DEVELOPING THE TOOLKIT
An advanced draft was pre-tested at a Health Commissioning event in January 2012, limited copies were distributed, and a second edition was published in June to correct few errors and incorporate initial feedback received from stakeholders.
The second edition of the tool was promoted through different channels including the Shadow Healthwatch e-network newsletters, health fairs and forums, and presentations made to various community groups to explain its aims, use and importance of completing the feedback form. Copies were put on display in libraries, GP Surgeries, Out-Patient Clinic at the Croydon University Hospital, and community centres.
Further reviews of the tool and its effectiveness led to us receiving an award from One Croydon Alliance Local Partnership Scheme to implement a project titled ‘Expansion of GP Partnership Tool within Croydon and environs. The project has three components:
- Distribution of printed tool to patients for use to test its effectiveness
- Upload tool onto websites of GP Surgeries and Pharmacies
- Develop a digital tutorial video that will circulated to create awareness and strengthen understanding among communities that are not fluent in English.
We continue to develop our tool and other services as an aid to addressing loneliness and isolation among the elderly through attendance at community events where they meet others, make new friends and have fun. Our project is different. Experience has shown that other silent causes of loneliness and feeling of isolation especially among people with multiple health conditions, even when surrounded by people, is that feeling of helplessness, anxiety or even fear. These result when one does not quite understand the nature of their illness, how to explain it when consulting with a doctor or nurse and engage in reaching a possible cure. These are the issues that the GP Partnership Tool project is trying to address in a sustainable way.
image-of-first-tool-cover
Toolkit-1st-Edition
toolkit-2nd-Edition
tool-review-2014
tool-3rd-Edition-1
toolkit-Final-Edition
GP OPEN MEETING
Clinicians were with us all the way
As mentioned earlier the GP Partnership Tool is the People’s Toolkit as a cross section of Croydon communities have been involved in the review, editing and overall development of the different editions to date.
Clinicians have also been involved in its entire Journey:
- its initial development in 2012
- reviews in Croydon and Merton in 2014
- open consultation at Croydon Clinical Commissioning Group, CCG, AGM in 2016
- review by One Croydon Alliance Health and Care Delivery Group in 2017
- Endorsement by Chair of CCG in 2017
- Endorsement by One Croydon Alliance Proactive and Preventative Board in November after an award had been secured from One Croydon Alliance Local Voluntary Partnership Scheme for expansion of the tool.
On invitation we participated by putting up a stall at the GP Open Meeting on 28th November at Croydon Masonic Hall, Oakfield Road. It brought together GPs and Practice Managers together to learn and share and to give them a taste of some of the health and care projects available in the community. Our stall attracted a lot of attention and feedback was very constructive.
So what comments did they make?
” Add a few pages of blank sheets so patients could make their own jottings”
This was done and four pages of note included in time for the first launch on 25th February 2020.
” If possible add a guide of some sort the will encourage interested patients, particularly those with language challenges to read on”
This has been done in the form of a tutorial voiceover video that will be launched on 25th September
” Maybe helpful to establish relationship with Link Workers who hold sessions with patients in different surgeries”
We made the move, then the pandemic and will continue to try
gp-open-meeting-03
gp-open-meting-11
gp-open-meeting-13
gp-open-meeting-12
gp-open-meeting-10
gp-open-meeting-09
gp-open-meeting-08
gp-open-meeting-05
GP-open-meeting-1
Report on the Review of the GP Partnership Tool
by Sylvia Wachuku-King
Brief background
The GP Partnership Tool, ‘How to make the most of your visit with the doctor or nurse’ was originally developed to improve communication between clinicians and people aged over 50s as an identified need. The project aimed at reducing health inequalities among over 50s in ethnic minority communities, was part of a requirement for the Croydon Voluntary Action Health Champions’ 2011/12 programme. Ideas for development of the tool, an adaptation of an existing tool, were provided by Sylvia Wachuku-King, one of the Croydon Champions.
As the ideas contained in the tool fitted well with its ethos of ‘ Health in your hands’, the then Shadow Healthwatch decided to adopt it and through it’s Empowerment Fund applied resources for the packaging and publication. Copies were widely distributed, including through the Out-Patient Clinic of Croydon University Hospital, GP Surgeries, selected Community Centres, groups and events to name a few.
Why the review
While feedback forms were included in the tool they were hardly completed and returned making it difficult to tell how useful it had been to those who had received copies. Meanwhile some centres had run out of copies and were asking for more. It was then decided to have it reviewed before new prints were made. Meanwhile Wellbeing You Ltd had been formed that will act as a vehicle to take activities related to the tool forward. A draft framework for the review was put together.
Mobilising resources for review.
