ARE YOU SERIOUS ABOUT PRACTICE MANAGERS? THE GOVERNMENT IS… During the last GMS/PMS health chapter, a core theme and outcome was GPs positively delegating all practice-wide management issues to the practice manager.

For the current chapter, practice managers were widely consulted in developing the policy for the white paper: ‘Equity and Excellence: Liberating the NHS’.

And now, CCG boards typically include two or three practice managers – as since GPs generally have little management experience, it is practice managers that are stepping up to take on the management support role.

A study into the practice manager’s responsibility for managing the income and expenditure within a practice indicated that: Practice managers are responsible for managing 68.6% of all income and 97.9% of all costs

Changing the way practice managers do business Our goal is to totally support practice managers in their role with strategic, managementfocused content If it doesn’t help practice managers to be more effective, it doesn’t make it into the magazine or onto the website

We think that to be useful, information needs filtering, context and, most importantly, practical guidance on how best to use it. Like many professionals, practice managers can be too busy to do all that, so we do it for them and deliver it in a format they understand; because we do all that for them, they read what we deliver.

INFORMATIVE, FOCUSED, RELEVANT A MANAGEMENT FOCUS

Our editorial content is based on a clear understanding of the health sector, primary care and, in particular, the way practices and practice management are evolving. We respond with appropriate, focused editorial to support and stimulate the reader in all aspects of their job.

TAILORED TO SUIT

We deliver across a range of media, so practice managers can choose how they want to receive our content, whether it be:  daily through our websites, blogs and social media feeds  weekly through our email newsletters and alerts  monthly in Practice Business magazine.  or throughout the year with our conference media partner arrangements.

Who is holding the purse strings?

As an advertiser, you can rest assured knowing your marketing budget is going straight to the decision-maker

The practice manager has significant responsibility for directly selecting, specifying and purchasing a wide range of products and services. They are also the custodian of the GP’s time and a gatekeeper to practice access WHICH PRODUCTS AND SERVICES? Practices are independent businesses contracted to the NHS and so maximising the value received in return for their spend is vital, including:  general products and services that all businesses have in common  clinical products and services specific to practices.  and pharmaceuticals – supply for prescribing practices and prescriptions for all practices.

The practice manager is the most important point of influence when it comes to selecting, specifying or purchasing in the practice.

WE MAY BE ABLE TO HELP YOU KEEP IN TOUCH The health sector is extremely fragmented, which makes it difficult to communicate with. We can’t solve that issue but we can guarantee you the eyes and ears of practice managers nationwide.

Practice Business addresses practice managers with intelligent editorial, relevant to the decisions they make on a daily basis, and because it’s targeted and relevant to them, they read it.

Our Strategy what makes us

We want you to keep coming back

So our approach is different. We really understand our readers and their market; our highly targeted, original, and useful content engages them; which means we’re perfectly positioned to help you engage with them.

Our role is to facilitate good engagement with the key purchasing audience within the primary care sector.

They’re extremely busy people with varied roles, and it’s difficult for suppliers to get their messages through to them without a strong marketing vehicle

SO WHAT MAKES OURS A STRONG MARKETING VEHICLE? OUR PEOPLE

We have a great team of talented and innovative individuals, who know how to go that extra mile and deliver mould-breaking marketing solutions. You’re in good hands!

OUR EDITORIAL

Our team of in-house journalists understand our readers intimately and deliver valuable need-to-know content that specifically meets their needs, in a way that best suits them.

This means our readership is loyal and fully engaged with our magazines and websites, and in turn, we know them and what they want.

VALUE TO YOU, THE ADVERTISER

We keep the percentage of advertising pages below 30%. We believe it’s the right balance to keep our readers engaged, and give our clients’ advertising content space to shine.

There are also ways for suppliers to get involved editorially, for example through case studies or offering expert opinion, but it is always at the discretion of our editorial team.

Our main objective is to ensure our pages are read thoroughly, which in turn guarantees that your marketing message is being seen and absorbed.

OUR DESIGN & PRODUCTION

All our products feature strong, easily recognisable design that reflects and enhances the editorial quality, ensures they stand out from the crowd, and encourages the reader to pick them up and read them.

OUR SALES APPROACH

Our view is that a true partnership will always benefit both parties.

We care about building strong relationships with our clients; really understanding their businesses and their marketing objectives; and then finding the most effective ways to meet them.

We are specialists, and we have way more to offer than simply space on a page. Our publications provide a strategic, effective and proven marketing channel for our clients - a true media solution.

While others talk – we deliver.

Approved Partners

We could never do it alone Our partnership with these individuals and organisations enhances our direct link to practice managers, offering further insight into the areas that interest them.

Our main priority is to deliver relevant, interesting and valuable content to our readers and our partnerships help us to achieve that.

NAPC “The National Association of Primary Care is delighted to have formed an approved partnership with Practice Business. We are confident that its management focused editorial strategy is perfect to help the practice manager cope with the many and varied demands of primary care.”

ROY LILLEY An independent health policy analyst, writer, broadcaster and commentator on health and social issues. He also provides consultancy to NHS organisations and the companies providing products and services to the health service.

Maggie Marum

NHS ALLIANCE “The NHS Alliance brings together GP consortia, PCTs, clinicians and managers in primary care. We are an independent nonpolitical organisation proud to be at the forefront of clinically-led commissioning. We’re delighted to be working with Practice Business.”

Chris Hanney

IHM DR PAUL LAMBDEN Dr Paul Lambden is a practicing GP and qualified dentist. He has been a GP for over 30 years, with over 20 in practice. He has previously worked as chief executive for an NHS district, LMC secretary, and special advisor to the Parliamentary Health Select Committee.

“IHM’s focus is continuous professional development, but we recognise that it will take a varied agenda, delivered by a wide range of organisations, to make a real difference.

That’s why the IHM is delighted to be involved with Practice Business. We believe that management focused editorial, delivered through testimonials, is a great way to help practice managers achieve their own goals.”

Sue Hodgetts

AMSPAR ROGER HYMAS Roger Hymas is chief executive of Healthcare Commissioning Services. He has been CEO of BUPA’s insurance division; founding director of Health Dialog in Boston, USA; a strategic adviser to Humana and Hampshire PCT’s director of commissioning.

“Is a professional membership and awarding body which provides a range of professional qualifications that sit both inside and outside the National Qualifications Framework. It also offers members advice, support, and guidelines.

AMSPAR is delighted to be working with Practice Business for the benefit of managers in primary care.”

Tom Brownlie

GP practices must register foreign-born patients or risk breaking human rights, new rules from NHS London stipulate.

Foreign-born patients include anyone from overseas students to tourists on holiday as “there is no set length of time that a patient must reside in the UK in order to become eligible to receive NHS primary care services” and they are entitled to the same NHS primary care as British citizens.

Basic pay for practice managers has dropped since last year, despite bigger work loads. The average income is now £38,758 compared to £39,059 in 2011.

There are also substantial differences based on location and practice size. Greater London remains the top-paying region of the UK, with average total earnings of

NHS London says “nationality is not relevant” to whether or not you can be treated in primary care and practices should not insist on seeing passports as it could be “discriminatory”. Critics worry it is not the best use of taxpayer’s money.

£42,263. However, this demonstrates a decline of three per cent since last year.

Scotland and Northern Ireland have traditionally been the lowest paying regions, however this year it’s Wales, with an average PM salary of £33,906.

as many as 729,606 people who had the jab may not be fully immunised against typhoid. The MHRA is urging people who may be affected to contact their GP if they feel unwell after going on holiday. While a working vaccine is still available, the Department of Health

emergency number could cause a steep rise in demand in general practice and

NHS chiefs are routinely assigning just one family doctor to districts that stretch over hundreds of square miles, in an effort to cut costs as a third of PCTs slash night and weekend spending over the past year.

The standard of out-of-hours care had been under scrutiny since

patient list of 8,685 of all respondents. The total average earnings by those managers with partner status is £55,510 – over 40% higher than for non-partner responders.

For the largest practices, the average manager/partner income is circa £60,000 and remains unchanged from the previous year.

Steve Morris, of First Practice Management, which surveyed 1,300 PMs, said: “At a time when activity levels in practices are

fast facts n 0.87% - the amount basic pay has dropped for practice managers over the last year n £38,758 – average practice manager’s income n Greater London is the UK’s top-paying region n Wales is the lowest paying region.

stepping up as commissioning gathers pace, and CQC requirements impose greater demands on managers and staff, there is a view that both practice and personal rewards are inadequate.”

Mark Dowden, sales and marketing director at Towergate MIA, which also ran the survey, says PMs are essential for the “successful running of a practice”, and it is important they are rewarded accordingly.

diary

(more than 14,000 patients) the average is £47,491, a 1.5% increase over 2011.

Bonuses have been in a steady decline for the last few years, however, more practice managers have partner status – increasing from three to 3.75 per cent in two

6-7 November EHI Live NEC Birmingham EHI.co.uk

28 November

Managing change: Transforming the public sector The Barbican, London PublicServiceEvents.co.uk

& 5,218 STATS

FACTS

2004, when a new contract enabled GPs to opt out of evening and weekend duties. Now only one in four works out of hours.

