Dr Michael Dixon describes how his patient group promotes self-care and raises money for extra services in his practice.
We have run a patients' group at our practice for over 10 years, and like partners, wives and husbands, it is exhilarating and frustrating but never boring.
As well as helping us develop the services we provide, it also runs health promotion initiatives itself, raises significant funds for us to develop practice services and has become a registered charity. It has become a vital part of our work and future stability of our practice and we could never go back to the days of not having a patient group. Here is how we did it.
What we did
We wanted to set up an active and effective patient group with energetic leaders, comprised of patients who, if you like, were in need of a ‘mission'. We did this by actively recruiting our fiercest critics – who are now among our most effective activists. In the early days, most of these leaders were recruited during a surgery consultation. Needless to say, we had to be very sensitive about who we approached and when.
In our initial meetings, our patient group members (with arms crossed) would battle it out with our managers (also with arms crossed) while the clinicians looked on nervously – unable to take sides.
A key moment was reached when our surgery undertook ‘advanced access' and patients had to book appointments on the day from 8:30am onwards. For the patients enough was enough, and from a moment of apoplexy they rose to the occasion, presenting us with much better plans for improving patient access.
The group is now a registered charity with an elected chair, secretary and treasurer and a small leadership group of movers and shakers. Nowadays, with its own newsletter and organisation, it can recruit its own members, but getting the right leaders at a formative stage was absolutely crucial. Many, I should add, had major axes to grind about the way the practice was run, but now devote considerable energy to making it run better.
Results
Our patient group has become a ‘co-provider' of health. It organises health lectures and health initiatives within the surgery. It also runs an integrated self-help library allowing other patients to borrow books on a variety of subjects showing how they can help themselves or improve their health using conventional, biomedical, lifestyle and complementary approaches. It organises art exhibitions on health by local schools in the waiting room, and leads ‘walk and talks' that enable other patients to become more active.
We are starting to get some evidence that the patient group is reducing the call upon professional time and resources.
The patient group also uses simple ideas to raise cash, with things like book-exchange services that raise thousands of pounds a year. With that money, we can now do a patient's INR on site, we have updated resuscitation equipment and patients can measure their own blood pressure and BMI before they get to the waiting room.
The patient group also takes care of our organic vegetable garden and tends our physic garden, with herbs grown that have healing potential. One gardener said she is often interrupted by patients who want to know how to grow and cook vegetables and fruit. Another leader within the group is negotiating a site for an attached community garden within the town's development plan. In our organic café, other patients lead self-help groups ranging from a group of patients with fibromyalgia to an activity group for the socially isolated.
The future
We have been able to develop self-help and self-care and to de-professionalise healthcare as much as possible. Inevitably there are risks, hassles and failures. Overall, however, it has been an immensely positive experience.
When (and if!) we ever have to face an aggressive market in general practice and primary care locally, our patient group has ensured a connection between professionals and our local community, which makes our practice very resilient.
Quite apart from all the health benefits, if we are successful in helping patients to self-care and improve their own health, then we are surely bound to save precious practice (and commissioning) resources.
Dr Michael Dixon is chair of the NHS Alliance and a GP at the Integrated Centre for Health in Cullompton, Devon.
