eGPlearning Podblast
Online meetings made easy in Primary Care

Online meetings made easy in Primary Care

January 24, 2020

Online meetings made easy in Primary Care



Why have online meetings

  • Transport / distance
  • Time
  • Remote/home working
  • Disability

Types of meeting

  • Online
  • Hybrid
  • F2F


  • Obvious -- cuts out travel time and parking -- but these can be big issues
  • Increases attendance, reduces the cost
  • People can watch the recording if they couldn’t come -- don’t even need to be available at the time of the meeting
  • Actually superior experience in some aspects -- can hear well, shared screen for content, slides, cocreation in documents -- these don’t need to be big meetings… 
  • Sometimes you are enhancing or replacing a big meeting.
  • But can replace smaller meetings and telephone calls


What equipment do you need for an online meeting?

Online Meetings for Primary Care

You can start and host a meeting with just your laptop with webcam or tablet

If you just want to get started and give it a try. But if you want to run an effective hybrid meeting:




  • Smartphone or tablet
  • Headphones


Other roles


  • Keep timing of the meeting, 
  • Agenda
  • Coordinates people in the meeting room. 


  • Ensures the tech works
  • Screen share
  • Coordinates online attendees -- hands up!
  • Chat


  • Keeps minutes -- separate or on screen
  • Action log




  • Switch off distractions, notice on the door
  • Check battery power
  • Test data
  • Scan background for items not to be shared ie documents with patient identifiable info, open windows etc
  • Use headphones if an attendee



  • Press record
  • Introduce yourself
  • Ground rules
    • Establish chair, coordinator, minute taker etc. 
    • Mute microphone if not speaking



  • Share recording of the meeting -- server /private youTube/ podcast. Playback hack. 
  • Confirm actions and attach minutes if kept
  • Establish next meeting if appropriate
  • If first time,  enquire how to make it work better. 



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Primary Care Network DES specification review 2019

Primary Care Network DES specification review 2019

December 31, 2019

Primary Care Network DES specification review 2019


My review of the 2019 Primary Care Network Service Specification- the good, the bad and the confusing. 


This is the live recorded review of the draft primary care network service specification.

To see the document in full use this link.

PCN Clinical Director resources playlist:

General Practitioner resources playlist:

Make sure you leave your own feedback via the survey here (see bottom of page), or send an email to

Below is the draft version of my notes.





My perspective on the primary care network service specs


Cover the good, the bad and the confusing. 

Check out my PCN resources and General practitioner playlist (in show notes)

Save you and your patients time with tech enhancing your primary care and learning


Why I am talking about this - am a GP also PCN director of NCE - 66k patients in a deprived area of Nottingham. 


Firstly the timing of the documents


Release of specs day before Xmas eve- while aware impacted by the election, purdah and process, it speaks to the perception that when PCN CDs work is irrelevant to NHS England. 


However, I commend Nikki Kanani’s engagement on SoMe and the will to gain feedback before making the spec official, 


as well as engagement events beforehand (twitter chat and webinars)


So emphasis that this is draft specifications and can be changed. So let us take a look…..


The document starts by talking about the investment being offered. While there is a significant increase in funding being offered, it is important to note the UK still invests less than most other western countries especially in the G8 at about $1000 less per person. 


It also mentions a 5-year contract. I would like to mention that it is not really a 5y contract but a 5y agreement of the funds. If it was a contract the terms would be clear from the start. Instead, we are having ongoing annual negotiations of the requirements - which is no different to what we have been exposed to in primary care. 


It then identifies seven asks or as they have been locally called the significant seven of which five are to start from April 2020 and another two from April 2021


  • Structured Medication Reviews and Optimisation • 
  • Enhanced Health in Care Homes (jointly with community services providers) • 
  • Anticipatory Care (jointly with community services providers) • 
  • Personalised Care; and • 
  • Supporting Early Cancer Diagnosis

1.8 When will we have clarity on the process and use of the Network Dashboard?


1.11 Funding is not allocated directly for the delivery of the service specifications - let that sink in. 


1.12 Extra capacity from the new roles in 20/21 - much of this was promised to stabilise practices not ask them to do more and does not allow for the extra 30% investment which is not supported by the existing pots. 


1.16 funding for community service providers commented - limited detail and asking us to agree based on limited responsibility awareness


1.17 Structured med reviews and EHCH from 20/21 other specs over 5 years. 


1.18 There is overlap between the specs, especially with the EHCH aspect. 


1.24 ‘Funding previously invested by CCGs in local service provision which is delivered through national specifications in 2020/21 should be reinvested within primary medical care and community services’ key line to be noted in regions


Structured medication review optimisation


Ideal to improve quality which may impact workload and a key target area for network pharmacists. 

Noted they recommend longer apts than standard GP appointment and keen to understand where this time will come from, and a focus on the switch to low carbon inhalers. 


There are comments about primary care organising the majority of prescriptions but no comment on secondary care variation and impact on prescription choice. Should we not move to a national formulary rather than regional variation which may help with supply issues.


2.6 looks at reducing GP appointments, but structured reviews do not reduce the number of primary care appointments but it may improve the quality of care. These are two different things. 