Discussions were held with appropriate stakeholders who would be interested in the tool and importance of it’s review, how they might want to be involved and what possible resources they could make available. Luckily the Association of Guyanese Nurses and Allied Professionals, AGNAP, Healthwatch Croydon, Healthwatch Merton and Croydon Voluntary Action and Wellbeing You Ltd agreed to apply resources as follows:
| Organisation | Resources applied |
| Association of Guyanese Nurses and Allied Professionals, AGNAP | Merton Hall Rental, refreshments for Merton, raffle items,, part cost of leaflets and ICT for Health workshop |
| Croydon Voluntary Action, CVA | Venue for Croydon review, photocopying, tea and coffee |
| Healthwatch Croydon | Part cost of publicity leaflet, refreshments for Croydon review and in kind admin support |
| Healthwatch Merton | Facilitation of table discussion, online publicity and typing Merton notes |
| Wellbeing You Ltd | Overall coordination |
The reviews
It was agreed to do two reviews one on 23rd at Vestry Hall Merton for residents at Merton and Wandsworth and the other on 29th April for residents of Croydon. A fitting publicity leaflet was designed and printed by CVA and distributed widely. Format for four table discussions were developed that assigned specific sections/pages of the tool to a particular table. Each discussion table was given a photocopy of the tool to allow space for jotting down comments and suggested changes. Specific questions were also asked as further guide
Results of the review
What is good about the tool?
- Colour draws you in/ cover is eye catching, attractive, it makes you want to pick it up
- Paper is very robust, quite durable
- Title is clear
- Like the content of each section
- Keep self assessment section, the boxes are good
- General design of front page is pleasant
What could be improved
- Do a question section on Dementia (use assistance of Alzheimer’s Society perhaps
- Health calendar could be extended so people can write more
- Make one list of important points for pages 6-10 to take with you
- Reduce comments by people
- Health history in the beginning or the end
- Have a forum or group to review the booklet and report back how they found it. Or ask GP to give to clients
- Introduction – too wordy, better font which is clearer. One or two sentences about using the booklet when going to doctor
- Acknowledgement should go to the back
- Tick boxes would be useful
- Computerised version
- Page 7 – Box 3 remind patient to ask how medication should be taken
- Symptoms- what are they and how long have you had them?
- Letting the GP Practices do the distributing
- Posting them out to people
- Middle section up to page 18 should be replenished
- The words on the front cover are too repetitive
- Start with clients going to pharmacy
- Page 6 – have a diagrammatic direction and tick boxes
How to make it easier to use?
- Information text to be larger
- Online version for people who IT literate
- Have envelope pocket at back of booklet to slot in the updated sections
- A larger size book to improve the view and content
- Carry out a pilot project with one GP Surgery using the booklet for all clients
- After 2 appointments perhaps have appointment plus agreed action as an additional card
- Pictorial aspect for people with learning disabilities
- Shorten to ‘Making the most of your visit’
- Feedback on one page- maybe three questions. ‘Where did you get this booklet from?’
- Asking about format and design
- Questions on the feedback form need simplifying and rephrasing
- Limited versions available for people who do not read English, Braille version etc
- Where does a person get this booklet? Could it be made available to GPs to offer patients?
- A plastic wallet similar to a car manual to add whatever you need to keep together
What else could be included?
- Intermediary health services
- The Global Community Project ( global college and clinics)
- Mobile health clinic <07403206843>
- Online training in healthcare
- Mention about the need to discuss important private areas
- Having a double page to list more health organisations relevant to the 8 listed on page 19
Some of these ideas are included in detailed notes and suggestions for change made on each page of the tool that are not included in this report.
Main constraints
Each table decided to do a review of the entire booklet such that there are several conflicting suggestions for many sections and there was no agreement on which suggestion to accept to develop a draft of the new edition.
Final remarks
At the end participants were thanked for giving three hours of their time to the exercise. The estimated plan was for a draft Edition 3 to be ready by September 2014 that will be shared with GPs for their comments after which a final draft will be produced for a pilot. This of course did not happen until 2016 due to unavailability of appropriate resources.
Participants Feedback
In all there were a total of 44 participants in the two reviews- 25 at the Merton review on 23rd April and 19 at the Croydon review on 29th April.
All the 20 participants that returned their feedback forms rated the overall event very high. Specifically they stated that:
- The session met their expectations.
- It was very informative
- They particularly liked the group discussions
- Would like to be involved in future similar reviews
- They were also satisfied with refreshments and venues
The following are improvements they would like for future reviews:
- Use of microphones by speakers
- Chance to read booklet before event
- Room was too hot and one person dominated discussion
- Spend more time on analysis and reach an agreement as opposed to varying views that will be difficult to put together
- Make provision for vegans in refreshments
Additional comments were:
- Do your best to include all boroughs so that eventually the word would reach a wider section of South London and beyond
- Perhaps not long enough
- Everyone present and official members seemed to be committed and have enjoyed this event
- I thoroughly enjoyed the hour that I was able to attend
- Excellent to meet colleagues and exchange of ideas
- Biscuits delicious and good to meet new people
- Having a good facilitator who is well informed of the booklet and issues surrounding it is productive and useful
