Our relationship with our patient community

17 July 2020

It was great taking a much-needed week off last week, so a massive thank you to Nicola Topping our First5 Lead who wrote last week’s blog.

I am taking a week off on 17 August, so if you would like to write the blog for that week get in touch and let us all hear your voice and share your experiences and opportunities. 

Post-CCT fellowship

I like the opportunity to read when I’m off - I’m sure it has something to do with a rested, unrushed brain! I genuinely enjoyed catching up on last month’s BJGP.

There are many excellent articles and papers in it, including some important ones about significant cancer diagnosis, so if you haven’t read it for a while, please give it another go.

Having enjoyed Nicola’s blog so much, I was really enthused by one of the articles by Dr Sophie Lumley: Trust me - I’m a Millennial GP.

It’s a great article and offers some useful insights to how the future of general practice could look. I particularly liked the importance placed on the post-CCT fellowship posts.

Our own fellowship posts have been very successful, so we will continue to highlight the benefits of investment in all post-CCT training and opportunities.

If you are one of our First5 members, please take time to read the article and get in touch with me - I would love to discuss it more with you and hear your views.

Our new patient group chair

During the week before I went on holiday, we had a happy and sad moment in our virtual College office.

We sadly said goodbye to Karen Mooney, the outgoing Chair of our patient group.

Our patient group has been incredibly helpful in reviewing NI Council papers and providing an insight into patient views and experiences on many of our policies and campaigns.

Karen has chaired the group with exceptional skill, and we are very grateful to her for all her work, which included some very public facing campaigns such as 3 before GP and important work to help reduce missed appointments in our surgeries.

While we were sad to say goodbye to Karen, it was a happy occasion to welcome John Clarke, our new patient group chair.

John is a Northern Ireland Ambulance Service controller based in Newry and brings a wealth of experience to the group, not only as one of our professional community colleagues but as a patient.

He has already developed and promoted a valuable guide to school attendance with sick children which is available to download, called Do I need to keep my child off school? (1.37 MB PDF).

It is vital we bring our patient’s experience and voice into our work and truly make them the focus of everything we do.

Relationships with our patients

My father had a wonderful philosophy with his patients: "If it is important to you, then it is important to me".

It was this generosity of spirit that inspired him to lead pilgrimages to Lourdes for 25 years with the Armagh and Dungannon diocese.

He gave this time freely and I remember some of his early experiences being quite challenging, with very sick children and a less advanced health system than is established in Lourdes today.

While I haven’t followed dad to assist pilgrims to Lourdes, a visit I have long wanted to make is to Bromley by Bow Health Centre in Tower Hamlets, London.

Sir Sam Everington is a GP visionary and for many years has worked in the Tower Hamlets area of East London - traditionally a very socio-economically deprived area of the city.

What he discovered and harnessed in his practice was the expertise of his patients.

This BMJ article, What's so special about Sam Everington's Bromley-by-Bow health centre? gives a flavour of what he had achieved almost 15 years ago and the link between the practice and its community has grown even stronger since.

Simple community facing projects such as enabling diabetic patients from minority cultures teaching each other to cook healthy low-fat meals resonated with me and, as with many effective health interventions, they were low-cost and didn’t involve medication.

Patient involvement groups

I was humbled at an experience in my own practice last month where we harnessed our own patient power.

We have a dear patient who has recently been diagnosed with Motor Neurone Disease (MND). It is a devastating diagnosis for her and her family.

One of her fears is the thought of not being able to swallow her secretions so it was wonderful to enable another one of our patients, whose husband died of MND, to support her using her experience and share some practical support. 

COVID-19 has also helped another one of our patients whose son has marked immunodeficiency.

He had been confined to receiving immunoglobulin infusion in our surgery weekly, so COVID-19 has necessarily enabled our nursing staff to teach his mum how to administer it herself safely.

This will hopefully empower them both more in the future and allow them some more freedom from the constraints of surgery appointments.

Patient involvement groups can be very helpful in a practice and we would love to hear from you if you have a successful group.

We would be glad to share what makes your group work well and any practical tips you can share which ensures it works well for the practice and does not become a cumbersome process.

Another possible way of gaining patient involvement from a number of practices in your area could be through your local Federation.

Opticians

Opticians are starting to reopen again slowly, and it is worth revisiting the Primary Eyecare Assessment and Referral PEARs scheme.

We have a fantastic local optician and I have lost count of the patients with acute red eye conditions she has managed with more expertise than I have.

Our surgery is a considerable distance from Royal Victoria Hospital Eye Emergency Referral Clinic, so it is great to have a local and professional alternative.

Developments in practice

My own surgery was especially busy this Tuesday. Normally, the day after the 12 July Bank Holiday is quiet, but this week it was full of traditional general practice:

  • establishing relationships with patients who have a new cancer diagnosis
  • joint injections for patients with pain too severe to wait until seen by orthopaedics
  • children with rashes

I had to counsel a patient with a temperature who needed COVID-19 testing and it was helpful to have the new test and trace information.

Our reception staff found it helpful to be able to direct patients straight to the 119 phone number. It is helpful that children under five can now get testing, so this NI Direct article, Coronavirus (COVID-19): testing and contact tracing, might be a good addition to a surgery website or Facebook page.

The Public Health Agency has a poster (219 KB PDF) and leaflet, Test trace protect needs everyone's support, (359 KB PDF) available, which may be helpful if you want to display or promote them. 

It was surreal coming back to my surgery having been away for only one week and considering how much has changed.

While we are performing remote consults, the core of our work continues, and the importance of childhood vaccination cannot be overstated.

Dr Nicola McFarlane a paediatric registrar is carrying out a short survey on behalf of PHA Immunisation Team so if you have a spare five minutes, please contribute to this work.

RCGP also has some good resources on Postnatal and Maternal Care during the pandemic (835 KB PDF).

Rescheduling

Even before COVID-19 changed all our worlds, RCGPNI was planning to host many events and offer new and interesting education opportunities in 2020.

We will get back to some sort of normality, I promise, but one event I am very disappointed we are unable to attend was hosting our own stand alongside BMA at Belfast Pride 2020.

The march was due to take place on 1 August 2020 and Ursula and I were looking forward to taking part and showing solidarity with our colleagues there.

The festival is still going ahead in a virtual format and will run between 24 July to 2 August, so we will still play our part online. Details about the festival can be found on the Issuu website.

If this event is important to you, please get it touch with any ideas on how we could celebrate this important day.

Time off

I hope you are all getting some down time and taking some time off over the next few weeks.

I am still trying to shake off my imposter syndrome in this job, so if you like a bit of quiet evening TV before bed, let me recommend Amazon Prime's Faking it. Series Five, episode five: Management consultant to dog trainer'.

It’s a wonderful episode and will appeal to all dog lovers. What I really liked was how the management consultant rose to the challenge of doing something totally different but staying true to his values of being kind and doing the best job he could - a bit like general practice during COVID-19.


Post written by

Dr Laurence Dorman, Chair of RCGP Northern Ireland

Dr Laurence Dorman took office in November 2019 after three years as Deputy Chair of Policy for RCGPNI. A GP principal in Mourne Family Surgery, Kilkeel, Co Down, since 2007, he is the fourth generation of GPs in his family. He was also, until recently, the Chair of Newry and District GP Federation. 

Laurence has particular interests in new ways of working in primary care, cancer care, and inspiring the next generation of GPs. He set up the successful 'Dear Colleague' initiative to improve the interface between primary and secondary care and has been a strategic advocate for interface and communication since September 2017.

During his time as Chair, he wants to support College members to ensure that the future of GP services is protected, supported and sustainable.

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