Workforce

2 Aug 2026 The plumbing: profit, partnerships, VAT and limited companies Why two identical practices make different profits, how drawings and capital accounts really work, why leaving money in the practice hurts, and the VAT and limited-company traps waiting for PCNs.

13 Mar 2026 Today my surgery is posting 2 job adverts on NHS jobs to expand our clinical trials team. LinkedIn Neil's surgery recruits a junior research practitioner and an experienced research nurse to grow its commercial clinical trials portfolio.

12 Feb 2026 Interesting post and I agree we don't have enough good managers in the NHS. LinkedIn Argues practice managers grown from within miss external talent, and calls for rotational manager training in general practice.

25 Oct 2025 Are current ways of delivering trials working LinkedIn Argues current models for delivering commercial trials in general practice are slow and inefficient, with 300 practices competing for 15 places, and trails ideas for reform.

21 Oct 2025 Smarter Model for Primary Care Research LinkedIn Argues against every practice being a self-contained research site, proposing a layered network of recruitment sites, delivery hubs and super-hubs served by a flexible shared workforce.

2 Oct 2025 Anyone GP practices or others have any experience taking digital retinal photographs? LinkedIn Asks whether GP practices have experience with digital retinal photography, seeking advice on equipment and available training.

24 Jul 2025 I think this is very informative of the debate especially around money, however I also… LinkedIn Argues the resident doctors' dispute is about more than pay - poor training, exam and GMC fees, and the loss of the 'firm' and consultant supervision.

14 Jun 2025 This is an interesting article and topic. LinkedIn Recalls the south Cheshire GP cooperative that once ran local out-of-hours care, disbanded by government without clear evidence.

15 May 2025 Digital fatigue: A treatment plan for DTLs Pulse PCN Argues digital fatigue stems from poor change management rather than the tools themselves, offering a nine-point framework for PCN digital and transformation leads.

2 May 2025 R u a research trained and experienced nurse and or practitioner who lives/works within… LinkedIn An early feeler for a research-trained nurse or practitioner near South Cheshire, ahead of any formal job advert.

30 Apr 2025 My wife Dr Carolyn Paul presenting today in London at a research conference on patient… LinkedIn Notes his wife Dr Carolyn Paul presenting at a London research conference, drawing on her expertise in patient recruitment and retention.

16 Apr 2025 I realise i may have asked something similar before but what 'GP' rota software do people… LinkedIn Asks what GP rota software copes with over 100 staff, departmental minimum staffing, skill mix and room-usage tracking.

19 Mar 2025 Is it the end of GP Appraisal? LinkedIn Argues GP appraisal should be scrapped in NHS cost-cutting: it never caught bad GPs post-Shipman and could be replaced by a website, mentoring or internal practice appraisal.

12 Mar 2025 If you are a primary care clinician of any sort GP/ANP/Nurse/Pharmacist/PA etc or in… LinkedIn Announces the return of free evening education meetings for primary care clinicians in Nantwich, with sessions on renal medicine and GUM.

6 Mar 2025 Some are saying that LLM AIs are running out of training materials and that AI won't keep… LinkedIn Counters fears that AI is running out of training data, arguing coded consultations, outcomes and wearables could unlock new health insights.

6 Mar 2025 Is the writing on the wall for companies providing services to PCNs with remote ARRS… LinkedIn Questions the future of PCN remote ARRS providers as looser rules let practices employ staff directly.

6 Mar 2025 What's in the latest contract LinkedIn Reviews the 2025 GP contract's CVD focus, risk stratification and access reforms, noting little clarity on integrated teams or the PCN role and no sign the profession actually loves the deal.

19 Sept 2024 Thanks for your contribution to our conference - we are hoping to put on another one next… LinkedIn Flags a planned conference for PCN clinical directors and managers on using ARRS underspend and slippage money.

9 Aug 2024 Streeting GPs LinkedIn Weighs how PCNs might deploy the ARRS-funded newly qualified 'Streeting GPs' — about 0.8 WTE per network — and worries about supervision needs and disruption to salaried GP pay scales.

1 Aug 2024 Letter just out. Interesting - contract uplift and expansion of ARRS scheme to allow… LinkedIn Flags a new contract letter that uplifts funding and lets ARRS money employ newly qualified, otherwise unemployed GPs.

