How to get the right care from your GP practice
Your doctor has been joined by a host of different health professionals to make sure you get the support and treatment you need.
GP practices have evolved. Nowadays there are not only more ways to get an appointment, but also more health experts you may be able to see.
Most surgeries now have their own website, so as well as calling them, you can go online to book a consultation and order repeat prescriptions, too.
And you might not always see a doctor first because new health and care staff have been introduced into GP surgeries.
In fact, 29,000 extra health and care roles have been filled. This ensures that people can be seen by the right professional first time.
So, if it’s appropriate, you may be offered an appointment with a physiotherapist, paramedic or nurse.
Or you may be advised to see someone outside of the surgery, such as a pharmacist or optician.
Not only does this get you the help you need as quickly as possible, it also helps tackle the ‘8am rush’ for an appointment. And it frees GPs to concentrate on the complex and serious cases that really need their expertise.
Change for the better
Some of the changes you are seeing in general practice began before the pandemic and were speeded up in response to the arrival of Covid-19.
Many GP surgery websites now include GP forms which can be used to request an appointment, get help and advice or ask other questions. You can still call the surgery or visit it in person.
Whichever way you contact your GP practice, trained members of the reception team will ask you what you need help with. It’s not because they’re nosy – it’s because they need to know who it’s best to book you in with. And it’s entirely confidential.
Once they know why you’re requesting an appointment, they can determine who’s the most suitable person for you to see.
It’s all done under the supervision and guidance of GPs, so if someone is unsure about your case, it will be passed on to a doctor or another senior clinician to assess.
Whatever they decide, it means that you’ll be seen as quickly as possible by the most appropriate professional.
Alternatively, if it’s better for you, you may be directed to experts outside of the surgery you may not realise you can see, such as community pharmacies and mental health services.
‘We’ve freed up about 50 per cent of GP appointments’
When the Hereford Medical Group first introduced the new system five years ago, patients were a little mistrustful.
Nowadays, they realise that providing information at the beginning can get them the care they need more quickly. In fact, the system – care navigation – has freed up about 50 per cent of GP appointments, leaving doctors to focus on patients who need their care most.
‘Without care navigation,’ says operations manager Kate Jones, ‘we wouldn’t have any available appointments.’
Liz Morris became a care navigator for the practice, which has 49,500 patients, last year.
She says: ‘We get a lot of training when we first start. We have two weeks of online training – it’s intense – where you learn about all aspects of the job.
‘Then you spend time shadowing other people, and when you do start, you’re coached on how best to channel those patients you’re dealing with.
‘And training is ongoing, because things change. We adapt the way we work to meet people’s needs and make it more efficient.’
She can book appointments with GPs, nurses, physios, mental health nurses, social prescribers, health and wellbeing coaches and physician associates in her own surgery.
Externally, Liz can refer people to opticians, school nurses, pharmacists, local mental health services, district nurses, dentists, midwives, the falls response team and social services.
‘A lot of the time patients can self-refer, but they don’t know they can,’ she says.
‘When people call about babies, they might ask to see a GP, but if it’s a problem with feeding or weaning, it can be dealt with by a health visitor.’
Direct referrals to pharmacies have also gone down well.
‘When we refer to a pharmacy, the patient will hear back from them and the majority of the time they’ll have been advised or prescribed something – it’s a much quicker process,’ says Kate.
‘If you’ve got red eye or conjunctivitis – which we get a lot of calls for – they can go to an optician.
‘If you’ve got asthma, it’s better to see the asthma nurse than a GP as they see it every day and know it inside out.’
Hereford Medical Group, which has five surgeries, also has three former paramedics now working as emergency care practitioners.
‘They help with home visits and do nursing rounds at care homes – this helps GPs because a home visit takes so much time out of their day,’ says Kate.
Having access to social prescribers – who can provide help for people who can’t read and write, refer people to food banks or the lonely to lunch clubs and organise respite care – also helps.
‘It means our GPs can see really complex patients,’ says Kate. ‘We’ve got some really unwell people who need their time and knowledge.
‘It’s important people realise our team just wants to help. We’re all here to help patients get the right care with the right professional as quickly as we can.’
Roles you may see in your GP surgery
◼ Paramedics have experience in everything from minor injuries to more serious conditions such as asthma, and now help manage routine and urgent appointments and carry out home visits.
◼ Physiotherapists can assess, diagnose and treat a range of complex muscle and joint conditions such as arthritis and back pain without needing hospital care. They can also arrange access to further treatment, investigations and specialists when needed.
◼ Physician associates work alongside GPs, treating a wide range of health conditions. They diagnose and treat certain health conditions, arrange tests and analyse results and perform physical examinations of patients, including those with long-term conditions.
◼ Care co-ordinators help make sure that patients are connected to the right services or professionals at the right time. They can also help people manage their own needs, preparing them for upcoming appointments, monitoring their health and responding to any changes.
◼ Social prescribing link workers help patients manage their social, emotional and physical wellbeing by connecting them to local groups and services that can offer practical and emotional. These include volunteering opportunities, physical activities and even debt and housing advice.
◼ Clinical pharmacists are experts in medicines who help patients stay as well as possible by supporting those with long-term conditions, such as asthma, diabetes and high blood pressure and people taking multiple medicines, to make sure their medication is working.
◼ General practice nurses take blood samples, give vaccinations and carry out screening. Many surgeries now also have mental health nurses, district nurses,
midwives and nurse practitioners (who can diagnose, treat and order tests), too.
◼ Nursing associates perform routine health checks and wound care while providing patients with general health and wellbeing advice under the guidance of a nurse or another health professional.
◼ Health and wellbeing coaches help people manage their own health conditions by developing their knowledge, skills, and confidence in dealing with the issue to prevent long-term illness or it getting worse.
◼ Mental health practitioners support adults whose needs can’t be met by local talking therapies but who might not need ongoing care from hospitals or mental health teams. They can refer patients to a range of different services.
◼ Dieticians diagnose and treat diet and nutritional problems such as diabetes, food allergies, coeliac disease and metabolic diseases.
◼ Podiatrists who diagnose and treat foot and lower-limb conditions.
◼ Occupational therapists support those with problems arising from physical, mental, social or developmental difficulties, helping them find ways to continue with everyday activities that are important to them.
■ This article is part of a paid-for partnership with HM Government