In this episode, Ben is joined by Catherine Pope, Professor of Medical Sociology at Nuffield Department of Primary Care Health Sciences, to explore how access to general practice really works in practice and what happens to appointment systems over time. Drawing on over 30 years of research and findings from a recent study, the discussion examines the sustainability of different access models, the legacy of initiatives such as Advanced Access, and why practices continually adapt systems to manage demand. The episode explores the limitations of top-down, standardised and digital first solutions, the impact of access systems on patients, reception teams and clinicians, and why variation is often necessary to meet the needs of local populations. The conversation also highlights patient experiences of navigating access, the risks of diversion and looping between services, creative approaches such as the 'Phones and Ladders' game to illustrate access challenges, and the case for more patient-centred, locally adaptable models that prioritise need, continuity and sustainable general practice.

Introduction (00:08)

Your recent study on access to general practice (01:00)

Did you find that practices were able to sustain the benefits of new access systems? (04:04)

Have practices managed to stick with the changes they made over time? (09:41)

Does this impact sustainability, because eventually people stop doing it? (13:39)

'Phones and Ladders' (15:30)

Should access start with local population needs? (19:28)

Are current access outcome measures too crude if they focus only on waiting times? (22:05)

If people want to access the research or learn more, where can they find it? (24:33)

Visit the 'General Practice: Innovation, impact and sustainable change' research here.

For all enquiries about the Ockham podcast, please contact Ben Gowland here.

In the first episode of 2026, Ben is joined by Dr Zalan Alam, General Practitioner, Director of Medical Education and GP Partner, to explore Rochdale's selection as a site for the National Neighbourhood Health Implementation Programme (NNHIP) and what this means in practice for general practice and PCNs. The discussion focuses on improving patient journeys, particularly for frail patients and those in the last year or 1,000 days of life, by strengthening connectivity between primary care, community services, hospices, ambulance services and acute trusts, using standardised frailty assessments, shared care plans and tools such as the Greater Manchester Care Record. The episode also covers targeted neighbourhood working in Rochdale South, the importance of peer leadership and measurable impact for frontline practices, and what comes next as the programme moves from planning into delivery, with an emphasis on locally adaptable models rather than a one-size-fits-all approach.

Introduction (00:08)

Why Rochdale was selected for NHIP (00:29)

Population, PCNs and deprivation (01:22)

How the programme is structured (02:42)

Early priorities and patient journey focus (03:35)

Targeting Rochdale South as a proof of concept (05:33)

Connectivity gaps and 'lightbulb moments' (06:25)

How neighbourhood working operates in practice (07:03)

Standardising care plans and frailty pathways (08:40)

Using data to identify priority cohorts (10:07)

Shared tools, shared vision (12:01)

Impact on PCNs and general practice (14:09)

System-level integration and why it works in Rochdale (16:12)

Moving from planning to delivery (17:42)

Measuring impact and managing expectations (18:40)

Learning from other NHIP sites (19:13)

Reflections & next steps (20:26)

Listen to Zalan's previous podcasts 'Innovative intermediate care' here and 'Integration working in practice' here.

Contact Zalan via email here.

For all enquiries about the Ockham podcast, please contact Ben Gowland here.

In this episode, Ben is joined by Judy Oliver from Oliver & Company to discuss the role of the voluntary, community and social enterprise (VCSE) sector in healthcare and general practice. Judy explains why the voluntary sector is essential yet often misunderstood. She explores how social prescribing and asset mapping can better connect patients with non-clinical support, highlights successful collaborative models such as the Bromley by Bow Centre, and discusses the challenges VCSE organisations face around funding and visibility. The conversation focuses on practical ways PCNs and practices can work more effectively with local voluntary groups, move towards neighbourhood-based care, and take simple next steps to build meaningful partnerships that improve patient outcomes.

Introduction (00:08)

The Voluntary Sector in General Practice (00:22)

What does VCSE mean? (02:23)

Does it deliver real benefit? (03:21)

How have PCNs worked with the voluntary sector? (05:22)

How to find what's available in your area (07:40)

Finding the right people (10:22)

From PCNs to neighbourhood working (15:01)

Next steps (18:18)

Getting in touch (19:47)

Visit the Oliver & Company website here, or contact Judy via email here, or Charlotte here.

For all enquiries about the Ockham podcast, please contact Ben Gowland here.