Passionate about Primary Care

If you are looking for operational support, development or project management, you’re in safe hands with DKJ.

DKJ and its associates are proud to support general practice and primary care, especially at a time of such high demand and pressure. Our team dont just talk the talk; they walk it too.

Kiran is a PCN manager and our associates all work within the sector, so they are best placed to offer you practical, tried-and-tested approaches to your mightiest challenges.

We have vast experience working with PCNs and general practice including:

  1. Supporting over 85 PCNs during late 2018/2019 setting up and developing their PCN providing advice and guidance on their workforce, legal structures, financial implications, HR and employment law and developing a shared vision, value and goals.
  2. Currently supporting over 115 PCNs on projects including workforce planning, governance arrangements, meeting the DES and IIF, setting visions and values, business planning, utilising population health management to set PCN priorities, change management and quality improvement programmes and audits. We are also providing medium term interim capacity management to several PCNs nationally.
  3. Delivering Leadership and Development Sessions to over 75 GP Practices as part of Practice Management Learning and Development programmes.
  4. Working with several LMCs to develop events and webinars for their constituents focusing on working at scale, PCN development and technical areas such as premises and workforce.

Our team of experts provide exceptional levels of experience, knowledge and capacity required to deliver this programme. We can provide a multi-disciplined team to deliver this project including GP Partners, Clinical Directors, PCN Managers, Project Managers, Coaches and Mentors all of who have extensive experience delivering training and development sessions on a wide range of topics.

DKJ can help you with

Primary Care Interim Capacity Management

General practice, primary care network and GP federation interim management support with a focus on supporting your organisation with management whilst recruiting for a substantive role.

Primary Care Network Support

Leading and supporting with all the things which your Primary Care Network needs including governance, Network Agreements, Data Protection, Board Development, Premises reviews. Workforce Planning, Contractual Support, DES and IIF Assurance, supporting Capacity and Access Plans and the limited company Journey.

Primary Care Training

Providing mandatory, statutory and required training for primary care. Areas we cover range from Infection Prevention and Control to Building Resilience in Reception Teams to Writing winning Bids and Business Cases amongst many other sessions.

Primary Care Projects

Setting up and developing primary care networks and community services including HIV clinics, practice management of GP practices, development and delivery of PCN leadership development programmes and extensive ARRS recruitment programme across networks.

Primary Care Packages

Handling a primary care project while trying to deliver everyday patient care is often overwhelming, time-consuming and can be physically draining if you’re not careful. That’s why we lighten the load and can help in lots of ways. Here are just some of them:

What do you need help to move forward and develop? Setting up initial membership? Building relationships between your members? Making sure your network agreements and schedules are robust? Meeting DES and IIF requirements? Embedding new ARRS roles? If it’s PCN related, chances are, we’ve done it. You won’t find the same level of service and commitment to developing your PCN needs anywhere else.

We regularly work with primary care networks at place-level to help them work together and develop joint services that benefit a larger landscape than a PCN footprint.

As part of the Stock Check, we will cover the following areas in detail.

Governance

  • Network Agreement and Schedules
  • Limited Company Feasibility
  • CD Election Process, accountability and leadership development support
  • PCN Vision and Values and Business Planning for the Future
  • PCN Board including structure, representation, effective decision making, voting rights and quorum
  • Bank Accounts, Budget, and Development Funding
  • Management Function and Support
  • Data Sharing Agreements
  • Place and ICS working

ARRS

  • Employment structure and whether it is fit for the future
  • Sub contracts, contract and performance management
  • Management of ARRS team
  • HR function and retention
  • Contract register

DES and IIF Assurance

  • A deep dive into all 7 DES areas including providing assurance that the requirements are being met
  • Utilising ARRS staff to meet the requirements
  • Setting targets
  • Planning for the future  

At the end of the health check, we would provide a RAG rated action plan and set of recommendations for you to progress your PCN.

Ones we have been doing recently include:

  • Visions and Values – Look at where the PCN is now, where it would like to be and then setting a Vision and Business Plan to get there.
  • Board Development – including looking at the current Board, roles and remits and redefining these so that they are fit for purpose (this is the one where we meet with the practices beforehand).
  • Limited Company Discussion – asking the ‘why’ question, going through the limited company checklist including business management support and drafting an action plan for completion.
  • Workforce – looking at skills of current staff and needs of patients, practices and PCNs and looking ahead to planning for your 23/24 workforce.

We go through your Network Agreement and Schedules and advise on any changes which may be required. We have a checklist which we would go through with you and your Board to make sure that all arrangements are what you require. Please note that this will need to be ratified by the lawyers.

