Chris Stocks is the Practice Manager of Grenoside Surgery and Managing Director of Network North PCN Limited. He has nearly 40 years of experience working in the NHS at all levels. The document discusses the national context of funding pressures and increased demand on primary care. It also describes the local response to the COVID-19 pandemic, where Grenoside Surgery mobilized clinics and vaccinated over 4,000 patients in 2 months. Key lessons learned included maintaining normal services despite challenges and implementing national strategies at the local level. Going forward, annual flu and COVID vaccinations will be ongoing, primary care networks will expand in scale, and recruitment efforts will be needed to offset retirements.

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Transformation Under
Pressure
Grenoside Surgery
Chris Stocks Network North PCN Limited

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Chris Stocks
 Practice Manager - Grenoside Surgery,
Sheffield
 Managing Director - Network North PCN
Limited
 Start my 40th year in the NHS next month
 Worked at every level within the NHS
 Husband, Dad and Dog Owner !

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#FuturePMO
 National Context
 Local Ask
 Outcomes, Achievements & Lessons Learnt
 The Future
 Questions
Delivering Change @ Pace

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#FuturePMO
 Funding and Resources
 Access and Demand
 Political Input and Influence
National Context

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Funding and Resources
• Based on ££ per patient and not per procedure
• Circa £100 per patient per year plus additional Enhanced Services –
average £155 pp
• Scarce Resources
• Staff in the main GPs – 2k less WTE than in 2015
• Funding not matching pay uplifts
• Average practice has 2K more patients than 2015

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Access & Demand
• Actual GP appointments are on the increase despite the
challenges and pre-conceptions
• Using the British Medical Association (BMA) data 26 million were
undertaken in July 2022 alone
• Patient Demand
• Grenoside – 6000 telephone calls a week – possibly 4 million in
sheffield and 40 million nationwide weekly into practices
• May 2021 – 27 million “standard” appointments as well as 8 million for
COVID
• All through COVID – the day job continued
• The bar at which patients call the surgery has lowered !

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Political Input and Influence
• The NHS is a national institution and as such is highly
politicised and subject to scrutiny, demands and change
• It is the 5th largest, non-military, employer in the world – 1.7m ! And
thus its size and complexity of layers means it cannot change overnight
• Recent Gov’t ask – GP appointment expected in 2 weeks !
• We deliver 120 GP appointments per day – 500 a week – what if 2000
Grenoside patients call for an appointment ?
• Daily COVID briefings – never seen such scrutiny – if there was a
slogan it should have been ….

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GET COVID DONE !!
GET COVID
DONE
!!!!!!!!

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Local Ask
 Demand
 Mobilising the patients
 Communications
 Staffing

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Local Ask
• The “day” job continued and the duty of care to patients remained
• We had to mobilise clinics in less than 2 weeks – targeting the most
vulnerable patients on the practice list, many of which are
housebound - starting with those 75 and over
• It was winter – traditionally the busiest period of the year for Primary
Care & the NHS
• No additional staff were available - despite national briefings
• Patients were asked to attend sites which were not their normal
practice bases

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Local Ask
• Challenges of communications – digital solutions are faster and
cheaper BUT 20% of the over 75’s do not have a mobile phone and
another 20% do not know how to use one !
• In some cases clinics were set up and the vaccines were not delivered
• We had to repeat this in 8 weeks – no more and no less at a time when
the “ask” was changing almost daily
• Keeping staff on-board and committed – in many cases working 7 days
each week was a challenge
• We had COVID as well !

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Outcomes, Achievements and
Lessons Learnt
• Grenoside – 4k patients vaccinated in 2 months, 20k in the PCN and 300k in
the city
• Second wave was only 8 weeks later and numbers needed repeating – same
logistics as before – in total in 12 – 14 months 16k vaccinations were
delivered by my staff !
• It was all to be repeated in Autumn but this time along side the Seasonal Flu
Vaccinations
• Normal Services WAS maintained despite the challenges
• We know our patients and the locality best – national strategy BUT local
implementation
• Mistakes will happen – just know when and why !

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The Future
• Autumn Flu and COVID Vaccinations – the new norm !
• Primary Care Networks (PCNs) – practices working together at scale
• Network North PCN Limited
• Recruitment V Retirement – keeping GPs onboard and attracting new
staff
• No let up of political imperatives, target and inputs
• All this against a backdrop of an aging population
• And finally …..

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This is PIPPA !!

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Thank You
 Do you have any
questions ?
 Chris Stocks
 chris.stocks@nhs.net