Many trusts have since outsourced the cover to private firms that

“We must ensure that any fee we charge is fair and proportionate. We have set out six principles to guide how we will charge fees, while we move towards the Government’s policy of full cost recovery from providers. In this consultation we are asking for views about our longer term fees strategy as well as seeking feedback on our proposals for revisions to our current fees scheme and extending it to primary medical services. The changes set out in this consultation demonstrate that we have listened to and acted on the views of service providers.”

David Behan, CQC’s chief executive, on the announcement of a consultation on fees

hire locum doctors to fill the shifts.

Using the Freedom of Information Act, the Daily Mail asked every PCT in England a series of questions about out-of-hours cover. Of the 90 that responded, 35 had cut their out-of-hours budgets by an average of 10% since last year. And 11 trusts employed only one doctor at night to cover between 180,000 and 535,000 patients.

A spokesman from Serco, the private firm which runs out-of-hours cover in Cornwall, where GPs were covering the most patients, told the Mail the company now ensured there were at least two GPs on call.

Almost two-thirds of patients surveyed by the Department of Health

The amount of staff hours per year it is claimed practices could save using online booking

in June found the time it took to get care from their GP service outside working hours was “about right”. Two-thirds also described their

(Source: Patient Partner)

experience of out-of-hours GP services as “good”.

06 november 2012

people AQP providers need to be approved by a PCT to go onto a list of providers from which patients are given a choice.

PCTs are due to have the contracts for the 39 service areas finalised by the end of October. They will then be able to advertise these contracts on the Supply2Health website, allowing providers from the private and voluntary sectors, as well as the NHS, to apply for approval.

The only circumstances in which commissioners can reject providers is if they reject the price offered, refuse to agree to local standards or to comply with pathways and referral thresholds, or if they fail quality standards.

of Defective Medicines Report Centre, Ian Holloway.

THEY

Lone GPs left to cover 500,000 patients out of surgery hours

years. Partner PMs are more prevalent in medium to larger-sized practices. The average practice list size for managers with partner status is 12,865 compared to an average

Trusts should have been ready to expand the Any Qualified Provider policy to 39 service areas last month, the Department of Health has said.

The rollout of AQP started last April after the DH identified eight community and mental health services that could be provided under the policy.

as soon as possible. “Anyone who has been to a typhoid region of the world and has a fever, abdominal pain and vomiting should contact a healthcare professional,” said MHRA’s head

survey of 1,700 users carried out by the University of Sheffield NHS 111 evaluation team has showed high levels of satisfaction with the service, according to the report.

commisioning news

PCTs expand Any Qualified Provider

says it is working with manufacturers to ensure any supply problems are resolved

also have a negative impact on out-ofhours GP services.

Despite these concerns, the Department of Health argues that the overall programme for national implementation is on course and a

SAID

For smaller practices (less than 5,000 patients) the average manager’s income is now £31,589, a two per cent reduction on last year, and for the very largest practices

your monthly lowdown on practice management

how well engaged GPs are in urgent care and development of a local urgent care strategy; Are they ready to innovate, especially around access? and How well engaged is the CCG in the local implementation of NHS 111?

The report warns that the non-

Practice managers have been illegally selling NHS access. GP practice managers and ‘fixers’ have been filmed illegally selling access to GP appointments to foreign nationals who would otherwise not be entitled to free hospital treatment. One practice manager was secretly filmed for BBC Panorama selling patient registrations at a health centre to an undercover reporter for up to £800 a time. The reporter went on to have an MRI scan, which should have cost her £800 via private healthcare.

empowering practices in a commissioning landscape

Practices must treat ‘health tourists’ or risk discrimination charges

More than 700,000 people immunised against typhoid recently may not have full protection after a dud vaccine has been recalled by its manufacturer. Sanofi Pasteur MSD has called back 16 batches of its Typhim Vi vaccine after

threat, the Medicines and Healthcare products Regulatory Agency (MHRA) worries it could be too weak and

what we learned

More work, less pay for practice managers

Typhoid vaccines recalled

test batches were found not to be strong enough. This could affect anyone immunised since January last year.

While the faulty vaccine is said to be safe and pose no

The report by the NHS Alliance, entitled ‘Getting to grips with integrated 24/7 emergency and urgent care’, raises concerns about the impact of working towards an integrated emergency and urgent care system while at the same time introducing NHS 111. It poses a number of key questions for commissioning groups, including

A DH spokesman told GP Online: “The choice of service made available for AQP is by no means ‘top down’. For 2012/13, PCT clusters were asked to offer patients a choice of AQP in at least three services which were identified as local priorities through local engagement.

“Of the 39 services listed, only eight were identified as national priorities. These were proposed after substantial engagement with national patient groups, and had their strong support.”

NHS in distress, says RCGP Dr Clare Gerada, chair of the Royal College of General Practitioners, has spoken out about the “turmoil” caused by reforms to the NHS and the pressure services are under to improve efficiencies while maintaining quality of care.

experiencing the mother of all top-down reorganisations. In fact, the most radical in its 60-year history.”

Gerada said that the whole of the UK’s health services (despite the Health Act only applying to England) are under a

Speaking at the RCGP’s annual conference in Glasgow, Gerada said: “In England, we were in the midst of the Health and Social Care Bill – and, despite assurances to the contrary, the NHS is

great deal of pressure to perform.

She described the bill as “longer than a Tolstoy novel” and as having been “rushed through at breakneck speed”. “As a result, our NHS is in distress,” she said

case study

case study

£1.5m allocated for personal budgets As much as £1.5m has been identified to support the potential roll-out of personal health budgets, according to care and support minister, Norman Lamb.

A personal health budget pilot programme is taking place across 60 PCTs,

Changing the System

an evaluation of which is due before the end of hte year. In order to be ready as soon as the findings are known, the Department of Health has identified £1.5m to be made available to support the first stage of a potential roll-out.

Lamb said: “We want to ensure more care is tailored around people’s individual needs and preferences. Giving those with complex health needs the control of how to spend money on their care gives them and their doctors the flexibility to try innovative new approaches to achieve better health outcomes.

“Subject to the results of the current pilot programme, our aim is to introduce a right to a personal health budget for people who would benefit from them most – the scale and pace of this will be informed by the independent evaluation.

“We want to be on the front foot as the results become known – that is why we’ve identified £1.5m to support the NHS in

Just over a month ago, Harbours Medical Practice in Cockenzie, East Lothian became one of the first practices in Scotland to introduce a new system to improve patient experience.

JULIE PENFOLD speaks to practice manager JANE JOHNSTON to find out more

the first stage of the roll out as it starts to implement personal health budgets.”

This is not new money, but NHS money put in the hands of patients to help them decide what treatments work best for them.

People with complex care needs and those with a range of long-term conditions, such as stroke, diabetes, neurological conditions, mental health needs and respiratory problems like chronic obstructive pulmonary disease (COPD), have been involved in the pilots so far.

10 november 2012

november 2012 07

COMMISSIONING SUCCESS

The lines were really busy and it was very difficult for patients to get appointments as a result. Patients were furious with the situation.

We also had patients who would queue at the surgery to try and secure an appointment. By the end of summer, we had over 40 patients queuing at the surgery. The demand for appointments was higher than what the

practice as usual; the receptionist takes their details and the GP then calls them back at a

practice was able to offer. Our receptionists had to say no to patients and would have

convenient time. Via this system, the GP is able to determine whether they need to see the patient or can diagnose and advise them

no alternative other than to ask them to call back the next day. Some of our patients were also able to work out that they could play the

over the phone. Participating practices have found, on average, only one in three patients actually needs to be seen. Jane Johnston,

system and gain access to a GP by being added to the duty doctor’s list for that particular day.

practice manager at Harbours Medical Practice in Cockenzie, East Lothian is the latest surgery to use the system.

What impact did this have on the practice?

We were concerned for our patients and were looking for a solution that would prevent

Could you describe how the previous

them having to call at 8.30am each morning to try and secure an appointment for that day

appointments system worked?

We offered appointments in advance and kept a number aside every day to be booked one

or later that week. We had instances of older patients who were feeling ill that were calling for appointments and been told there were

or two days before. Patients could also call on the morning for appointments that day. We also introduced steps, such as having GPs offer

none left for that day, they would not push the situation at all. Instead they would just keep trying to book appointments day after day;

management

november 2012 29

property

property

Property woes

D

eciding when is the right time to buy your GP practice can be tough, but

in less than five months’ time you could be forced to make a decision whether you like it or not. Come April 2013, PCTs will be no more and any GP practice buildings that are currently owned by the PCT will be taken over by the NHS Property Services company. Recent reports in the press have suggested practices could be at risk of massive rent increases when the it takes over from the PCT. GP magazine recently put in a freedom of information request, to which 132 PCTs responded and 104 admitted to not having signed lease agreements for

many practices in fear of extortionate rental increases. However, PCTs have now been tasked with producing the correct documentation before April and ensuring that a signed lease is in place for all practices renting their property. As straightforward as this may sound, there are a still number of issues that practices should think about before they sign their lease. Issues such as the rent level you will be expected to pay and whether this will be reimbursed; how and when your rent can be reviewed; the length of the lease; restrictions around what the property can be used for and whether the building is compliant with health and safety regulations, should all be clarified before you sign.