2.11 the line about SMR apt being longer than an average GP appointment. This means it is not cost-effective and not within the envelope of the funding being offered. PSSRU data puts currently at £39 per 9.22min consultation and a band 7 nurse (no pharmacist data) at £55 per hour compared to over £200 for a GP.  


2.15 What Funding is there for lead?


Would this be part of the prescribing QoF for 20/21 or in addition?


Confusing:  'written communication to patients invited for an SMR, detailing the process and intention of the appointment' to clarify the term written as many can interpret this as paper. With increasing digital use, reducing carbon waste etc this needs clarification to include digital. Also, why is spoken not acceptable as an explanation at new patient check with a hca may have a much better impact?


A focus on medicines of low priority- this still requires a national approach and guidance on complaints about when medications are appropriately recommended or not - given the workload and implications this has - especially in deprived areas where this creates challenge and conflict. 


Would a better option be to have a review of prescription exemptions and eligibility for free prescriptions? In deprived areas medication poverty exists for those who work but can not afford their medications when current exclusions mean a patient with a slightly low acting thyroid can have all medications for free but a patient with brittle asthma, high risk of urgent deterioration can not have their inhalers for free. 

How this discussion moves forward is for wider debate but should all scripts be charged a nominal fee like the plastic bag principle, or all prescriptions free or all OTC meds not available on prescription. 


Also talks about community pharmacy involvement and this replacing the MURs would be an option - but only likely truly effective if community pharmacies have access to the GP notes- a key data-sharing issue. 


The proposed metrics are actually very sensible and clear patient benefit and practice outcomes if funded appropriately. 

I would ask that an additional metric looks at the workload created by brand switching in primary care from cost saving as well as supply issues which may support the national picture more effectively than medicines of low priority - this si where local impact with a network-based pharmacy team can improve practice workload and patient service. 

EHCH- enhanced health in care home


3.2 comments about patients in care homes being treated with the same support as those living in their own home. So if mobile and ambulatory then these patients should be coming into the surgery and supported by the homes to be brought in rather than practices visiting unless bed-bound hence providing equitable treatment.


3.5 The evidence talked about makes reference to Nottingham’s enhanced care home LES prior to 2017. This was based on two yearly contacts with patients a year with a basic monitoring template. This required a once-monthly ward round by a single clinician for a near 10k practice population with about 50 care home residents to deliver outcomes that are cited in the paper.

3.8/9 Clarity on the distribution of care homes is key and no specs should be agreed till this is offered. Given the CCGs have limited power to implement this over patient choice it seems almost a faux statement. Also, there is no direction on how finance will be directed to support denser care home areas, which are typically in more deprived areas due to lower land costs. 


3.10 four focus areas:

  • Enhanced primary care support
  • MDT support
  • Reablement + rehab
  • High-quality end of life dementia care


3.12 bringing OOH provision under the umbrella of PCNs is a complicated process and a clear threat to workload and viability. 


3.14 comments about supported living are not part of EHCH yet and 3.15 suggested these could be included in care homes work in future - a significant increase in work for no commented extra funding at that time. Clarity needed. 


3.16.1 where will funding for a clinical lead come from? 


3.16.3 offers challenges of registration and the choice agenda. If this is to function then removal of the choice agenda must be considered to align to systems and reduce confusion and risk of complex system care. 


3.16.6 This is frankly the worst specification I have seen. A weekly home round that must be led by a GP (or community geriatrician) on a minimum of a fortnightly basis and regular MDT staff.

This obliterates any positive work around skill mix, reinforces the false belief that a GP must coordinate all care, is unfunded for that skill of workforce delivery on this scale and negates the option of using digital methods to support innovative care. 


Mandating GP time doesn’t account either for the cost - at a minimum of one session, a week of GP time is about 10-12k incl on costs outside of London which is not supported by the DES funding so must be found by the practices. This will also vary if a higher number of patients in each network. 


Whoever created this specification needs firing from NHS England. 


3.16.7 what is with the obsession over care plans? Seven days within arrival at a care home or post-admission- this will see potential exponential work for the care home staff who should be coordinating this work and the clinical teams supporting them. Surely a better structure is ‘follow the plan from the place of discharge….’ This line does speak to personalisation as per later point and spreads over the SMR as per 3.16.8.



Pcn can, therefore, charge for training delivered to care homes as the mention of funding for this extra work is not mentioned nor comment of cost-sharing. 


Care home staff would normally have flu vacs via their GP not via place of work. How will this impact the ordering and storage of vaccines and the cost balance for those practices in the PCN. 


3.16.12 All dependent on the GP IT futures and interoperability issues beyond the control of PCNs and should include a line to reflect this. 


3.17 the metrics (aside from 4)  are reasonable data extractions if you agree with the existing plan. Given I do not then this needs serious consideration. 


  1. Anticipatory care


So for clarity, this is not in respect to end of life care per se as in anticipatory medications but supporting patients with high or complex needs and working towards pre-care. Pushing us further towards doing public health or population health care work in primary care. 


4.3 outlines the service three key aims:

  • Benefitting patient with complex needs (and carers) to stay healthier
  • Reduce reactive care for specific health groups
  • Better interface of care in and around the health systems 

4.4 This is done by population segmentation, tools and MDTs. 

4.6 a standardised approach is planned but not clear yet - this is concerning as if you action some great work and this does not align with the ‘standardised plan’ at a future goal post moving date then this risks further frustration and conflict. 


4.8 requires working with ICS/ CCG ie areas on respiratory disease if high prevalence in your area or during winter periods. 


4.12.1 Again - funding for the clinical lead role. Who is paying for the population tool if no local access / will ICS be asking networks to contribute to the cost?

4.12.2 Will we have a unified data sharing template offered rather than each networking creating the structure. Are the existing data-sharing agreements acceptable for this purpose? 


Who will be holding the liability of these data sets given most PCNs are not formal entities unless a LTD company?


4.12.3 Sounds similar to the unplanned admission DES


4.12.4 another MDT being created. Should there be one MDT that does this and EHCH and directs SMRs too?


4.12.5 The timeframe to deliver comprehensive needs reviews in these anticipatory patients is very short. 


4.13 the final metrics again should be a quick pull of the dataset if appropriate coding tools are offered in time rather than each area creating their own. I do think the delirium risk assessment is not suitable for all these patients and already counted in the EHCH. Also benchmarking falls risks may assume a more elderly population. If your local need is focused on more mental health issues then this may point to a younger population. 


Looking at a reduction in attendance in primary care and/or admissions may be a better metric for this group pending the cohort reason chosen. 


Personalised Care


This crosses over with anticipatory care but moves to an individual basis over anticipatory care which is more population-based. 


5.2 first mention of health inequalities in the document with a focus on the reduction of unplanned care. 


5.4 signposting to social prescribers having a key role in this area. 


5.5 Lists the 6  points of the comprehensive model for personalised care. 

  1. Shared decision making 
  2. Personalised care and support planning 
  3. Enabling choice, including legal rights to choose 
  4. Social prescribing and community-based support 
  5. Supported self-management 
  6. Personal health budgets (PHBs) and integrated personal budgets


5.6 Graduated increase in patient selection and outcomes working up to the unplanned admission DES level of workload starting at 5-10/1000 in 20/21 to 20-25/1000 in 23/24 and repeatedly comments additional situations to be confirmed- not inspiring. There is also a focus on msk based shared decision making ie use of FCP and other roles. This could feed into the SMRs for chronic pain suffers. 


5.7 another unfunded clinical lead position


5.8 I do not agree with metric 2 and 4 as it is unclear how quality will be measured of personalised care plans and shared decision conversations. Again unifying a metric looking at unplanned care with anticipatory care would be more useful in my eyes.  


Supporting Early Cancer diagnosis


6.2 Improving processes will require system integration with ICP partners. I do think taking a local focus on tackling screening programmes is sensible. 


Most of this reads sensibly if able to work with ICS and ICP partners. Cross over with QoF plans for next year are sensible but as usual, the devil is in the detail. 


6.11 the aims for 21/22 could be clearer ie expanding on safety netting and providing high-quality information on referral is not clear what that relates to ie process of referral, what to do if no contact, documentation, etc. Also with increasing those diagnosed at stage 1 or 2 - it does not state by how much. While a number is just artifact I would hope there is not an artificial number in the ether. 


6.12 yet another unfunded clinical lead position.

The safety netting seems to take away from the patient ownership of their responsibility in their pathway of care - making us at risk of being more paternalistic. Information provision like videos etc is good but chasing patients is a blurry line. 


Improving the outcomes part is further unfunded work as would be in addition to practice-based learning objectives unless combined across a PCN- this requires further admin process which is not funded. 

To give feedback you need to use the survey this has the following questions



  1. Is there anything else that we should consider for inclusion as a requirement in this service? For example, are there approaches that have delivered benefits in your area that you think we should consider for inclusion?


  1. Are there any aspects of the service requirements that are confusing or could be better clarified?


  1. What other practical implementation support could CCGs and Integrated Care Systems provide to help support the delivery of the service requirements?


  1. To what extent do you think that the proposed approach to phasing the service requirements is manageable in your area?


  1. Do you have any examples of good practice that you can share with other sites to assist with delivering the suggested service requirements?
  1. Referring to the ‘proposed metrics’ section of each of the services described in this document, which measures do you feel are most important in monitoring the delivery of the specification?

I don't feel this asks for critical feedback, just positive comments with only question 4 challenging the viability of what we are being asked.


Unfortunately, this does impact my view on NHS England wanting decent feedback.


Also, do you reply as an individual or as a network/ group of networks coordinated in your area ie by the LMC or federations etc?




Aims to improve quality and there is cross over between the parts that make much of it less a challenge than an initial read. However, there is still ALOT of work being asked from networks in a short space of time.

Not funded within the scope of the DES to do so. Either additional funding needs adding or several of the requirements removed and tailed back. 

If not significantly adjusted- especially the EHCH part I see many practices leaving the DES making it unviable. 


I would not agree to these specs and task our GPC colleagues to work with NHS England to make it more sensible and not something that is renegotiated each year. 


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Email use in General Practice

Email use in General Practice

December 6, 2019

Does sorting out your email just suck all your time away? Andy and Gandhi talk in this episode about the frustrations managing your email can bring, the challenges we have in primary care and importantly - solutions to bring you control and increase your spare time. 


