The General Practice Podcast

This week, Ben is joined by Katie Collin, Partner at Ramsay Brown, to discuss NHS England's consultation on Single Neighbourhood Provider contracts and Multi-Neighbourhood Provider contracts.
They explore what the proposed contracts could mean for GP practices, PCNs and federations, including the potential impact on funding, governance and locally commissioned services.
Katie explains the different contract options, whether PCNs should consider incorporation, and the potential role of federations and collaboratives as MNPs.
The discussion also looks at the opportunities and risks of shifting more services into primary care, and why strong governance, transparency and financial planning will be essential as neighbourhood working develops.
With the consultation still underway, Katie shares her thoughts on what practices and PCNs should be considering now.
Introduction (00:08)
The NHS England consultation on neighbourhood provider contracts (00:30)
Why the consultation is a positive step for general practice (00:51)
Single Neighbourhood Provider contracts: what do they mean for GPs? (03:57)
PCN DES vs a local variation: understanding the options (05:47)
Could locally commissioned services move through PCNs? (08:39)
The financial implications for GP practices (09:00)
What the IIF taught us about collective funding (11:01)
Why PCN governance could become more important than ever (13:40)
Should PCNs consider incorporation? (15:29)
The benefits of incorporation and stronger governance (15:57)
What are Multi-Neighbourhood Providers (MNPs)? (18:16)
Could MNPs create new opportunities for general practice? (20:18)
The risks of following the funding into primary care (21:38)
How can federations and collaboratives fit into the new model? (23:37)
Why governance and transparency will be critical (25:06)
What should PCNs and practices do next? (26:03)
Visit Katie on Linkedin here, or email Katie directly here.
Visit the Ramsay Brown website here.
For all enquiries about the Ockham podcast, please contact Ben Gowland here.

Integrated neighbourhood working has been talked about for years, but what does it actually look like when it's put into practice?
In this episode, Ben Gowland is joined by Bobby Pozzoni-Child, Director of Partnerships and Transformation for the Buckinghamshire Primary Care Provider Collaborative. Bobby explains how Buckinghamshire has evolved from a GP Provider Alliance into a truly integrated primary care collaborative, bringing together general practice, community pharmacy, dentistry and optometry to create a stronger collective voice and deliver better care.
If you're interested in neighbourhood health, integration, system leadership or the future role of primary care, this episode offers practical lessons from a system that's already making it happen.
Introduction (00:08)
Why Buckinghamshire expanded beyond general practice (01:29)
Bringing GPs, pharmacies, dentists and optometrists together (02:41)
Creating a stronger voice for primary care across the system (04:31)
Why neighbourhood working needs relationships and delivery (06:05)
How Buckinghamshire is turning collaboration into action (08:01)
Building neighbourhood teams and local leadership (10:23)
Keeping practices engaged as neighbourhoods grow (11:45)
Delivering measurable results through integrated working (14:27)
How attitudes towards primary care are changing (16:49)
From planning neighbourhoods to delivering care (18:51)
Why Bucks isn't waiting for national contracts (20:57)
Lessons learned from leading system-wide integration (22:40)
Why expanding to wider primary care was the right move (25:59)
For all enquiries about the Ockham podcast, please contact Ben Gowland here.

In this week's episode, brought to you in partnership with Practice Index, we welcome back Robyn Clark and Ed Kennedy to discuss the new "return to good" inspections, how they differ from previous CQC visits, and why many practice managers feel these are now effectively practice manager inspections.
Ed shares his first-hand experience of being among the first practices inspected under the new approach, while Robyn discusses the wider concerns being raised by practice managers across the country. Together they explore the benefits, challenges and practical steps practices can take to prepare, as well as the growing recognition of practice managers as leaders within the NHS.
The new CQC inspection model explained (02:31)
Ed's experience of being one of the first practices inspected (04:27)
Why these are becoming "practice manager inspections" (05:43)
The benefits and limitations of the new approach (07:07)
Can practices improve their CQC rating? (07:52)
Why inspector consistency remains a major concern (11:45)
The increasing pressure on practice managers (14:23)
Practical advice to prepare for a CQC inspection (16:18)
Key compliance areas inspectors are focusing on (17:08)
What to do if you disagree with your inspection report (21:45)
Practice managers influencing national NHS policy (22:41)
How the role of practice manager is gaining national recognition (24:18)
Listen back to a Practice Index – Navigating CQC Inspections with Confidence feating Kay Keane here.
To visit the Practice Index website, click here or contact James Dillon here.
For all enquiries about the Ockham podcast, please contact Ben Gowland here.

