Lots of questions; some answers

Dr Shane GordonDr Shane Gordon, GP in Colchester and chief executive of the North East Essex GP Commissioning Group, deals with lots of questions, hears some answers and faces a well-informed patient.

This week was a chance for me to have a long chat with Department of Health colleagues involved in developing and extending Payment by Results (PbR).

Some interesting discussion about the pros and cons of the models for Mental Health and Community Services, plus a general whinge about the existing system! I’ve foolishly volunteered to help. By co-incidence I attended a talk by Ben Richardson and Hal Wolf from Kaiser Permanente later in the week. They waxed lyrical about the benefits of not just pathway integration but organisational integration. I questioned them closely on how they would make their model work under PbR and Any Willing Provider (AWP). Answer came there none…

Had my first session of leadership co-coaching today in my role as joint-lead of our GP commissioning cluster. Very helpful and all funded by the National Leadership Council. I would strongly recommend pathfinder colleagues to take up this excellent offer. We are navigating through some very tricky planning with our PCT colleagues and a bit of time and external reflection is very valuable.

A presentation to our region’s Community Services Chief Operating Officers was very interesting. Understanding some of the concerns and the willingness to build new customer relationships is useful. Lots of worries about the future of PCT estates. Many unanswered questions remain at this stage.

In my surgery a patient ended our consultation with a very well informed discussion about the future of GP commissioning. Some probing questions about our priorities, what would be different and whether it would be a distraction from our clinical duties. I was heartened by the level of understanding and cautious optimism. We must endeavour to deliver for all our patients in these challenging times.

Thanks for all your questions and comments last week. Keep them coming.

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5 Responses to Lots of questions; some answers

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  2. Zara says:

    Dear Shane,
    Which therapy areas will be your priority…I know that the prevention of Osteoporosis could make a huge impact on finances as hip fractures can cost around £30k and just wondered whether this would be an area of interest for you?

    • Shane Gordon says:

      Our priorities will be determined by our local JSNA and strategic planning round, in partnership with the local Health and Wellbeing board.

  3. Andy Cowper says:

    Hi Shane. Kaiser can select both their customers and their ‘Kaiserised’ clinicians, which consortia are not able to do with the Bill (as it stands). Surely this affects what we can learn about their ability to integrate pathways and organisations?
    Since PCT estates are state assets, surely creating a cast-iron asset lock and leasing facility is not all that complex?

    • Shane Gordon says:

      Hi Andy. I think there is a fundamental issue in the very close association of specialists with their institutions which makes it difficult to create a ‘knowledge economy’ separate from the buildings. That makes a very integrated Kaiser-type model difficult to achieve, I agree.

      With regard to Estates, I don’t know how complex it is, but I suspect it is not that simple!

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