GP Team of the Year – sponsored by MPS
The finalists for the General Practice Awards, which celebrate leading examples of innovation, hard work and leadership within primary care, were revealed at the end of August.
The awards, which will be held on 30 November at the Park Plaza Westminster Bridge hotel in London, are in their tenth year and, in the run-up to next month’s awards ceremony, Management in Practice is profiling the shortlisted candidates.
For the GP Team of the Year award, the judges were looking for an outstanding multidisciplinary team – one that has had a measurably positive impact on patient experience and the care given within their practice or local area.
Church Street Medical
Multiple healthcare professionals have been added to this Gloucestershire-based practice team, in order to improve patient care and staff experience.
A senior clinical pharmacist was employed as part of the NHS England pilot, which began in 2016. Since then, a paramedic has joined the team, three nurses have been recruited and a trainee nurse programme developed.
The practice is also looking at its mental health and physiotherapy provision, and has offered placements to physician assistants. Two split pre-registration pharmacist placements are also being added in 2019.
Around 260 minutes of GP time a day has been saved as a result of the work of the clinical pharmacist alone. The paramedic, who averages between four and eight home visits a day, has also had a positive impact on GP workload.
Other successful implementations include bringing in electronic repeat dispensing, another measure that has contributed to the reduction of the GP workload.
Dr Owen Thomas, Lynwen Francis and the North Cynon Cluster virtual ward team – St John’s Medical Centre
This multidisciplinary team has helped ‘enhance the lives of patients’ to enable them to stay well and remain at home and in the community for as long as it is safe for them to do so.
The team includes social workers, pharmacists, GPs, occupational therapists and nurses.
They have seen close to an 80% reduction in hospital admissions for those cared for by the virtual ward, alongside a 60% reduction in GP appointments and a 90% reduction in out of hours demand.
The health and wellbeing of patients is discussed at weekly team meetings to ensure consistency of care, and patients are seen in their own home as much as possible.
Hall Green Health Practice Team
Serving 26,000 patients in Birmingham, this practice and its team has used capacity management, closer collaboration and increased use of online services, to create an additional 400 appointments per week.
The practice website today has around 19,000 visitors a month, compared to 900 when it launched in December last year, which has helped prevent as many as 1,224 phone calls, 680 visits and 223 appointments.
The site now processes around 800 requests every month, contributing to alleviating the pressure on reception staff and free up time for other tasks. It has also allowed those patients who are not online to get through more quickly on the phone.
Additional staff has been brought in; including six new doctors, two pharmacists, and a paramedic.
The team also uses a visual dashboard which shows practice performance across key areas. This means departments such as the reception team can see where resources might need to be reallocated to if demand is high.
Hillview Family Practice Team
This practice was ‘crippled’ by lack of GPs and patient demand 18 months before entering the awards. But following changes to its appointment system and prescribing practices, this GP surgery has turned itself around.
A flexible appointments system was introduced in 2017 and GPs now work a 9-hour day, with 15-minute appointments, and time for admin tasks, lunch and a coffee break – helping improve their work/life balance.
Two thirds of appointments are now pre-booked, and receptionists are told to direct patients to other methods of care, such as social prescribing, where appropriate.
Since the introduction of this new model of working, out of hours attendance and has dropped from 965 between January 2016 and January 2017, to 592 between January 2017 and the same time this year – a 39% reduction.
Prescribing spend fell by almost £84,000, year-on-year, after a new medicines management strategy was put in place. This includes encouraging patients to buy over the counter where appropriate.
Lea Vale Medical Group
Over the 18 months preceding entering the awards, this practice in Luton was in the process of moving from a traditional GP model to a multidisciplinary approach. It now employs pharmacists, paramedics, diabetes nurse practitioners, minor illness nurse prescribers, and emergency care practitioners, among others.
This wider clinical team is available to see patients between 7.30am and 7pm, with housebound patients benefiting from the addition of pharmacists and physicians’ associates, who are able to make house calls, to the team
Now, 70% of paperwork, pathology links and medication queries have been removed from clinicians’, helping to ease their workload. The practice has also seen complaints decrease by 12%, with appointments per 1,000 patients increasing from 88 in 2016 to 112 in 2018.
Call answering has gone up by 33%, and the practice is now 4.5% under prescribing budget.
The practice has been called ‘fantastic’ by patients, and ’inspiring’ by Dr Peter Graves, chief executive of Bedfordshire and Hertfordshire LMC.
Norwood Surgery Team
This surgery is an ‘inspirational place to work’, according to staff members. Patients are given the option of a lifestyle-based approach to health and treating medical conditions, rather than automatically resorting to taking medication on a long-term basis.
This strategy has seen the practice spend £38,000 less a year on diabetes medication that the average in the CCG.
There is a Monday evening support group for patients with diabetes, non-alcoholic fatty liver disease, and pre-diabetes – which has been up and running for five years.
The practice also has a walking group that has seen over 200 people join and that aims to help people coping with issues such as anxiety and depression.
Alongside healthcare professionals and practice staff, this practice considers patients to be ‘vital team members’, and six of the eight walking group walk leaders are patients themselves.
The practice believes strongly in leading by example, which is why the GPs and practice managers have completed 12 marathons between them.
SEL GP Group – City View Medical Practice
In 2015, City View Practice in Leeds, which had a list size of 12,200 patients and just two full time GP, was struggling to stay afloat.
The practice – which is located in a deprived part of the city – decided to branch out and transform into a multidisciplinary team. They saw that 35% of GP consultations were for minor illnesses and 10% for mental health concerns, so decided to employ two advanced nurse practitioners and a mental health nurse to meet this demand.
An improved triage system was also put in place to cope with daily demand, and additional members of staff, including pharmacists, added to the team.
In 2015-16, GPs carried out 30 mental health reviews, and in 2017-18 they carried out just one. The mental health nurse, on the other hand, did 53 reviews last year, and also conducted 245 follow up reviews.
Referrals to the community mental health team dropped by half between 2016-17 and 2017-18, with the current figure at 34.
Team NPC, Northumbria Primary Care
Team NPC, which consists of seven GP practices and a multidisciplinary team, consulted with patients and staff to develop a five-year strategy designed to improve services.
Targets incorporated into the plan include bettering quality of care; greater public and patient engagement; increasing staff retention; and growing and developing the range of services offered to better meet population needs.
Following the creation and implementation of this plan, patients are able to access longer appointments and take part in group consultations. Patients with long-term conditions can now benefit from structured support planning.
The team has grown to include professionals such as medicines technicians, nurse practitioners and clinical coders. New initiatives, such as employee of the month and other forms of staff recognition and rewards, have improved the working atmosphere across the team.
One staff member said working for Team NPC had been ‘one of the best years’ of their life.