To buy or, not to buy?

With all the ongoing issues to consider around rent, is it worth practices just taking the plunge and buying their premises?

“Unlike the wider commercial property market, i.e. office, retail and industrial, we have seen healthcare rents continue to rise since the economic downturn,” says Ben Willis, partner at law firm Veale Wasbrough Vizards. Demand for clinical buildings currently exceeds supply due to a number of factors, including an ageing population and an increase in secondary care treatments being moved over to primary care. Therefore, rental prices are continuously on the increase. “The rental value of a property is key to determining the market value of a property,” says Willis. “So if rents continue to rise, then the price of healthcare property will also continue to rise – so now may be the time for GPs to buy their surgeries.”

32 november 2012

november 2012 33

advice

advice

Partnership: is it for you?

Covering both clinical management and general management issues. For the practice manager, an ideal opportunity to learn something new and make a real change in the way you do your role.

Thinking of becoming partner at your practice? CARRIE SERVICE looks at the risks involved for PMs and how to navigate the change of role

F

or a practice manager, achieving partner status might feel like the icing on the cake

and the perfect recognition of your efforts at the practice. The prospect of earning more money

advice for busy lives

WORK LIFE

Becoming a partner will ultimately mean losing many of the basic rights you have as an employee at the practice, as you will effectively become self-employed. You will therefore need to decide whether your relationship with the other partners is strong enough for this to not become an issue.

right? But as the old saying goes, with great power comes great responsibility and it is not a decision that should be taken lightly. Practice manager partnerships are a bit of a rarity, with just 3.75% of PMs in the UK having partnership status to date, so if you’ve been approached to become partner at

If you have worked at the practice for a number of years – which is probable if you are looking to become partner – then it is more than likely that any potential conflicts have already arisen and been resolved by this point. But if you are relatively new to your current practice, be sure to

your practice, you must be doing something right.

Steve Morris, general manager of First Practice Management and an ex-practice manager, advises PMs not to get blinded by flattery and keep a level head. “Manager partnerships are not for everyone,” he says. “You need to be clear on your personal

think it through before you sign on the dotted line.

You may all be getting on like a house on fire at the moment, but things could look very different when reality sets in and you come to realise that your partner’s actions directly affect your own

motives and do your homework thoroughly – and in advance.”

44 november 2012

Losing your rights

– 40% more than non-partner PMs according to a recent survey – and having greater influence over business decisions sounds like a win-win situation,

investment in the practice – and vice versa. It’s also worth bearing in mind that you will no longer be able to bring unfair dismissal claims and may

november 2012 45

work/life

MANAGEMENT

emergencies. However, the problem of never having quite enough appointments available to meet patient demand always remained.

process of direct communication between the GP and patient. When a patient wants to make an appointment, they simply call the

all the GP practices they currently lease to. The GPC raised concerns that there is insufficient information available about the NHS Property Services company, leaving

business intelligence and management sense for practice managers

Our best practice management section - real interviews and other inclusions from real practice managers. It’s always better to hear it from one of your own kind.

phone consultations in between appointments and having a duty doctor every day for

clinicians, practice staff and patients much happier in turn.

Practices using the system use a simple

To rent or to own? With PCTs being abolished in April and properties being handed over to a new property services company, is it time to bite the bullet and buy your practice? And if you’re renting, what can you expect when ownership is handed over from the PCT to the new owners? CARRIE SERVICE takes a look at rent and property issues for GP practices

work/life

PEOPLE IN PRACTICE

atient Access was formed as a social enterprise in 2011 from a community

discovered a way to improve patient access to GPs and reduce waiting times, making

28 november 2012

SECTOR Considered news reporting and comment from our editors and regular contributors.

P

of over 40 GP practices around the UK. The movement now serves over 350,000 patients and continues to grow. The enterprise

management

A comprehensive section dedicated to this crucial, health-sector-changing topic. It will fundamentally affect the way healthcare is delivered and is always in and around the front pages.

Water-cooler stuff…recognising that every practice manager has a life too!

people

A report on the progress of NHS 111 has highlighted concerns, including its impact on out-of-hours GP services.

primary provider

practice news

Report raises 111 concerns

clinical news

practice news

sector

sector

Practice Business

PracticeBusiness november 2012

Practice INSPIRING BUSINESS SOLUTIONS FOR PRACTICE MANAGERS

NOVEMBER 2012

LTCS | PRACTICE PR | COMPETITION

The road to long-term health Are you doing enough to tackle chronic conditions?

DON’T SELL YOURSELF SHORT Promoting your services to the CCG

COMPETITION CLAUSE

Practice Business is an approved partner with...

How to stand a chance against corporate primary providers

BEST PRACTICE MANAGEMENT Case studies, interviews and stories from real people – all examples of best practice, all bringing together the practice management community as a professional group with common goals, issues and interests.

ESTABLISHED

SO MUCH MORE THAN JUST A PUBLICATION We act as a practice manager’s content filter. We read, we listen, we interpret, and we deliver with context. Only relevant content gets through, and it’s delivered with opinion and practical guidance on how best to use it.

12 per annum

2005

USP The first, and still the only, monthly management-focused publication for practice managers

FREQUENCY CIRCULATION 7,500, comprising: • 6,112 practice managers • 391 practice managing directors • 997 GPs

OF WHICH (included in the above): • 4,725 are subscribed • 1,321 are in private (general) practice • 146 are in commissioning groups

READERSHIP Practice managers within the UK’s GP practices. In our terms, a manager is someone genuinely empowered to make decisions on behalf of the practice, this includes office managers through to practice partners, and everyone in between.

The commissionning agenda

If the Health Bill goes to plan, the future of funding in the NHS lies with the CCGs and their commissioning boards at group area level and practice managers for individual practices – there will of course be some cross-over with PMs who also represent at board level.

PCTs are now involving CCGs in NHS contracting, with a view to transferring functions in full by April 2013 (when the PCT will be completely abolished). But transferring of functions is happening now, with more advanced CCGs already powering forward and implementing strategy for commissioning.

This year will see a high shift in funds transferred to CCGs with plans and outlines already in place. This is why it is important to begin discussions with CCGs now, and be in the minds of commissioning boards who will overlook budget transferring. Commissioning Success is leading the way to provide that communication path.

With the implementation of commissioning in the NHS, the former PCTs will eventually slide away to be replaced by Clinical Commissioning Groups (CCG). The listening exercise earlier the year resulted in the changes to the levels of responsibility being placed at the CCG (then known as GP consortia) – at present a £60bn budget for primary, secondary and acute care will rest with the board members of the CCG, who will work under their respective commissioning board.

What is Commissioning Success?

W

e published Practice Business as the first monthly magazine of its kind for the health sector more than seven years ago and stands firm as a champion of anyone in a business, financial or management role in health.

Commissioning Success, brought to you by the Practice Business team, is a magazine that supports individuals involved with the new commissioning agenda.

The CCG agenda and the future of NHS funding means an increased opportunity for healthcare service providers and suppliers – a more fragmented point of influence, with more local knowledge, equates to a much bigger opportunity – the only challenge is finding a route to the decision-maker audience. That’s where Commissioning Success comes in.

We guarantee a captive audience for your marketing message. We have a dedicated team of health journalists in-house. Their focus is always on the best content for the CCG board audience. Coupled with our excellent specialist contirbutor list, the Commissioning Success editorial content is bang on remit and of great interest to the reader.

Our strapline, ‘supporting excellence in healthcare’, drives everything that makes us unique and leading in this sector. We feature a host of editorial content to help decision-makers involved with CCGs choose the right options to ensure they do best by their patient population. From case studies to in-depth sector analyses, quick tips to news, Commissioning Success has all the information to help make those decisions,

whether they be financial, managerial or strategic in nature.

The face of healthcare in the UK is changing, and will continue to change, Commissioning Success will walk the path with its readers, offering insight, support and information along the way, helping them to be at the very top of their game.

At Commissioning Success, we ensure our on-target and meaningful editorial delivers a captive audience to our advertising partners. Associating with our publication in front of our captive audience will be crucial in delivering your marketing message to the commissioning groups.

This means your marketing spend works harder by not only hitting the relevant people, but ensuring it’s placed within a framework that is extremely effective.

There is a difference between knowing who you need to reach and reaching them effectively

Commissioning Success COMMISSIONING UPDATE This section will feature news, views, analysis and commentary surrounding the progress of clinically-led commissioning and the Health and Social Care Bill. Here we will take an in-depth look at budget handovers, clinical commissioning group mergers and any news surrounding best practice in commissioning and policies from the NHS Commissioning Board.

UPDATE NEWS

The two operations directors of the NHS Commissioning Board Authority’s national leadership team have been named.

Ann Sutton, currently chief executive of Kent and Medway PCT cluster, has been made director of NHS commissioning (corporate) and will be responsible for devising and overseeing the national framework for the NHS Commissioning Board’s direct commissioning responsibilities,. including specialised services, primary care, public health, healthcare for military personnel and their families and for offenders.

While Lyn Simpson, currently NHS director of operations in the Department of Health, has been appointed director of NHS operations and delivery (corporate) responsible for NHS planning and performance, assurance of delivery by CCGs and national lead for NHS emergency preparedness, resilience and response.