9 May 2024 Just been having a play with AnalyseRx on my EMIS system.. LinkedIn A first look at AnalyseRx on EMIS, praising the interface and seeing a real use case, once he completes the training.

15 Mar 2024 My PCN Manager Luisa Garlick and I were asked to take part in a Pulse Roundtable… LinkedIn Neil and PCN manager Luisa Garlick join a Pulse roundtable on PCN digital transformation, where he notes unlimited demand for DTL staff.

11 Mar 2024 What does the end of the 5 year deal mean? LinkedIn Urges PCNs to review value for money from ARRS roles now the five-year deal and funding growth have ended, weighing favourites like pharmacists and MSK FCPs and floating a DTL per practice.

8 Mar 2024 New GP Contract Letter LinkedIn Reflects on the 2024 GP contract letter's proposal to let non-GP specialists work in general practice, seeing opportunity in hospital-grade clinics shifting care left rather than a threat.

8 Feb 2024 I was having a look at www.how2.training earlier - It is the not for profit free to use… LinkedIn Revisits the not-for-profit How2.training platform for primary care IT that he helped set up, struck by how much content it now holds.

7 Jan 2024 Performance Reviews - We need more time LinkedIn Describes a federation Peer2Peer referral review scheme where paid GP reviewers gave anonymised feedback, and argues untapped GP capacity exists for quality improvement work beyond extra surgeries.

26 Dec 2023 Quantitative measure of workload LinkedIn Argues raw appointment counts miss the complexity and stress of GP workload, asking whether systems could weight consultations — or a Bluetooth dice log stress levels.

11 May 2023 I think the real question here is, what actually is a doctor? LinkedIn Questions whether doctors should be narrow subspecialist technicians or generalists who connect findings, positioning GPs as true doctors.

10 May 2023 Anyone else feel the ARRS portal could be a lot more useful and easier to use/get useful… LinkedIn Argues the ARRS portal is hard to use and yields little value, despite monthly staff input that could aid planning and track underspend.

28 Apr 2023 We are still looking for a few more sponsors for our inaugural Physicians Associate… LinkedIn Seeks sponsors for Howbeck's inaugural Physicians Associate Conference at Keele on 7-8 June, outlining the audience and PA roles on show.

28 Mar 2023 Advertising our 1st ever PA conference - Howbeck Healthcare supports the training of PAs… LinkedIn Promotes Howbeck's first physician associate conference, with a half-day for employers on getting the most from the role.

9 Mar 2023 Is it time to break the link between ARRS and New Roles? LinkedIn Asks whether ARRS funding should be decoupled from prescribed roles, whether practices should fund new roles from GMS money, and whether ICBs should top up PCN budgets.

1 Feb 2023 Primary Care Physician Associates Annual Conference - Will you be coming? LinkedIn Invites sponsors to the 2023 Primary Care Physician Associates Annual Conference at Keele Hall, with a clinical CPD day for PAs and a workforce half-day for PCNs and GP leaders.

26 Jan 2023 Best buys for available funds LinkedIn Suggests equipment and education as lasting uses for year-end capital pots, recommending a PCN-wide bulk purchase of Agilio's iLearn training package linked to GPTeamNet.

23 Jan 2023 Business opportunity or not?` LinkedIn Brief musings on gaps in urgent transport: is there a market for private ambulances, and should taxis ferrying patients to A&E carry defibs or first-aid-trained drivers?

6 Jan 2023 Hopefully you know I help run a not-for-profit free to use IT training site called… LinkedIn Promotes how2.training, a free non-profit IT-training site for NHS staff, and asks people to register and follow to secure funding.

30 Jul 2022 Did you know that our free to use How2.training website not only has videos on using EMIS… LinkedIn Highlights the free How2.training site's videos on EMIS Web, other GP IT systems and manager topics like CQRS, now also on YouTube.

24 Jul 2022 The current tax rules mean that some doctors (hospital docs as well as GPs) basically… LinkedIn Argues that pension tax rules penalising extra work worsen NHS waiting lists, and urges support for a petition to change them.

6 Jul 2022 We have just done a quick video of the new e-sign function in EMIS web for Fit notes and… LinkedIn Shares a free how2.training video on EMIS Web's new e-sign feature for fit notes and sending them to patients electronically.

10 Mar 2022 from april - patients can see all of their notes including free text. LinkedIn With patients able to read free-text notes from April, Neil points to How2 training videos on when and how to redact entries.