Got a project? Here are just some of the many types we take care of for you:

  • Review practice access – recommend actions for improvement and implement those changes
  • Develop business cases to reduce covid backlog in services such as MSK etc
  • Mobilise and implement clinics – past clinics we’ve setup include Covid hot hubs and HIV clinics 
  • Interpret the DES and/or IIF – we can break down the information, disseminate it to your leadership teams and then develop action plans to meet the contractual requirements and performance indicators as well as monitor their performance
  • Recruitment of ARRS and practice staff
  • Advertise and create job specs etc
  • Review CVs and present suitable candidates
  • Arrange interviews in collaboration with the practice
  • Once your candidate is chosen – complete contract, offer letter, job description, DBS (if required), arrange mandatory training, NHS email, confidentiality agreement etc
  • Health inequalities projects – using population health management data, we can help you identify patients who require specific support and design and create these services plus ensure they run effectively.

To understand the roles and responsibilities of your Board representatives and whether they are the right people ‘around the table’ and to develop the Board to ensure that contractual and financial obligations are met with the patients at the front of the decision making.

  • Meet with the individual practices to have an open and honest discussion regarding the PCN, their engagement with the PCN, a SWOT analysis from their view point and direction of travel with regards to what March 2024 looks like for them.
  • Pull together key themes arising from these conversations and prepare recommendations on potential changes to the Board.
  • Present to decision makers.
  • Work with the Board/Leadership Team to develop their skills and knowledge to ensure that the PCN is run effectively.

Delivery Plan

We will meet individually with the PCN lead to understand their current workforce, their workforce intentions and how this links to PCN operations including looking at population health management data, meeting the service specifications, IIF, development of projects/services and practice support to reduce workload off GPs and other clinicians.

We will deliver an online Workforce Planning Workshop where the participants will be guided through completing a PCN Workforce Plan based on the discussions we have had with them individually and sharing our experience of supporting 37 PCNs nationally with their workforce planning.

Outcomes

Once this has been completed, we will:

  • Consideration given to in year and future financial planning for ARRS roles.
  • Consideration given to embedding ARRS team members.
  • Consideration given to succession planning and looking at March 2024 and beyond.

Using our Limited Company Checklist, we will coordinate the whole process for you.  The coordination would include ensuring that all the legal and finance requirements are completed working with the providers you choose. We would be able to recommend 2 providers for each if you would like me to. Please note the quote is for our time only and there will additional costs for the lawyers and accountants.

We would be able to support with the business side of setting up your limited company including ensuring that there is a management function, policies and procedures are in place, develop your business plan and make sure that the limited company is business ready.

Case Studies

We have a lot of experience supporting general practice and primary care teams. Read about some of our projects below:

Introduction & Problem

Four Primary Care Networks (PCNs) in the North requested us to facilitate several workshops so that the PCNs could discuss areas which they could work on together at a PAN PCN scale and deliver using the Additional Reimbursable Roles Scheme (ARRS) Funding.

The aim of working across the locality was that all Clinical Directors felt that they were facing some of the same challenges such as frailty and mental health. Therefore, rather than setting up services within the PCN area it would be beneficial to patients to set up such services across the locality utilising the jointly funded ARRS roles and being managed by one management structure freeing up time for GPs and non-clinical staff.

The Process

The workshops covered an in-depth look at the patient population and health inequalities across all four PCNs, determining commonalities and key themes, understanding the roles currently employed by the four PCNs and what roles they would require for any such pan PCN projects. 

The Results

By facilitating these workshops, the four PCNs agreed to top slice their ARRS funding and provide a frailty service across all four localities therefore reducing duplicate work and utilising the funding in the best and most effective way possible.

We believe that our services are valuable for any PCN or groups of PCNs who wish to work together at a larger scale. If you have any questions or would like to learn more about what we can do for you, please don’t hesitate to contact us!

Introduction & Problem

A large GP federation from Yorkshire commissioned us to undertake a project to understand where they were as a business and to develop a vision and underpinning plan for the future.

The Process

As part of this project, we met with over 30 key stakeholders from all sectors including community services, ICBs and member practices to understand their perceptions of the Federation, how it best works for them and how they hope to work with the Federation in the future. As we were seen as independent to the Federation, we were able to have frank and honest conversations which led to rich and valuable feedback which we could relay to the Federation Board.

The Results

We collated all of the feedback and presented our findings to the Federation Board. We led them through a Visions, Values and Strategy session based on the feedback and at the end of the session we were able to co-design a Federation Strategy fit for the future.

We believe that our services are valuable for any primary care organisation who are wanting to develop a strategy, vision and values. If you have any questions or would like to learn more about what we can do for you, please don’t hesitate to contact us!

Introduction & Problem

A large GP Federation were looking to deliver a Leadership Development Programme across 15 Primary Care Networks (PCNs). The programme was aimed at Clinical Directors and PCN Managers to support leaders in being able to successfully lead their PCNs through the challenges which they faced as leaders including the pandemic.

With delegates from a range of clinical and non-clinical backgrounds, leadership experience was varied amongst delegates so the course needed to be designed and delivered in a way that would accommodate these differing levels of experience.

The Process

We designed a course that was flexible to accommodate the learning needs of each individual.

Our approach was to incorporate a variety of delivery methods which included interactive workshops, incorporating case studies from existing Clinical Directors and PCN Managers and an opportunity to reflect on how learning could be implemented. These workshops were supported by the opportunity for each individual to complete a leadership styles questionnaire and receive individual coaching from our team of experts. Recognising that this group of senior leaders also needed to be given ‘head space’ to absorb and reflect on their learning to enable effective implementation was a priority, we provided this time in a structured and supported environment.

