Ben was CEO of Nene CCG for 8 yrs. He was a Director of an acute trust and has run national improvement programmes. He is a founding director and Principal Consultant of Ockham Healthcare, which he describes as ‘a platform for change’.

Throwing a lifeline to General Practice

How do you make a difference? How can you make a contribution that offers the possibility of delivering something genuinely helpful?Thinking about these questions led Ben Gowland to resign as a CCG CEO, set up Ockham Healthcare and develop the Practical Steps programme for general practice.

Albert Einstein famously said, ‘If I had an hour to solve a problem I’d spend 55 minutes thinking about the problem and 5 minutes thinking about solutions’. So that is what I have been doing for the last three months: visiting practices, talking to GPs, and trying to understand the problems of general practice.

What I found surprised me. I thought the challenge was going to be how to create at scale general practice. It is not. The challenge is a more fundamental one. The previously well-oiled machine of general practice is juddering to a halt. It cannot cope with the growing pressures of day to day demand and serving ever more demanding populations. As a result staff, including GPs but not just GPs, are leaving. And there are not the replacements in reserve to take their place. 

Those outside general practice do not understand this. Maybe it is because general practice has wrapped itself in a set of impenetrable acronyms and phrases (such as PMS, MPIG and notional rent). Whatever the reason, it means that general practice receives little or no support. Worse, no one seems to see it as their job to provide the support that is so clearly lacking.

Solutions, however, do exist. Up and down the country there are some great examples of how individual practices have met the challenges faced by general practice head on. Innovative solutions that have the potential to work anywhere. What doesn’t exist, however, is the space for the rest of general practice to find these examples and take them on board. Even when new ways of working are obvious there is often a shortage of the skills necessary to adapt these solutions to make them work locally.

So Ockham Healthcare's first initiative has been to create a programme, Practical Steps, to support practices to find the changes that will make the biggest difference for them and to implement these changes. This is what I think will make a difference.

The Practical Steps programme will give access to resources and conversations; diagnostic tools that will enable practices to identify the areas that require the most urgent attention; and a wealth of case studies in a variety of media formats that practices can access easily.

We are looking for practices to work with us to fine tune our approach and make sure that we can, truly, make a difference. We are putting together a group of practices from maybe one or two federations or CCGs, who want support with the problems of today as well as with preparing for the challenges of tomorrow. These "foundation practices" will access the programme at a generously discounted price, be offered a selection of Healthcare Innovation Monitor content opportunities and in return will help us evaluate the course and provide real time feedback on how it can be improved for practices in future. If you are interested in this offer, and in working with me and the Ockham Healthcare team, then please get in touch on


Together we've got the public sector covered