As general practitioners we like to pride ourselves that we are the branch of medicine that listens to our patients. That we are more than mere medical technicians as our hospital specialist colleagues can be, but see our patients holistically not only with their medical problems but also within the context of their psychological and social setting. So how do we cope when the patient cannot express their own worries and concerns?
We can all recall being in a situation where we could not understand what is being said, maybe while being in foreign country or as we start to explore new areas of clinical practice but are not quite ready for the challenge of the terminology or abbreviations. It is an unsettling experience.
That’s just a small glimpse of what life can be like for a third of stroke survivors who have aphasia. Remember, this is a disability in communication that affects your ability to read, write, speak, or understand – but not your intellect. Recent research from the Stroke Association charity reveals that more than two fifths (43%) of stroke survivors said that they find communicating with their GP difficult. This is a worrying statistic given the fact that we are one of the main sources of aftercare support when stroke survivors return home.
In a time when there are increased pressures on GPs and our practices, it is not hard to see how people may find it difficult to communicate with us. In fact one fifth (19%) of patients from the charity’s survey said that they have encountered problems making a GP appointment. To help us understand and address the inevitable challenge that aphasia can pose in a time-stretched environment, the Stroke Association is launching a simple new animation.
It is structured around the concept of 'Ask. Wait. Listen' and is based on what over 800 stroke survivors with aphasia say helps them to communicate with their GP and practice staff.
The animation encourages people to check 'yes' and 'no' answers are reliable; some stroke survivors can say the words but may get the meaning mixed up. Writing down 'yes', 'no', 'I don’t understand' so that patients can point if they are confused is recommended by the team of stroke survivors behind the research.
I believe this simple concept could really work across our surgery from reception through to special clinics and one-to-one appointments.
This is an excellent concept and we are planning to use the animation alongside some staff training involving patients at the Westcliffe Group of practices in Bradford.
This focus on communication through the whole of the practice team, from the first contact a patient has with reception to the consultation will re-affirm that we are the listening branch of medicine, which sees the person and not the ‘patient’. Accepting we have to adjust for the disability and not compromise the quality of care we give to all.
Practice managers, GPs and other surgery staff can request resources, book bespoke training on how to improve communications through the Stroke Association. The charity also provides specialist communication services and local groups to support stroke survivors with aphasia.
Dr Matt Fay is a GP at the Westcliffe Group, Bradford and standing member for general practice on the NICE quality standards committee