1. Productive General Practice First support day: Getting started

2. Introduction Description of Lean Methodology Objectives and structure of Productive General Practice Communicating PGP with your practice

3. Lean: Core Principles 2.Specify what does / does not add value – from the patient’s perspective.  Identify steps necessary to design, order and produce across the whole value stream.  Make those actions flow without interruption, detours, waiting or rework.  Only do what is pulled by the patient.  Strive for perfection by continually improving & removing wastes as they are uncovered.

4. What is “Lean”? Lean is a systematic approach to reducing waste through a process of continuous improvement Waste is defined as non value-adding activities A Lean ‘Goal’ is to supply a product or service to the patient’s demand with 100% quality

5. Why use Lean? To reduce in-process waste thus creating additional capacity 3 activity types: –Value-Adding –Non Value-Adding –Necessary BUT Non Value-Adding –Examples?

6. Waste is… Anything other than the minimum amount of equipment, materials, space and practice time which are essential to add value to the patient or service.

7. Wastes in General Practice… Motion –Practice searching for vaccines in various fridges Overproduction –Too many practice leaflets printed Overprocessing Defects Waiting Transport Inventory 7

9. Lean in action Using a spaghetti diagram one practice moved the script printer to the front office Reduced walking distance for reception staff and GPs by half No-one had realised the wasted time till spaghetti diagram drawn

10. Lean in action Using the 5S tool one practice STANDARDISED the forms and venepuncture in each consulting room Trainees and other itinerant staff found they wasted much less time looking for forms Admin staff found re-stocking much quicker Senior GPs stay in own room so never realised it was a problem!!!!!

13. Informing your practice http://www.qihub.scot.nhs.uk/quality-healthcare- resources/continuous-improvement-in- healthcare/productive-general-practice.aspx Resources tab, Download “Programme Guide” 21 pageshttp://www.qihub.scot.nhs.uk/quality-healthcare- resources/continuous-improvement-in- healthcare/productive-general-practice.aspx Video of PGP in Scotland

15. Timetable First support dayToday Getting Started and Making It Stick Weeks 1-3 Knowing How We are Doing Weeks 4-10 Involving Patients In ImprovementWeeks 10-11 Second support dayThree months time (to be confirmed)

16. Support Modules Online forum - LinkedIn group Website Advisers Feedback e.g. FAQs, innovations

17. Celebrating Success in Your Practice Tell your Staff Tell your Patients Tell Yourselves Tell your Appraiser Tell the Health Board/CHP Tell us!

18. Sharing Your Successes Electronic Survey –Examples of what worked and what didn’t work –Benefits and core measures If agree to share will go on website

19. Networking