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Bevan Exemplar shares innovative project with Isle of Man GPs

12th Sep 2019

Bevan Exemplar Dr Arfon Williams has been sharing his innovative project to improve patient care in his Nefyn surgery with GPs in the Isle of Man.

The North Wales GP, who presented his project at the Bevan Exemplar event in January this year, showcased his findings to the Isle of Man GP Educational Forum and the Isle of Man National Health Service transformation team.

He also told his story about how he and his team improved both capacity and patient access to services to local radio station Manx Radio.

Dr Williams said, “This was such a fantastic opportunity to share this Bevan Exemplar work that has made such a huge difference to both patients and staff at our GP practice in Nefyn."

“The Bevan Exemplar programme provided lots of support to the work and has opened doors to enable myself and my team to tell our story about how even in adversity you can succeed by really looking at what needs to be changed and then embracing the transformation.”

Dr William’s 4,200 patient practice, covering a large rural area, was on the brink of closing a few years ago due to a sudden shortage of GPs. In fact, it was flagged by Betsi Cadwaladr University Health Board as the GP practice most likely to fail at the time.

It was also struggling to meet the demands of an increasing older population with 20% more elderly patients than the UK average for GP practices. To survive, the system needed to find ways to work better to ensure patients were seen as soon as possible.

After a thorough review of the practice, a number of changes were made to ensure a more efficient service could be delivered where patients were seen promptly and by the most appropriate healthcare professional.

This included;

  • training receptionists to be able to sign post patients to primary care services in the community such as physiotherapy, Welsh Eye Care Service, minor injury unit and counselling
  • recruiting an advanced nurse practitioner
  • changing the My Health Online system so only appointments to a nurse not the GP were allowed (enabling receptionists to make sure patients were seen by the most appropriate professional)
  • introducing the ‘one telephone call rule’ so that all patients receive a solution to their needs before the end of the call

The changes were embraced by patients who understood that the GP was not always the best person to meet their needs and were happy to be seen promptly by the most appropriate healthcare professional in their local community.

As a result, waiting times for those who did need to see the GP were almost halved and no patients were turned away without help. The practice now also has lower than the local health board average for referrals to unscheduled care and secondary care, antibiotic prescribing and is under budget for prudent prescribing.

Dr Williams said, “Both patients and staff have been so receptive to the changes which have made a big difference to the care we provide.

“Most people just want to have their problem solved and be seen promptly, so we’ve received very positive feedback to the new ways of working.

“Our staff are also happier because instead of turning people away they know they can now offer something to help.”

Dr Williams will be following his Isle of Man visit with further presentations of his Bevan Exemplar project at two Management in Practice events (for GPs and practice managers) at the Olympia London later this month and the National Conference Centre in Birmingham in December.

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