Energising Primary Care Posters 615 – 621
615 Facilitating a coordinated approach to work experience in primary care for potential medical school applicants
Aim – to facilitate a coordinated approach to offering work experience to prospective medical students in the North East and north Cumbria Promoting general practice from the start of a prospective doctors training will hopefully encourage more to consider a career in primary care. Prospective medical students are encouraged to explore what a career in medicine involves and to reflect on their experiences prior to applying to medical school. For many this can be challenging to arrange and those with medical contacts can be at a potential advantage.
A survey of general practices in the North East and north Cumbria revealed that a significant number were offering work experience when approached, but they had issues with the time taken to deliver this, and concerns about confidentiality for prospectives students from their locality.
Medical defence bodies share concerns about confidentiality and recommend general practices offer work experience to people who are unlikely to have contacts with patients in the practice.A list was produced of practices willing to be contacted and this was placed on HEE[NE] website – along with a Google map.
A list of potential activities to offer as work experience was also produced. Guidance on the length of an attachment was also provided. A copy of the link was sent to all schools with a 6th form along with the offer of a visit from GP trainees.To date two careers talks have been delivered and many hits have been made to the website.
617 Building GP networks to deliver better clinical care
Relevance/Impact: This study was conducted in a multi-ethnic borough that serves a socio-economically deprived population. In 2009, eight geographic practice networks were introduced (involving 36 GP practices) to deliver improvements in clinical care. Financial investment incentivised network-wide achievement and encouraged co-operative work across practices. Quantitative evaluation has shown improvement in clinical outcomes.
Aims: This project sought to provide insight into change processes during network development and implementation; it considered both clinical and managerial perspectives.
Content/Methods: Semi-structured interviews were conducted with 19 key informants including doctors, nurses and managers. The topic guide was informed by existing literature on integrated care and GP federations. Interviews were recorded and transcribed; thematic analysis was applied to identify and analyse emerging themes covering the aims, implementation and evolution of the networks.
Outcomes: There was a shared sense of purpose as well as agreement that networks succeeded in improving clinical care and reduced inter-practice performance variation. Increased investment into primary care was also recognised. Network implementation was facilitated by the balance struck between ‘given structure’ and the autonomy to seek local solutions.
The pivotal role of ‘data driven quality improvement’ helped practices improve service delivery.The navigation of differences in practice culture, reluctance to share data and increased workload were major concerns. These were overshadowed by perceived benefits of sharing staff, resource, and ideas. Discussion: The successful introduction of GP networks in this context provides lessons for other areas. Aspects of the implementation are discussed with reference to theories of change management.
618 Improving patient access to core primary care services and enhancing the overall patient experience
Aims and objectives: To design a more efficient and accessible appointment system; to meet the needs and wants of our practice population, with appropriate capacity within a changing practice team. Data about capacity and demand collected and analysed by the Primary Care Foundation. Consultation with our Patient Participation Group to identify patients’ needs and wants. Information from both sources synthesised to allow development of a new appointment system for better core service delivery.
Content: Data collected showed inefficiencies in working patterns, exacerbating access difficulties. Consultation identified high priority areas for our patients. Comparisons allowed proposals for a different appointment system and a process of change within the practice allowed a redesign and launch in January 2015. Data assessing impact on capacity and demand and patient satisfaction measures were collected over 12months of the new system. Interpretation of that data suggests improved efficiencies and higher patient satisfaction rates with their overall experience.
Relevance/Impact: Evidence-based radical system redesign provides a platform for further developments; allowing working within a broader primary care team, managing more complex patient needs within primary care, reducing demand on secondary care and improving patient satisfaction.
Outcomes: The main outcome measures were assessing adequate capacity and flexibility for varying demands; the efficiency with which the system worked and a review of patient satisfaction. All areas assessed had improved in the new system. Discussion:We have developed an innovative and flexible system that meets our aims. It provides us with a platform to develop further efficiencies and flexible working.
