The state of general practice in England has dramatically changed over the past 20 years.
Rising workload, tighter financial constraints, recruitment issues and restricted access have led to the current crisis most practice managers are facing.
But there is always an exception that proves the rule.
One practice manager has found a way to make her practice stand out. Kay Keane, practice business manager at the Alvanley Family Practice, and her partners thought they could deal with the crisis before finding out they would never have enough appointments for their 4,200 or so patients.
However, things started to look better when they turned to social media and social prescribing.
‘The first thing I did when I started at the practice was to look at how we interacted with our patients. I sat in the waiting room and asked them why they would join our Patient Participation Group (PPG).
‘They were all just swiping their phone, on Facebook, and didn’t lift their heads up. I spoke to some other practice managers about doing Facebook and they all told me to not go anywhere near because it would be a place where people would complain,’ she says.
Fortunately, Ms Keane didn’t listen and set up a Facebook page for her practice, which turned out to be one of its biggest successes.
‘The key thing is to be active everyday. It’s hard work to be able to post all the time but for a practice this size, we’ve got around 850 people who follow us on Facebook.
‘They might not be our patients but people who want to know about health and what’s going on in our area and we’ve become a bit of a hub for those things,’ she says.
When Ms Keane introduced social prescribing eight months ago, the practice registered around 800 new patients. The scheme is as a wellbeing prescription sheet where patients can tick social activities they’d would like to do with practice health champions.
‘GPs like the prescription forms because they feel like it’s the end to a consultation without prescribing the medicines,’ she says.
Variety of activities
The activities are led by the practice health champions volunteers, willing to give between three and 15 hours a week each to support the patients. The Alvanley Family Practice champions were all recruited via Facebook with the help of the organisation Altogether Better.
Some of the activities include coffee and conversations, pram pushers walks, telephone support and cook and taste.
‘These are things that were happening in the community but as a practice we had no idea that were going on. There’s a café next to the practice and they have a knit and natter activity and we have a lot of patients going there,’ she says.
While benefitting the community, social prescribing has also enabled the practice to reduce its GP workload.
‘GP workload is something we haven’t got a magic wand for but we have been able to reduce the number of consultations that the GPs have in the clinic.
‘We went from 15 appointments in a session to 12. We seem to be managing our access and the mood in the practice is better,’ she says.
The practice also has group consultations for people diagnosed with pre diabetes and COPD. The idea came when its nurse repeatedly had to answer questions asked by individuals with pre diabetes.
By creating group consultations, not only did the practice save time but also created a network of people who can discuss their same condition.
Kay is currently working on two new activities. One of these, called feed the birds, focuses on isolated people by giving them bird feeders and having a practice champion who would regularly spend some time with them.
‘Medicines and money won’t necessarily help patients but, in some cases, spending time with them does. People come to us because we do things differently and they like it,’ she says.