Innovation Posters 807 – 813
807 The Housebound Project – Delivering holistic care to the elderly housebound population of a GP practice
Aims/Objectives: To provide a GP lead, multi-professional service for housebound patient’s within a practice population
Content:An acurate practice based housebound patient list was generated. One in-house GP ran this service for the practice Each housebound patient had a 1 hr GP consultation at home at least annually. Each patient was followed up with a minimum of 1 telephone consultations with the same GP approx. 4 weeks later. A proforma was created covering all aspects of the patients care including physical, social and emotional assessment. The GP worked closely with the wider multiprofessional team to improve social care, physical well being and reduce the risk of falls. Clinicians, carers champion and the reception team within the practice could refer patients to the GP.
Relevance/Impact This service provide the vulnerable housebound population with a holistic review at least annually which allowed careful care planning and aimed to provide overall better patient care and acute visits. Outcomes: A patient survey was collated on SurveyMonkey showing improved subjective patient care. An audit of practice acute home visits was done showing a reducing in overall visits for the same period.
Discussion: This is an exceptionally vulnerable population group which is difficult to manange in General Practice due to the large amount of time and resources needed to care for these patients. This service enabled many new diagnosis’ to be picked up and managed including breast cancer, dementia, depressions to name but a few. Socially isolated and vulnerable patient at high risk of falls were supported by the multiprofessional team and the GP. Relatives were also offered support and had regular contact with the lead GP.
808 Back to the Nature – a community based approach to improving mental health
Struggles with mental health are commonplace with 1 in 4 suffering with mental health problems annually. While many people don’t present to their GP, services remain overwhelmed. The Five Year Forward View urged us to engage the charity sector to improve patient health while Natural England promote the role of more nature-based interventions. We have embraced the opportunity to work alongside our local RSPB officer in a scheme called Natural Choices. Service users are recruited by posters, promotion by GPs, practice staff and through the referral hub.
The course of sessions involve a mix of walks, art and practical work with the goal of increasing confidence and developing an ongoing positive relationship with nature. While our project is in its infancy with limited feedback, schemes across Dorset have very positive reviews from patients, GPs and third sector partners The stresses on general practice are giving us a great opportunity to be more outward looking, forward thinking and to engage our local community.
809 Liverpool healthy lung programme (a proactive approach to finding undiagnosed early stage lung cancers)
Liverpool has one of the highest lung cancer mortality rates in England, particularly within lower socioeconomic groups, and double the national average of cases diagnosed. The Liverpool Healthy Lung Programme (LHLP) was devised to tackle this health inequality. LHLP, which began in February 2016, aims to increase knowledge in communities, promoting positive messages around lung health, thus recognising and tackling fear and fatalism surrounding lung cancer. It is doing this by a series of coordinated focused public engagement events throughout the city, starting in Wards with the highest incidence of lung cancer.
These events are then followed by patients between the ages of 58-70 who have COPD, or have smoked, being invited to a local face to face lung health check conducted by a lung nurse. Part of this assessment involves a calculation of their risk of developing lung cancer in the next 5 years (My Lung Risk Score). People who trigger a 5% threshold are invited to have a low dose thoracic CT.LHLP is planned to last 3 years.
Projections suggest 34,000 patients will be eligible to participate. LHLP aims for an ambitious 70% uptake, meaning 24,000 will have a face to face lung health check, with 25% of participants reaching the threshold for receiving a CT scan.In the first 11 weeks 696 patients have attended the lung health check, with 34% triggering the offer of a CT. Data for 2468 patients (Picton Ward) will be presented at the conference.LHLP is the collective working of the CCG,primary and secondary care, Liverpool Public Health, and the University of Liverpool. The programme has been adopted by the national ACE programme.
810 How Can We Meet the Needs of GP Trainees on Maternity Leave?
Relevance/Impact More than half of GP Trainees in our VTS are female and this is set to increase to 70% in the future. With recruitment and retention becoming a major problem in some areas of the UK, we need to nurture and support our trainees to build confidence, knowledge and resilience for the future as well as a stable workforce.
Introduction Maternity leave benefits are not standardised or guaranteed (above statutory) once trainees have qualified as GPs. It therefore follows that a significant proportion of female doctors take maternity leave during their GP training (some figures suggest 13-15%). Maternity leave is a time of great change; a significant period of time out of training plus new roles/responsibilities at home means this cohort of GP Trainees may have particular needs.
