The intiative, called The Wessex Model, was started by GP Dr Sally Ross on a small scale in Portsmouth in 2015 before being taken up across Southampton and over 200 GP/consultant pairings have taken place to date. The idea is now being promoted by NHS England as a way to deliver local service improvements.
GP partner and Southampton CCG board member Dr Pritti Aggarwal, who rolled out the scheme in the city, said that it was 'easy and low cost' to implement, but the benefits were 'exponential'.
'As time's gone on we’ve all just got busier and busier, we're not actually getting to talk to one another as much as we used to,' Dr Aggarwal explained. 'There used to be regular meetings between GPs and consultants – now it's becoming very much depersonalised. This is a way to help put those relationships back into the NHS.'
Quality improvement activity
Under the scheme, GPs and consultants in Southampton were invited to volunteer to spend half a day with each other to see the challenges facing different parts of the NHS. The doctors involved could use this as a quality improvement activity for their appraisal.
Dr Aggarwal said that the model can take place on a small scale and involve just one GP and consultant, but she wanted to run it across Southampton CCG and collect the doctors' reflection templates to help identify local issues where improvements could be made.
An event at the end of the process enabled the GPs and consultants who took part to share their learning and look at ways to spread the ideas nationally. 'There were some amazing case studies - and things that have gone forward and actually changed local practice, which is fantastic,' Dr Aggarwal said.
Dr Aggarwal, who herself took part in the scheme, cited an example from her own experience about one change that has been introduced. She hosted an orthopaedic consultant who was surprised at the amount of admin work coming through the practice.
'He said "you know what, you don’t read 90% of the letters that I send you. Why am I wasting my time writing all this stuff back to you? I could make your life easier",' Dr Aggarwal explained. 'He said he was going to start writing "for information only" or "GP action required" at the top of all his letters.
'He started doing it and we took this to all of our providers and asked them to do it as well. It is a game changer.'
The approach is 'basically about learning from each other', said Dr Aggarwal. 'Everyone’s busy doing the big stuff but actually as a jobbing GP myself, it is the little things that count.'
Dr Aggarwal said that the initiative could have an important role as part of the integrated care agenda and help primary care networks as they develop.
'It is important that we try and bring back those one-to-one relationships because otherwise we can't make change develop or move forward. It is all about relationships at the end of the day. The other thing that's exciting about this project is it doesn’t just have to stick with GPs and consultants – managers could do it, nurses can do it, healthcare support workers can do it.'
The Wessex Model has produced a guide on how to set up workplaces exchanges, which includes practical examples and templates particiapting doctors can use. You can find full details on NHS England's website here.