Energising Primary Care Posters 600 – 606
600 Developing a 7-day Service and Improving GP Quality of Life
Delivering routine Primary Care 7 days per week during the day and evenings is a challenge for the NHS. In 2015 our CCG challenged our practices to deliver this service. We joined forces, forming a federation of 4 practices and have successfully delivered this service through the development of an Extended Access Hub.We have seen an increase in both patient and staff satisfaction and a reduction in demand at the beginning of the week.
Our model has allowed practices to choose whether they want to deliver some of the service themselves or have the Hub deliver the service on their behalf. Working in the Hub has been by choice with no staff being compelled deliver Extended Access service.We have seen a reduction in out-of-hours GP and A&E usage with patients being able to access routine Primary Care Services instead.We will tell our story how this service was initiated, developed and successfully delivered with the benefits it can provide to Primary Care.
602 #MumTalk – GP led Twitter Q&A session: Perinatal Mental Health
The negative impact of maternal mental health problems is particularly significant in the perinatal period (from conception until 1 year postnatal). Research shows that perinatal mental health problems are underreported and under-diagnosed (20% women affected but only half of these detected). As well, only 50% cases are appropriately treated and the consequences of this are far reaching for the woman affected, her partner and their child.
On 25th February, Sport Relief launched a campaign to raise awareness of perinatal mental health problems on various media outlets including Twitter with the hashtag #MumTalk trending most of the day. In conjunction with the RCGP twitter account, Dr Ladd and Dr De Giorgio co-hosted a live Q&A session open to all. Discussions included some important issues in this area such as how GPs can better detect symptoms of perinatal mental health illness and advice on the cautious use of some antidepressant medications in pregnancy and breastfeeding.
The RCGP Twitter account was 3 times as busy as usual and there were hundreds of tweets, retweets and mentions related to the Q&A #MumTalk session. Within a week of the event, the conversation has had 263 views on Storify.com and informal feedback has been universally positive with a clear appetite for more of this type of work. This unique project took advantage of social media to create a neutral forum for communication between members of the public, other health professionals, and GP colleagues to discuss, share and learn from each other’s expertise and experience.
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603 RCGP Clinical Fellows – what could you do with this role?
In the current climate, perceptions of a lifelong career in general practice may be less attractive than previous years so it is essential that those who are working as GPs in more unusual or specialist roles make junior colleagues aware of these possible career routes within general practice to promote #TeamGP. CIRC is a part of the RCGP that many GPs are unfamiliar with and in particular, these Clinical Support Fellow opportunities which are available in the Clinical Priorities for all First 5 GPs. There are currently 8 priorities and 9 Clinical Support Fellows although some of these are due to finish their post at the end of March 2016.
These posts are largely unfunded but they may lead to paid work within that speciality such as commissioned journal articles or teaching workshops but more importantly they allow younger first 5 GPs to develop useful non clinical skills that they may have not had the chance to work on since leaving medical school. Fine tuning communication skills both writing, presenting and teaching are useful for all GPs but in particular for those who want to follow a further route into education or training. In addition, Clinical Support Fellows gain an understanding more of how the RCGP works, the role it plays in lobbying government and policymakers, as well as liaising with other professions and third sector organisations – all of this gives a broader context of where general practice fit into our society which then strengthens day to day clinical practice.
604 Could a salaried service deliver more sustainable conditions for a future GP workforce?
Aims/Objectives Against a background of rising numbers of GPs employed on non-partner contracts, this paper explores differences reported by GP partners and salaried GPs in levels of job satisfaction, job stress and intentions to quit.Content of PresentationA series of surveys exploring GPs’ experiences of their working lives (2010, 2012 & 2015) has tracked levels of job satisfaction, job stress and intentions to quit general practice for doctors working in a range of roles and types of practice.
Relevance/ImpactIn recent years the balance has shifted from a predominantly GP partner model towards more diverse patterns of GP employment. There is increasing concern that GP recruitment and retention levels are insufficient to deliver current and intended levels of medical care in the primary care workforce. This survey explores the factors driving dissatisfaction, providing vital evidence to underpin ongoing efforts to improve the sustainability of general practice.
Outcomes Analysis is ongoing but early work indicates an emerging gap in levels of job satisfaction, job-related stress and intentions to leave practice as reported by GP partners and salaried GPs. Furthermore, there has been a shift since 2012, with GP partners’ satisfaction declining more than that of their salaried colleagues. Aspects of work which enhance or diminish work experience can be mapped for both groups.
Discussion Building a workforce characterised by resilience and career longevity is vital for efficient, effective and high quality NHS primary care. This paper will consider how conditions associated with different contract types may influence GP workforce stability.
605 Energising GPs through a medical book group and its potential for teaching medical professionalism and ethics
Poster aims to explore the benefits of a medical book club for general practitioners and explore its potential to teach medical professionalism and ethics to medical students and GP registrars. Established medical book club of approximately 6-8 GPs & medical educators meets every 6-8 weeks to discuss books with a medical and GP connection. Discussions are energising and explore ethical dimensions of general practice as well as personal opinions on book and how it has affected us personally and influenced our practice and views of our patients.
A medical thriller like Fatal Impact by Kathryn Fox includes an account of an ageing country GP who uses a dose of amoxicillin to diagnose glandular fever for instance which raises ethical issues. Group has started doing book reviews to inform debriefs with registrars and encourage them to read and reflect on their practice. Dirty Work by Gabriel Weston looks at topic of abortions and is useful to discuss registrar’s personal views. Mendel’s Dwarf by Simon Mawer is a good way to discuss genetics with registrars – an area registrars struggle to cover in their portfolios’.Medical professionalism can be explored by close reading of books or extracts.
Asking meaningful questions, understanding life stories and cultivating emotional resonance all help develop ethical dimensions of general practice. Considering multiple perspectives in Stuart a life backwards by Alexander Masters explores homelessness and his admirable qualities in a life of abuse, violence and drug addiction. Encouraging reflection and critical thinking is fundamental in developing professionalism.
606 Energising primary care using inter professional education
New training hub aimed to energised local education through an initiative to train local educators in IPE. Local medical and nursing university academics have put on a series of 6 workshops in IPE. 58 participants have attended – including 30 GPs, 7 nurses and 21 – academics, managers, pharmacists, or social workers. Practices have been encouraged to engage all their staff and attached professionals in educational meetings where we learn together. Positive feedback at the time has been followed up by 2 pilots using IPE with medical and pharmacy students.
The first pilot involving 24 students was around Polypharmacy. A medical and pharmacy student interviewed a patient at home. They discussed issues together and made recommendations in a group facilitated by a GP & pharmacist. Recommendations were taken back to the patient’s usual doctor who authorised implementation of changes by students who then fed back to patient’s, community pharmacists and practices.
Substance misuse IPE pilot involved a medical and pharmacy student interviewing 2 patient’s with substance misuse issues and presented their findings to a MDT meeting. Students’ awareness and knowledge around substance misuse were assessed pre & post the session using an attitudinal questionnaire. Participants found the experience energising and enlightening.
This project is being formally assessed and will be published separately but initial interviews with primary care team have been encouraging. Learning about different professional perspectives helps students appreciate different aspects of patient care and differing approaches. We plan to embed IPE into our normal student primary care placements long term.