Aims/Objectives Identify the perceived needs of GP Trainees while on maternity leave. Consider ways in which these can be supported by GP Educators.
Methods & Methodology Seven trainees were interviewed (at different stages of maternity leave) to gain insight into their needs. This practitioner research used non-positivistic paradigms as a foundation to embrace the complexity of human thoughts, to prevent bias/skewing of data. The rich narrative data was analysed thematically.
Outcomes Trainees consistently expressed needs that were Educational/Professional Development/Pastoral. The logistics of any education opportunities were important (location & regularity of meetings, ability to bring their babies, appropriate facilities, voluntary attendace, etc).
Discussion/Plans Discuss the findings with the GP Education Team locally. Consider ways in which identified needs can be met. Start a programme of education opportunities locally to meet identified needs. Consider expanding these opportunities to qualified GPs in future.
811 Engaging with schools – raising the profile of General Practice
AIMS This work engaged year 12 school pupils, who are thinking of applying for medicine , in an interactive multi-station workshop raising the profile of General practice.
CONTENT Utilising Careers Wales contacts invites were sent to 18 schools within South Wales.The workshop was designed to have ten stations through which the participants would progress, spending 12 minutes at each station. The content of the stations was varied and ranged from hands on examinations and procedures to patient stories. Facilitators for the workshop were recruited from the South East Wales faculty and the local undergraduate department ( tutors and students), and all gave up time freely on a Saturday morning.
IMPACT The intended impact of this first ever workshop, entitled “GP – the Frontline of medicine”, was to make an early impression on these aspiring youngsters that General Practice is a good option as a career choice in terms of variety, flexibility and challenge. Impact on the students was assessed by use of a questionnaire administered at the start and the end of the workshop.
OUTCOME Questionnaires, completed by all 48 students, at the end of the morning, showed improvement in knowledge about what it means to be a GP. Positive free text feedback was also left, with suggestions for improvement largely pertaining to lengthening the time of the stations.
DISCUSSION It is possible to engage large groups of school pupils in a workshop promoting General practice as a good career choice. The planning, implementation and outcomes of the workshop will be compiled into a “How to do it “ guide that other faculties could use as a blueprint for their own school workshops.
812 What can we learn from the Supporting Federations Online Learning Network?
Aims/Objectives To describe the core components of RCGP’s Supporting Federations programme, delivered in partnership with the Nuffield Trust, and outline its offer to members and achievements in the first year of operation.
Content of presentation The poster will explore the impact of the programme to date. It will present statistics from the Online Learning Network, examining the growth of its membership, participation in webinars and the main areas of interest for users, including key findings from the most visited resources and lessons from learning events.
Relevance/Impact General practice working at scale is a topical issue for practitioners and policy makers. The RCGP and the Nuffield Trust are working hard to ensure that avenues of support are available to anyone with an interest in this way of working. It is important that the support available through the Supporting Federations programme is widely publicised.
Outcomes An evaluation of the programme undertaken at the end of the first year, which demonstrated the reach it has had and the offer it is able to make to GPs, the primary healthcare community and their local commissioners.
Discussion We are keen to hear from more colleagues working at scale about their experiences, find out about the gaps that still remain and increase the offer from the College and Nuffield Trust.
813 “Be a GP” recruitment and careers event for sixth form students interested in a career in medicine
Aims/Objectives To engage 6th form students interested in studying medicine at university and promote an interest in a career in general practice.
Content of Presentation Local sixth form students were invited to attend the two-hour long evening “Be a GP” recruitment event held after the GP specialist trainee day release course. Local surgeries were invited to offer work experience to students and workshops run on medical school applications and interviews. We offered a communication skills challenge using a novel approach “REACH” which allowed students to “have a go” using a consultation model on non-medical scenarios.
Relevance/Impact There is a real and serious GP workforce crisis with the shortfall being attributed to a reduction in medical graduates applying for GP training roles. The event was intended to promote a career in general practice in a fun and innovative way.
Outcomes 46 sixth form students attended the event in March 2016 and provided written feedback which was very positive. Many of the students suggested that they would consider GP as a career following the event and had not considered this previously. The REACH communication session received positive feedback and students felt that they had a far better understanding of what is involved in being a general practitioner.
Discussion The results of the feedback suggest that engaging 6th form students prior to attending medical school is an avenue that should be explored further with a view to reenergising perceptions of general practice and promoting it as a career.