The final session of the day on 'The future of health and care' at the NAPC 25th anniversary symposium event last week focused on 'Using the potential of AI in healthcare now and in the future'.

Listen to our podcast on #IntegratedNeighbourhoodTeams

In this episode, we switch things up and interview Katrina Percy who normally hosts these sessions. We discuss what an Integrated Neighbourhood Team means, where it’s working and what the future holds.

Our non executive director Dr Edward Bosonnet is at the two day Primary Care Partnership Network (PCPN) in London. This event brings together 150 multidisciplinary leaders from across Primary Care.

#PCPN #PCPN 2024 #PrimaryCare #NAPC #Event

Do you know the three characteristics of the Community Health and Wellbeing model? Find out below -

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There's a lot of talk about Integrated Neighbourhood Teams but what does it mean?
Here's what we mean by INTs #neighbourhoodcare

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Dr David Colin-Thome, GP and Council Member of NAPC recently celebrated a significant birthday. We caught up with him about his career in Primary Care. Read more - napc.co.uk/catching-up-wi…

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SUMMARY: most GP remote consultations are SAFE, because clinical and support staff work to make them safe. But when harms occur it’s typically due to inappropriate allocation of a complex patient to a phone call and poor communication in that call.
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PATIENTS WHO NEED PARTICULAR CARE
- Very young
- Very old
- Learning difficulty of cognitive impairment
- Unable to communicate effectively for any reason in the language of the clinician
- Poor understanding of health or the healthcare system
- Complex social needs
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HIGH-RISK CLINICAL CONDITIONS
These [examples only] often need to be seen in-person
- New chest or abdominal pain
- Vague deterioration where the story doesn’t make sense
- Patient already has multiple health conditions and is unwell
- Has got worse despite phone advice
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COMMUNICATION ISSUES
Safety incidents often include an element of
- Not establishing rapport
- Not listening carefully to the patient
- Not probing or questioning enough
- Ignoring parental concern
- Lack of clinical curiosity
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ORGANISATIONAL FACTORS
Risky situations are more common with
- Understaffing
- Busy, stressful days
- Staff getting distracted
- Undertrained staff
- New staff unfamiliar with practice routines
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We found that in rare incidents when harm occurs in a remote consultation, it’s often due to a combination of organisation issues before the consultation, communication issues during the consultation, as well as factors relating to the illness and the patient.
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So a BIG finding from this study was how safety incidents are almost always AVOIDED through the conscientious actions of front-line staff (from receptionists to senior docs). However, we did find some tragic safety incidents after looking at national records.
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In our study, clinicians doing remote consultations had a low threshold for ‘bringing the patient in’ for an in-person assessment. In other words, they always erred on the side of caution. This led to some double-handling but no doubt prevented some safety incidents.
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Receptionists and duty clinicians were alert to known patients with particular needs (e.g. elderly, complex health conditions, communication difficulties) and used judgement and ‘workarounds’ to make sure they got an appropriate appointment.
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Staff in these 12 GP practices took a lot of measures to make sure that safety incidents didn’t happen. They often told patients “sorry you can’t have a phone consultation for that problem, you need to come and be examined”.
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