Innovation Posters 821 – 827
821 Use of mobile phone application (HealthTouch) in conjunction with home BP monitoring is effective in contributing to a reduction of systolic blood pressure
Introduction Hypertension accounts for 12% of GP consultations costing approximately £2 Billion. A rise in systolic blood pressure (SBP) by 2mmHg increases risk of mortality due to IHD by 7%, and stroke by 10%. The use of mobile phone applications can increase compliance and empower patients whilst reducing unnecessary treatments, appointments, and complications. This pilot study aims to demonstrate the effectiveness of HealthTouch in reducing SBP.
Methods Patients with diagnosis of hypertension were consented then enrolled into a pilot cohort study. Data was collected over 3 months. Patients downloaded the HealthTouch app. Home monitor readings were entered into the app, removing the need for appointments and enabled the GP to analyse changes in BP. The GP set thresholds, which if exceeded, would result in notification. Changes in management and their subsequent effect could then be observed. Additionally, the app could be used to send notifications to monitor more.ResultsFourteen patients were enrolled.
The average SBP at the start was 135.3mmHg. At the end it was 133.6mmHg. Ten out of the fourteen patients SBP reading were between 140-160mmHg. The average start SBP was 146.8mmHg and at the finish was 140.1mmHg.
Conclusion This pilot study has shown that the use of HealthTouch with home monitoring and remote management by a GP can contribute to reducing SBP. Further research to confirm these findings, as well as the role in improving compliance and empowerment, is needed.
822 Preliminary results of a GP-led community outreach health initiative at a national Muslim lifestyle exhibition
We developed a community-based initiative to assess the health status amongst attendees of a national Muslim lifestyle exhibition in the UK and provide intervention to improve cardiovascular health and cancer screening. A literature review and previous pilot informed our questionnaire design which included demographics, health status, measurements of body mass index (BMI), waist circumference (WC), systolic and diastolic blood pressure (SBP, DBP) and participant feedback.
Participants attended our “Health Zone” opportunistically. 160 questionnaires were completed by 40 volunteers over two days. Here, we present a preliminary analysis of 50 respondents. The mean age was 42 years, 84% were women, 44% of South Asian origin and 40% were housewives. 10% had a history of heart disease, 4% of stroke/TIA, 12% diabetes and 14% hypercholesterolaemia. 10% and 4% met national recommendations for diet and exercise respectively, 40% reported that their health was fair or poor and 58% of eligible women received cervical cancer screening. Two-thirds had a BMI >25, 16% had an SBP >140mmHg, 18% had a DBP >90mmHg and 79% of women had a WC >80cm. For the intervention, 40% received verbal and written advice on weight reduction, 96% on exercise, 24% on nutrition, 24% on cancer screening and 14% were signposted to their GP for other health concerns.
Our preliminary results demonstrate unmet health needs in the UK’s Muslim population, especially women, around lifestyle, excess weight, hypertension, cancer screening and poor self-reported health, a strong predictor of premature mortality. Health professionals and policy makers should develop innovative ways to engage this population, such as culturally- sensitive community outreach programmes. We will complete the analysis of the full dataset and participant feedback to supplement our initial findings.
823 RCGP Bright Ideas programme
The RCGP’s Bright Ideas programme, run by the Clinical Innovation Research Centre, gives GPs a platform to share innovation and good practice to their colleagues throughout the UK. Historically, practitioners lacked the resources to distribute methods of better working to a large audience who might benefit from the shared knowledge. Bright Ideas provides a peer-reviewed forum for sharing innovation to the RCGP membership, especially useful for trainee and First5 GPs.
Formed in September 2015, the Bright Ideas programme invites GPs to submit their innovation to the programme for further promotion. Once successfully submitted, the Bright Idea is published, and then promoted, with selected articles featured in social media and a quarterly printed media reaching 50,000 readership. The ability to rate and comment on each Bright Idea demonstrates engagement, and allows interested parties to comment about applying ideas to their own practice, and suggest amendments to ideas.Bright Ideas has proved popular. 14 CCGs contacted the College regarding one Bright Idea’s promotion of exercise, with the associated patient resource website seeing a 30% user rate increase following publication. Other similar schemes, such as the NHS’ Academy of Fab Stuff, also promote each Bright Idea, thus furthering reach.
Bright Ideas has provided a tool for GPs to demonstrate their commitment to continuing innovation. The impact provided by the adoption of schemes has not only saved time and money across healthcare, but has also reduced waste, provided a CPD opportunity, influenced methodologies, and as a result energised primary care as a whole.
824 Workplace Mental Health First Aid Training can significantly reduce the workload on Primary care services
Aim: Public awareness and reduced stigma around mental health allows patients to present earlier to their GP with mental health symptoms. This increased burden of mental health assessment often for short lived incidents, impacts on primary healthcare service delivery. The study sets out to investigate if teaching mental health first aid within a community allows for earlier intervention to those in need of further care and treatment and appropriate signposting of those who are not in need of professional help.