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Despite being so ubiquitous and groundbreaking in its time, this is a medium that is almost universally loathed…


Today we’re talking about email...


We have a complex love-hate relationship with email… Mostly we hate it...


As a clinician email can be particularly frustrating. We have so many ways to receive information tasks and work. And we spend most of our dealing with patients or tasks directly related to patient care. It can feel like Other people working in primary care have more time allocated for purely administrative activities like reading email… 


It is definitely worth giving how you manage email some thought...


Why is email frustrating?... (Identifying the challenges)


Email overload


Time issue, can take so long, when do i do it?

Email anxiety - what’s in my inbox?...

Discussion vs response - wrong tool?

Etiquette - why am i getting this email? Tone and controversial topics...

Emails at intrusive at times


What are the possible solutions?


Basic Principals… Three Ps

Parkinson’s Law - allocate set, limited time - batching

Pareto Principal - 80/20 - concentrate on where your efforts will have impact

Pomedoro - 25 minute dashes, 5 minutes break to complete email or tasks


Getting Organised

Inbox Zero & Getting to Done…. 

2 min rule

Scheduling for later

Tag, Folders or archive and search?


Check out Gandhi’s episode on productivity:



Should this be an email at all? email / phone / meet

reply all, waiting on replies, cc, bcc

Font and confidentiality

Emojis in professional emails

Use the right address for the right reason - security log in

Add the email address last - just in case

Identify action or information

Use the subject line well… and first 2 lines - Project management style - timelines

Templates and signatures, 


Dealing with volume/overload

Unsubscribe and whitelist vs junk

Do not disturb


Choose your tools wisely? But don’t obsess 

We discuss our current email setups and tips for email platforms and apps

Interface/platform - bluemail 

What do you use?

Gandhi - blue mail and Gmail

Andy - outlook

But my phone is always with me… Do not disturb mode

Switch off the notification?


How to email patients: Email use by practices in General Practice


Email audit

Set aside a time frame to do an email audit - sources, folders, and freq - put it in your calendar!!!


Things to think about as clinicians…

Use the right platform or email address for any clinical or sensitive information.

Secure your device.



People are trying to make email better

Slack, Asana…. Adding project management and team coordination


So how do you feel about email now love or hate? 


Let us know...


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Wearable technology in General Practice

Wearable technology in General Practice

October 25, 2019

How will wearables change General Practice? Watch as Andy and Gandhi of the eGPlearning Podblast explore the world of wearable technology for general practice

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Wearable Technology for General Practice - eGPlearning PodBlast Show Notes

Wearable health technology, is it all hype?

We discuss our experience with wearable technology in our day to lives as GPs. How patients and health professionals are beginning to use devices such as smart-watches and fitness trackers, the impact on Primary Care and how this class of device might develop in the future.

What have we been up to?
Andy - Beginning to work as a Primary Care Network Clinical Director and promoting the Nottingham Based Digital GP Fellowship
Gandhi - Attending a number of conferences, working on the eGPlearning platform

Gandhi has featured in an episode of AskPat, the hugely popular Podcast from @PatFlyn. Listen here 

A word from our partners - HTN
HTN The health tech news paper - an innovative daily news and opinion website for the health tech network
HTN Health Tech award winner revealed - go have a look!

What is wearable health tech?
What is wearable health technology
No real definition...
We have always had wearable health tech - hearing aids, early insulin pumps, overnight pulse oximetry...
Previously been expensive, but now rapidly developing areas as smartphones, and later health tracking industries have created a volume market for sensors, processors, wireless communication chips/tech. Meaningful wearable health technology is now cheaper to produce and develop.

What does wearable tech do?
Capture information
Tracking vital signs and observations
Monitoring for events such as falls & fits
Movement and activity
Treatment compliance - activity, physio, medication adherence
Body-worn biochemical sensors - e.g. glucose, ECG

Use the data
Identify unrecognised events or track vitals during an event - eg. palpitations - For a good example see Kardia:
Monitor disease activity - eg. diabetes
Make sense of larger data sets for meaningful health insights

Suggest and administer medication such as insulin
Alert family or paramedics to intervene - e.g. fall

What do we think about Wearable Health Technology?
Andy discusses his experiences with the AppleWatch platform.
AppleWatch on Amazon - 

Gandhi discusses experiences with:
Fitbit - Good brand, reliable, fits well, great metrics, less smartwatch that tracker - universal platforms

LetsCom  fitness trackers - Pros- cost, battery life, simplicity, rugged. Cons- function, basic

Gandhi is also a fan of those devices with the tracking capabilities of fitness trackers but the appearance of a normal watch such as the Muse and Withings ranges.

We discuss our thoughts on the current situation with wearables and the future… Including...
It would be great if/when apps available to make sense of the data - perhaps integrating with my health record…
But, sometimes I want to wear a different watch… Perhaps seen only as a health/comms device...
Will those who need it want to use it - Grandads and hearing aides…
Are they just for exercise and fitness?
Security & privacy concerns?
Apple vs Google - will there be a small number of dominant players due to platform effects?

