Links Project Report:developing the connections between general practices and their communities
The Links Project was established between October 2010 and May 2011. Staff in ten Scottish General Practices explored connections with their communities. Six of the practices were in areas of deprivation in Glasgow and four in different areas of Fife.
It was particularly significant that four weeks after an initial consultation, 35 out of 131 patients living in deprived areas in Glasgow were still using a service which had been recommended by a GP. A shared view was that improved relationships between community resources and General Practice could have a positive impact on patients and practice teams.
There was real enthusiasm from most practice staff to learn about new resources and a willingness to utilise them more fully. Practitioners could see the benefit of local collaboration if this was properly supported by an organised approach and technology. Facilitating protected time for staff to make connections was key. Provision of central support and coordinating leads provided a good method of improving links with communities.
Making a case for General Practice developing links with community resources
Scotland's public health record, changing demography and economic climate demands that all opportunities for joint working are considered. Radically different, unsiloed approaches are required to capitalise on individual and local assets, tailored to personal need. An important aspect of personalising care in very diverse populations is an ability to be flexible and to ensure staff are aware of the range of available options.
Tapping into opportunities to connect agencies will have economic benefits as a proactive, organised approach to pooling resources will enhance each contribution and save precious resources. Understanding the nature of local contributions and complimenting, not duplicating, services will nurture sustainable healthy communities.
A recommendation from a practitioner may have extra value. The significance of having local knowledge was highlighted during a meeting, when Clinical Leads described the therapeutic value of discussing non clinical aspects of care. A clinician who knows about local walking clubs may be regarded by patients as showing a special interest.
Developing reciprocal approaches may not only enhance relationships with patients but provide much needed support to local groups and organisations.
How to make links
The nature and practicalities of making links was explored. Forming face to face relationships was key in making decisions on whether or not to signpost. Staff who visited local resources were usually impressed after meeting service providers and learning how services were delivered, which increased confidence to signpost.
Time was a factor highlighted throughout the project; time to form trusting relationships, meet others in the community, consultation time, time to update information and share local knowledge.
Engaging particularly interested individual members of staff had a high value. For instance, in Glasgow practices, one GP in training was a very enthusiastic participant, one employed a PhD student and another was assisted by an attached GP trainee. The role of reception and administrative staff in making links was seen to be very important.
There were many references to how best to maintain links once they were made. The vital enablers were opportunity to meet face to face complimented by appropriate technology to allow access, storage, printing and distribution of information. There were many ideas on how this could be achieved, for example local (urban) practices could pool resources and distribute responsibility for curation of information. There were suggestions of regular updates from community groups and annual "fairs" to maintain links.
Primary care is in a unique position through the system of patient registration to form trusting relationships with local citizens over long periods of time. There is an opportunity to mirror these trusting relationships between GP practices and communities. There are numerous pioneers in Scotland ready to champion strengthening connections and community networks, but just as care needs coordination, so does available expertise and innovation. We will all reap the benefits if support is pooled to address the needs of the increasing numbers of Scots living longer with long term conditions. However, there was insufficient time within the project period to find a sustainable model.
Email: Tim Warren
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