Method: Selected members across a Battalion of 600 soldiers were selected to attend a two and half day mental health first aid course (MHFA). Mental health presentation to and referral from the Battalion medical centre were compared 6 month before and after the first aid course to assess the impact of the first aiders within the military community.
Results: The training was well received by participants in feedback taken immediately post course and four months after attendance. On average participants stated they had used their skills to make a positive change with colleagues 2.3 times over the four month period following the course. This was reflected in presentation rates to the medical centre as well as referral rates onward to Defence Community Mental health centre.
Discussion: Resilience of future General Practice relies on innovative measures to improve general health of the community and reduced primary care burden. This pilot study demonstrates that an educational intervention can result in better health and reduced mental health burden within a community setting. This study was done within an small and relatively closed community. The impact of the MHFA course within the wider community must now be assessed.
825 Warmer homes, healthier patients
Aims/Objectives: Our pilot aims to identify vulnerable patients at risk of fuel poverty, seen in a Primary Care/Community setting, and refer them directly to a local innovative ‘single point of contact’ hub for cold home support, using a simple online referral pathway. Determine whether national roll out of the referral template is warranted, given the results of the pilot.
Content: The project is ongoing. The poster covers the approach, learning outcomes, challenges and successes so far, including: The development of the referral template The engagement of local practices The drive for referrals The outcome of referrals made Impact: Tackling fuel poverty reduces preventable excess winter deaths, improves health and wellbeing, resulting in reductions in demand for primary care appointments, and hospital admissions, as shown by other similar initiatives.The simple referral process offers targeted help to vulnerable patients at risk of fuel poverty, with minimal additional Primary Care workload.
Outcomes: External evaluation of the model will use anonymised data from participants, and organisation databases, online surveys and qualitative interviews.To evaluate the viability of national roll-out, we will assess: the efficacy of the patient screening tool? is the referral mechanism viable/valuable for primary care to deliver, and does it provide an effective referral source for the advice hub? what is the participant experience? what patient outcomes are delivered? what is the cost locally, and when scaled nationally?
Discussion: Through collaboration with the advice hub, local CCG and Council, we are ensuring a system-wide, integrated approach to reducing fuel poverty and excess winter deaths across a locality.
826 Can the NHS afford to manage without GP Clinical Evidence Fellows?
Aim To support and promote translational research in primary care.
Content The poster will report on a project which is a collaboration between the LETB and the Academic Health Sciences Network (AHSN), and the strategy has been to appoint GP Fellows to work one or two sessions per week with CCGs to foster a culture of evidence informed commissioning, and to identify and lead educational initiatives for the GPs in each CCG area.
This project brings advantages to: Health Education England – providing a tangible way of engaging with the commissioning/educational agenda of CCGs, and improving capacity for multi-professional CPD for GPs, nurses, ECPs, pharmacists and others; AHSNs – for whom the use of best evidence and spread of good practice is a core function; CCGs – providing ready access to research evidence that has been interpreted and evaluated by GPs who have experience of what is likely to work in practice; their GPs should also adopt more evidence-based practice; Fellows – who receive training in research evaluation, and acquire educational and leadership skills.
Relevance This project is designed to address these problems: CCGs not always accessing research evidence in a way that influences their commissioning decisions, and CCGs struggling to disseminate information about commissioned clinical pathways to clinicians in ways that are effective in changing the behaviour of clinicians. Outcomes The poster will report on the progress and products of the fellowships, with examples of both projects in progress and those completed.
Discussion It evaluate the effectiveness and feasibility of the project as a model that could be replicated elsewhere.
827 Clinical Advisers Programme: An opportunity for GPs to shape the future of general practice
Vaesa Blasco Bergelino
The RCGP’s Clinical Advisers Programme, run by the Clinical Innovation and ResearchCentre, provides GPs the opportunity to raise their voice for general practice. Launched in 2011 to address the need to represent primary care in national guidelines and projects, the programme allows GPs to provide their point of view about the practicability and feasibility of the guidelines and projects in primary care.
The clinical areas covered by the programme were increased to align with NICE priorities in June 2015, and since then 150 GPs with an extremely diverse profile have volunteered and been registered with the objective of shaping the future for general practice. Since the beginning of 2016, there has been an increment of 39% GP registrations. Moreover, the rate of response from Clinical Advisers has been increased by 48%.
The Clinical Advisers have contributed to over 200 requests, of which 73% came from NICE. It is important to highlight that 30 NICE Quality Standards have been endorsed as a result of the Programme’s involvement in just one year. The ability to review and comment on guidelines and projects demonstrates engagement and allows organisations to produce much higher quality documents. For instance, NICE Asthma guidance has been delayed due to comments following Clinical Adviser consultation in March 2015. The Clinical Advisers Programme has recognised the importance of the GP’s generalist knowledge to ensure guidelines are fit for purpose for primary care. As a result, current guidance is now shaped by GPs to provide appropriate tools for general practice.