Matching the needs of practices and patients is the real point of the GP Forward View

4 July 2018
More than two years on from publication of the GP Forward View (GPFV) it is perhaps inevitable that some of the shine has come off a document that got a warm reception.
 
Speakers at a PCC event to be held in Manchester and London in September can help practice managers and GPs rekindle that warm glow for a vision that promised to help them manage rising demand and other pressures.
 
Sheinaz Stansfield, who leads the Oxford Terrance and Rawling Road Medical Group practice in Gateshead, will outline the redesign and innovation around staff roles, social prescribing and care navigation over the last five years that ensured her colleagues had something of a head start in responding to the forward view.
 
She explains: “We looked at population needs rather than simply trying to manage down the GP workload which is the idea behind a lot of the workforce development strategy such as clinical
pharmacists. When GPs’ vacancies arose, we looked at the needs of the population and saw the value of a highly skilled nursing team for house bound frail elderly people, alongside care navigators to support their health and wellbeing needs though social prescribing. Meeting those needs is a core component of what we do and we have gone from
the highest number of referrals and A&E attendances amongst that client group in the clinical commissioning group to the lowest.”
 
Stansfield argues that the focus on population need and integration rather than employing or positioning staff with an eye principally on hitting QOF targets is crucial.
And that means redesigning roles and investment in staff training.
 
“You need to make roles in general practice more interesting and exciting. We trained our health care assistants to work part-time in that role and part-time as care navigators so they have more varied jobs. We’ve also trained staff in social prescribing and self-management so they can support patients – especially those with long term conditions, to care for themselves or alongside support from voluntary groups, and specialist clinical support when needed.”
 
Building up links with the third sector is a vital component of that aim.
 
“We engage with voluntary sector providers and our health and wellbeing co-ordinator makes sure their details are kept in our dynamic directory of services.”
 
A Productive General Practice audit identified that some patients were attending 20 appointments or more a year to have individual long term conditions monitored; these patients also had high attendances to A&E.
 
Stansfield says practice staff are now skilled in managing the person rather than the condition. “The Year of Care approach has been important to us in managing people with long term conditions (LTC). Really good relationships with patients is a key component of this and they have become active participants in their own care. Patients now attend the practice about three times a year to have their LTC monitored through longer appointments. We provide support for carers too.”
 
At the September events Stansfield will emphasise that practice managers and GPs need to embrace the GP Forward View’s ten high impact actions that free up GP time to care for those with the most complex needs.
 
Another key speaker, Dr Steve Kell, GP partner in Nottinghamshire, will also emphasise the need to focus on workforce. His group has taken on three clinical pharmacists and three paramedics in response to GP recruitment and retention difficulties.
 
He favours a team model that involves all staff and concentrates on the systems and processes needed to keep everything going, including a clear view of what data you need to tell if it’s working. “Measure what you value,” he advises, “and ignore the noise in the system.”
 
While Steve has been a supporter of the National Association of Primary Care’s (NAPC) “primary care home” and other initiatives, his message is to keep things clear and simple.
 
“Keep it all as light as you can. In most cases, the issues will be access and sustainability. If GPs want to take control of their own destiny, that’s what they need to be addressing.”
 
The event – The real GP forward view: what practices can do now – is in Manchester on 4 September and London on 20 September. For more details, see our event calendar:
 
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