Richmond Road Medical Centre, recognised at last year’s General Practice Awards, has transformed services for its patients in Hackney, east London. Rachel Carter reports.
In 2016, the team at Richmond Road Medical Centre (RRMC) in Hackney, east London, knew that without ‘drastic change’ their practice risked going under.
As a small practice with just 3,770 patients, an influx of young adults with particular healthcare needs and access demands put pressure on the team and their method of working. At the time, there was already a one-to-two week wait for a GP appointment.
‘The patients joining our practice wanted to see a doctor as quickly as possible,’ says RRMC partner Dr Gopal Mehta. ‘We realised that if we didn’t make a change it could be catastrophic for the practice.’
Two years later and the team have overhauled the practice’s access system and introduced a range of innovative services, resulting in the patient list growing by 57% in just 18 months. The team’s work was recognised at the General Practice Awards 2017, where they won General Practice Team of the Year.
Dr Mehta says the team decided to focus on four key areas to improve the practice. The first – and most important – was the health outcomes for patients. The senior management team set up a new ownership model, which sees all staff taught about the importance of patients managing long-term conditions, such as diabetes.
This means the administrative team now manage patients along with a ‘clinical buddy, ie a doctor, ensuring that patient reviews are set up on time and any issues are identified ‘right from the time someone picks up the phone’. ‘It’s become a collaborative team effort and that model for ownership and accountability has now been launched all over Hackney,’ says Dr Mehta.
The second area – and the practice’s greatest achievement, Dr Mehta says – was to implement a new access system for booking appointments. ‘We absolutely had to change our access system to remain fit for purpose, so we created our own model, known as Patient First,’ he says.
The model guarantees that everyone is seen within 48 hours of making contact with the surgery, as long as they call between 8am and 10am or book in online. Such a turnaround time ‘just doesn’t happen in London’, Dr Mehta says, and it has ‘revolutionised’ the experience for patients.
The model has also helped the practice achieve some impressive statistics, Dr Mehta adds. In a 12-month period, A&E attendances dropped by 21.3% from 820 in 2016/17 to 645 in 2017/18, emergency admissions by 31.6% from 155 in 2016/17 to 106 in 2017/18, and the ‘did not attend’ rate for appointments dropped from 18% to just 0.8%. At the same time, the patient list grew from 3,770 to 5,952, which is significant for a small practice.
‘By addressing the access problem it’s now easier to get appointments and people can see the GP of their choice — so patients are happier and they tell other people to register,’ Dr Mehta says.
‘The other day we had a group of 26 people walk in who had all been recommended to join Richmond Road — that was quite heartwarming, really.’
The team’s third key improvement area included embracing digital technology more widely, such as an electronic prescription service.
Dr Mehta says that 97% of patients now request prescriptions online (apart from controlled drugs, such as morphine and methadone), which ‘makes things much more efficient and safe for them’.
‘A patient recently contacted me to say they were going on holiday, flying from Manchester Airport, but had a urinary tract infection,’ he explains. ‘Within 20 minutes, I’d spoken to her and sent a prescription to the pharmacist at the airport.’
The fourth and final area of improvement was to engage patients beyond the practice’s GP services with something more ‘innovative’. The team first focused on complex mental health issues, after seeing an increase in patients with such problems. Many of these patients didn’t just want counselling and medication, Dr Mehta says, and after an extensive search, the team settled on in-house yoga classes.
‘I used to see those patients every week for a catch-up about their mood, I now just see them at yoga – it’s amazing how transformative it’s been for them. ‘Patients come to yoga and have a chat. It’s become a really good network. We’re now looking to start our second class on Thursday mornings.’
It has been a good two years for Richmond Road. The practice’s access model is now being trademarked and launched across other practices in Hackney, and there’s a visit from NHS England’s national medical director Professor Stephen Powis on the horizon.
Dr Mehta says the improvements have taken a lot of time and energy, it has been a massive but collaborative effort. ‘I’m very passionate about this work, but I couldn’t do it without the most amazing team, who are just as dedicated to the cause as I am,’ he adds.
‘At Richmond Road we’ve instilled that culture of “we’re all in this together” and that’s why the GP Team of the Year Award felt so fitting, really.’
Rachel Carter is a freelance journalist