Ian Dalton, chief operating officer and deputy chief executive of the NHS Commissioning Board Authority, commented: “These two posts will provide the strategic leadership and oversight to ensure that we have a strong, innovative and patientfocused commissioning system that improves outcomes, tackles inequalities and supports the NHS in England to be the best it can be.”

FIRST LOCAL AREA TEAM DIRECTORS The first round of appointments to the 25 local area team director posts has also been made as follows:

Community Care will feature articles and case studies surrounding improved clinical pathways in the community, as well as moves towards better integrated care and any examples of a CCG that is undertaking a specific project or method to see their commissioning through in their local community. This section will also feature best-practice articles on improving patient engagement and outreach, alongside success stories on how CCGs are tackling conditions in their local area.

INFORMATION AND TECHNOLOGY Data management and technology will play a huge part in successful clinician-led commissioning. Here we look at innovations in managing information and IT that will help a CCG succeed at delivering care to its local population – whether it be procuring better machines for clinics or improving the back-office system used across your member practices.

• South Yorkshire and Bassetlaw: Andy Buck • North Yorkshire and Humber: Chris Long • Durham, Darlington and Tees: Cameron Ward.

Significant savings were made at Mid Essex Hospital Services NHS Trust by clinical and non-clinical teams working together to reduce procurement costs in the areas of reconstructive and trauma orthopaedics.

Over £300,000 was saved in three months on hip products alone, with the final savings across all categories, including upper and lower limb, trauma and pulse lavage, forecast to be £500,000, representing a 28% saving.

A cross-functional commercial and clinical team was formed that reported directly to the clinical director, CFO and COO. Bill Martin, consultant orthopaedic surgeon and lead clinician on the procurement project, said: “The initial worry that financial pressures would lead us towards accepting substandard implants or major inventory changes has not been borne out, and it was reassuring to be involved in the process as a surgeon.”

The work is part of a wider programme of procurement cost reduction, led by procurement consultancy Inverto.

UK MD Richard McIntosh said: “The results clearly demonstrate the power of clinical engagement and what can be achieved when you combine specialist procurement expertise, clinical and commercial expertise and the backing of the trust board.”

Midlands and East • Essex: Andrew Pike • Hertfordshire and the South Midlands: Jane Halpin • Leicestershire and Lincolnshire: David Sharp • Derbyshire and Nottinghamshire: Derek Bray • Shropshire and Staffordshire: Graham Urwin • Birmingham and the Black Country: Wendy Saviour.

• London • London: Simon Weldon South of England • Surrey and Sussex: Amanda Fadero • Wessex: Debbie Fleming • Devon, Cornwall and Isles of Scilly: Ann James.

National award for NHS Nottingham City CCG

Macclesfield GPs receive faster A&E updates

NHS Nottingham City Clinical Commissioning Group (CCG) was named BMJ Clinical Commissioning Team of the Year.

Dame Barbara Hakin, national MD of commissioning development at the Department of Health, sat on the awards panel and said of the judging process: “We, as judges, were unanimous in our decision that the winners should be Nottingham City. They showed strong leadership, great organisational development and were really looking at an enormous number of areas where they could effect change. But most of all, what stood out for us was that they were already making changes and delivering better outcomes.”

BIT OF BACKGROUND There will be 27 local area teams with staff working from a number of office bases across their geographical area. All local area teams will have the same core functions around CCG development and assurance, emergency planning, resilience and response, quality and safety, configuration, system oversight and partnerships and stakeholder engagement, with the senior leadership of the local area team participating as a full partner on health and wellbeing boards.

East Cheshire NHS Trust’s A&E department can now collate and send clinical patient information to GPs electronically for all patients that attend the department.

This development complements the eDischarge Notification Forms (eDNF) to GPs – a system that has helped them achieve an 84% compliance for meeting the NHS 24-hour communications delivery target.

Patient information is input into Extramed (the operational management and coding system for all A&E attendances) this automatically generates a discharge letter, which is then stored and delivered electronically to GP practices across Cheshire, streamlined by Medisec Trust eDelivery software.

Customer service delivery manager Debi Lees said: “Patients visiting their surgery after being discharged from our A&E Department the previous day can now rest assured their GP will be fully up-to-speed with their condition and any emergency treatment they may have received. This marks another significant step in our continuing drive to improve patient care.”

more involved A Family Doctor Association survey of 100 commissioning GPs showed that GPs want to be consulted at every stage of commissioning in a genuine two-way dialogue with CCGs. The study also found there to be a wish for democracy and genuine representation of practices and protected time for doctors to increase their involvement.

Over 50% of GPs questioned felt able to influence their CCG’s decision making, but one in eight (13%) felt unable to do so and felt disempowered.

There was also a clear desire for a fresh start. National chairman Dr Peter Swinyard said: ”The message to CCGs is clear. Talk with your member practices and listen to them.”

Poor hospital data threatens commissioning Hospitals in England are not supplying accurate patient data to the wider NHS, which could undermine GP commissioning, a report published by the NHS Information Centre claims.

The report found that up to a fifth of data returns by hospitals and councils contained errors in patient records and cited the ‘reorganisation and reconfiguration of services’ as a factor leading to poor returns.

On average, hospital trusts made errors in seven per cent of all data submissions, likely to have affected millions of patients’ data.

TRUSTS DENYING TREATMENT ARE BREAKING THE LAW

Patients who are denied approved drugs by their local health trust should take legal action, Sir Michael Rawlins, chair of the National Institute for Clinical Excellence (NICE) wrote in the HSJ. He said “numerous trusts” were unlawfully denying patients drugs approved by NICE or were employing “delaying tactics” to save money and that this should not be tolerated.

He gave the example of patients with retinal vein occlusion who would benefit from dexamethasone intravitreal implants, but many trusts have been refusing the treatment for financial reasons.

There is also sometimes dispute between the PCTs and hospitals on who should pay for the treatment – often at the expense of the patient’s sight.

Sir Michael called on campaign groups like RNIB to seek judicial overview to ensure rightful provision of the treatment. He also called on clinicians to “whistle-blow” on trusts failing to provide the drugs and treatments patients are legally entitled to.

DIARY 16-17 October Four Nations, One Challenge – Improving Patient Outcomes Manchester Central FMLMconference.com

SEND IN YOUR STORIES

We are always looking for local commissioning news. If you have a story to share, email editor@intelligentmedia.co.uk.

SEPT/OCT 2012 | 05

IN ACTION CASE STUDY

IN ACTION CASE STUDY

Clinical commissioning groups in the southwest have found strength in numbers. POLLY ELLISON looks at how federating has helped their smaller practices survive

T

he GP federation model adopted by Somerset Clinical Commissioning Group, although still evolving, must be one of the most successful approaches to commissioning being carried out around the country.

A nominated GP from each federation sits on the CCG board, ensuring that each federation has equal representation, in the well-organised over-arching structure of the CCG. The key to the CCG’s success is in its recognition that the nine GP federations in Somerset differ from each other geographically, and that they have very different patient populations. In order to tackle this, each federation has adopted a different way in which they operate; a different working style and their aspirations vary tremendously from federation to federation. Recognising this, and supporting it, by allowing the appropriate management funds to flow through to local level, the CCG has empowered its GPs to become actively part of the commissioning process.

One example of this is the South Somerset Healthcare Federation. The federation is made up of 17 practices serving 108,000 patients across a region from Langport to Yeovil, through to Wincanton.

As Len Chapman, treasurer of South Somerset Healthcare Federation, explained: “What we have developed is a federation of the South Somerset practices, with our focus on the commissioning agenda, with a view to interacting with the Somerset CCG in order to do that.” Aiming to provide effective, coordinated commissioning and healthcare provision via existing and new services, the group is used to working together, having originally been a co-op providing out-of-hours services and part of

THE C O L L A B O R ATO R S

WyvernHealth, delivering practice-based commissioning. Those involved have a wide range of skills and local knowledge.

They are also establishing close working relationships with other stakeholders in the area, such as Yeovil District Hospital Foundation Trust, Somerset NHS, Somerset County Council and Somerset Partnership.

POWER TO THE PM The federation currently has a monthly evening meeting for GPs and practice managers plus a monthly steering group meeting to facilitate the implementation of agreed work plans. They are proposing a change to regular meetings of a smaller GPand practice manager-led working group, bi-monthly federation evening meetings and task groups as required for specific subjects.

The federation holds educational workshops, such as a recent reablement programme, which gives the group more information on the new reablement service and telehealth and provides it with an opportunity to learn more about the aims of the joint NHS/local authority programme.

Another development has been to assign practices to one of three working sub-groups to cover important areas of work, such as paediatric emergency admissions, zero- and short-length-of-stay admission, as well as identifying local commissioning priorities.

The close working of the GPs with their practice managers is the key to success, as practice managers are involved in all that is going on. In some areas of the country, practice managers would not necessarily know who the GPs on the CCG board were, never mind being involved in working with them and assisting with the development of services. Tapping into the expertise of practice managers is so important as they form the essential link

SEPT/OCT 2012 | 17

COMMUNITY CARE SHARING SERVICES

COMMUNITY CARE SHARING SERVICES

SHARE ALIKE &SHARE

Sharing services between practices sounds like a practical way of ensuring patients have access to a range of treatments in their local area. So why aren’t we seeing more CCGs implementing the idea? CARRIE SERVICE investigates

S

haring services should be easy and effective. In theory, a GP who is trained to provide a specific treatment should be able to provide this to anyone within the local community who needs it. It should be as simple as a couple of clicks on a mouse and a taxi to take the patient to the nearest provider. However, for one reason or another, this has not been the case for many. I spoke to David Thorne, chief executive of Newcastle West Clinical Commissioning Group, about the challenges involved in sharing services.

