Coping with change for a sustainable future Nuffield Trust - June 2016 Large scale general practice: can we rise to the challenge?

Change is ever present Brings life Cements relationships Teaches acceptance Sustains growth Develops learning Is part of being human let alone part of being an organisation

Doesn’t stop it feeling horrible

Est April 2014 Merger of 3 practices on 4 sites 33,000 patients 125 staff and partners PMCF Wave 1 Service Provider Rapid Test Site for Primary Care Home – a new model of care

Our parables of change…… #1 Merger of three practices Two on one site Merged reception teams – 72 years collective experience Change isn’t always seen

Our parables of change…… #2 20 partners across 4 sites Responsive vs Cohesive Change happens every day Wotter, duty, telephones

Key lessons Attitude – you are different, the world is different Governance structure Leadership, leadership, leadership Staff engagement Honesty and openness with patients Written policies Fairness and strong values Resilience and GSOH The change curve Attitude – you are different, the world is different

No pain no gain Increased access to patient care Non-core funding +27% Reduced secondary referrals by 70-80%, £1.1m out of acute system New extended opportunities for clinicians Renewed energy from GPs Staff understanding their role and how it links to Beacons objectives +43%; feeling able to put ideas forward +72%; feeling recognised for a job well done +48% Patient confidence in our Nursing Team +9% GP team +3% Good, good, good

Staff said this transition had been handled well and had improved resources. Patients told us they had been made aware of the changes but said they had not found the changes disruptive. There was a clear leadership structure and staff felt supported by management.

A pep talk for change @iamkidpresident