Ultimately we believe there is lots of health potential in the future...
Huge potential…
Because getting cheap...
Platforms for sharing data are maturing - Apple Health, Google Health, NHS App
Perhaps we will reach a critical mass in the near future and use will explode.

Thanks for listening

What do you think? Will wearables be a help or hindrance to Primary Care?


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Zoom Video Conferencing Masterclass

Zoom Video Conferencing Masterclass

September 5, 2019

Zoom Video Conferencing Masterclass with eGPlearning Podblast


See how to use Zoom with Andy and Gandhi, to have great video meetings with your primary care network (#PCN), colleagues and friends. We cover simple hints and tips and also dive deep and discuss some of the more powerful features.

Sign up at

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💻 I really like Zoom. If you want to sign up see:

This video shows you:

🔷 How to start a Zoom meeting
🔶 How to change your audio and camera settings
🔷 How to quickly switch your audio on and off
🔶 How to invite new people to a meeting
🔷 How to start a screen share
🔶 How to chat and send messages in your web meeting
🔷 How to record your Zoom meeting
🔶 Showcase all this from a mobile interface

✅ If you wish to use our web conference checklist see this link:

#primarycarenetworks #videoconferencing #zoom

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👨🏾‍⚕️Dr Gandalf’s essential GP equipment list 👨🏾‍⚕️ see here:

📸Equipment to record patient consultations for teaching – a guide📸:

Subscribe to or follow the eGPlearning platform for more videos, app reviews and content to support technology-enhanced primary care and learning.

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Register with the NHS app

Register with the NHS app

August 8, 2019

Register with the NHS app - a Walkthrough guide


Do you know how to register with the NHS app?
Do you know what it can do?

Watch this video to see this walkthrough guide and share with your practice if they are not using it.

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This video is sponsored by Connected Nottinghamshire

Listen in as I show you:

📲 How to download the NHS app
📲 How to use the symptom checker
📲 How to create an NHS login ID
📲 How to use the login to access the app
📲 How to register with the NHS app
📲 How to book an appointment at your practice with the NHS app
📲 How to confirm your donor preferences with the NHS app
📲 How to access your settings and more information in the NHS app.

Watch the video by clicking the image below:


See here for how to register at your GP practice:

⭐Top posts⭐:

👨🏾‍⚕️Dr Gandalf’s essential GP equipment list 👨🏾‍⚕️ see here:

📸Equipment to record patient consultations for teaching – a guide📸:

Subscribe to or follow the eGPlearning platform for more videos, app reviews and content to support technology-enhanced primary care and learning.

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How to work quicker in primary care using technology

How to work quicker in primary care using technology

June 16, 2019

How to work quicker in primary care using technology - our top 10 tips.

Watch this episode recorded for the HTN Digital week on how you can work quicker in primary care using technology.

Join Andy and Gandhi of the eGPlearning Podblast team as they share their top tips on how you can work quicker in primary care. These are universal tips for all members of General practice like GPs, nurses, paramedics, pharmacists, health care workers and more

Tracking Time

This is important to understand which areas you may need to focus on in order to work quicker in primary care.

One tool to consider is Clockify which can easily be used to track your time. See our video which explains this tool and why it might be the best one for use in general practice.

Text expanders and autoconsulations

Each system in primary care has its own method of helping you document more information quickly. EMIS has shortcodes, Systm One has autoconsultations. If you want a tool that sits outside of the clinical system, consider a text expander like in the eGPlearning support pack.

Things to consider is hot to personalise these tools and the probity of use.

Automation and protocols

Each clinical system has ways to help you automate the work you do. SystmOne has autoconsultations and protocols, EMIS has macros, and I am sure other systems have similar.

Using these tools can significantly save you time. As SystmOne users, Andy and I use autoconsultations for streamlining work like our anticipatory medication prescriptions for end of life care. If you want access to this join the eGPlearning mailing list or a community of support like S1 FBUG or EMIS web FB user group.

Companies can offer these systems without you making your own. This can further save time but comes with a cost. See Ardens for SystmOne or for EMIS try PrimaryCareIT.

Workflow and remote working

How you manage workflow in your practice will drastically affect your workload. Look at these four points about any task:

  • Who
  • What
  • Where
  • When

You can even add why on there at times. Remember, if a task does not require a face to face encounter, can it be done remotely and hence at scale. Remote working can also help with job satisfaction. See the video below

Type faster

If you want to work quicker, then typing quicker can really save you time. To help, see our episode on Keybr - an online tool that can help speed up your typing speed. A great PDP item for your appraisal and will definitely help you work quicker in primary care.

Another great tip we got from Deen Mirza in his FRAYED consultation book is to type while the patient is there. What do you think? Would you do this.


If you really do not like typing, then dication may be the answer. Modern systems have significantly improved and learn with in built systems to refine how they interpret your voice. Modern systems like Dragon, Lexacom and can really save you time as you formulate your letters, or even be used in consultations.

Messaging and meetings

Modern general practice and primary care is filled with meetings. How you manage them can significantly affect your time. So improve your communication. Andy and Gandhi both use WhatsApp to manage our partner role in practice for effective communication. Be wary not to discuss patient data, and we may see other systems like Microsoft Teams, Glip, Slack and GP Teamnet take over, but for now WhatsApp with is simplicity and mass user base can be really effective.


