Asset Based Approach to Patient/Community Engagement In General Practice

fabstuffThis week’s Bright Idea comes from NHS Academy of Fabulous Stuff, a portal which, like ours, shares examples of innovation in general practice and primary care.

Written and submitted by Sheinaz Stansfield

General practices are currently required to have a patient participation group. However, over the past 7 years our experience has been that these are of limited value and do not give an opportunity to engage patients as active participants in service redesign or corporate decision making.

We currently hold a PPG 3 monthly and for the last 7 years we have had the same 6 patients attending, despite trying numerous strategies to increase engagement.

Traditional models of patient engagement are not working for us.

In March 2014 Oxford Terrace and Rawling Road Medical Group were given the opportunity to become involved in developing patients as practice champions (volunteers).

We took this opportunity and at the very first recruitment event 19 patients volunteered to start working with us to develop an Asset Based Approach to Health and Wellness in General Practice, though engagement of patients as volunteers.

Over a period of 6 months 39 Practice Champions were appointed and provided training to support the practice, patients and the broader community to take a population health approach to the provision of General Practice through: supported self-care, health promoting events and activation community assets around the practice population.

Through this approach we aimed to look beyond a traditional disease model of health and instead widen our scope to embrace the broader determinants of health and wellbeing, to manage demand in the practice and engage patients proactively in self-care/management.

This asset based approach is a core requirement of the FYFV, and helped us to:

  1. Look beyond traditional disease models in health care and to take action on the social determinants of health and wellbeing;
  2. Adopt salutogenic concepts – identifying the factors that create and support human health and wellbeing and that moderate against stress. (Salutogenesis is a well-established concept in public health and health promotion);
  3. Ensure that individuals and communities had access to a range of integrated, holistic wellbeing interventions;
  4. Forge partnerships with individuals, communities and other agencies and work co-productively to reduce health inequalities.

What is the benefit of the idea over current methods or products used?

  • Active patient engagement;
  • Improved access to social sources of support/ community services;
  • Strengthened relationships between the Practice, patients and other 3rd sector organisations;
  • Increase staff confidence in addressing wellbeing in everyday practice, and;
  • Ensure holistic approaches to healthcare provision are embedded within the practice.

All of the above would enable to:

  • Empower patients engage in self-care/self-management;
  • Enable them to use existing skills to support others through mentorship and peer support;
  • Improve access to primary care;
  • Support integration of primary care with other health and wellbeing services;
  • Prevent ill health and reduce health inequalities;
  • Have a focus on early diagnosis and supporting people to care for themselves;
  • Support the coordination of care and care planning;
  • Reduce the reliance on unscheduled care, and; Patients, the 3rd sector, local authority, voluntary and community led groups came together to develop a network of support.

This approach enabled us to maximise the potential of our complex care team. In addition, it enabled us to engage hard to reach patients in innovative ways to embrace self-care.

We already use wellbeing mentors in our Type 1 KDZ work and wanted to replicate this for people with dementia, mental health problems and long term conditions.

The model is now fully implemented, without additional funding.

We have redesigned roles in the practice to support the practice champions. This has enabled both a structural and behavioural change in the way we work with patients.

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