9 Mar 2022 An interesting article about how ARRS or Aroles staff are going in general practice.' LinkedIn Shares an article on ARRS additional-roles staff and reflects on the culture, contract and estates problems, and his PCN's devolved approach.

15 Feb 2022 Some quite depressing GP workforce figures out today. LinkedIn Unpacks GP workforce data showing 0.45 qualified GPs per 1,000 patients, down from 0.52 in 2015, with rising list sizes.

10 Feb 2022 Free to use for all NHS staff. LinkedIn Promotes free, high-quality IT training for a growing range of general practice software, open to all NHS staff.

2 Feb 2022 Some of you will know that we run How2.training as a not for profit GP IT training… LinkedIn Introduces How2.training, a free not-for-profit GP IT training platform with 1,500-plus users, and its new YouTube channel.

17 Dec 2021 AI amazes me more and more every day. LinkedIn Shares his surprise that solving image captchas helps train Google's driverless-car algorithms.

16 Dec 2021 Locally we are thinking absolute worst case (plan for the worst and hope for the best) -… LinkedIn Sketches a worst-case plan for a single shared triage hub letting clinicians from any local practice cover appointments if staff absences soar.

12 Oct 2021 Is it time to rethink what GPs do? Argues for segmenting GP work — minor ailments, chronic disease, palliative care — and asking which services belong at practice, town or PCN scale, and who should deliver them.

6 Jul 2021 Looking for any EMIS or primary care IT experts who might be interested in helping us… LinkedIn Seeks EMIS and primary-care IT experts to record training videos for how2.training as paid freelance work.

5 Jul 2021 Great to have myGP on board !' LinkedIn Welcomes myGP as a partner in How2, his not-for-profit site aimed at raising IT skills across primary care.

30 Jun 2021 You can now find a bundle of videos on how to use iPlato and set it up for your GP… LinkedIn Announces free iPlato how-to videos on the not-for-profit how2.training site he helped set up for NHS staff.

21 May 2021 Lovely quote/feedback from one of the new users on www.how2.training the FREE primary… LinkedIn Shares a new PCN clinical pharmacist's testimonial praising the free how2.training site for learning EMIS.

8 May 2021 An interesting interactive tool published on GP workforce https://lnkd.in/dcVHVTR … LinkedIn Shares an interactive tool mapping the GP workforce, including GPs over 55 per head, that may flag areas facing future shortages.

7 May 2021 Today we launching How2.training. LinkedIn How2.training launches with around 80 free videos on primary care IT systems and the GPAD programme, funded by Cheshire and Merseyside HCP.

17 Mar 2021 Another view: of Covid-19 vaccination centres Lessons from running PCN Covid vaccination sites delivering 20,000 doses: the technical setup effort, the NHS's chaotic mix of collaboration tools, and a call to fund IT roles via ARRS.

25 Feb 2021 Howbeck Healthcare Limited has been working closely with one of its local GP Federations… LinkedIn Shares a Howbeck guide to the Trainee Nurse Associate role and its ARRS funding for practices.

2 Oct 2020 Returning to work since lockdown Surveys how Covid transformed general practice — empty waiting rooms, video consulting, virtual locums — predicts working at scale, and asks whether GPs should give up urgent care.

23 Apr 2020 Use GP@home from X-On to record trainees doing telephone calls LinkedIn Suggests using GP@home call recording from X-on to train GP registrars and advanced practitioners by reviewing randomly selected telephone consultations.

9 Apr 2020 OK I've done a quick screen-recording/blog about how the activity in my practice has… LinkedIn Shares a screencast showing how his practice's activity shifted during Covid, using Apex reports from Edenbridge.

5 Apr 2020 I've started a video blog/podcasty thing on howbeckhow2 (our free to use IT video… LinkedIn Launches a video blog on the howbeckhow2 site reviewing IT tools such as GP@home and Nye Health's app.

4 Dec 2019 Kings fund survey of GP trainees https://lnkd.in/eJ5qU4h ' LinkedIn Discusses a King's Fund survey finding only 27% of GP trainees want long-term full-time practice, and reflects on recruitment struggles.

18 Oct 2019 Do GPs need more training?' LinkedIn Argues GPs need leadership and management training to run the new multidisciplinary teams that the DES and PCNs are funding.

