Case study summary
Ryalls Park Medical Centre radically changed the way that patients interact and receive care from their practice. With a shortage of GP appointments, Ryalls discovered that GPs were seeing a lot of patients who either could have been helped by another professional or were unclear in their own minds why they needed to see a GP.
Ryalls Park Medical Centre is a medium sized general practice. Staff decided as a whole team to radically change the way that patients interact and receive care from their practice.
The Practice worked with all team members and patients to define the problem which ultimately culminated in a shortage of GP appointments, however they discovered that GPs were seeing a lot of patients who either could have been helped by another professional or were unclear in their own minds why they needed to see a GP.
- Enable patients to see the right person in the right place at the right time.
- Ensure that the GPs have more time to see patients only they can help.
- When patients are seen, the professional has the right information available to them.
- Patients have the opportunity to reflect what they want to discuss with the professional.
- Patients are proactively supported to create their own plan to support their health and wellbeing.
Redesigning the systems and processes across the practice involved the whole team. A patient centred approach was adopted to the redesign, keeping the patient journey at the heart of the process.
Old system: The patient telephoned surgery and was booked a face to face appointment with a GP.
New system: The patient telephones the surgery, receives a message explaining the new system and then speaks with a receptionist who asks them:
- How the doctor can help them today
- How long have they had symptoms
- What steps have been taken before phoning the surgery
- Whether anyone else has asked them to call
- What has prompted the call today
The patient and receptionist can then discuss the patients’ needs and then the patient can choose the option they feel most appropriate. The choices now include the pharmacist, practice nurse, MSK practitioner, health care assistant, health coach, midwife, health visitors, acute community eye care service, third sector support, and the doctor.
If the patient chooses to see the doctor they are encouraged to pick up a copy of the practice’s guide ‘making the most of your consultation’. This helps the patient to reflect on their unmet needs and present them to the doctor in a coherent manner.
As part of this process the practice recognised an unmet need and created the role of the health coach. The primary focus of the health coach is to proactively enable and empower patients to take ownership of their own health. Health coaches accept self-referral, and referral from the whole team when they recognise the patient has an unmet need. They are also creating innovative ways of working with patients that include:
- “Health Coach Corner” – a noticeboard in the waiting room on which they place information that is less-medical
- Wordplay – an opportunity to build confidence through word games/poems to reflect/reveal emotions not easily discussed otherwise, to support people to feel more able to speak out and be heard in their daily life.
- Peer Support Group – members of Wordplay were invited to use their increased confidence to form a Peer Support Group.
- Health Walks – two health coaches have completed Walk Leader training with South Somerset District Council (SSDC) and have started a new group “Walk and Talk”. It is aimed at people who have done little or no exercise recently. Hopefully in time people will gain increased confidence and stamina and may like to join other walks or even train to lead walks themselves.
- Buggy Walks –these walks offer an opportunity to make links with and support parents, and enable them to meet others.
- Flexercise – training in September for all health coaches. Seated, fun, exercise sessions for people with restricted mobility that take place in the waiting room so people get to know about this opportunity and join in.
- CAB – onsite weekly, to meet with people who would find it difficult to get to the office in town for advice.
- Liaison with other organisations – for example, attending meetings at SSDC Community Forum, SSDC Healthy Lifestyles Officers, Westfield Community Association, South Somerset Mind, Knightstone Housing, Yarlington Housing, South Somerset Association for Voluntary and Community Action (SSVCA), Somerset Skills and Learning, and the Gateway Church in a bid to raise awareness should they become aware of people who may benefit from support.
Tips for adoption
The new models of care are focussed on creating a sustainable NHS. The work carried out so far has demonstrated better outcomes for patients with a wider clinical team. This reduces the reliance upon GPs as the only primary care provider. This can be replicated and transferred to other practices, particularly where there are GP vacancies and opportunities to reallocate spending on a wider primary care team.
For more information please contact;
Ryalls Park Medical Centre Marsh Lane
Direct Dial: 01935 446812
Tel: 01935 434000
Fax: 01935 473531