Thistlemoor Medical Centre case study

Organisation

Thistlemoor Medical Centre (Thistlemoor) provides general medical services (GMS) to the residents of Greater Peterborough. Thistlemoor looks after nearly 30,000 patients from diverse backgrounds. 80% of consultations need the help of language facilitation from trained staff. The main staff and population groups are from Eastern European and Asian backgrounds.

What was the aim/problem?

As part of its effort to help reduce the transmission of coronavirus (COVID-19) it in its community, the practice needed to change the way it worked.

Thistlemoor’s model of care is to provide open access to registered patients five days a week, with up to 400 patients during morning surgeries, across three receptions and seven waiting rooms.

Early information on the effects of coronavirus were key to the need for change as it became evident that people from a black, Asian and minority ethnic (BAME) background were more likely to be affected. While colleagues with long-term conditions, in certain age groups and those who were pregnant were able to work from home or be deployed to green zones with no patient contact, the large number of BAME staff (70% of doctors 80% of nurses) meant remote working was not always feasible for these groups.

The aim was to change the service to one that met the needs of patients and also ensured that staff were protected by reducing foot fall to the practice.

What was the solution?

Thistlemoor’s clinical and management team conducted a daily review against Royal College of General Practitioners (RCGP) and British Medical Association (BMA) guidance, with support from Cambridgeshire Local Medical Committee (LMC).

The walk-in service trialed a triage for COVID-19 symptoms and acute febrile illness or cough, with temperature monitoring at the front door. Patients were separated into red and amber zones depending on their presenting symptoms.

After four days, staff feedback suggested patients were not disclosing their symptoms correctly – which was a risk to colleagues at a time when personal protective equipment (PPE) was in short supply. The difficult decision was made to close the walk in service.

As an alternative, the practice invested in a new telephone system and web-based communication allowing safe contact with patients.

The changes were communicated through social media and SMS in community languages with signposting on the practice website.

Urgent medical needs like smear tests and childhood immunisations continued, while other procedures were carried out by alternative methods.

Thistlemoor continues to seek feedback from members of staff on further ways to keep staff and the local community safe.

Results

The practice has continued to provide a general medical service to its patients through COVID-19, with highly positive feedback from both colleagues and staff.

Nursing lead Ajmal Raza said: “The feedback from staff is that they have felt well protected at work during COVID-19. We have focused on their safety by providing PPE and have been responsive to their concerns. We have issued consistent and clear guidance to promote their safety.”
Paulina Janczura, Practice Manager, said: “Although we had to rapidly adopt new ways of delivering care, our patients have been amazing at using them, which has allowed the practice to protect our staff and at the same time to continue to care for our patients. We are incredibly proud of the impact our practice is having and that we are able to make a positive difference supporting our patients at this difficult time.”
Dr Neil Modha, GP, said: “We knew what changes we needed to make and realised that involving staff and listening to their feedback was key to successful delivery of these changes. Our staff were understandably worried about coronavirus and listening to their feedback and building this into our practice’s response has been a beautiful example of partnership working. At Thistlemoor we continue to challenge ourselves on meeting our populations needs whilst protecting our staff.”

Want to know more?

Please contact the practice manager: paulina.janczura@nhs.net or Dr Neil Modha: neil.modha1@nhs.net