What does it take for general practice to lead system transformation rather than simply respond to it?
In this episode, Ben Gowland is joined by Dr Sunaina Khanna and Dr Imran Zaman to discuss how they have built a unified leadership model that is helping shape neighbourhood health across one of England's largest Integrated Care Systems.
Starting with a collaborative response to winter pressures, they explain how GP leaders came together to create the GP Partnership Board, giving general practice a stronger voice in system decision-making while developing services at scale. They share the practical lessons they've learnt about building trust, securing buy-in from practices, working alongside community providers, and creating leadership that is focused on delivery rather than representation alone.
The conversation also explores how general practice can prepare for the future NHS landscape, why working at scale matters, and the importance of demonstrating value through action.
Whether you're a GP Partner, PCN Clinical Director, practice manager or system leader, this episode offers valuable insights into building collaboration, influencing change and strengthening the role of general practice within neighbourhood health.
Introduction (00:09)
How winter pressures sparked a new model of GP collaboration (01:26)
Using population health to redesign services at scale (03:20)
Building multidisciplinary teams around neighbourhood health (05:59)
Why Birmingham & Solihull created the GP Partnership Board (08:25)
Winning practice buy-in through delivery, not persuasion (11:39)
Balancing uncertainty with opportunity in the changing NHS (13:10)
Evolving towards a 24/7 general practice leadership model (16:22)
Making general practice easier for the system to work with (17:33)
Building stronger partnerships across community services (19:30)
Why every area needs a unified GP leadership voice (22:19)
Practical advice for creating collaboration at scale (25:30)
Learning by doing and proving what works (28:30)
Final reflections (29:36)
Contact Sunaina directly via email here. 
For all enquiries about the Ockham podcast, please contact Ben Gowland here.

The Carr-Hill formula sits at the heart of GP funding, yet few people fully understand how it works, or the impact it can have on individual practices. In this episode, Ben is joined by Dr Matt Jones, GP Partner in Cardiff, who has spent years investigating the formula after discovering significant funding differences between seemingly similar practices. Drawing on Freedom of Information requests, published papers, and detailed analysis, Matt explains why Carr-Hill remains such a controversial issue and why a long-awaited review could have major implications for general practice.
Together they explore how the formula's different indices interact, why some practices can lose out by hundreds of thousands of pounds each year, the role of deprivation and fixed costs, and how funding inequalities can affect workforce capacity, patient access, and sustainability. Matt also shares his thoughts on what meaningful reform could look like and why greater transparency is essential if practices are to understand the challenges they face.
Introduction (0:09)
How did you become interested in the Carr-Hill formula? (0:19)
What prompted your research and submissions to the Welsh inquiry? (1:05)
Why is understanding Carr-Hill so important ahead of the current review? (1:54)
Is the problem really about deprivation, or is it more complex than that? (2:45)
Which parts of the formula have the biggest impact on funding? (3:18)
Why are some of the formula's deprivation measures now outdated? (4:12)
How do the different Carr-Hill indices compound to create large funding gaps? (6:14)
Do practices actually know their Carr-Hill scores? (7:49)
How large can the funding differences between practices be? (8:43)
Why do funding inequalities become harder to fix over time? (10:17)
What happens if the formula is adjusted to better reflect current deprivation? (11:31)
Does Carr-Hill underestimate the fixed costs of running a GP practice? (12:42)
Why does the age and sex index potentially exaggerate funding differences? (13:24)
How do fixed costs reduce clinical capacity in lower-funded practices? (14:27)
What changes could make the funding model fairer? (15:50)
Should national pay uplifts be separated from the Carr-Hill formula? (16:59)
Why are funding inequalities continuing to grow? (17:57)
What does this mean for access targets and patient care? (19:18)
Could funding be based on workload instead? (20:24)
What would Matt like to see from the Carr-Hill review? (22:11)
Why transparency around funding matters for practices and patients (22:50)
Closing thoughts (24:11)
Read Matt Jones' paper here.
For all enquiries about the Ockham podcast, please contact Ben Gowland here.