The Results

48 delegates from across 15 PCNs attended 5 workshops and individual coaching sessions. Despite being run remotely, the sessions were interactive with the opportunity for shared learning and provided that much needed headspace for Clinical Directors and PCN Managers to share their ideas with their peers.

Introduction & Problem

A training hub in the Midlands recognised their internal team required support through training on understanding workforce planning and training needs analysis so they could have meaningful conversations with PCNs about these areas. 

The Process

Working with the client, we understood the learning needs of the delegates, developed learning objectives, designed the sessions and delivered two 2.5 hour online training sessions covering workforce planning and training needs analysis. We measured the impact of the training immediately after the session and 3-months after completion, providing ongoing support where needed. Feedback has been extremely positive with staff stating they are confident to provide support to the PCNs they cover.

Running alongside this, they commissioned us to support their 17 PCNs with their workforce planning intentions to enable them to complete their PCN Workforce Plan submission through two workshops. To understand the needs of the PCNs, we met them individually to understand their current workforce, workforce intentions and how this linked to PCN operations including looking at training needs analysis of their team, population health management data, meeting the DES, IIF, development of projects/services and practice support to reduce workload off GPs and other clinicians whilst also covering change management and quality improvement initiatives.

At the end of the 1-2-1s, we held two 3-hour remote workshops where participants were guided through completing a PCN Workforce Plan based on the individual discussions and sharing our experience of supporting PCNs nationally with workforce planning.

The Results

The sessions were very well received and we have been recommissioned to deliver further training for the client on clinical areas such as SMI and QOF and Health Inequalities in General Practice.

Introduction & Problem

A large GP practice in the East of England with approximately 18,000 patients contacted us as the Practice Manager was leaving the practice, and the practice wished to review the current situation, identify any areas of concerns, and develop an improvement and recruitment plan.

The Process

We started by reviewing all our external information: the website, social media, NHS data streams – anything that would give us insight into how people were interacting with the practice. We reviewed their systems and processes to see where they were falling short. We talked to staff members on a one-to-one basis and held team meetings so we could get a sense of where they felt like things were going well, where they needed support, and what they thought could be improved.

We also did an assessment tool that looks at how well practices are functioning in various areas like business and finance; relationships and collaborative working; population health and analytics (QOF audits); capability (staff levels); responsiveness and compliance (CQC, statutory requirements); and digital tools used by the practice.

Finally, we observed how things worked in person – sitting in on various teams’ meetings and observing the process from start to finish, and we collected anonymous feedback from staff using an electronic survey.

The Results

After a thorough review of the practices’, we’re pleased to report that we were able to identify and address all the “red flag” issues that have been holding the practice back from achieving their goals.

We identified a PM recruitment plan, which will help us hire new PMs and retain existing ones. We also created an agenda for change that aligns with staff needs and expectations. In addition, we identified the need for a triage model that better meets the needs of patients, as well as creating a cash flow model to ensure the visibility of the practices’ finances so they can measure future business performance.

Strategic planning is about making sure that your company is on track to achieve its goals. It’s about making sure that you’re doing what you need to do to get there and that you’re not wasting time or money on things that don’t matter. We hope this case study has helped convince you that hiring a professional company to do a strategic review can help you make sure your company is where it needs to be.

Introduction & Problem

We helped a Primary Care Digital Health Specialist by supporting the delivery of a program of work to highlight the benefits of advanced telephony in primary care. They provide digital healthcare services throughout the UK, including GP video consultations, as well as GP and nurse retention.

The Process

The delivery of a program of work for a primary care trust (PCT) was supported by a detailed assessment of the required capabilities and adoption of advanced telephony in primary care.

This was achieved through the following steps:

Webinars addressing the use of advanced telephony, including case studies for the features.

Assessing demand and capacity in the context of advanced telephony, utilising telephone data to understand “real” demand, and using call centre techniques to assess required capacity.

The Results

The benefits of telehealth have been well-documented, but many practices are still not taking advantage of the technology.

We are currently still working with the client on how to get started with telehealth, and we have been running webinars aimed at engaging practice staff in thinking about their use of advanced telephony and offering support to maximise their benefits.

We are currently awaiting clear commissioning intentions from the client as to what the next stage of the project will be. We may run more webinars, be more actively supporting the practice or producing tools and information for the practices to use.

Dr Sandeep Rai, GP Partner and Chair of KPA Federation.

Kiran is fantastic- she reignited the enthusiasm and motivated our collective of GPs. She showed us what was achievable, her outside experience was invaluable and gave us a fresh perspective on how things could be done. As a result of her engagement, we recruited a number of staff, have a corporate structure in place and clear plans. She has extensive regulatory knowledge and has steered us - this includes a restructure of the networks, no small thing. She also has contacts with law firms and easy access to specific knowledge banks should she not know (although that hasn’t occurred yet)

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