Webinars can be time saving and negate some of the costs of face to face meetings like transport costs and time. A great system to use is Zoom, which we have been using as part of our PCN working, and we find it is more effective than others.

Try it here:

File sharing:

Cloud based file sharing can really streamline your work process and help you work quicker in primary care. Many of these services are more secure than paper/un-encyrpted USB drives. Which would you consider using?

GP TeamNet:
Google Drive:

Conquer information overload

While all these can help, being able to manage your information workload is something to consider. Methods like zero inbox, unified information feeds, sticking to one social media platform and keeping simplicity at heart can help.

Thank you to our sponsor for this episode HTN.

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📸Equipment to record patient consultations for teaching – a guide📸:

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Digital Assistants in Healthcare - Alexa, Google Home and Siri?

Digital Assistants in Healthcare - Alexa, Google Home and Siri?

June 9, 2019


Digital Assistants in Healthcare - Alexa, Google Home, and Siri


This is our first “Super Test” episode! We put Alexa, Siri and Google Assistant through their paces as we explore the current state of Digital Assistants as Health Technology and discuss the future possibilities for the technology.


Watch this episode on YouTube for the best experience:


1.50 What we have been  


2.05 Nikki Kanani episode


2.50 Standing desks for GPs


3.45 HTN and Digital week - How to work quicker in primary care


4.40 RCGP Bright Ideas


5.40 Digital GP fellowships - contact us


6.30 How we are testing them


8.00 We tested performance in the following areas:


  • Emergency Assistance
  • Finding Services
  • Accessing and Booking Services
  • Health Information
  • Health Advice/Assessment


How we scored for each question:


  • Winner = 3 points
  • Runner up = 2 points
  • Bottom of the class but gave a sensible answer = 1 point
  • Fail = 0 points
  • Safety concern = -3 points


If you are interested:


Alexa Echo: Bought at Amazon or major retailers RRP £89.99


Alexa Dot: Bought at Amazon or major retailers RRP £39.99


Google Home: Bought at Google or retailers RRP £49-89


Apple Siri: Available on all Apple products like the Apple Watch or iPad.


Emergency Assistance


  Amazon Alexa Apple Siri Google Home
08.30 Call me an Ambulance 2 3 0
11.15 Tell me how to do CPR 0 2 3
14.45 How to treat a nose bleed 2 1 3
17.50 What do I do if someone swallows bleach? 0 3 -3!!


12.15 Explaining what Alexa Skills are.


20.45 Note - Apple switched the search engine behind Siri back to Google from Microsoft Bing on 25/9/17


Finding Services


  Amaxon Alexa Apple Siri Google Home
22.10 Where is my nearest A&E? Can you send me directions? 0 0 3
26.15 I think I have a sexually transmitted infection? 0 1 3


Accessing and Booking Services


  Amazon Alexa Apple Siri Google Home
30.00 Book me an appointment at my GP? 0 0 0


Health Information


  Amazon Alexa Apple Siri Google Home
37.20 Tell me about simvastatin? 2 0 0
… Common side effects? 0 0 3


Health Advice/Assessment


  Amazon Alexa Apple Siri Google Home
42.00 I have a headache… what should I do? 1 0 1
48.25 Open Headspace - no winner 3 3 3


43.15 Doctor Alex Alexa Skill -


47.20 What could happen if others try to develop skills like Babylon Health or Ada Health?


Special mention to some other Amazon Alexa skills


  • Headspace
  • Bodycoach
  • First aid by British Red Cross - Alexa, ask first aid how to look after someone with a seizure


50.40 Summary impressions


52.30 Considerations


Security of data and use.


55.10 Regulation


55.30 Check out ORCHA


Final Score Cards:


Winner: Google Assistant - 16 points


Impressive and surprised us in places.


The Good


  • Generally the best at recognising our questions.
  • Good to see sources of information are mostly provided and tended to be recognised and reputable.
  • The ability to ask a follow on questions which are processed within the context of the previous question was very useful and made interactions feel more conversational. We can ask about a drug and then follow up with a question about side effects.
  • Good integration with phone. Could send directions to A&E department to phone.
  • Supports voice interface for third-party apps such as Headspace.


The Bad


  • Sometimes tried to do more than it could do safely
  • Concerns about privacy and data security. Will Google sell us headache remedies - is health data identified as a more sensitive category? Would we want adverts for sexually transmitted infection clinics nearby?




Runner up: Siri - 13 Points


After adding up the points after the show, Siri actual came second...


The Good


  • Best to summon help in an emergency - direct link with phone
  • Primarily serving up web search results - but this is often useful.
  • Available in many form factors; HomePod, iPhone, Apple Watch, AirPod earphones.
  • Didn’t try to do more than it could do safely
  • Apple sacrificing performance for greater privacy


The Bad


  • Behind in terms of voice and question recognition
  • Apple sacrificing performance for greater privacy




“Second runner up”: Amazon Alexa - 4 points


The Good


  • Was able to find useful information and often provided the source
  • Lots of potential for Alexa Skills and their simple development environment.