23 Aug 2019 The Power of GP Federations Showcases what his 29-practice federation delivers at scale: a shared GDPR service, practice websites, IT trainers, cloud dictation with Lexacom, a Technomed ECG service and peer-reviewed referrals.

7 Jun 2019 Role of PCN pharmacists? LinkedIn A Howbeck Healthcare crib sheet for appointing the new PCN pharmacist role under the DES: funding models, training, supervision, indemnity and a long list of network-wide tasks.

22 May 2019 Physicians Associates Conference LinkedIn Announces the RCGP-endorsed Staffordshire Physician Associate Internship spanning primary and secondary care, and the first Physician Associate in Primary Care Conference at Keele.

3 Apr 2019 My latest column is out https://lnkd.in/drgs3-n Do we need to learn from how AI learns… LinkedIn Shares a column asking whether clinician training should be reinvented using lessons from how AI learns.

10 Jan 2019 Latest GP workforce figures out - less WTE GPs again.... LinkedIn Notes the latest GP workforce figures show yet another fall in WTE GPs, contrary to the promised extra 5,000.

23 Oct 2018 Hire your own trainer? How a GP federation locality used non-recurrent funding to employ its own IT trainer with EMIS and Docman expertise, and why other areas should copy the idea.

14 Aug 2018 Online training tool needed for EPRs Argues primary care needs a structured competency framework and certified online training for EMIS and other EPRs, since most staff learn the systems by trial and error.

14 Aug 2018 Do we need ultrasound training? or Technicians? LinkedIn Suggests the next practice-based revolution after embedded pharmacists could be ultrasound technicians in every surgery, cutting referrals and speeding cancer diagnosis.

10 Aug 2018 My latest DigitalHealth.net column is out https://lnkd.in/etDzg2h' LinkedIn His DigitalHealth.net column arguing that proper EPR training is central to getting value from practice IT systems.

14 May 2018 Why I like Q Doctor - its a virtual locum on an hourly rate Praises Q Doctor's model of hourly-rate video locums booked by the practice, who write into the practice's own system — working with general practice, not against it.

20 Apr 2018 Could we improve quality of dermatology referrals and improve skin cancer detection rates… LinkedIn Asks whether giving every GP a dermatoscope and training would improve referrals and skin-cancer detection.

9 Apr 2018 Is NHS England wasting £45Million? Questions whether NHS England's £45m online consultations programme is the best use of the money, suggesting new hardware, training, process consultancy or first-contact physio schemes instead.

9 Mar 2018 Crowdsourcing Home Visits from DocAbode - the new Uber? A look at DocAbode, an Uber-style app that crowdsources home visits from nearby GPs, with a local idea to use it for out-of-hours palliative care coordinated by the hospice.

1 Mar 2018 EMIS Web for Community Pharmacists LinkedIn Welcomes EMIS software giving community pharmacists GP record access, seeing potential for meaningful medication reviews, drug monitoring and chronic disease management.

26 Jan 2018 An app to put photos into clinical records? Yes, please. Argues for a streamlined way to get clinical photos into GP records, drawing on his federation's crowdsourced dermatology advice app and the potential gains in wound care and district nurse triage.

22 Jan 2018 GP Locum Platform Introduces Howbeck Healthcare's fee-free GP Locum Platform, an online locum bank funded by CCGs or federations to help practices fill sessions and grow the local workforce.

31 Oct 2017 Another View: of Private Doctor Apps Weighs up private GP apps: worries they become virtual walk-in centres without records, but suggests practices and federations could use the platforms as locally staffed overspill.

23 Feb 2017 My latest article is out - how do we develop clinical IT champions? LinkedIn Shares a column asking how to train, qualify and formally recognise clinical IT champions as a career choice.

12 Dec 2016 Should General Practice be more like McDonalds.... or NISA? LinkedIn Argues practices should share back-office functions faster, asking whether a McDonald's-style franchise or a Nisa-style buying-and-support group is the better model for general practice at scale.

18 Oct 2016 Another View: of Handling Letters On taking admin off GPs: practice pharmacists, medical assistants, a five-practice letter-processing hub saving GPs 40 minutes a day, and how cloud-based Docman 10 could enable shared admin teams.

6 May 2016 Speech Recognition Revisits an earlier dismissal of speech recognition after trying Nuance's Dragon Medical, imagining voice commands that code consultations and automate GP system tasks.

