Across the course of 2 days in June 2019 we delivered 6x 3 hour workshops. This involved 76 staff, in mixed role groups of 7-18 people, ranging across the spectrum of roles, managers, receptions, admin, GPs, Nurses, paramedics, HCAs, pharmacists. The aim was to engage the whole team, and generate interest and a cohesive whole team approach to consider person centred approaches in their practice.

We covered:Exploration of person centred care, why do it, and what do we mean by this.Introduction to the concepts of patient activation, how to measure it, and what knowing someones activation enables you to do differently.Introduction to coaching approaches, how these can be tailored to suit different activation levels.Explored how these concepts could add value to Larwood practices.

Feedback from the Larwood engagement sessionswith Ollie Hart and Anthony Owens

Our reflections from the training

Key themes:Staff - Strong sense of team, and pride in the practice, but often feeling overwhelmedPatients- Very demanding, passive, sense of entitlement fueled by political rhetoricOpportunities – The team sees potential for activation and coaching to make life better and improve outcomes-Time to talk as teams quickly reveals many untapped assets in the team

We explore these in a little more depth below:

We asked each of the groups what matters most to the them at work. It was clear there is a strong:-Sense of identity, and being part of the team is crucial.-Sense of purpose- want to deliver excellent care/ make a difference to people, it feels rewarding when recognised-Pride in being innovative and effective – ‘we are good’

There was also a general feeling of being very busy, which at times is overwhelming and very stressful. Exacerbated by recent GP shortages Patients are very demanding, and generally quite passive.Expectations are high “It’s your duty of care to me”, “I pay your salary” Sense that political rhetoric not helpful (local and national) – “patients can expect everything from us, no honesty/reality”

However there was an optimism that new approaches could lead to better outcomes for all, as illustrated below…..smiling staff, quieter phones, better relationships (between staff and staff: patients), less stress and better flows of information. We would need to address the need for staff education, and more realistic patient and political expectation.

It was clear that there are a range of people in leadership positions – across clinical, managerial and admin roles, who have ideas skills and appetite to embed person centred approaches in the practice. There were ideas about where changes could start, and been expanded, across a range of longterm conditions and review processe

It was particularly noticeable that the more junior staff, when given space to talk and explore their experiences, awaken to the fact they can have a role in generating person centred care. They identified that they often pick up on insights that the more senior members of the team and clinicians are shielded from “we know who they (the difficult patients) are”, a junior receptionist says “ we can tell who they are because you (other receptionists) bolt to the back”“we see the real people……frightened, aggressive, But there was a sense of needing permission to play more of a role

It led us to consider what sort of important insights could be fed into patient assessment and management from the wider team? You already use care navigators and have a community hub, lots of potential to build on.

As a final illustration of the depth of engagement and innovative thinking you have in your teams, 3 of the admin team spent 15 mins brain storming and came up with this list of ideas to progress coaching and activation in the practice: