Thread by @NHS

Hopefully a heartwarming Thread: Healthy Lives clinic - what was it, what impact it had for individuals and for the group.

Using NHS vanguard funding, @ModalityGP, in partnership with community charity @NishkamCentre ran a small clinic where people with chronic diseases, or on lots of medication could get additional support in an innovative way

People saw a GP for a single, one-off 1hour appointment, focussed on “what matters to you?” to guide the conversation towards some realistic goals and actions to improve health. The conversation was totally individual but a few common themes emerged

People wanted to come off tablets if safe to do so, people wanted to feel better in themselves, people wanted to improve their health but often didnt feel that was even possible. Remember we are talking about Handsworth, an ethnically diverse, but very deprived area of Bham

Conversations variably involved: compassion, empathy, health education, building a shared understanding, shared decision making, diet, physical activity, relationships, stress, sleep, behaviour change, motivational interviewing, social prescribing. All rolled into one!

Every person left with a “prescription” like this, co-written, co-signed, and everyone agreed to share their plan with a close family member or friend @B_I_Tweets @stephenrollnick

They were already under routine planned care for various chronic conditions, so we didnt increase the appointment burden by making more appointments. It’s hard enough work being a “patient”. Also we didnt want to create “dependancy” on this service that we knew would close at 1yr

And HERE’s THE IMPACT. For the overall group these are the outcomes 1 year after this single conversation. Demonstrates there is room for improvement, and the conversation really should be how we can apply the learning from projects like this into routine primary care

Personally I prefer graphs and stories. Here’s the graph of average GP consultation rates in the 12 months before and after the single consultation

And here’s the stories. First up is Colleen, who was interested in meditation/mindfulness prior to the appointment and wanted to put this in her plan. She describes how this appointment changed her life

Next is Nora who explained that she always put other’s needs above her own. Wanted to improve her mobility and pain. Just doing 5 mins moderate exercise with her children everyday led on to +++other improvements.

This short youtube video about the healthy lives service explains more from clinician and patient perspective

And here’s the video that makes me well up with emotion every time. Please listen to Bev, one of the most incredible people I’ve had the privilege to meet, explain how despite much adversity, she changed habits and found a new love for life

I have been struggling to explain all week on the @NHS account how rewarding person-centred care feels for me as a health professional. I hope these videos give you an insight and I’m very grateful to Bev, Nura, Colleen, Chris and all others for sharing their stories

There are challenges to scaling this type of model and there are definitely more than one way of achieving these outcomes. Major limitations of this project were the small scale and lack of an in-house MDT. Looking back, providing a follow up appt may have also been beneficial

Since the clinic completed last year, I have tried my best to have the same sort of conversations in routine primary care, dipping in to social prescribing, lifestyle medicine, health literacy, motivational interviewing as required, and guided by what matters to the person!

Actually it is probably having a better impact now but we aren’t formally gathering the data. The amazing thing about primary care is that LOTS of associated specialities are geared up to person-centred care, i refer to and rely on the expertise of all of them.

So I hope that sharing our small project with you all, especially the videos warms a few hearts this evening. Any feedback always welcome