PRACTICALLY IMPOSSIBLE Newcastle West is a small but extremely proactive CCG for one of the most deprived inner city populations in the country.

Thorne explains that although the group is well engaged they have still not managed to get around some of the practical issues that prevent practices from sharing services.

One service that Thorne believes does have the potential to be shared is contraceptive implant fitting. Some patients may prefer to be fitted by a female GP and the CCG recognised the potential for the service to be made available to patients from outside practices where a female GP wasn’t

available. With this in mind, Newcastle West trained up around 30 of their female GPs in hope of allowing patients from practices in surrounding areas to use the service. However, the project didn’t achieve the level of success that Thorne believes it could have, and has now fallen by the wayside. When I ask why, he explains that there are practical issues that may seem trivial, but have a profound impact on the success of this sort of project: “The practical difficulties you always get with things like this are the clinical IT systems that practices have. We’ve only got 18 practices, but we’ve got four different systems and they don’t talk

to each other.” Not having a universal IT system across the CCG meant that medical notes could not be easily shared, creating a clumsy process that in theory should have been pretty straightforward. There was also the issue of payment and who should be acknowledged for having provided the service. “It’s always the same things that come up about systems, permission, and contractual issues around payment,” reflects Thorne. “It’s just the sheer complexity of the NHS and the arcane nature of the system.

Can you get a £25 payment for putting that contraceptive implant in, even though it wasn’t your patient?”

Another drawback that has made many wary of referring patients to a different practice is the danger of losing them altogether – do practices really want to risk sending their patients off to a GP that they might prefer? “That is a concern [of many],” says Thorne. “But in our practices it isn’t.” He puts this down to good teamwork and collaboration across the group. An issue that he believes does warrant some concern, however, is

transport: “Because most of our patients don’t own cars and they are on very low incomes, there are practical difficulties about how you get someone from one place to another. In theory, there’s no problem at all, we’ll get some kind of small contract with a taxi company to take people back and forth.” In practice though, this never quite came off, but Thorne stresses it is something that will have to be addressed for services to be successfully shared in deprived areas.

“Everybody knows what we want to do, but not how to do it” THE FUTURE Despite not seeing much success with it so far, Thorne does believe there is a bright future in sharing services; commissioners just need more time to tackle some of the practical issues involved. With authorisation taking up a great deal of time over the past six months, there has been little left over to spend on planning

26 | SEPT/OCT 2012

INFORMATION TECHNOLOGY DIGITAL COMMUNICATION

The myriad communication possibilities opened up by the power of the internet offer a cost-effective and relatively simple way for commissioning groups to release information and gain feedback from the patient population. GEORGE CAREY finds out what options are available

D I G I TA L D I S S E M I N AT I O N

F

rom surveys to digital services and social networking, there are now more ways than ever to inform and keep in touch with your patient population. While some elderly patients may have resisted the move to disperse more information through digital channels, this method is constantly increasing in popularity and will only do so at a faster rate in years to come. So what are the best ways to harness the internet to enable your commissioning group to benefit its patients?

SURVEYS Surveys in healthcare are nothing new but the digital age has made them significantly easier to carry out.

The entire process has been streamlined and the difference in costs is huge, with no paper or expensive postage to consider. Making patients aware of the surveys is now simple through email and the increased feeling of anonymity can result in a higher rate of survey completion and entirely uninhibited answers from those who do choose to participate. Collating the data has been simplified as well, with software

30 | SEPT/OCT 2012

new projects. “We’re frustrated,” he tells me. “We were making more progress on clinical projects last year than we probably are now. And we’re a very active group – although we’re small we have forty clinical commissioning projects going on at the moment.” As well as relaunching the contraceptive implant shared service, there are other projects that Thorne is hoping to see develop nicely after the storm has settled, including a new nursebased ENT service for syringing ears. This would work in the same way, with nurses based in peripheral sites so that if the practice nurse isn’t available that day, the patient can be referred elsewhere. What commissioners need now, says Thorne, is some success stories so that they can follow suit: “Everybody knows what we want to do, but not how to do it. It’s getting the right people together, going through it and cracking all of these permission issues and transactional-type boundary issues, and then using that in a way that you can replicate as a template for other specialties.”

SEPT/OCT 2012 | 27

INFORMATION TECHNOLOGY DIGITAL COMMUNICATION

MANAGING COMMISSIONING This section will focus on the logistics behind delivering better commissioning. It aims to help readers see-through their commissioning plans succinctly and successfully. It will focus on budgetary issues, and ensuring CCGs make the most of the Government’s £25 per patient management allowance. Here we will also feature interviews and advice from PCTs and SHAs invested in seeing the NHS succeed under the reforms. It will also touch upon how to get the member practices of your CCG to get involved in commissioning and contribute their support.

CLINICAL CORNER

04 | SEPT/OCT 2012

The Commissioners in Action section will focus on movers and shakers and forward-thinkers in the clinical-commissioning sector. It will include interviews with commissioning leaders, diary pages from commissioners and CCG case studies. Readers will turn to this section for a look at how other people in the rest of the country are undertaking the commissioning task and learn by example.

COMMUNITY CARE

LOCAL NEWS

CLINICAL ENGAGEMENT DRIVES MAJOR SAVINGS AT ESSEX TRUST

GP practices COMMISSIONING BOARD: KEY DIRECTORS APPOINTED want to be

North • Cheshire, Warrington and Wirral: Moira Dumma • Merseyside: Clare Duggan • Greater Manchester: Mike Burrows

COMMISSIONERS IN ACTION

UPDATE NEWS

NEWS

“New parents receive regular emails and text messages containing relevant and timely NHS -approved advice as their pregnancy develops”

available to analyse and interpret the information supplied at the click of a button and present it clearly and attractively in a range of different formats. It can then be distributed among all members of a commissioning group with ease to aid a discussion of the results.

DIGITAL SERVICES The NHS has embraced the chance to enrich patients lives with digital services and a great example of this is the NHS Information for Parents service, launched in May. It gives new parents information and advice they can trust, covering a wide range of issues related to staying healthy in pregnancy, preparing for birth and looking after their baby. By signing up to the service, parents-to-be and new parents receive regular emails and text messages containing relevant and timely NHS-approved advice as their pregnancy develops and as their child grows. Links to videos showing midwives demonstrating practical advice such as bathing babies, and parents discussing issues that affected them and how they supported each other, will also be sent at appropriate times.

SOCIAL NETWORKING With 50% of the UK now using Facebook and the increasing prevalence of Twitter in everyday life, social networking can be an incredibly effective tool for commissioning groups to communicate with those whose care they are responsible for. One of the biggest challenges is using social media and other digital channels without breaching confidentiality rules and regulations, when you are potentially talking about people’s very private healthcare needs. Alex Talbott is digital communications officer for NHS London and founder of NHS Social Media (nhssm.org.uk), a blog designed to help NHS staff and those interested in healthcare and the web communicate. He believes that confidentiality is not under as much threat from social media as some would make out: “It’s something we’ve discussed a lot on the NHSSM blog and time and again people try to knock social media out of the comms toolbox because of confidentiality issues. Of course there are issues around that, but we shouldn’t just throw it out because of this one concern, there are too many positives that we can get out of it.” He goes on to explain: “The standard rule applies that if you don’t want to say it in public, don’t say it through social media.”

It is important to bear in mind that CCGs do so much more than treat people and there is a duty to inform patients of vital public health messages. This is where social media is at its most useful. Already, initiatives such as NHS Smokefree are using a Facebook page as a place for people using the service to keep up to date with important information and discuss their experiences with other people trying to give up smoking. It’s these kinds of applications of social networking that use all of its strengths and avoid its potential pitfalls. While these pages can be vulnerable to trolling – perpetual posting of abusive messages – and other internet abuses, it doesn’t use any confidential information and therefore poses little threat to those using the service. Talbott concludes: “There needs to be an understanding that social media isn’t big and scary and only for big companies to mess around with. There is a possibility here for the NHS and other healthcare providers to increase the service offer that they currently have for patients.”

It’s time to digitise your interaction with patients and ensure that you are getting full value from the huge range of communication tools available. Research carried out in June by NHS Local involving 328 people found that more than half of those questioned would be happy to Skype their GP. Proof if it were needed that these advances in communication will continue to diversify. The most progressive CCGs will grasp the chance with both hands.

SEPT/OCT 2012 | 31

THE FACTS YO U R G U I D E TO

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It will be a must-read for anyone interested in clinically-led commissioning. Whether they’re on a the board of a clinical commissioning group, participating in commissioning, a provider or interested from the side-lines, Commissioning Success magazine will help them stay one step ahead of the Government’s plans to give clinicians power over £60bn of the NHS’s budget.

Commissioning Success is a unique proposition. It’s a focused publication for a focused audience; a management agenda magazine, with relevant and useful information covering all aspects affecting commissioning. Editorial is never sold, it’s written for the audience and not the sector suppliers – we make no apologies for that – because the more people that read it, the more beneficial it is to everyone.

commissioning HAS LANDED A bi-monthly magazine from the Practice team to help Business you succeed in commissioni ng Commissionin g Success prom ises to be the management only title specifically targeted at CCG members, part board icipants in com missioning, and related health all networks and shadow boar ds

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This magazine is aimed at GPs, practice managers, secondary healthcare clinicians and nurses – anyone who has an active role in commissioning. It will provide them with the must-have tips and tools to make a success of clinically-led commissioning.

Be one of the first to sign up and receive a six-month subscription for free (worth £69.99) commissioningsuccess.com subscriptions@intelligentmedia.co.uk BROUGHT TO YOU BY THE TEAM BEHIND

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VENDOR PROFILES

38

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Designed to fit with the style and feel of the magazine, a vendor profile looks like a Practice Business feature but it is paid for, so it is your space to use as a platform to communicate strategic messages about your organisation or perhaps the details of a new campaign or promotion. It’s a great way to make our readers sit up and take notice.

Change is good With so much happening in healthcare, it’s important to have your practice team on board. Jonathan hills seeks some good advice on how to motivate your team, put changes in place and assert your authority as practice manager and within the CCG

26

vendor profile | pelican

26 27

vendor profile | pelican

In quality

32

You train them up and you m welfare is at the heart of wha at it is then you have usually

we trust

management | legal Pelican Feminine Healthcare is a name GP practices trust. Practice Business finds

out more about the company and just what makes it such a trustworthy name in the world of disposable feminine health supplies as the nhs cuts start to take hold, your practice

Pelican Feminine Healthcare Limited underwent a rebranding; separating from the stoma care side of the business, and further emphasising its speciality in gynaecological and obstetric products.

Pelican has also embarked on an ambitious development plan intended to transform its spacious premises in Cardiff to a state-of-the-art manufacturing and distribution centre and shares a joint research and development facility, based in Northern Ireland, with its sister company, committed to bringing innovative, quality products to market for the benefit of its customers.

ProduCts you Can trust Pelican’s primary care customers are particularly loyal to its gynaecological products. One of Pelican’s most popular and well-known products is its PELIspec disposable vaginal speculum, which is the leading product of its kind with 70% market share and is available on NHS contracts.

Pelican’s newest addition to the PELIspec range is the PELIspec with Light Source, which uses an attached light source to visualise the cervix, ensuring maximum visibility for the professional to carry out any gynaecological procedure.

The PELIspec with Light Source was mainly created using feedback from nurses and doctors, who complained of awkwardness when using separate, unwieldy light devices and, in some cases, the inability to see the cervix, which resulted in expensive hospital referrals. Ensuring everything runs smoothly is imperative when patients undergo what can be such a sensitive procedure, but it can save money too. The ability for a clinician to see what they’re doing can cut down on time, reduce the need to have another person in the room and also reduce repeat referrals.

vendor profile | pelican

of its products, and a dedicated customer services team, helps to explain why some of Pelican’s customers have been buying from them for all 18 years it’s been in business. Particularly for practice managers who are not doing the actual clinical procedures but are buying the products, having the support of a company they can trust is priceless.

So while going for a smear test is probably last on the list of pleasant experiences for female patients, high quality products from companies like Pelican are there to ensure it’s as comfortable and efficient a procedure as possible, which not only helps the patients but the practice too.

For practice managers who are not doing the actual clinical procedures but are

will be money coming inbuying to the practice, then you are going to the products, having the support of aresources.” company they can trust is priceless forced into finding more innovative means by which to have to pool your keep an effective patient service running with growing Wright believes his staff have an altruistic approach costs and a reducing budget. like in any business, to dealing with patients, and therefore is something this will result in you needing to find more and more that can be used when reasoning with staff about taking innovate ways to cut spending and reduce costs. over roles and financial changes within the practice. it is a time to be pragmatic and learn new skills to “i think it is seeing what appeals to staff,” he ensure that your practice does not suffer as a result; standing bycontinues.

“What motivates them to come in and do their values you will need to ensure that your staff are flexible and the work? Most, even 90%, of staff are very patient accommodating, ready for a challenge and prepared centered so they are very much dealing with the public Contact details to move into areas of responsibility that they might be and like speaking to them. in fact, most of them would thus far unfamiliar with. rather speak to them than do a lot of paperwork, and some practices particularly might have certain staff practice managers should think about this when remembers who are extremely proficient at the job they allocating roles in the practice. ordinarily perform, but when asked to move into a new “You train them up and you make sure that patient arena might become apathetic or reluctant to excel. welfare is at the heart of what they do, and as long at it Michael Wright, practice manager at Whyburn is then you have usually got their buy-in,” he added.

Medical Practice thinks that practices working the integration of technology will also have a together will be key in tackling the implementation of profound effect on the running of your practice, the CCGs. and you and your staff will have to be prepared to “one of the main things, and one of the learn how to use it – and with the introduction of 38 39 things which is really going to come out of all the the CCGs the role of technology looks to become work/life | change management commissioning going on now, is working together,” more prominent. he says.

Wright that use of the same back office You train them up and states you make sure the that patient welfare is at the heart of what they do, and as long “there are going to be times in your locality system is vital in the smooth running of a practice, and at it is then you have usually got their buy-in when you can share some of the back office functions. especially between consortium members: “one of the there is going to be pressure and there is talk of a problems at the moment is that there are a lot of it new contract, so if that means there is going to be less systems out there – if you have an it system, everyone

A negative impact

30

MANAGEMENT | service redesign

Quality has always been a priority for buyers of healthcare products. Purchasing high-calibre clinical supplies is instrumental to the health and wellbeing of patients and with the onset of increased patient choice of GP practice, never has this been more important. A debate at the BMA’s annual conference last month further reiterated the importance of the subject when it called on the NHS to take a firmer stance on procuring products from trustworthy sources.

One company that has always prided itself on the trustworthiness and reliability of its products Pelican Feminine Healthcare is Pelican Healthcare. Under the mission statement ‘quality, service, trust, innovation and value’, 02920 747400 gill.sims@pelicanhealthcare.co.uk Pelican has a loyal fan-base of GPs, nurses and practice managers who are confident in the fact its www.pelicanfh.co.uk disposable medical products will not let them or the patient down.

Pelican started life in 1994 and from the outset manufactured disposable products for stoma care and feminine healthcare. The following year, the company

acquired Nightingale Limited which has since become the Pelican Home Delivery Service that supplies its stoma customers and serves all parts of the UK. In 2007, the company was bought by TG Eakin Limited, a world-renowned producer of specialist medical adhesives and wound care products, and is now part of the Eakin Group of companies. Its stoma care products are now available in the UK under the Pelican brand with an increasing number of international customers served by Eakin under the Eakin brand.

This year Eakin went on to further acquire Clinical Innovations Europe Limited, which extensively added to Pelican’s obstetric and gynaecological product range. One of the more popular products brought on board was the Kiwi Vacuum Delivery System, essentially a single-use ventouse that works with an integral hand-held pump.

Since the acquisition, the feminine health division of Pelican Healthcare has become its own entity.

Ensuring quality of product, particularly in the field of gynaecology, is so important to patient relations. One bad experience can put a patient off from returning to that practice or going for a future smear test altogether. With this in mind, Pelican also supports Jo’s Cervical Cancer Trust, by donating 5p to the cause from every box of speculums sold.

Jo’s Trust offers information and support to help women understand the importance of cervical screening and encourage them to attend their smear test appointment.

Pelican offers free delivery to its customers and is also the only company in its market to manufacture its products in the UK, which not only ensures a certain quality standard, but also reduces the risk of damage to the product en route. This, the reliability

july 2011 | practicebusiness.co.uk

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practicebusiness.co.uk | july 2011

advice for busy lives

Is negative equity once again rearing its ugly head? OlIver POOl, an associate at veale Wasbrough vizards, asks the question, and discusses the implications for GPs owning surgery premises

Rising to the challenge work/life

These can be horizontal, vertical, double- or single-page, running Change across the bottom or along the outside edge of the page. Banners is good can run in multiples of three, five, eight or just on their own, on consecutive pages or scattered throughout the magazine – a great Practical approaches to improvement in the NHS need alternative to standard page advertising for brand recognition. to be combined with strategic thinking, says MARK EATON advice for busy lives

Recent concerns over the future values of commercial may be unwilling to participate if they are risking being october 2011 | practicebusiness.co.uk property raises the spectre of negative equity in surgery bought out for a loss in a few years’ time (the best idea With so much happening in healthcare, it’s important to have your practice team premises. There is no doubt that values have fallen, even for partners nearing retirement is not to participate on board. Jonathan hills seeks some when valuers take account of the fact that notional rent atyour all,team, but to allow the others to ‘get on with it’ and good advice on how to motivate put changes in place and assert your authority is paid when coming up with valuations.as Partners in indemnify them). practice manager and within the CCG the middle of careers should be in for long enough to Incoming partners may be reluctant about buying ‘ride out the blip’, but for incoming partners, and those into negative equity. We often hear incoming approaching retirement, it is important. partners asking why they should have to take In the last recession, it often came as a nasty over the share of a liability not of their own surprise to retiring partners who owned a share of the making. The answer is that partnership ‘comes surgery premises that they would be expected to buy as whole’ – if you want to be a partner you themselves out on retirement. But this is what happened have to accept the whole package and can’t in a number of cases, especially partnership the bits you don’t like –now the alternative Withwhere a £20bn challenge onreject the table for the NHS, is not the time to be deeds were silent on the issue, and especially where is toare finddone. a different or toachieve be a tinkering with the way things Thepartnership, NHS cannot this level of partners had been involved in costly new-builds, where salaried GP. improvement through buying cheaper paper clips or banning the purchase of the price of the development had exceeded the market At the same time, what cannot be achieved sticky tape. value. This situation may be rearing its head again. by the partnership deed is to bind incoming partners Just ‘working harder’ will only deliver incremental improvements in performance It is not uncommon for a partnership to ‘shield’ to buy in at a certain price unless they specifically andequity even by applying of ‘working smarter notincoming harder’partners will only pay off if what retiring partners from negative includingthe clichéagree to it, because of course you arethat working in the place.of the partnership provisions in the partnership deed provide on for is the right aren’tthing yet bound byfirst the terms Now is least the time for thinking differently about how andforwhere retiring partners to be bought out for at what they deed. Further, it may be permissible the services are contributed, or at least the delivered. previous acquisition cost. having partnership buy a retiring partner outevidence above This means to make to tough, but logical and based, choices management | legal This raises the issue of the goodwill rulesservices – paying above market locally. value, butIttomeans insist that an incoming about how are organised having to tell some people they the market value for surgery premises can beadeemed partner pays more than market value isservices much will be getting lot less money than previously and shifting between to be a transfer of goodwill, which is, of course, illegal. more likely to be a breach of the goodwill rules. organisations to ensure they are delivered both safely and productively. It means However, in practice these arrangements have not been The best way for this to be dealt with is to having to work with unproductive organisations to help them improve, but also called into question, as long as there is a clear presee the transaction as one in which partnership having the courage toany move the funding if they can’t or won’t rise to the challenge. again rearing its ugly head?

OlIver POOl, existing agreement, and to dateIs negative there equity haveonce not been protects retiring partners from negative equity, rather an associate at veale Wasbrough vizards, asks the question, and The keys that will enable leaders at all levels in all organisations to rise prosecutions under the goodwill rules. than the incoming partnerand directly taking on the discusses the implications for GPs owning surgery premises to in thethechallenges unlockpartner’s improvements are going to case be found Including such provisions partnershipahead deed andoutgoing share of liability.

In any it may in two strategically actions. will be particularly important for practicesimportant that are be worth checking the partnership deed to see if it deals contemplating new-builds – older partners in particular adequately these issues.

The first action will be to create awith structure that enables teams and organisations

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as the nhs cuts start to take hold, your practice will be forced into finding more innovative means by which to keep an effective patient service running with growing costs and a reducing budget. like in any business, this will result in you needing to find more and more innovate ways to cut spending and reduce costs. it is a time to be pragmatic and learn new skills to ensure that your practice does not suffer as a result; you will need to ensure that your staff are flexible and accommodating, ready for a challenge and prepared to move into areas of responsibility that they might be thus far unfamiliar with. some practices particularly might have certain staff members who are extremely proficient at the job they ordinarily perform, but when asked to move into a new arena might become apathetic or reluctant to excel.

Michael Wright, practice manager at Whyburn Medical Practice thinks that practices working together will be key in tackling the implementation of the CCGs. “one of the main things, and one of the things which is really going to come out of all the commissioning going on now, is working together,” he says. “there are going to be times in your locality when you can share some of the back office functions. there is going to be pressure and there is talk of a new contract, so if that means there is going to be less

money coming in to the practice, then you are going to have to pool your resources.”

Wright believes his staff have an altruistic approach to dealing with patients, and therefore is something that can be used when reasoning with staff about taking over roles and financial changes within the practice. “i think it is seeing what appeals to staff,” he continues. “What motivates them to come in and do the work? Most, even 90%, of staff are very patient centered so they are very much dealing with the public and like speaking to them. in fact, most of them would rather speak to them than do a lot of paperwork, and practice managers should think about this when reallocating roles in the practice.

“You train them up and you make sure that patient welfare is at the heart of what they do, and as long at it is then you have usually got their buy-in,” he added. the integration of technology will also have a profound effect on the running of your practice, and you and your staff will have to be prepared to learn how to use it – and with the introduction of the CCGs the role of technology looks to become more prominent.

Wright states that the use of the same back office system is vital in the smooth running of a practice, and especially between consortium members: “one of the problems at the moment is that there are a lot of it systems out there – if you have an it system, everyone

should be able to use it, trained up and able to access your surgery regardless of what practice you belong to,” he said.

Emphasising that practices need to be braced for the plunge, Webster argues that both personnel and financial steadiness are required for the transition if practices are to survive it. her advice on how the practice can ready itself for the financial implications of the transition is quite different, however while managing staff often reuires a tailored, individual approach, managing finances relies upon uniformity. whereas in managing staff importance in management should come with individualism, when it comes to finances, the greatest importance is upon uniformity. “it’s about adjusting roles within the practice because actually, certain elements of commissioning like scrutinising data and making sure everyone’s referral patterns and prescribing habits are the same, all takes time, so you have to adjust your workload accordingly – making sure the practice finances are robust enough, in case the worst happens and

october 2011 | practicebusiness.co.uk

Written and designed by Practice Business, a vendor case study is

practicebusiness.co.uk | october 2011

32

an effective way to get company messages and services in front of A negative impact our readers. Featuring an exemplary GP practice, it allows you to really promote your services in a meaningful and interesting way.

Case studies are one of the best read parts of our magazine, great JARGON BUSTER Legal update sponsored by Veale Wasbrough Vizards Transformation for exposure. mapping Recent concerns over the future values of commercial property raises the spectre of negative equity in surgery premises. There is no doubt that values have fallen, even when valuers take account of the fact that notional rent is paid when coming up with valuations. Partners in the middle of careers should be in for long enough to ‘ride out the blip’, but for incoming partners, and those approaching retirement, it is important.

In the last recession, it often came as a nasty surprise to retiring partners who owned a share of the surgery premises that they would be expected to buy themselves out on retirement. But this is what happened in a number of cases, especially where partnership deeds were silent on the issue, and especially where partners had been involved in costly new-builds, where the price of the development had exceeded the market

may be unwilling to participate if they are risking being bought out for a loss in a few years’ time (the best idea for partners nearing retirement is not to participate at all, but to allow the others to ‘get on with it’ and indemnify them).

Incoming partners may be reluctant about buying into negative equity. We often hear incoming partners asking why they should have to take over the share of a liability not of their own making. The answer is that partnership ‘comes as whole’ – if you want to be a partner you have to accept the whole package and can’t reject the bits you don’t like – the alternative is to find a different partnership, or to be a salaried GP. At the same time, what cannot be achieved

provisions in the partnership deed that provide for retiring partners to be bought out for at least what they contributed, or at least the previous acquisition cost.

This raises the issue of the goodwill rules – paying above the market value for surgery premises can be deemed to be a transfer of goodwill, which is, of course, illegal.

However, in practice these arrangements have not been called into question, as long as there is a clear preexisting agreement, and to date there have not been any prosecutions under the goodwill rules.

Including such provisions in the partnership deed will be particularly important for practices that are contemplating new-builds – older partners in particular

aren’t yet bound by the terms of the partnership deed. Further, it may be permissible for the partnership to buy a retiring partner out above market value, but to insist that an incoming partner pays more than market value is much more likely to be a breach of the goodwill rules.

The best way for this to be dealt with is to see the transaction as one in which partnership protects retiring partners from negative equity, rather than the incoming partner directly taking on the outgoing partner’s share of liability. In any case it may be worth checking the partnership deed to see if it deals adequately with these issues.

to work together. This doesn’t mean a monthly meeting where the normal procedure is to send substitutes and where the energy levels start at mediocre levels and then go downhill. This means working together to create a clearly structured transformation map (see box out) that sets out the roadmap for local improvement by clarifying the local strategic objectives and the outcomes that need to be achieved to deliver each of them.

The second action will be to create a structured, logical and pragmatic approach to implementation that will both deliver the roadmap and enable organisations to work together to realise the benefits.

Legal update sponsored by Veale Wasbrough Vizards Answering the £20bn challenge will not only involve the delivery of organisational improvements such as shorter hospital stays, faster diagnostic turnaround times and fewer patient safety incidents. Changes will also have to be made in areas that need a different and often more collaborative approach such as providing care in new settings, improving end-to-end pathways and tackling the underlying issues that prevent the flow of information.

