I've been wondering for a while about the real potential within primary care for person-centred care and self-management support, and various conversations recently, not to mention tweets in response to May's comments, have finally made me finish off this blog and press publish...
One of the arguments I hear about federated GP surgeries is about the economies of scale. I get that in terms of procurements, and have heard many examples of the benefits of economies of scale meaning they can bring in specialists such as in house physio’s and diagnostic equipment etc. I also think economies of scale in primary care mean there are great opportunities for person-centred and community centred approaches in federated GP surgeries. Think what a large Trust can do - patient experience team, engagement teams, information teams, support workers.... If large services in NHS Trusts (community/pathway specific) can do it, a la David Gilburt model of patient director in Sussex, so can primary care in the federated models. Let me share my optimistic vision for person-centred federated GP practices, facilitated by a specific job role... I know no-one in primary care has any time for this 'nice to have' stuff, but it is important, so lets gets someone to really focus on it. I'm not asking GPs to do this - god knows they have enough to do already.
The reception and waiting areas: as part of some work I did with People First Dorset on behalf of NHS England, we found that patients have to process over 40 pieces of information, and much of the information is out of date, inaccessible and not used. Rethinking the presentation of information, through themed information boards, ensuring key information is easily accessible can make a big different here.
Being part of the team for those unavoidable 'inappropriate' appointments: I've had a few people who have rung me as a self-management coach saying they weren't sure to call me or the GP, but needed a specific bit of information. They rang me first, and I was able to give them the information (simple signposting). If dedicated non-clinical support workers are seen by patients as an equal member of the team (and importantly, easily accessibly like that), receptionists and GPs can easily triage patients to see the non-clinical worker (with rapid access to GP following to manage risk perhaps).