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At the heart of general practice since 1960

Does size matter?

Dr Graham Abbott and staff were astounded at the popularity of their stroke awareness evening. Here he explains what lay behind the crowd-puller and how it boosted the practice's quality points tally

What we were up against

Some 18 months ago we had an open evening, to look at how we could improve our services generally ­ and attracted just three patients.

I have had an interest in stroke care for some time and with the new GP contract wanted to target this group of patients in an organised fashion, but without setting up another chronic disease clinic. Many patients fall into multiple chronic disease categories and so tire of repeated recalls to clinics.

Our practice is in Ripon, a North Yorkshire market town. We have a patient list of 9,000 who are predominantly middle-class and living in rural/semi rural areas.

The practice has seven doctors (not all full-time) and is PMS.

What we did

We wrote to 150 selected patients with a diagnosis of stroke or TIA who hadn't had recent blood pressure or cholesterol measurements (see copy of letter, right). We received about 100 replies and 63 indicated their intent to attend.

The stroke evening was billed as a chance for patients and carers to learn more about their condition and to ensure they were receiving the most recent recommended treatment. We also highlighted the presence of the carer's resource team who had been keen to attend. Our secretaries laid on a lavish buffet after liaising with the local dietitian. The evening was sponsored by a pharmaceutical company. In exchange the reps got to see all the GPs in the surgery ­ no mean feat in our practice.

On the night, cars were queuing down the street to get into our overfilled car park and we raided consulting rooms for chairs. Latecomers were left standing in the corridor. We got quite a buzz from the interest we had raised.

Our practice nurses worked flat out offering BP checks and taking blood samples for cholesterol levels, but due to high demand, some patients had to be asked to make an appointment to return in normal surgery hours.

Our stroke evening programme

1 Introduction - Dr Graham Abbott outlines what stroke and TIA actually are, what patients can

do to help themselves, what to expect from

the practice.

2 Local physiotherapist and occupational therapist explain their roles in the management of stroke.

3 Question and answer session.

4 'Mingle' time. Collect Stroke Association leaflets.

Eat from the free buffet. Talk individually to GPs, therapists, or other practice members.

5 Have blood pressure and blood sample taken

for cholesterol test

What we achieved

There has been very positive and complimentary feedback from patients through an evaluation questionnaire, comments made to staff in surgery and even by three patients at a recent PCT open meeting in our city. Credit must go to our practice staff who worked extremely hard to make the evening such a success.

The evening was very rewarding in that patients now feel more empowered in dealing with their illness. It highlighted some incorrect and dubious diagnoses and improved the level of care for our patients. Through the smoking questionnaire, cholesterol tests and the improved disease register we have gained maximum clinical QOF points for stroke care. We have been asked to offer further events and are considering this.

I think the success of this evening was due to direct invitation to a focused group of patients enabling the gathering of a wealth of appropriate knowledge and information of interest to everyone that attended. We are considering evenings for epilepsy suffers, patients who have suffered falls or even subgroups of the diabetic population.

Interview by Emily Wright

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