MANAGEMENT redesign Rising| service to the challenge will need new types of thinking, something that can be delivered successfully by combining practical approaches to improvement, such as ‘lean’, with a strategic edge to it from such concepts as transformation mapping.

value. This situationto may be rearing its head again. contact by the partnership deed is to bind incoming For further information on legal issues relevant GPs, please Oliver Pool, anpartners associate at Veale Wasbrough Vizards It is not uncommon for a partnership to ‘shield’ to buy in at a certain price unless they specifically from negative equitythose by including advising agree to it, because who offers specialist legal advice to theretiring GPpartners sector and GPs,of course on incoming 0117partners 314 5429 or opool@vwv.co.uk

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suddenly you are not able to pay the wages,” she says, mentioning that this year her staff had to deal with a pay freeze for the first time in preparation for the future. her advice concerning the management of staff and how to handle personnel centres upon trust and openness. she upholds that being honest, including asking staff for their opinions on changes in the practice, leads to greater respect in her team, and ultimately, a better practice.

“When you tell people why and give them the option to come back with concerns or alternative proposals they will respect the decision you make,” she says. “if people think you are just the boss in the practice, people will not go out of their way for you.”

Whatever the future holds for practices in the nhs - and truthfully everyone may have an indication but no one actually knows the repercussions that will come with the introduction of the CCGs – one thing is certain, and that is it’s best to have a tight and accountable financial structure, and a solid practice team around you when you make the change.

Transformation mapping is a visual way of developing and linking strategy to implementation plans.

Typically, this is achieved using a large diagram that depicts where an organisation wants or needs to be within a specific timescale, along with the associated implementation plans.

Advertisers have the opportunity to brand or sponsor a feature or section. We choose our sponsorship partners very carefully because as a valued Practice Business partner, it follows that we’re also endorsing their brand. Placed on very targeted editorial sections of the magazine, it’s a en extremely stategic and pretigious way to promote your brand. Something a bit different, a bespoke sponsorship position aligns you with the magazine’s message.

For further information on legal issues relevant to GPs, please contact Oliver Pool, an associate at Veale Wasbrough Vizards who offers specialist legal advice to the GP sector and those advising GPs, on 0117 314 5429 or opool@vwv.co.uk

In qu should be able to use it, trained up and able to access your surgery regardless of what practice you belong to,” he said.

Emphasising that practices need to be braced for the plunge, Webster argues that both personnel and financial steadiness are required for the transition if practices are to survive it. her advice on how the practice can ready itself for the financial implications of the transition is quite different, however while managing staff often reuires a tailored, individual approach, managing finances relies upon uniformity. whereas in managing staff importance in management should come with individualism, when it comes to finances, the greatest importance is upon uniformity. “it’s about adjusting roles within the practice because actually, certain elements of commissioning like scrutinising data and making sure everyone’s referral patterns and prescribing habits are the same, all takes time, so you have to adjust your workload accordingly – making sure the practice finances are robust enough, in case the worst happens and

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Quality has always been a prio of healthcare products. Purcha clinical supplies is instrumenta and wellbeing of patients and w increased patient choice of GP this been more important. A de annual conference last month f the importance of the subject w NHS to take a firmer stance on from trustworthy sources.

One company that has alw Contact details the trustworthiness and reliabi Pelican Feminine Healthcare is Pelican Healthcare. Under th ‘quality, service, trust, innovati 02920 747400 gill.sims@pelicanhealthcare.co.uk Pelican has a loyal fan-base of practice managers who are con www.pelicanfh.co.uk disposable medical products w patient down.

Pelican started life in 1994 a manufactured disposable produ feminine healthcare. The followi

CASE STUDY july 2011 | practicebusiness.co.uk

Rising to the challenge

Mark Eaton is MD of Amnis

nhs but will thin acco team

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Practical approaches to improvement in the NHS need to be combined with strategic thinking, says MARK EATON

Transformation mapping is a visual way of developing and linking strategy to implementation plans.

Typically, this is achieved using a large diagram that depicts where an organisation wants or needs to be within a specific timescale, along with the associated implementation plans.

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Mark Eaton is MD of Amnis

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30

With a £20bn challenge on the table for the NHS, now is not the time to be tinkering with the way things are done. The NHS cannot achieve this level of improvement through buying cheaper paper clips or banning the purchase of sticky tape.

Just ‘working harder’ will only deliver incremental improvements in performance and even applying the cliché of ‘working smarter not harder’ will only pay off if what you are working on is the right thing in the first place.

Now is the time for thinking differently about how and where services are delivered. This means having to make tough, but logical and evidence based, choices about how services are organised locally. It means having to tell some people they will be getting a lot less money than previously and shifting services between organisations to ensure they are delivered both safely and productively. It means having to work with unproductive organisations to help them improve, but also having the courage to move the funding if they can’t or won’t rise to the challenge.

The keys that will enable leaders at all levels and in all organisations to rise to the challenges ahead and unlock improvements are going to be found in two strategically important actions.

The first action will be to create a structure that enables teams and organisations to work together. This doesn’t mean a monthly meeting where the normal procedure is to send substitutes and where the energy levels start at mediocre levels and then go downhill. This means working together to create a clearly structured transformation map (see box out) that sets out the roadmap for local improvement by clarifying the local strategic objectives and the outcomes that need to be achieved to deliver each of them.

The second action will be to create a structured, logical and pragmatic approach to implementation that will both deliver the roadmap and enable organisations to work together to realise the benefits.

Answering the £20bn challenge will not only involve the delivery of organisational improvements such as shorter hospital stays, faster diagnostic turnaround times and fewer patient safety incidents. Changes will also have to be made in areas that need a different and often more collaborative approach such as providing care in new settings, improving end-to-end pathways and tackling the underlying issues that prevent the flow of information.

Rising to the challenge will need new types of thinking, something that can be delivered successfully by combining practical approaches to improvement, such as ‘lean’, with a strategic edge to it from such concepts as transformation mapping.

sudd men a pa the f

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Online PRACTICEBUSINESS.CO.UK WHAT DOES IT DO?

We have maintained a website alongside Practice Business since the magazine’s launch and we have seen it go from a resource in support of the magazine to a popular news website in its own right. Decision-makers in practices come to practicebusiness.co.uk for news, bringing them stories relevant to the role of the practice manager on a daily basis. They also stay on the site for the fantastic quality analysis and resources we provide for them.

SOCIAL MEDIA WE DON’T JUST TWEET… WE SHAPE THE CONVERSATION

Social media is at the heart of what we do online, it not only helps us keep our finger on the pulse of what’s happening in the health community and the stories that affect the role of our readers, but it also helps us become conversation shapers. We understand that interacting online is not just about speaking to readers – it’s also about hearing what they have to say to us.

BLOGS AND DISCUSSIONS WE’RE NOT JUST HELPFUL, WE’RE RESOURCEFUL

Combined with our top drawer news analysis, we publish blogs authored by everyone from readers to policy-makers. Our website also boasts a comment section under every news story so our readers can let us know what they think about what’s going on. Combined with our regular surveys and competitions, this has established Practicebusiness. co.uk as a crucial resource for anyone interested in the business of practice management.

EMAIL COMMUNICATION STAY IN TOUCH WITH PB WEEKLY

Every week, we send out the PB Weekly news round-up email to our 8,500 email addresses that have signed up to receive it. Content often relates back to web news stories, but it can also point to editorial items in an up-coming issue. While email is an excellent method of driving response, it’s vitally important your message is conveyed in a way that ensures that its relevant and stands out in a crowded inbox. We have advertising opportunities in PB Weekly to help you ensure your message is delivered to and read by the decision-makers in practices who matter.

Practice Business is taking the lead when it comes to B2B publishing – by continuously looking for ways to better engage with our readers. The way people communicate has evolved and more importantly this has shaped how people buy. To be effective in the marketplace, a company needs to be forward-looking and innovative. We offer a range of digital inclusions that, combined with our print offering, will drive engagement with decision-makers at schools, further build your brand and help generate a valuable response.

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We have developed an audience across our magazines and websites that loves to get its opinion across and engage with our content.

FIND US ON:

Opportunities for you WEB/PRODUCT NEWS: Do you have news that our readers might be interested in? Web advertorials are a fantastic way to get your message across. They sit nestled into the content on the front page of the website and are known to generate a substantial response.

BANNERS AND BUTTONS Web buttons and banners are a great way to catch the reader’s eye, whether its helping them associate your company with our brand or driving them through to your website.

Our audience is responsive and always interested in offers and info that help them in their role.

SURVEYS/COMPETITIONS We regularly run competitions and surveys – it’s a great way to keep people coming back to the site. We often run them on behalf of companies looking to get some direct response from our audience.

EMAIL MARKETING With over 2,500 readers signed up to receive regular news updates from Practice Business in their inbox, email marketing is a great way to get them reading information from third parties too. Our key watch word is ‘relevance’ – we make sure the people who want our emails get them and work hard to make sure that we only send them things they are really interested in, this makes them some of the most responsive readers in the B2B market.

PB WEEKLY: There are opportunities to take out a product news slot on our PB Weekly email, which is a great way to get info to our readers and get them clicking through to your website.

SOLUS This is where we send out an email to our database on your behalf. A crucial part of any marketing mix, this turns branding into response. (We only send out a few emails a month, we don’t over saturate our audience and they stay responsive.)

VIDEO/PODCASTS We host videos on the front page of practicebusiness.co.uk (all linked to our YouTube channel) and we can include your video on the front page.

We also produce podcasts that are hosted on the website and YouTube. These can consist of an interview or an overview of what your doing in the sector. They are another great way to engage with our audience.

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