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We are the champions – when engagement is more than a tick in the box
30 August 2017
Patient engagement has moved from being a tick box exercise based on surveys to playing a key role in addressing the pressures on primary care at one Gateshead practice.
The Oxford Terrace and Rawling Medical Group in Central Gateshead has won awards for its comprehensive approach. It stretches from care navigators through to extensive use of signposting and social prescribing and a key role for volunteer “practice champions” whose scope goes well beyond chatting to patients in the waiting area.
The practice has also seen significant results from an engagement programme that empowers young people with type one diabetes while reducing their emergency department attendance and hospital admissions.
The practice manager, Sheinaz Stansfield, says: “You have to reach out to patients – think differently to do things differently.”
She urges practices to seek funding available from CCGs to develop new roles and approaches to working with patients. She says they should also build relationships with the third sector, both because it offers services that can alleviate the pressure on general practice and because they can help train practice staff in listening, communication and signposting skills.
“People do want to work with us to make things better,” she said.
A recruitment exercise for practice champions resulted in a diverse group of 19 people. This included nine people with mental health problems – most of whom regularly booked GP appointments.
The champions now run a neighbouring third sector “clubhouse” which provides activities such as cooking classes for people with diabetes and a “knit and natter” group.
“[The people with mental health problems] support each other and because of that – plus the fact they are so busy running the centre – they have far fewer GP appointments,” Stansfield says.
The original network of 19 practice champions has grown to 39 – with the training of the second wave funded by a £2,000 prize the scheme won.
Stansfield emphasises they play a much greater role than that of the volunteers of old – too many of whom were used just to teach patients how to use a touch arrival screen or to help them roll up a sleeve for a flu jab.
“We’re creating a social movement. They are ambassadors for the practice and they advocate for the under-represented. They lead patient engagement activities such as sitting in the waiting room gathering soft intelligence – which is so important when redesigning services.
“Instead of having a flu clinic we had a flu fair to encourage supported self-help. They organised a tea dance to launch our long term conditions strategy and 250 people turned up. The practice is now becoming a hub for the community as other services break down. But it’s happening in a way that means people don’t always need to see the GP: they have alternative choices to the ten minute GP appointment – we’re changing that dynamic.”
Stansfield also highlighted how several teenagers are now running Saturday morning clubs for young people with type one diabetes. These events build on a self-help group launched in 2014 that promotes self-management and self-care. It was initially aimed at addressing a pattern which saw high levels of missed appointments in this client group; resulting in over-representation at the emergency department and unplanned admissions.
Stansfield and her colleagues found that transition services across Newcastle, Durham and Gateshead offered no support for self-help. Young people wanted to continue in the care of the clinicians who had worked with them as children.
However, the engagement with this group also highlighted the need for:
- More informative leaflets and reading material outside clinics – including clearer information about alcohol and sexual health
- Better diabetes education for secondary school and college teachers – including what to do in an emergency
- Better use of technology – with greater access to insulin pumps and continuous glucose monitoring
- Texting with nurses
- Supported self-help though peer mentoring and social activities resulting in self-help education.
The interaction with the young people led to a successful bid for £42,000 which has funded the creation of self-help groups in Durham and Newcastle – as well as Gateshead.
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