Dr Junaid Bajwa's GP Portfolio Career

This week expert contributor Dr Junaid Bajwa shares his experience of his portfolio career

I have developed a portfolio career over the last few years including a variety of roles and responsibilities as well as the opportunity to learn from leadership training. My roles currently include:

• GP at the Conway PMS surgery in Greenwich: providing primary care medical services and clinical leadership role in practice transformation
• CCG Board Member NHS Greenwich: leading on Mental Health, IT, and supporting Integrated Care through the Pioneer Initiative
• Public Health Associate, Royal Borough of Greenwich
  • Providing clinical support to Public Health
• Clinical Senate Council Member, London
  • Providing clinical oversight on issues brought to the council
• LMC Member, Greenwich
  • Providing a voice for practices, and negotiating with NHSE
• VTS Programme Director, Greenwich, Health Education England
  • Education and Training lead, supporting the future generation of GPs in Greenwich

It may seem to be a lot of hats, but many of the roles interweave and allow me to see how we can improve outcomes for patients as well as helping them navigate the system.

What are my day to day priorities and challenges?

• GP at the Conway PMS surgery in Greenwich
  • Providing appropriate access, ensuring safe practice, safe prescribing, and ensuring I maintain aspects of the NHS Contract, NHS Constitution, and the local constitution with our CCG
• CCG Board Member NHS Greenwich
  • Ensuring we work to deliver improved health outcomes across the population we serve, whilst keeping in line with the financial envelope assigned to us by NHSE, and delivering against our CCG objectives. Working with other commissioning organisations, e.g. Local Authority, and aligning our priorities and objectives across health and social care.
• Public Health Associate, Royal Borough of Greenwich
  • Providing clinical support to Public Health
• Clinical Senate Council Member, London
  • Providing clinical oversight on issues brought to the council, eg how to enable self care across London
• LMC Member, Greenwich
  • Practices will face financial, and regulatory challenges in the future; how could the LMC as a membership and national organization linked with the GPC and the BMA support practices who feel under threat.
• VTS Programme Director, Greenwich, Health Education England
  • Ensuring that trainees have a positive and safe experience of training in hospital, and in their training practices. Ensuring that trainees are supported to achieve their AKT and CSA

Describe your role on the CCG, time commitment and remit

I spend at least 1.5 days per week on CCG activities. This includes:

• Strategy meetings
• Public Board Meetings
• QIPP meetings
• Financial Performance and Quality Meetings
• Contract review meetings
• Contract negotiation meetings

I am supported by another clinician who is my “commissioning project lead” who does 1 day per week, and has a dotted line management to me. Although the contracted officer role is for 1.5days per week, I think on most weeks it feels as if I am doing at least 2.5-3 days.

It has been an amazing learning curve for both clinicians and managers within the CCG, and I would say that the first 6-9 months were about getting used to our new structure, and trying to “fly the plane, whilst we were building it at the same time”.

What is the Clinical Senate, time commitment and remit?

The Clinical Senate model comprises a wider Senate Forum and smaller Senate Council: members of the Clinical Senate Council have a role in supporting the ongoing improvement of quality and outcomes in London.

The Clinical Senate Forum is a diverse multi-professional group providing the Council with ready access to experts from a broad range of health and care professions. Membership encompasses the ‘birth to death’ spectrum of NHS care across all settings: patients and the public, public health and social care.

The Clinical Senate Council is a smaller multi-professional group with a membership of made up of: patients, CCGs, AHSNs, Providers (Hospital and Mental Health organisations). It provides overall leadership and manages the Senate’s business. It maintains a strategic overview across London and is responsible for the formulation and provision of advice that is sought from the Senate, drawing on the views and opinion of the broader Forum. It also advises on clinical networks’ strategic priorities and assures delivery.

Clinical Senates are non-statutory advisory bodies. The London Clinical Senate is hosted by NHS England (London Region) though operates independently of it. This independence is a core principle of Senates’ ways of working. The focus of the Clinical Senate function is that it provides impartial advice which is in the best interest of patients, not of organisations or professional interests.

How has my “leadership training” impacted on clinical practice?

I have been fortunate enough to have learned about leadership in a variety of settings:

• By "osmosis" like many medics, observing and at times replicating the behaviours of senior leaders around me (eg during training, and house jobs);
• Through programmes such as "Prepare to lead" (NHS London 2009/10)
• And the Executive Fast Track Programme (NHS Leadership Academy 2014/15)

Each of these experiences has taught me something new about the nature of leadership, and what it means to me, the organisation I work in, and most importantly the patients I serve.

This last element is probably one of the key elements for me which has impacted on both my leadership and clinical practice: the notion of "servant leadership" and how this has led to a change in my behaviour and actions. This has been most apparent when I am both managing patients (on a one to one), & when I am having to take responsibility for decisions effecting population care (on a one to many level).

These programmes have allowed me to understand myself better and how I engage with others, including patients, & overall I believe have made me a better clinician.