The Bad


  • Privacy concerns
  • Ease of production of Alexa skills may lead to large numbers of poor quality or unsafe skills Safety
  • Single trigger word leads to unintentional, and annoying, accidental activations.


Final thoughts.


57.15 What we think of Alexa and Google. What does Siri do well and why?


59.00 Activation issues - is one word better than two?




Potential for Digital Assistants and health in the future


  • Digital assistants acting as translators (where human translator not available)?
  • Digital assistants providing triage of symptoms and providing signposting to self-care and alternative sources of care.
  • Linking-in to pharmacy sales could enable a business model for triage (1.06.00)
  • Helping patients find and navigate health services along their patient journey
  • Monitoring of long term health conditions and vulnerable individuals such as dementia sufferers (1.07.15)


1.08.10 - An opportunity to join us for future episodes???


Thanks for listening!


How to get your CCT

How to get your CCT

May 23, 2019

How to get your CCT - as a GP with RCGP First5 lead Jodie Blackadder-Weinstein

Watch this video if you want to know all the steps and processes you need to follow to get your CCT - with current RCGP First5 lead - Jodie Blackadder-Weinstein

In this video, we cover sorting out your GMC allocations, ARCP, what an outcome 6 is, performer list issues, indemnity, and networks after finishing including supporting organisations.

This is a must see video if you are about to become a newly qualified GP.

CCTing… What you need to know and do.

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You should get an email from the GMC approx. 3-6 months before you are due to CCT inviting you to make sure all your details are up to date, including your email address. Check it!

Once your final ARCP is completed and you get an Outcome 6, you will be contacted by RCGP/or via eportfolio to click ‘apply for CCT’ and you will be guided through the process. Remember you need to pay your fee to the GMC to be added to the GP register (£399, currently being reviewed)

Performers list

Make sure you are on the performers list and clarify your region’s requirements to update the record from ‘registrar’ to ‘GP salaried/partner/locum etc’. If you are moving areas, there are notification forms on the website.


Make sure you update your indemnity provider with your changing work details (with dates) and continue to do so.

Pensions and Financial Advice

Consider your finances, and what and how you are earning will likely change on CCTing. Ask around for accountants and financial advisors that colleagues use, and consider income protection.
Watch our video on Money advice for GP locums, salaried and partners -


Get in touch with your local First5 network. Almost every faculty is holding an AiT/First5 ‘Life after VTS’ and ‘Welcome to the faculty’ event over the next 12 months, currently available dates here:
Find out who your reps are here:
Find out about and get involved in your local medical committee here:

Need some support?

CCTing is a time of change and can be overwhelming. You are not on your own. A list of support and wellbeing facilities can be found here:

What is ORCHA?

What is ORCHA?

April 11, 2019

Hear about ORCHA (Organisation for Review of Care and Health Apps) from Liz Ashall-Payne its CEO and winner of Most Influential Technology CEO of the Year 2019 and an offer to use for free below!!!!!

Hear about how ORCHA was created, how it is like the BNF of apps and how you can use it for patient care, PLUS a special offer for interested clinicians.

🔴 Subscribe: 🔴

Andy and Gandhi speak with Liz Ashall-Payne, the innovative CEO leading ORCHA into tackling digital health application use and providing validity and safety to a growing area of healthcare.

We talk about her journey, what ORCHA is and how they review apps. We talk about the review and prescribing process, how you can use it as a clinician in primary care, and more.

Finally, we finish with a special offer for all clinicians who want to use ORCHA for free...

Subscribe to or follow the eGPlearning platform for more videos, app reviews and content to support technology-enhanced primary care and learning.

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Money advice for GP locums, partners and practices

Money advice for GP locums, partners and practices

March 14, 2019

Watch this video to learn all the important financial and money advice tips when you work as a GP locum, partner, salaried, portfolio doctor and even as a GP practice.

Useful for anyone in primary care including covering IR35, new tax, pension (including NHS pension) and tech tool tips and more.

Subscribe here to watch more technology-enhanced primary care and learning videos:

02.10 Claim back exam fees
04.00 Register as self-employed especially as a locum or partner
05.58 Designated business account - how and why.
07.37 Register with an accountant. Consider : Folman & Co
08.54 Should you use the practice accountant or not?
11.00 Pensions!!! A brief explanation of this complicated area.
14.35 Submitting pension payment forms and the Capita amnesty on this…
16.00 GPSurvival signposting as a guide to sort out your pension access -
17.20 What can I claim my tax back for?
20.30 Can you claim tax back for your home use?
22.00 Insurance claims and others…?
23.35 Making tax digital
24.30 Accountancy software like Xero and Quickbooks - what you should consider using as a practice or as a locum
28.30 What is IR35 and how does it affect you as a GP?
30.25 Working as a limited company as a GP.
32.20 Contact Jenny Folman at either or

Subscribe to or follow the eGPlearning platform for more videos, app reviews and content to support technology-enhanced primary care and learning.


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Social Media Guidance for clincians

Social Media Guidance for clincians

March 1, 2019

Welcome to this session on social media guidance for clinicians by Andy and Gandhi of eGPlearning Podblast in conjunction with HTN digital week. They explore the various platforms including Facebook, Twitter, LinkedIn and others, and how to use them, including relevant aspects for UK based clinicians to understand when using social media.

