Note: Some sections of this case study refer to clinical commissioning groups (CCGs). On 1st July 2022, integrated care systems (ICSs) took over statutory commissioning responsibilities in England, and CCGs were closed down. You can learn more about integrated care systems (ICSs) here.
Case study summary
A video was produced of dialogue between two junior doctors (hospital and GP trainee), using the structural framework of the NHS Standard Contract 2017-19. The video shows the junior doctors exploring solutions for common clinical scenarios based on their own experience, to enhance the patient journey and improve the primary and secondary care interface.
It is intended that the video should be used as a starting point for discussions about how to deal with specific situations and issues that arise, in a spirit of collaboration.
An investigation was carried out by the local hospital and CCG, looking at specific cases or causes for concern. A recurrent theme was identified, namely, a lack of awareness amongst junior doctors of the implications of work generated in secondary care and the direct impact on primary care workload and patient care. Current medical training allows all GP trainees to attend hospital as part of their training rotation, but not all hospital speciality trainees spend time in general practice. The induction for junior doctors on joining a new setting covered common procedures but, as an extremely busy programme, did not cover working as one system across different care providers, for the benefit of the patient.
To build a culture of collaborative working as a team of professionals across different organisations, which breaks down barriers and delivers joined-up care for maximum benefit to the patient.
- Building a case for raising junior doctor awareness, by logging and analysing specific causes for concern
- Engagement and good working relationships with the LMC, CCG and hospital medical director
- £1,000 membership experience funding from RCGP
- Shared across the 6 CCGs in the Nottinghamshire ICS
- Won RCGP award for vibrant faculty innovation
- Two local acute trusts will be using it during induction or signposting junior doctors to it
- Included in BMA GP Trainee June 2018 newsletter
- Showcased on Nottinghamshire LMC AGM and Vale of Trent VTS leavers event
We would like to see the video included in junior doctor and nurse specialist induction nationwide, or for other areas to develop their own videos. The video can be tailored to the requirements of the hospital/directorate and can be used as a starting point for discussion on how to deal with specific situations. The intention is to produce two more videos, one between a hospital consultant and experienced GP and another between medical director and clinical chair of CCG. There is the potential to develop a video with patients, using the guidance leaflet what to expect when your GP refers you to the hospital.
Improving the interface between primary and secondary care by the RCGP Vale of Trent
This video aims to improve the primary care and secondary care interface, ensure high quality patient care
Dr Sonali Kinra, GP and Vice Chair Vale of Trent faculty of the RCGP