Skip to main content

No need for GPs to be over-awed by the members of the Shelford Group

The 10 NHS Trusts that are members of the Shelford Group see themselves as members of an elite group. But the members of this elite can be dealt with by general practitioners (GPs) and clinical commissioning groups. Here are my tips on how GPs and CCGs can do this.

1. Form your own consortia. General practices can work in federations and networks to share resources and expertise. CCGs can come together in joint commissioning activities. Working in larger groupings - whether it is of general practices or CCGs - will give you more bargaining power and greater consolidation of expertise to challenge the members of the Shelford Group.

2. Become skilled in using the language of evidence-based medicine, healthcare evaluation and data-driven healthcare in your dealings with the managers of the Shelford Group NHS Trusts. You will soon discover that many NHS managers are poorly trained in these essential components of modern healthcare delivery and in using NHS data to evaluate the performance of health services.

3. The Shelford Group Trusts may be large but like many NHS Trusts they often operate on very narrow financial margins and even a small shift in GP referrals (and hence in their income) can destabilise their clinical services - and sometimes even an entire NHS Trust. Use your commissioning power to move referrals to NHS Trusts that are more flexible and more responsive to your needs. If your CCG won't do this, then a group of practices can - under NHS hospital funding arrangements, money follows the patient. Write to the Finance Director, Medical Director and Chief Executive of the Trust to let them know what you are planning. The more GPs that contact an NHS Trust on a single issue, the more effective you will be at influencing the Trust.

4. Take back power from NHS England and Commissioning Support Units (CSUs). Many NHS managers in the former NHS commissioning organisations obtained new positions with NHS England and CSUs. What are all these managers doing and what value for money do they provide? Hold them to account for any top-slicing of your budgets to fund their activities and make a case with the Department of Health that consortia of clinical commissioning groups can take over many of their functions (and thereby make their managers redundant).

5. Finally, NHS managers often hope - that as busy clinicians - you won't have time to keep on dealing with them on a single issue. So if you have a strong case, be tenacious and don't give up in your dealings with them.

The 10 members of the Shelford Group are:
Cambridge University Hospitals NHS Foundation Trust
Central Manchester University Hospitals NHS Foundation Trust
Guy’s and St Thomas’ NHS Foundation Trust
Imperial College Healthcare NHS Trust
King’s College London Hospital NHS Foundation Trust
Newcastle upon Tyne Hospitals NHS Foundation Trust (Leonard Fenwick): £850m
Oxford University Hospitals NHS Trust
Sheffield Teaching Hospitals NHS Foundation Trust
University College Hospital NHS Foundation Trust
University Hospitals Birmingham NHS Foundation Trust

Comments

Popular posts from this blog

Improving how secondary care and general practice in England work together: the NHS Standard Contract

Due to the increasing pressures on general practices within the National Health Service in England, the interface between primary and secondary care, and the division of labour between these, has become an important issue. This has long been an area prone to difficulties and conflict, the consequences of which can directly impact the quality and safety of patient care, particularly for patients with chronic conditions who regularly transition between these two sectors. In an article published in the Journal of the Royal Society of Medicine, Amy Price and I explore the measures recently implemented in the NHS Standard Contract which aim to target common issues at the primary–secondary care interface, with an aim to reducing inappropriate general practitioner workload in England. We discuss the context behind the implementation of the NHS Standard Contract as well as current concerns and areas for further consideration.

The current crisis in primary care means the NHS Standard Contract…

Patients are more satisfied with general practices managed by GP partners than those managed by companies

General practices in England are independent businesses that are contracted to provide primary care for specified populations. Most are owned by general practitioners, but many types of organisation are now eligible to deliver these services. In a study published in the Journal of the Royal Society of Medicine, we examined the association between patient experience and the contract type of general practices in England, distinguishing limited companies from other practices.

We analysed data from the English General Practice Patient Survey 2013–2014 (July to September 2013 and January to March 2014). Patients were eligible for inclusion in the survey if they had a valid National Health Service number, had been registered with a general practice for six months or more, and were aged 18 years or over. All general practices in England with eligible patients were included in the survey (n = 8017).

Patients registered to general practices owned by limited companies reported worse experience…

Dr Demis Hassabis, Co-Founder and CEO of DeepMind, Speaks about AI in Healthcare

On 28 September 2017, I attended the Annual Institute of Global Health Innovation Lecture: Artificial General Intelligence and Healthcare, delivered by Dr Demis Hassabis, co-founder and CEO of Google DeepMind. Artificial intelligence is the science of making machines smart argued Dr Hassabis, so how can we make it improve the healthcare sector? Dr Hassabis then went on to describe the work that DeepMind was carrying out in healthcare in areas such as organising information, deep learning to support the reporting of medical images (such as scans and pathology slides), and biomedical science. Dr Hassabis also discussed the challenges of applying techniques such as reinforcement learning in healthcare. He concluded that artificial intelligence has great scope for improving healthcare; for example, by prioritising the tasks that clinicians had to carry out and by providing decision support aids for both patients and doctors. Dr Hassabis also discussed some of the ethical issues in using …