Managing change in the NHS – £129m Investment

Investing £129m to join up local services using technology sounds great. But does general practice have a say in where that money goes?

The ICS in South Yorkshire and Bassetlaw has announced a £129m investment to address “significant healthcare challenges and inequalities” in the region. Sir Andrew Cash, Chief Executive stressed “more options for care while joining it up … and stay healthy … and introduce new technologies”. But how will improvements be delivered if there is not an opportunity for GPs to reflect on how Covid-19 has impacted on their working lives?

Working with Primary Care in North East England, we know that the digital services agenda that has been escalated by Covid-19 and provided practices with a somewhat necessary opportunity to test new ways of working. We are now reaching the point where clinicians need to assess the impact of those changes. Not only on delivery of services to patients but also on their own working patterns and conditions. There is much talk about recovery and back to normal but the phrase “new normal” is also being used liberally.

General practice, like all business during and post Covid-19 must reflect, adapt and develop and yes, that change will involve digital tools. But like any other workplace, it is greater than just the way it goes about things and the technology used to support that change.

The ICS 5-year plan will concentrate investment on new treatment centres and community services to decrease hospital admissions and enable care to be delivered closer to patients’ homes. All good outcomes and all objectives we share. The investment will invest in digital services, improving access to online appointment bookings and technology to enable patients to view their own health records and access video GP appointments. The system plans to introduce Doctorlink across the System and it is already being used by some GP practices across the area. You will likely know that systems such as Doctorlink, Docly, eConsult and EMIS Online Triage allow patients to complete a symptoms assessment, which when completed, will direct them towards the most appropriate care. These platforms can reduce GP appointments by 20%-25%.

Some in general practice may just want to go back to the way things were before and not have to use the (let’s be honest here) sometimes harder and less comfortable ways of working that digital practice involves. Not all, but maybe some. The draw of the familiar in all of us (and patients too) may mean a return to how things were before. Can we deny people generally respond well to a crisis, but the human condition seeks the normal and the familiar? This is a great time to take stock, put your foot on the ball and any other throwaway phase you want to use to hear yourself saying “what future do I want for me, my practice, patients and partners?”

Adopting new and different approaches to delivering what you do is a key part of ensuring your practice remains resilient. But first understanding your needs and your patient’s (real) needs and then align your service delivery. Simple right?

Not quite. So, make sure you use all the tools and information at your disposal (NHSE, NHSI/X, NHSDigital, PHE and places like offer great inspirational resources) to help you better understand just how much information is already there on health and wellbeing data, wider demographics and population growth. Practices have allocated practice and PCN funding to support digital transformation such as Total Triage, Digital Fund and the PCN Digital Funding.

Many across the country are anticipating major changes when this crisis becomes less of a crisis. There are fundamental issues arising from those changes that will impact on their way of working and your way of working. We all have a shared need for resilience, a term much used in general practice but also in a wider business context. The message is you should really be thinking about those issues now. Learning and understanding what you liked and did not like, what you did and did not do, what your customers (patients) wanted and will want in the future, and to plan to deliver those things.

At Scale’s consultancy and support offers tailored advice and support to GP practices across the UK in managing change in the NHS both during and after the Covid pandemic and those seeking to improve and develop their services and workforce. We support practices deliver new ways of working, maximising digital transformation. At Scale have helped other GP practices with similar projects and have worked with practices change the way they operate and become more resilient.

At Scale work with GP practices across the UK come together and implement more efficient ways of working by managing change in the NHS. If you think that’s something your practice needs, drop an email to and he will be happy to chat with you. And find out a little more information about South Yorkshire and Bassetlaw’s, click here