In the time since Tim Goldsbrough became Practice Manager at Hope Farm Medical Centre in West Cheshire, he had integrated several new strategies in patient care and placed a renewed focus on building a strong team – including some more unusual activities such as a group trip to the zoo to study apes…
In the first of a two-part interview with FPM, Tim discusses how he has shaped Hope Farm into a progressive and care-driven service for its 12,000 patients, placing a focus on care and social factors, working closely with care organisations and taking part in innovative pilot schemes– and how he expects the practice to develop even further in the future.
To start things off, how long have you been practice manager here at Hope Farm?
I joined the practice in October 2014, so nearly two years now. I came from the private sector and was looking for a career change, saw the opportunity here so I applied and I’ve been here ever since.
This was an anniversary year for the practice, celebrating 25 years, what's the secret? How has it kept the momentum after all this time?
I think the secret really is investing in the staff, making it a really enjoyable place to work, making sure the patients are happy, the staff are happy… I think it’s a real credit to the culture and the long-term strategy that the partners have had to make sure that people feel like they really want to stay here. It’s often commented that when you start at Hope Farm, you don’t leave!
I understand that when you started here at Hope Farm, you began to redevelop the way that the practice interacted with and supported patients. Tell us about this Patient Services Team that you set up.
When I first started we had this traditional reception and admin staff split, and certainly coming from a non-NHS background and engaging with the team, you start to understand that they have a huge amount of knowledge and expertise. Sometimes the patients’ perspective was that they were just the receptionists and administrators, and didn’t really give them the sort of recognition that they deserved.
We decided to rebrand the team, and rather than having a receptionist, or an administrator or a typist, we have a Patients Services Team. Again, it’s about putting the patient at the centre… the team are here to serve the patients’ needs, but also have a lot of knowledge that they can pass on to the patients.
How did the team take that approach? Was it something they were accepting of from a new manager coming in, new ideas and new methods – how did they take to this?
I think as with any change, people deal with it differently – some staff members engaged straight away, some were a little bit more reserved and needed to see it in action. I spent quite a bit of time with them going through the changes, the reasons for them, and obviously getting their input.
And I understand that you had some unusual ways of developing the team?
I’ve always been very pro-training and development. With a GP practice it’s very easy to have GPs, nurses and administrators that almost function independently as three separate teams, and what I wanted here was to have one fully functioning, interactive team.
One of the things I developed with the partners quite early on was a training strategy to really build on that, so one of the things we did was attend a training afternoon at Chester Zoo on their Ape Management course. It looks at different groups of monkeys and species, how they interact as a team or a group, observing them and then going back and thinking about how we can apply some of those traits to our team here.
As with a group of monkeys, we’ve all got different personalities, we all handle pressures and conflicts differently – team members do fall out at times, that’s just a natural process of being human, but what we were able to learn from the course was how they resolve those issues, and how they got to function as a group.
That’s quite an ‘out of the box’ method – how did the team react to a trip to the zoo?
I think by this point they had realised that nothing was off the table with me, so I think they expect the unexpected! I do like to push the boundaries slightly, and see things in a different way. In the autumn I’ve arranged some training with a company that is coming in to run a session looking at the power of laughter. I know that’s probably going to push some people out of their comfort zones, but it’s good to challenge people in a non-confrontational way.
This year, you began a pilot to extend appointments up to 20 minutes for patients with Long-Term Conditions. How did that come about?
The West Cheshire CCG were looking for a couple of sites in this locality to trial a new way of delivering care to patients with long-term conditions (LTCs), and because we had just recently won the West Cheshire CCG Awards for supporting patients with LTCs, they felt we were a natural fit.
Basically it was looking at the whole process of people coming in for their annual reviews, streamlining it for the practice so that the practice benefits [from the process], but also looking at the outcomes for the patients.
From a practice perspective, what the patient does now is get their annual recall letter, come in and see the Healthcare Assistant who does an initial appointment, and do all of their health checks, tests, blood tests etc. for their specific long-term conditions. They then book the patient in with a Practice Nurse for a follow-up appointment, and in that interim period, the patient is sent their test results so that they have them in advance.
The idea behind that is that they can actually think about the results, prior to their annual review with the Practice Nurse, and within the results letter there is also actions for the patients to think about – what goals do they want, what outcomes do they want… The idea of this is to empower the patient. It’s been very much in the past that the patient has come in and been told that they need to do this or that, rather than asking the patient “what is it that you want to achieve”.
There’s quite a lot of research out there that says if you tell someone to do something, they’re less likely to do it, whereas if you say to someone “What is it that you want, and how can we help you achieve that”, they are more likely to achieve the results.
That’s the key emphasis to the pilot - to turn the tables so it’s not just us telling the patient ‘you must do this’. It’s very much about helping them achieve their goals and then putting the steps in place to give them that support.
Stay tuned for more from our interview with Tim next week, featuring discussion on the work his practice has done in social prescribing. For the full transcript of the first half of our our chat with Tim, you can download the Word document here.