619 Working collaboratively – Innovative and integrative care pathway for patients with Medically Unexplained Symptoms
Patients with MUS (also called somatisation disorder or “functional symptom/distress disorder”) have significant unmet health needs and are often difficult to engage in holistic care. Consequently treatment is often ineffective despite frequent presentation at primary and secondary care services, resulting in high cost pressures to the health economy.
The contested legitimacy of such symptoms frequently leads to problems between doctors and patients, resulting in patients complaining about their frustration with services and professionals feeling disempowered and exhausted; therefore new ways of collaborative care are required, energising primary care pathways.We are going to present findings from a pilot study in East London, that introduced a novel “one-stop-shop” service in GP surgeries including Identification, Assessment, Engagement and innovative Group Interventions (Psychoeducation, Mindfulness Stress Reduction and Body Oriented Strategies for Better Living Groups).
All interventions were entirely focused towards fostering a collaborarive working model and help patients to improve their overall coping and to foster wellbeing, without challenging and patient’s health beliefs and or explicitly working psychologically.
The outcome analysis demonstrates that patients who participated in the project gained significant improvements in symptom levels and this resulted in corresponding significant reduction in health care utilisation (GP contacts / consultations and referrals to specialist services). Vice versa, GPs gathered new insights into this health condition and experienced the service as “revitalising”. Patients who participated in the intervention had additional health benefits in terms of a more inclusive understanding of and new insights into their health condition and improved self-management control and coping skills.
620 To SWOT or not? Using a Strengths, Weaknesses, Opportunities and Threats (SWOT) Analysis in an educational setting to its use for personal development
Aims Delegates will be able to develop their understanding of a Strengths, Weaknesses, Opportunities and Threats (SWOT) Analysis through the example of its use at a university undergraduate primary care module setting and be able to translate this to using it to assess areas for personal/practice developmentContentIt can be a challenge to identify areas for improvement.
A SWOT Analysis can be a practical way of identifying areas where development may be needed. The presentation will cover an example of engaging with a SWOT Analysis at an undergraduate university level to identify areas for development within a primary care module and how the lessons learnt translated into engaging with a process of change. Delegates will be able to consider how a SWOT Analysis can be used for their own personal/ practice development.
Relevance SWOT Analysis can be implemented across a range of areas including personal, practice and organisational development. Delegates with an interest in engaging with change will find particular benefit with the practical skills taught on using a SWOT Analysis
Outcomes From the material and the example of a SWOT Analysis delegates will be able to engage with their own SWOT analysis for personal development or be empowered to engage with a practice-wide SWOT Analysis to identify areas of development.
Discussion Delegates will be able explore how SWOT Analysis has been used to implement change at a University level and how the SWOT Analysis tool can be applied at an individual level for continual professional development.
621 Together for Health; a CCG wide approach to patient engagement
Together for Health is a CCG wide programme based on the principles of prevention, self-care, self-management and shared decision making. It aims to meet the challenge of patient centred care outlined in the NHS Five Year Forward View. Together for Health is working with patients, clinicians, commissioners and the voluntary sector to develop an integrated health service which responds to the demands of healthcare in the 21st century.
As part of the Together for Health programme asset based community development projects have been successfully piloted and are being spread to involve more areas of the community. The ‘Health Help Now’ app is being introduced to help patients self-care and have knowledge to access the most appropriate service 24 hours a day. Group consultations are being piloted across six general practices to support patients with long term conditions feel confident to self-manage. Work is ongoing to develop a package which will allow general practices to work with their patients to integrate shared decision making into their practice culture.
Together for Health is also developing shared learning opportunities for primary and secondary care staff with commissioners and patients to facilitate collaborative working in a specific disease area and promote use of brief interventions for behaviour change. As a CCG wide strategy Together for Health offers a unique opportunity for joined up working and to embed patient centred care in the health economy. Working also with public health and local council provides a consistent message of empowerment for health to the whole community.