RCGP Bright Ideas: Improving patient services through co-production

11 January 2019

Dr Sue Goodfellow and the West Quay Medical Centre team

Dr Sue Goodfellow (pictured left) with the West Quay Medical Centre team

The RCGP Bright Ideas Programme provides a platform for innovative ideas to be shared to encourage GPs and primary care professionals to try new ideas which reduce workload and increase efficiencies within GP practices.  

The College recently recognised Dr Sue Goodfellow from West Quay Medical Centre in Barry, Wales with a Bright Ideas Award for her work to improve patient services through co-production with patients at her practice.  

West Quay Medical Centre is a mixed urban and semi-rural practice with around registered 14,000 patients. The surgery ran a standard capacity-based appointment system, which was accessed by phone. A patient survey at the practice showed very high satisfaction with clinical advice and treatment but poor access to appointments and difficulty with relational continuity with their known GP.  The surgery was not adhering to the Principles of Prudent Healthcare, especially 'Equity of access' and 'caring for those with the greatest health need first'.

Patients with the greatest need are dealt with first

The Surgery now provides online access to clinical advice for all appointment requests for GPs and Advanced Nurse Practitioners (ANP) to ensure patients with the greatest health need are dealt with first, and face to face appointment time is used appropriately, with the most appropriate health care professional.

The practice team took action with the Patient Participation Group to change things, initially focusing on communication with patients via traditional methods, by social media, and then on changing the access from capacity based, to demand-based.  

In August 2018, West Quay Surgery launched online access to clinical advice for all appointment requests for GPs and Advanced Nurse Practitioners. Effectively, this put out most senior clinicians on the front line of triage, to ensure patients with the greatest health need were dealt with first. This was also to ensure existing face-to-face appointment time was used appropriately, and with the most appropriate health care professional. The team was expanded to include a pharmacist, plus more Advanced Nurse Practitioners and a minor illness nurse. 

Upskilling staff to improve patient services

This "Bright Idea" is several fold, none of which on their own are particularly revolutionary, but together became bigger than the sum of its parts. 

Here are some of the little things the practice implemented to improve patients services with a very different skill mix of staff:

  • Every member of staff was offered training to upskill them to the best of their ability. This led to all staff being able to perform each other’s duties, for example, all reception staff can use our CRP machine, apply ECG and BP machines. All staff have attended training programmes on signposting and triage. About half are now qualified dispensers. 
  • Two reception staff now work helping the manager with administrative tasks. This working ensures cross cover at times of sickness and leave. It improves staff morale and self-worth and encourages an aspirational work ethic.
  • All requests for an appointment with doctors are triaged to signpost patients to the most appropriate clinician, not necessarily the GP. 

The project is still in its early stages, and the next part of this will be to further alter the skill-mix of the primary healthcare team to closely align with the needs of the patient population. West Quay Medical Centre is a beacon practice for others within the Central Vale cluster who are watching progress closely. Dr Sue Goodfellow was recognised as a Bevan Exemplar for this Bright Idea and will continue to deliver this project this year. 

Bright Ideas Workshops

The College is organising workshops to share some of the Bright Ideas to help GPs try new approaches to improve the quality of care and adapt to the changing primary care landscape.

If you would like to attend the workshops, please complete the Bright Ideas Expression of Interest form and send it to: brightideas@rcgp.org.uk. 

We'd like to hear from you!

If you would like to be considered for the 2019 Awards, please contact us by emailing: brightideas@rcgp.org.uk. You can submit your own Bright Idea to be showcased on our website by completing this online form.  

 

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