Another interesting week…

Dr Shane GordonIn the first of a series of regular blogs, Dr Shane Gordon, GP in Colchester and chief executive of the North East Essex GP Commissioning Group, gives an insight into preparing for the new commissioning system.

Another interesting week begins. So many things to get to grips with as a proto-consortium lead. This week I’m juggling commissioning our organisational development diagnostic, our in-house apprenticeship programme, getting to grips with the QIPP workstreams and our 200 page system QIPP plan, reading 200-page board papers, the 367-page Health Bill, negotiating the transitional governance structures with the PCT and starting to think about scary things like safeguarding. Sleep is for wimps!

Great news this month about getting our pathfinder status. This will focus minds in the consortium and the PCT – should help move things along faster. The Pathfinder launch event is this week – a good chance to network with the other consortium leads. I know there will be lots of familiar faces but some new blood too, which is great. Everyone has their war stories but always one or two great ideas. Heard a good one last week about using timesheets to drive up productivity for district nurses by 20 per cent – simple but apparently effective.

We’ve been inundated with offers of ‘help’ and training from every quarter. The difficult bit will be choosing which ones will really add value. There will undoubtedly be a national development programme but we will also need some bespoke development input. Our GP, nurse and practice manager leads have such vastly different experience that we will have to construct quite tailored development plans for each of them. The planned leadership competency framework should help identify the gaps.

We’re also preparing for one of our big set-piece events, our quarterly primary care ‘shutdown’. Top of the agenda is quality in primary care and starting to develop some answers to what are good outcomes in primary care and how do we measure them? I’m set for a challenging debate but I think this is key to future success.

In Pathfinder Learning Network, Shane Gordon | Tagged , , , ,

13 Responses to Another interesting week…

  1. Mike Hobday says:

    Dear Shane,
    Pretty obvious that you’d be deluged with offers of (as you say) “help.” I wonder how you decide what could be helpful?
    Mike Hobday
    Head of Policy
    Macmillan Cancer Support

    • Shane Gordon says:

      Thanks Mike
      It can be really tricky! I suspect a national ‘kitemarking’ system for external commissioning support will follow in due course. How quickly we’ll be allowed to use external support is a hot topic among pathfinders…

  2. Andy Cowper says:

    Shane, what’s your sense on the timescale in which primary care can demonstrably improve outcomes? Media and political priority will combine with people who are ‘losing’ from the changes – be it status, power or jobs – to focus great attention on whether consortia or pathfinders ‘work’? How is the realism-ometer?

    • Shane Gordon says:

      Thanks Andy. I suspect 1 to 2 years in truth as the plans for next year will be pretty much set due to PCT QIPP planning and it will take a while for GP Commissioners to get to grips with the scale of the task. Significant change always takes more time than we expect.

  3. Hi Shane
    As a newcomer to the NHS world, either I have missed something or noticed something significant. Measuring patient outcomes in a meaningful, practical way is impossible using the traditional ways these are measured. As an advocate of simple metrics like NPS, why is it that all healthcare entities don’t use this metric as a starting point to measure and improve patient outcomes?


    Martin Kentish
    MD, Free Range People Ltd.

    • Shane Gordon says:

      Thanks Martin. I agree that the Net Promoter Score is a very good index of overall satisfaction and indeed is now widely used by providers and commissioners alike. However, we often want to look at things that influence overall satisfaction and some things that patients might be very satisfied with but which don’t measure up to clinical quality requirements.

  4. Jonathon Tomlinson says:

    Dear Shane, Where will services you commission fit into the choices presented on Choose and Book? e.g. what will be the tension between patient choice + awp and commissioning? and what impact do you think EU competition law will have on commissioning freedom?
    Thanks, Jonathon Tomlinson. City and Hackney PCT

    • Shane Gordon says:

      Dear Jonathon
      Where services go under Choose and Book will likely be determined by national CAB policy. In my view the artificial separation of hospital and ‘primary care’ services is not good…

      The AWP question is interesting as unfettered provision (via a national arrangement, for example) plus unfettered choice = cost pressures ++. However, if AWP is a tool we can choose to use for areas of provision where quality or responsiveness is an issue then, as we’ve found locally, it can be very useful.

      EU law will have less impact than the internal competition and collaboration rules for the NHS, I suspect.

  5. Ron Singer says:

    Dear Shane, Do you think the name National Health Service will be appropriate after all hospitals are FTs, Consortia are supported by mega health companies and consortia can choose whether or not to offer a particular service in their area which may be a very different list from a neighbouring consortium?

    • Shane Gordon says:

      Dear Ron
      Do you really think it’s all homogenous now? I’m sure you’re not that naive! What we’re after is quality services for our communities, with minimum standards but no limits on innovation to deliver better care.

  6. Jonathon Tomlinson says:

    Final questions. Do you think a patients’ rights directive could open up awp Europe-wide? Might commissioned services disappear in a provider ocean? And can you predict what impact international corporate commissioners might have on the UK scene?

    • Shane Gordon says:

      I don’t know the answer to the EU-wide question, but I suspect that if significant numbers of patients choose to vote with their feet then local providers will have to up their game. We’ve already seen this effect with the extended Choice network.

  7. Wendy Slator says:

    Hi Shane

    re the offers of help and the possible variance between the anticipated national development and the bespoke needs for GP staff – how do you think the skills currently held within PCT’s can be aligned with consortia?

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