Thistlemoor Medical Centre serves more than 27,000 patients and around four fifths of its consultations usually take place in languages other than English – mainly Eastern European languages and also Urdu and Gujarati.

The centre’s team of nurses and healthcare assistants come from a similar range of backgrounds to their patients, which means they are able to help each other with the language barrier.

Before the COVID-19 response began, 80 per cent of consultations were delivered through a walk-in service, so the team has had to come up with a new way to offer the same level of service accessibility that the diverse team delivered previously.

Investing in new tech

Dr Neil Modha, one of the practice GPs, says that investing in communications technology has made a real difference to how the practice staff can care for patients when face-to-face contact is necessarily limited.

“We invested in EngageConsult, an online ‘front door’ which allows patients to get in touch with their requests so we can look at the best way to support them – an electronic prescription, a phone call, video consultation, or pre-booked treatment appointment. This went live on 20 March and more than 2,000 contacts a month are now being made through the system.

“In mid-April we launched a new phone system with Convergence communications, facilitating many more lines out to communicate with patients. Our healthcare assistants and nurses call patients to gather information, which is then passed on to the doctors to help decide the care plan. The team then communicates back to the patients in their own language. We can also conference-call patients with staff supporting communication between the patient and doctor.”

The practice also uses Accurx software for video consultations and to send medical certificates and letters electronically.

Support for patients with long term conditions

The practice has been using the new systems to reach out to patients with long term conditions, for example carrying out asthma checks and diabetes reviews. The staff also support more self-care, with the most severe COPD patients encouraged to get pulse oximeters and patients with severe asthma provided with peak flow meters so that they can keep track of their condition. This support means some of the most vulnerable patients are being safely managed at home.

Boosting patient communications

Because patients were accustomed to turning up without an appointment, the practice has been communicating the new arrangements through as many channels as possible including a Facebook page, Twitter posts and videos in English and a number of different languages including Polish, Lithuanian, Russian and Romanian.

The practice has also batch-messaged patients, in English and their first languages, to let them know about the changes and signpost them to the website for updates (link to www.thistlemoor.co.uk). As a result, daily hits on the website have risen from around 50 before the pandemic to 150-200, and reached approximately 2,000 hits on the days following bulk messages to patients around service changes.

Positive feedback from patients and staff

When the lockdown began in March, the number of patient contacts with the practice initially fell but by mid-April had risen again to normal levels, and the total number of appointments in the week beginning 13 April was higher than the same week a year ago (1,792 compared to 1,409).

Calls to 111 from practice patients have increased during lockdown from an average of eight a day to 10. However, the rates of A&E and walk-in centre attendance are lower, which Dr Modha feels may reflect a more responsible use of the NHS, with people calling on primary care rather than the urgent care options where appropriate.

The practice has had positive feedback from many patients, particularly in relation to the ease of access, response time and satisfaction with the treatment received. Comments have included: “I have many chronic conditions and being able to email in my blood pressure readings and have my medications reviewed has made life a lot easier” and “It is reassuring to know that I am able to contact my doctor in many different ways and that they will respond”.

Looking to the future

Dr Modha added: “We believe our response to the coronavirus has revolutionised the way we manage the needs of our patients, particularly with routine medication reviews, skin conditions, and chronic diseases.

“We’re going to be supporting more self-care in the future by upskilling the team in health coaching for patients. This will enable our team to offer more support to patients with making lifestyle changes and addressing areas such as work-life balance, stress and wider determinants of health and wellbeing such as housing.

“With our diverse team using modern communication methods we can not only rise to challenges like the pandemic, but we can support people’s health and wellbeing as we move forwards.”