In the last week, I have managed to catch up with two old friends who are the sort of GPs who I would be delighted to look after me or my family. As I listened to them both, I empathised with the pressures general practitioners face. On top of the burden of more and more patients with co-morbidities for whom more and more is expected from general practice, GPs are expected to find time to get deeply involved in commissioning. The pressures on GPs and practices are growing and they are under strain.
Recently I also paid a visit to another friend at his place of work. He is involved in a family business. They manufacture high quality steel components for the gas and oil industry. He took me round the factory. He showed me the “cells” where employees not only produce precision engineered flanges of exceptional quality but also give feedback on their morale at work. Amongst the measures relating to productivity and quality which they have on display for everyone to see, staff morale is given as much prominence. My friend transformed the business in the last few years. Working with a knowledge transfer partnership with the local university, he brought in someone to introduce lean methodology across the business. In the last three years, in a time of recession, the company has doubled turnover, employed more staff and continuously improved quality. The passion and pride evident in the company and their ambition is inspiring. Even more inspiring is that they are prepared to share their learning with others in their industry.
It was talking to him, listening to GP colleagues, and my role in developing commissioning that made me think we had, perhaps, missed a trick. If practices and GPs are not only going to be providers, but also commissioners, then they need help to do both. We have focussed a lot of resource and energy on GP commissioning development. I began to wonder if we needed to focus just as much on developing GP provision. This takes me back to my GP friends. One of them told me all about his involvement in piloting Productive General Practice for the NHS Institute. His enthusiasm and description of its impact, the way it empowered staff to improve the working of the practice for both patients and staff, echoed what I had heard in the factory I visited. Reading about the Productive General Practice programme, I began to wonder if by inviting practices to participate and supporting them to do so, we could help practices become better providers of care, release time to address the commissioning agenda, and improve services for patients.
Which is why I am thrilled that 51 practices have indicated they are interested in participating in the Productive General Practice programme and we are getting ready to roll it out across Lincolnshire. Maybe, just maybe, this will be a win for practices as providers, a win for commissioning but, most importantly, a win for patients?
Martin McShane qualified in 1981 from University College Hospital Medical School. He trained in surgery until 1990 then switched to general practice where he spent over a decade working in a semi-rural practice on the edge of Sheffield. In a fulfilling job, with a great lifestyle, he decided to give it all up and take on a fresh challenge. He entered NHS management, full time, in 2004 as a PCT chief executive after experience in fund holding and chairmanship of both a primary care group and subsequent professional executive committee. Since 2006 he has been director of strategic planning for NHS Lincolnshire, where there are 5,600 miles of road but less than 50 miles of dual carriageway.