Tag Archives: Secondary Care

GPCB outpatients group seeks to improve primary and secondary interface

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The General Practice Collaborative Board (GPCB) was set up by all practices in BNSSG to represent the voice of general practice in system discussions and decision-making.

To ensure general practice is properly represented within Integrated Care System (ICS) programmes of work, the GPCB created its own infrastructure for general practice transformation programmes.

One of these programmes is outpatients. The GPCB set up a committee, bringing together GPs and practice managers from across BNSSG, to provide general practice input to the ICS outpatients programme. It is led by Dr Nicola McGuinness, clinical lead, and Ruth Hughes, programme manager, and works closely with the Avon LMC and the clinical lead for planned care at the Integrated Care Board.

The GPCB outpatients network is funded by the ICS, which allows general practice to be part of key discussions and decision-making in the same way as the acute trusts and Sirona. This is significant for general practice as it allows us both to influence the existing projects and raise our own at-scale issues at a system level to find solutions together.

This improves the relationships and interface between general practice and secondary care, which supports the new ways of working in an ICS: putting the patient in the centre and building support and services around them.

One of the successes of the group so far has been collecting feedback from staff in general practice about advice and guidance processes to bring into the system review of the service. This means the views of both primary and secondary care are brought into discussions about how to improve the service.

The network has also worked with the trusts and the Integrated Care Board to think about how data can be used to support understanding of waiting times for hospital appointments. Following these discussions, the trusts and the ICB are looking at how to ensure accurate, local data is available for clinicians referring into secondary care, and for patients who are waiting for their appointments. This is important to give patients a realistic expectation of wait times, and what they can do in the meantime to support their health.

Dr Nicola McGuinness, GP in North and West Bristol and clinical lead for this programme, said, “The GPCB outpatients network is key to ensuring general practice is represented in the wider ICS outpatients programme. Our successes so far show that involving general practice in system outpatients work ensures the patient experience at the community end of their care is represented.”

‘It’s not OK’: healthcare staff stand together against unacceptable behaviour

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Local NHS health and care organisations are repeating calls for people to be kind and respectful, following a rise in violent, aggressive and abusive behaviour towards staff.

Whilst the majority of patients and visitors to healthcare settings are respectful and appreciative, there has continued to be a worrying rise in abusive behaviour during the pandemic.

Healthcare staff know and appreciate that there will be occasions where patients, due to the nature of their condition or through cognitive impairment, may become confused or stressed in unfamiliar environments; which can lead to challenging behaviour. Staff are offered de-escalation training to help deal with these kinds of instances in an appropriate manner.

However, there are many violent, aggressive and abusive incidents which do not involve such patients and can have a lasting impact on NHS staff who deserve to be able to feel safe when they come to work.

A campaign called ‘It’s not OK’ is under way, which features healthcare staff sharing their experiences and urging the public to respect healthcare staff and remember that they’re people, too, following the rise in incidents.

Lizzy Hooper, deputy matron at Yate’s Minor Injury Unit (MIU) says: “I shouldn’t have to be fearful for my team’s safety, yet this is a large part of what I am facing at the moment. We work very hard to ensure people in our care can be safely assessed and supported with their health care needs. It can be very challenging when individuals expect us to be able to see conditions we are not able to treat; we can only see minor injuries less than two weeks old. Some people visiting the department are reluctant to accept there are more appropriate options available to meet their needs. We would ask people to be kind and understand the pressures that we are all facing in these challenging times.”

Hannah Walker, a sister in the children’s emergency department at the Bristol Royal Hospital for Children which is part of University Hospitals Bristol and Weston NHS Foundation Trust (UHBW), said: “Unfortunately, we have seen a significant increase in the number of incidents of violence and aggression displayed towards staff by members of the public. This is not acceptable. It impacts on how staff feel at work and can also be really challenging for other families to witness. Please remember our staff are people too, please treat us with respect.”

Donna Walker, receptionist for Yate’s Minor Injury Unit (MIU), says, “I can feel quite vulnerable while working at the front desk and not knowing who I may deal with every day, particularly when it is really busy. It can also feel very unsettling and demoralising when trying to help a person, only to be yelled at and sworn at along with negative and quite mean comments made towards me and my colleagues.”

Michaela Winkworth, a call handler for the outpatient appointment centre at UHBW, said: “I absolutely love my job as a call handler and find it very rewarding to help patients. Unfortunately, there have been many occasions when patients call and can be verbally abusive and use abusive language. This can make me feel deflated and drained and can be quite stressful.”

Robyn Clark, practice manager at Kingswood Health Centre, said: “There is enormous pressure on the healthcare system at the moment and surgery staff are doing their best to support and assist patients wherever possible. Sadly the amount of abuse being directed at them is still continuing and I have had to write to more patients regarding unacceptable behaviour in the last six months than in the previous four years. Many reception staff are now leaving their roles as a result, making it even harder for patients to get through and obtain the help they need. We want to reinforce that healthcare staff are people too, and patients should treat staff how they would like to be treated in the same scenario. We are all in this together.”

Dr Katrina Boutin, GP at Old School Surgery in Fishponds, says: “Unfortunately, we are still seeing too many cases where patients become violent and aggressive with our clinical or reception staff, which is extremely distressing for them. Staff in GP surgeries are working harder than ever to see and speak to as many patients as we can in the face of extremely high levels of demand.

“We want to make sure that you see or speak to the person who can best help you with your concerns and that we prioritise those who have the greatest clinical need. We understand that this can be frustrating at times if you have to wait longer than you’d like for an appointment, but aggressive or abusive behaviour makes things even more challenging for us. We would really appreciate your patience and understanding.”

There are a number of measures in place to support healthcare staff when experiencing violent or aggressive behaviour from patients; ranging from warning letters and acceptable behaviour contracts to patients being excluded from the premises and, in some circumstances, involving the police.

NHS staff should be able to carry out their work free from the threat of aggressive or abusive behaviour, while being treated with respect and remembering they are people, too.