1. Releasing time in general practice Dr Robert VarnamPhD MRCGPClinical lead for CCG & primary care delivery, NHS Improving Quality Head of general practice development, NHS England GP, Robert Darbishire Practice, Manchester @robertvarnam #GPdev @NHSIQ robert.varnam@nhs.net

2. Releasing time in general practice The issue The Productive General Practice Examples National general practice development programme Top tips 3. The issue@robertvarnam #GPdev @NHSIQ 4. Quality safety effectiveness experience Care & support Secondary / specialist careAccess DiagnosticsCommunity servicesProactivityCoordinationPharmacySelf care@robertvarnam #GPdev @NHSIQCCGATLA 5. @robertvarnam #GPdev @NHSIQ 6. @robertvarnam #GPdev @NHSIQ 7. The Productive General PracticeLean-based redesign for busy general practices Practical, guided, comprehensive@robertvarnam #GPdev @NHSIQ 8. The Productive General Practice@robertvarnam #GPdev @NHSIQ 9. The Productive General Practice@robertvarnam #GPdev @NHSIQ 10. The Productive General Practice 12 modules packaged in a box set The programme is divided into manageable, easy to follow, self-directed modules A large range of supporting resources spreadsheets, documents, eLearning and guidance films@robertvarnam #GPdev @NHSIQ 11. The Productive General Practice Support packages from expert teams Options for sharing & collaboration between practices Aligned with strategic commissioning priorities@robertvarnam #GPdev @NHSIQ 12. Typical results Extra nursing capacity identified, providing extra capacity worth 11k Test site testing, Consultation moduleMore accurate staff planning resulted in the cancellation of planned appointment of staff avoiding 15k of staff expenditure year on year Test site testing, Consultation moduleTime taken to retrieve prescriptions requests reduced by 82%, releasing 12.5hrs of staff time per week Test site testing, Front of House moduleTurnaround time for medical reports reduced by 43% Test site testing, Back Office module14% reduction in stationary costs Test site testing, Back Office module57% reduction in blood test resource costs Test site testing, Planning and Scheduling module82% reduction in nurse sickness and absence Test site testing, Planning and Scheduling module 13. I seem to manage to get home on time much more often than I used to It makes a big difference to my work-life balance. Knut Schroeder, GP Partner, Concord Medical Centre, BristolOur list size has started to grow for the first time in a good while the practice is more efficient, friendly, flexible and productive. Dr Paul Cook, GP, Welbeck Road Health Centre, Bolsover@robertvarnam #GPdev @NHSIQLed to changes that were really life changing for me. Improvements mean I do not stay late evenings and this means I am not making mistakes because I am tired. Dr Angela Bradley, GP, Lisle Court Medical Centre, Leamington Spa 14. eg Maryport Improving todays practice Process redesign given us a structured approach to making improvements reduced the number of calls GPs have to make by 80% and released time for an extra 2 patients to be seen each day@robertvarnam #GPdev @NHSIQ 15. eg Maryport Shaping our future practice Radically re-thinking & transforming focus on self-care, group consultations, technology patient-led design approach segmentation of high profile patient groups proactive multiple LTC review clinics@robertvarnam #GPdev @NHSIQ 16. Taster What is it like? What is possible? Sheffield practices workplace improvement project@robertvarnam #GPdev @NHSIQ 17. Workplace improvement 5S SortRemove non-essential thingsSetOrganise necessary things Assign each object a placeShineStandardiseSustainRegularly clean & maintain the areaDevelop procedures, arrange similar areas in similar ways, use colour codesUse regular audits and embed 5S in the everyday routine 18. Workplace improvement 5S SortSetShineStandardiseSustain 19. Workplace improvement 5S SortSetShineStandardiseSustain 20. Workplace improvement 5S SortSetShineStandardiseSustain 21. Workplace improvement 5S SortSetShineStandardiseSustain 22. Workplace improvement 5S SortSetShineStandardiseSustain 23. Spaghetti diagrams 24. The current workplace 25. Sort 26. Set in order 27. Set in order 28. Standardise 29. Spot the missing numbers 30. NHS Englands strategic framework@robertvarnam #GPdev @NHSIQ 31. Aug 13 Call to action on general practice. Strategic framework for commissioning general practice. 9 workstreams. Mar 14 Emerging Findings Apr 14 Phase Two @robertvarnam #GPdev @NHSIQ 32. General practice development programme 1. Innovation spread Learning networksPeer networking Innovation hub Bureaucracy2. Release capacityClinical clutter Internal productivity3. Capability-building4. Business development Development advisersService improvement Leadership Legal Financial ManagementNational Coordinating Centre Strategic Development leadership advisersNational guidancePMO support Evaluation 33. Top tips@robertvarnam #GPdev @NHSIQ 34. Top tips Create strategic alignment Create a values-based shared purpose Do it collaboratively Engage, engage, engage Be realistic about time commitment Build local support resource Use it as it is meant to be usedbit.ly/1hD0GCD 35. Top tipswww.nhsiq.nhs.uk/capacity-capability/productive-gp.aspx@robertvarnam #GPdev @NHSIQ robert.varnam@nhs.netbit.ly/1hD0GCD