8 Mar 2016 IT Check-ups Findings from in-depth IT health checks across two GP federations: training by Chinese whispers, unused Docman and Lexacom features, and the case for federations employing IT teams.

17 Nov 2015 Return to IT for GP Federations What GP federations need from IT suppliers: video conferencing between staff, home working, tools for supervising new roles, cross-practice phone answering and open, extensible systems.

8 Oct 2015 we are hearing on the grapevine that at least one of our pharmacist working in GP land… LinkedIn Signals a successful pharmacist-in-general-practice bid and invites pharmacists keen to become GP-based consulters.

18 Sept 2015 Howbeck Healthcare has just helped 3 GP Federations submit Pharmacist in Primary Care… LinkedIn Reports helping three GP federations submit Pharmacist in Primary Care bids worth £1M combined.

8 Jun 2015 Hanging up the Phone Argues practices should move beyond the phone: federated call handling across surgeries, smarter online triage and booking, automated follow-ups and secure portal messaging to patients.

13 Feb 2015 Just do IT Argues the NHS should copy Sky and telecoms firms by giving district nurses tablets — for lone-worker safety, paperwork in the field, remote advice and data to match resource to need.

29 Dec 2014 Local A&E reporting a 9 hour wait! LinkedIn Notes a nine-hour local A&E wait and urges patients to try a pharmacist first for minor ailments.

1 Aug 2014 Very poor story on BBCNW news last night about high cost of locum drs&nurses why do TV… LinkedIn Criticises a BBC North West report on locum doctor and nurse costs for missing the real point on NHS staffing.

27 May 2014 Saving £50m A back-of-envelope case for moving the NHS off ageing servers and Windows XP onto a shared cloud platform, reckoning practice and trust hosting savings near 50m pounds.

2 Apr 2014 Code4Health Reflects on Code4Health's plan to teach the NHS coding, arguing what's really needed is informatics and process-mapping skills, programmable clinical software and funded support.

27 Nov 2013 Another View: Twenty Six Reads the new GP contract against a looming retirement crisis and argues future primary care IT needs smarter triage-led appointment systems, integrated video consults and business intelligence.

25 Feb 2013 Another View: Seventeen Applies easyJet-style self-service thinking to general practice: let patients reprint fit notes online, automate hypertension checks, and build a searchable directory of services.

15 Aug 2012 Im thinking of selling some training videos online, basic powerpoint stuff with voice… LinkedIn Seeks recommendations for a secure, low-cost platform to sell voice-over training videos with built-in billing and embedding.

10 Jan 2012 Another View: Three How a hunt for cholecalciferol exposed EMIS's unforgiving drug search and misspelt hospital letters, prompting calls for medical spell-checkers and electronic prescribing links from consultants.

19 Dec 2011 We are looking for a maternity Locum to cover one of our doctors from end of feb for 6-12… LinkedIn A recruitment notice seeking a maternity locum to cover one of the practice's doctors for six to twelve months from late February.

20 Sept 2009 Jing: free screen capture for practice IT training GP magazine A review of Jing, a free screen-capture tool for recording annotated screenshots and short videos to share IT tips and training around a practice.

1 Jun 2009 Review: Nuance's Dragon 10 Medical GP magazine A hands-on review of Nuance's Dragon 10 Medical voice recognition software, weighing impressive dictation against poor integration with GP systems.

4 Apr 2007 Book review: Leadership and the One Minute Manager GP magazine Reviews Ken Blanchard's book on situational leadership and how matching management style to staff competence and commitment changes the way you delegate.

6 Feb 2007 The Concept2 website: more than a rowing machine GP magazine Describes taking up rowing and recommends the Concept2 website as a rich source of exercise physiology and weight loss material for GPs and their patients.

10 May 2005 Choose and Book: my first impressions GP magazine An early adopter's candid account of the NHS e-booking system - the training, the clunky software and the practical headaches of going live.

9 May 2004 Switching from EMIS LV to FrontDesk for Windows GP magazine Reports on a practice's first months after swapping the EMIS LV appointment book for FrontDesk, covering training, LED call boards, home visits and reports.

22 Apr 2003 Careful with your coding GP magazine On the perils of miscoding diagnoses in GP records, with real examples, and why symptom [D] codes are a safer choice until a diagnosis is firm.