Healthcare Leader is speaking with decision makers and those on the ground dealing with the coronavirus pandemic to find out what’s happening nationally, and how best to solve problems.
Today, we speak with Berkshire GP and PCN co-clinical director Dr Rupa Joshi. She is also a GP for “Time for care” and a CD representative for S.E. England on the NHS Confederation board.
Virtually all GP practices have by now set up video consultation software for seeing patients. But some practices have been using this technology to engage with and reassure their communities during the Covid-19 pandemic via virtual group clinics.
Dr Joshi’s practice, Woodley Centre Surgery in Reading, and its regional partners have held a number of these sessions for groups on their lists identified as in need of extra support and guidance.
The meetings, which last for roughly one and a half hours, are about ‘informing patients and giving them a chance to ask questions to a panel of specialists.’
For new mums
Last week, Wokingham North had its first PCN-wide video meeting for new mums, hosted by the GP along with a health visitor, health coach, social prescriber and mental health therapist.
‘Some new mums are finding it difficult to manage without the support they would normally receive, having been isolated from friends and family. We invited them along to talk about their concerns, and to see how we can help answer any questions they might have,’ Dr Joshi explained.
‘Our social prescriber is also looking at what services are available locally from our voluntary and charity organisations to see if we can put people in touch.
‘We realise it’s a busy time for new mums. They may be busy feeding, changing nappies, or looking after toddlers in the house, which could make it difficult to join. In the invitation, we say we fully understand, and explain they don’t need to be on the video and can be on mute, if they just want to listen in or type in the chat box,’ she says.
Great turnout today at our first PCN-wide video group consultation for new mums consulting with patients from 5 surgeries #MDT #wokinghamnorthpcn with #healthcoach #socialprescribinglinkworker@TTBerkshire #healthvisitor @BHFT @BerksWestCCG @CdsPcn #timeforcarepic.twitter.com/s9cYIOx2P9
— Dr Rupa Joshi (@DrRupaJoshi1) May 13, 2020
For anxiety patients
The practice also held a virtual group consultation for patients suffering with anxiety, which required extra consideration and planning.
‘Practice colleagues invited anyone finding things more difficult at the moment without their support network and patients who have concerns about finances, such as those who cannot work or have been furloughed.’
Some patients dealing with anxiety may not want to appear on video, so the practice makes sure they know it’s not a requirement. It also makes the sessions ‘interactive and informal’ in style and tells participants not to worry about things such as spelling mistakes. ‘We just make it as inclusive as we can,’ Dr Joshi adds.
‘They can form a network of support between themselves as well, though we do need to be very careful around confidentiality and consent.’
Asthma patients
The practice also previously invited high-risk asthma patients for a discussion on Covid-19. It advised them on protective measures they should take, distinguishing symptoms of asthma from coronavirus symptoms and on what to do if they contract the virus.
‘It’s about reiterating the message that we are open and happy to see patients and that they can contact us via telephone and online.
‘It also gives them an idea of what to expect if they are invited to attend the hot hub, so it’s not frightening if they are asked to visit. We explain what it will look like and reassure patients that staff will be in PPE and that they will be invited to wear a mask.’
Patients, notably those presenting with silent hypoxia, have also benefited from information about keeping active and monitoring their breathing, helping them to identify deterioration. This ensures those who do develop breathing difficulties ‘get in touch with us rather than manage their symptoms conservatively.’
Additional roles
It is very important that PCNs make full use of the additional role reimbursement scheme (ARRS), Dr Joshi explains.
The practice has had its social prescriber, from a charity called ‘Involve’, talk to vulnerable patients in the community about the available voluntary services, such as food and prescription deliveries. Also, the health coach has talked to people about lifestyle, nutrition, sleep and breathing exercises.
‘We’ve seen patients working hard on self-care by doing more exercise at home and eating better by cooking from scratch. All these good changes are taking place.’
Deciding session topics
The practice decides which cohorts to invite for sessions through group discussions about the type of cases they are regularly seeing, what patients are talking about and their concerns.
The practice also has similar discussions as a PCN, a wider collective of four PCNs in Wokingham and as a broader group of 13 PCNs across the whole of West Berkshire.
The goal is to organically broaden the number of people getting involved and to encourage more GP practices and PCNs to adopt group consultations. Dr Joshi, has led a number of workshops to encourage take-up in the past.
‘There has been a lot of interest from practices who are keen to start doing this because they see a need from their own patients.’
