I found our visit to Hope Citadel very inspiring. We met with Dr James Matheson, Dr Jon Patterson, 2 of the GPs working within the practice, and Dr Laura Neilson the CEO of the group (who had initially set up the foundation as a medical student) along with Lisa, a focussed care worker. They shared their experiences of how they set up the group and how they approached and developed their ideas about caring for patients in a very deprived setting. We also discussed the role of the focused care worker, the difference in their role between a social prescriber/community advisor and the impact they have had on patients in the practice. We learnt about the Manchester GP training scheme and how they are integrating opportunities to learn about health inequalities into training from medical school to post CCT. We were also treated to some delicious home-made soup for lunch, made from the produce from the practice’s vegetable garden that is run by their patients.
It was really helpful to speak to Lisa, the focussed care worker, about her job. Having watched “Frontline Care: Saving the NHS?” a program shown earlier in the year on ITV covering what work they do, and having heard about their role at the Health Inequalities conference in Glasgow, it was interesting to hear about practical aspects of how the role works such as what training they have and how they are supported. There seems to be a number of advantages of this role compared to the role of a social prescriber. Social prescribing seems very concentrated on supporting through signposting whereas focussed care seems to have the scope to go one step further than this e.g. taking patients to appointments, filling in forms, organising transport, attending and running community projects within the practice for patients to get involved in. I can think of many patients I see in surgery with complex physical and social problems that I feel could benefit from a member like this in the practice team.
The discussion from the GPs who had developed the group was also very interesting. Having heard Laura speak at a Next Generation GP lecture previously I was aware of the amazing story of how they started and developed. We learnt more about the difficulties they had faced and how they had approached tackling them. Focussing on the right staff in the practice seemed critical. They demonstrated an increase in smear uptake by 50% over 5 years through improving access to appointments, ensuring all members of clinical staff were trained in smears and the encouragement of opportunistic smears. We have a lower percentage uptake of screening in our more deprived branch surgeries and the discussion offered some interesting ideas as how we could approach this as a practice that I will feed back.
Date of visit – 22nd February 2019
Dr Katie Burgass