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My learning curve as a clinical director

Primary Care Network clinical director Julie Hoskin reflects on the sharp learning curve of her first 100 days in post

Primary Care Network clinical director Julie Hoskin reflects on the sharp learning curve of her first 100 days in post

Illustration depicts shapes of human heads with multiple thought bubbles above them.  In this article Primary Care Network clinical director Julie Hoskin reflects on the sharp learning curve of her first 100 days in post.
Picture: iStock

Primary Care Networks (PCNs) came into existence in July 2019. Progress is being made, although for many of us new to clinical director roles it feels slow and painful.

In Sheffield we had been working together in ‘neighbourhoods’. My own neighbourhood had well-established links with the voluntary care sector, local government agencies and neighbouring practices.

It shouldn’t have felt like a quantum shift, but somehow it did. The large injections of money from NHS England suggest that PCNs will be able to initiate great projects to increase access for patients, reduce health inequalities and improve health outcomes for our populations.

I was initially reluctant as I assumed it was for GPs only

However, there is no infrastructure to facilitate this: we are still working in the same buildings that house our practices, using practice equipment or our own personal phones, computers and printers, and this is a hidden cost to the service we are being asked to provide.

A constant refrain among network colleagues is, ‘We will take it out of the £1.50,’ the increasingly elastic amount per capita that is extra to the money allocated for the new roles, including that of the clinical director. Which is where I meant to start this piece.

When I was approached by colleagues about the clinical director role, I was initially reluctant as I assumed it was for GPs only, and I knew so little about the role or indeed about PCNs. This reluctance came despite being active in my locality’s Clinical Commissioning Group and being an Executive Nurse group member since 2013.  When the managers from the neighbourhood asked me to apply, I realised I had better do some research.

There is so much to learn and so much to read

There is so much to learn and so much to read that I still feel a novice. However, my GP colleague from our sister PCN is supportive, there is a growing national nurse clinical director group and Karen Storey, NHS England primary care nursing lead, has been a source of support.

I am starting to feel more of a contributor than an impostor. My current and previous experience in teaching, workforce and new roles has paid dividends, as I have taken the lead in recruiting, selecting and appointing two social prescribers who I will clinically supervise.

Having previously taught on the physician associate’s course and acted as preceptorship lead for the Sheffield GP physician associate scheme, been involved in a musculoskeletal project steering group and also in arranging multidisciplinary educational sessions, I am able to play an active role in enabling the take-up of the reimbursable new roles in 2020-21.

I understand the importance of details but I am more of a problem solver

That said, I have my blind spots. I struggle with the pharmacy scheme and the reimbursable role element, particularly where practices previously had a pharmacist under the NHS scheme administered by our local federation and have now contributed those hours into the networks, changing the figures seemingly weekly.

However, we have a hugely experienced locality manager supporting us and a small team of experienced practice managers who take this in their stride.

Questions about VAT implications and limited liabilities are issues that I will need support and guidance on, but I am learning to celebrate my strengths. These focus on relationships, workforce, practice staff and patient care rather than the mathematical finer points.

I understand the importance of details but I am more of a problem solver. I have good ideas but I need the support of our team to make them work. So far we are doing fine. If we can translate our team ethos to the whole of the PCN then we can do great things. The early signs are good.


Picture of Julie Hoskin, clinical director for one of the 15 Primary Care Networks in Sheffield. In this article she reflects on the sharp learning curve of her first 100 days in the postJulie Hoskin is clinical director for one of the 15 primary care networks in Sheffield

 

 

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