This is recorded as part of the HTN Digital week.

Contact Andy:

Contact Gandhi:


Social media guidance for clinicians

Working knowledge of key social media platforms to include Facebook, Twitter, YouTube, Whatsapp + others. How to use these platforms for education and CPD

Understand the implications of using these platforms as a GP

The do and do not rules of social media including guidance.

Our hints and tips to make it all manageable

Other sessions in this series

Facebook groups: See the blog post: for a full list of useful GP and primary care groups.

Twitter: Dr Gandalf’s UK Primary care list: Feed: Members:

Social media guidance playlist:

Link to wecommunities:

GP Journal Club:

YouTube eGPlearning:

Arora Meded:

Social media guidance: GMC:




Multi-use tools: Loomly:



Contact Andy:

Contact Gandhi:

CPD Certificate of engagement:

Subscribe to or follow the eGPlearning platform for more videos, app reviews and content to support technology-enhanced primary care and learning.

Facebook -

Twitter -

Twitter -

Website -


Tech to enhance CPD collection

Tech to enhance CPD collection

February 8, 2019

Watch Andy and Gandhi discuss how to use technology to enhance your collection of CPD (CME) for your appraisal and revalidation.

They explore useful resources and tools that can help make the collection of continuous professional development units easy and effective, including their own hints and tips.

This is recorded as part of the HTN Digital week.



Contact Andy:

Contact Gandhi:


A brief summary of hardware and system options to enhance your CPD collection.

A comprehensive list and guide of clinical resources

How to create systems using the above resources to enhance your CPD collection.

A summary of advanced methods to help automate and share your learning experience.

Our hints and tips to make it all manageable

Other sessions in this series

Bullet Journal:

Dingbats book

Frixion pen
Rocketbook Wave:

Clarity Appraisal toolkit walkthrough



News Now RSS feed

eGPlearning Resources page:
eGPlearning elearning page:

eGPlearning Podblast:
eGPlearning Podblast iTunes:
2 GPs in a pod:
The General Practice Podcast:
RCGP podcast:
Inside Health:
On The Pods:
The Good GP:
Best science :



Dictation services:
Dragon: Live:


Contact Andy:

Contact Gandhi:

CPD Certificate of engagement:

Subscribe to or follow the eGPlearning platform for more videos, app reviews and content to support technology-enhanced primary care and learning.

Facebook -
Twitter -
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Website -


Are video consultations the future of primary care?

Are video consultations the future of primary care?

November 30, 2018

eGPLearning Podblast Video Consultations Nov 2018


Welcome & Thanks to our sponsor

  • HTN - Health Tech Newspaper, an innovative daily news and opinion website for the health tech network.
  • Recently had their HTN awards and sign up for the HTN week (£32 for the whole week) but we are on the afternoon of Thursday Jan 24th afternoon - sign up here:
  • Sign up here to our Patreon account:


Welcome to those watching us on youtube...

We are trying something new we are recording a behind the scenes video as special content for our youtube followers.


Thanks for your feedback and retweets...






@somedocs doctors on social media group - retweeted us- thanks

@annalise2406 - great feedback re the app and iplato

@orcha - app review organisation connected with NHS App Library - kindly retweeted us

@NikkiKF - acting Director of Primary care for NHS England


What have we been doing?


Today main Topic is Video Consultations…


Remember listeners - we are not experts, these are just our opinions


Is there demand?

  • Venture capital and investors are putting money behind it so there is believe in the technology and concept from investors.
  • @UNHS_Cripps Have experimented with
  • @MattHancock (Health Secretary) is a GP at Hand patient and advocate of technology and is behind the concept.


But what problem are we solving?

  • Low capacity or convenience?
  • Probably more for patient convenience than increase capacity - but maybe if replaces home visits?...


What happens in a typical video consultation?

Gandhi describes his experience of working with Babylon Health @babylonhealth


Discussion of video consultation business models…

Babylon / GP at Hand, LIVI, QDoctor, Push doctor, NOW Healthcare, GPDQ, Zoomdoc (listen to our interview with founder Kenny Livingstone )



What problems do we see with video consultations?

  • Reduced continuity?
  • Overprescribing of antibiotics? (but discussed later)
  • Do video consultations drive an increase in demand? Does making it easier to speak to the GP make people more likely to feel the need to contact their GP?
  • Destabilising traditional General Practice Partnership business model?
  • Destabilising the Primary Care workforce - pulling GPs that might otherwise work at practices into the “private” sector.


Potential positives of video consultations?

  • Does patient spend in the private sector taking pressure off NHS?
  • Some patients may self-select away from NHS services to private video providers, leaving NHS to meet needs.
  • More options and convenience for patients.
  • Options for using as part of innovative systems - perhaps true power comes when part of a system including eTriage, remote monitoring, video consult and face to face?


How can surgeries prepare for video consultations?

Work together with federations, neighbours. Benefits likely to come from handling patients at scale.


Our verdicts… Good or bad?


Thanks for listening - certificate of engagement.


Comments and feedback…


You can now support us on Patreon!

  • $1 just to support us if we doing a good job
  • $ 10 new banner drawn by Andy and you can be part of it