The practice is located in a market town in Buckinghamshire, with 5,000 patients and four GPs. As a long-established surgery that works extremely hard to provide the very best possible care, we were concerned when we began noticing a trend where some patients were continually phoning in to book GP appointments, telephone consultations, or home visits. On further investigation it became apparent that these repeat requests were coming from our more vulnerable and socially isolated patients, who were booking appointments simply as a means to gain more human contact.
We’re dedicated to consistently maintaining the highest possible practice standards and we pride ourselves on the caring nature of the services we provide. We want all our patients to feel cared for and be able to talk to us.
We realised that we needed to find a more effective way of reaching out to these vulnerable groups, while increasing capacity within our valuable GP resources for our many other patients who also need them.
What we did
Following discussions between our clinical and administrative teams we came up with our ‘Welfare Champions’ idea.
Designed to specifically help more vulnerable patients, the initiative was initially implemented for those deemed to be lonely or socially isolated, before being rolled out to those who are housebound.
Since we introduced the initiative, these individuals now receive weekly calls from a welfare champion within our administrative team, who has been fully briefed about what questions to ask. From checking how a patient is feeling to asking if they have enough medicine; the welfare champion uses these calls to assess whether or not an individual needs additional support or care – such as arranging for a district nurse to visit their home if they have a bed sore.
Patients using the Welfare Champions service also have access to a dedicated fast track telephone number if they need our support at any other time, which can be picked up by any of our admin team and a welfare champion is alerted to deal with their call. This allows us to effectively deal with any subsequent queries patients and their families might have; such as in a recent case where a patient’s relative queried their blood test results – a concern that we were able to swiftly resolve.
No extra money was required to set up the service, the only investment we had to make was to find time to administer the initiative.
Patients are identified for inclusion in this initiative when they register or should their circumstances change – such as following a diagnosis or bereavement.
As with any new service rollouts, it can take a while before they are running smoothly. A busy GP practice’s biggest challenge is time, so it was vital that we protected some time to make these weekly calls and speak to clinicians when queries arise.
It took careful planning and analysis of our existing resources including available staff, opening hours and the number of patients eligible for the service before we launched it. We were able to introduce the initiative without requiring any additional external staff training by utilising our existing patient care training, and providing staff members with the tools to ensure they asked the right questions to our patients to capture all necessary information.
Since its introduction our GPs have noticed a marked difference, with fewer clinically unnecessary calls and appointment bookings. We estimate that our Welfare Champions initiative is saving us roughly four hours and half a dozen appointments a week, giving us much more time to spend on critical queries and patient care.
Our patients, who were initially surprised to receive these weekly calls, are hugely appreciative of the extra support.
Our Welfare Champions initiative has also been commended by the CQC, which praised us for our outstanding practice and approach to local care in their latest CQC report – something we are very proud of.
We are really excited about this service and are already considering rolling it out to palliative care patients, or others with long-term health conditions who could really benefit from the extra care and support. Our first step in any plan to extend our welfare service would be to ensure these patients could gain same-day access to a GP, if not face-to-face, then a phone call as a minimum requirement.
With a bit of thought and planning other practices could easily set up a similar scheme – they just need to be willing to invest the time and resources. The long-term benefits far outweigh the initial time it takes to set up, by strengthening the support you can offer to the wider community and freeing up valuable GP resources.
Dr Anthony Nicolaou is a salaried GP and Fazilat Shivji a Practice Manager at the Kingfisher Surgery in Newport Pagnell, Buckinghamshire