Wessex LMCs Guide To Primary/Secondary Care Exchange Schemes.
Many GPs and consultants talk about days gone by where you picked up the phone and talked to a colleague for a chat about a difficult case. Now many GPs and consultants lament that they do not know their fellow colleagues in that way and there is a distinct divide between the primary and secondary care medical workforce. There are very few forums in which they meet. Workload and work pressure have increased along with the introduction of new ways of working. This can mean that interactions are formal, pressured and difficult thus reinforcing that sense of ‘us and them’.
Increased demand and investment have led to expansion of the Consultant workforce which in turn has meant a significant increase in consultants with whom a GP might interact. In addition, the advent of technology to help with referrals, such as e-referrals, has the effect of formalising and distancing communication.
These factors, combined with different working patterns in primary care, have led to an increasing sense of disconnect between the primary and secondary care workforce.
On talking to all doctors, they agree that relationships, trust and mutual understanding between colleagues all help in trying to provide quality, holistic care for a patient moving between the two parts of the ‘single’ NHS.
To this end the LMC has supported a number of Primary/Secondary care Exchange (Twinning) events across Wessex over the last few years. The aim has been to ‘reconnect’ clinicians across primary and secondary care. Benefits can include a better understanding of the challenges that we are all facing, seeing how things have changed since each doctor was last in a hospital or General Practice, improve lines of communication, seeing what technology and innovations are being used that might transfer. Through all of these we hope to improve collaborative working relationships.
These have proved immensely popular with all participants and feedback has been universally positive.
Twinning is entirely flexible to the participants involved, and benefits can vary according to what participants want to get out of the scheme.
The schemes usually involve the pairing of a clinician from General Practice with a clinician from another provider organisation and them spending a half day in each other’s workplace. They are asked to reflect on the experience, complete a brief feedback questionnaire and invited to attend an evening catch-up meeting for all participants.
Nurse twinning in Wessex pairing Nurses working in Primary Care, and either Community or Acute Hospital nurses is getting underway in 2020 and is being led by Helene Irvine, Nurse Advisor at Wessex LMCs.
Contact email@example.com for more details
Manager twinning in Wessex between Practice Managers and Managers in Hospital or Community Trusts is being led by Louise Greenwood, Director of Wessex Local Education, Training and Development.
Contact Louise.Greenwood@wessexlmcs.org.uk for more details.
‘Walk in my Shoes’ is an Inter-Professional Exchange project in which staff from GP practices are given the opportunity to visit community pharmacies and community pharmacy staff are given the opportunity to visit GP practices. Going live 2019-20
Contact firstname.lastname@example.org for more details.
Pairing a GP with a hospital consultant or community provider. The outcomes have been to build relationships, but some twinning schemes have also led to collaborative projects, development of a specialist interests or alternative ways to provide clinical care within the OPD and community settings.
- “Generally, a very positive worthwhile experience, many thanks”
- “Really useful experience, very enjoyable and educational. Well worth it. Was an excellent opportunity to meet local GPs which we no longer have otherwise”
Various schemes run in the different Wessex patches. Contact email@example.com who will let you know if there is an active scheme in your area, or if you might be interested in setting up a scheme local to you, and we can support you with this.
https://www.england.nhs.uk/publication/the-wessex-model-how-to-set-up-and-run-a-workplace-exchange/ – This has extensive information on how to set up a twinning scheme
https://www.youtube.com/watch?v=-LAQ7080NhQ&feature=youtu.be – This has a video on GP Consultant Liaison in Southampton
There are also examples of international twinning with NHS organisations:
The RCGP runs a number of exchange programmes, including short observerships in primary care in other European countries, and longer duration opportunities globally