Would you be happy to see your GP with more than a dozen other patients? That’s what’s happening in trials across England, where doctors are seeing groups of people with the same condition.
Shared medical appointments (SMAs) are being piloted in some GP surgeries, with initial feedback being ‘very positive’, according to the Royal College of GPs. Up to 15 patients with the same condition are sharing sessions for advice on conditions such as raised blood pressure, rheumatoid arthritis, chronic back pain and asthma.
The RCGP said some people benefited from the support of fellow patients and that shared appointments reduce the need for GPs to repeat the same information a number of times, although stressed that the approach would not work for everyone.
Shared appointments first came to the UK from the US around 10 years ago, with small-scale trials increasing in recent years across England. RCGP chair Professor Helen Stokes-Lampard said: "We are already aware of practices that are offering shared appointments for patients with similar conditions and the feedback has been very positive.
"Some patients have even said they have benefited from the support they receive from their fellow patients, in addition to the care they receive from their GP. However, this approach will not work for everyone and GPs will know what best suits their patients and practices. There is no pressure on patients to participate if they would prefer to continue seeing their GP in a one-to-one consultation."
SMAs are already working well in hospitals, such as in Torbay and South Devon NHS Foundation Trust. Consultant rheumatologist Dr Kirsten Mackay wrote in the BMJ last year: “The rheumatology outpatient follow up burden doubles every five years. Finances in the NHS are tight, thus additional staffing cannot be provided to manage this increase in work, demanding a novel approach be instituted to initiate disease modifying therapies (DMARD) and biologic therapies quickly.
“For nearly ten years, our department has extensive experience developing a range of shared medical appointments or group clinics. We audited our practice in 2015. Of 607 patients starting DMARDs, 60% started in a group clinic and 27% were started via a telephone consultation. Only eight percent requested an individual face-to-face consultation with the specialist nurses. Time saved, over one year, was equivalent of 1,664 rheumatology nurse appointments of 30 minutes each, allowing the nurses to see more patients with urgent problems.
“Patients were equally satisfied with this new arrangement as they were with a traditional one-to-one consultation with a specialist nurse. This level of patient satisfaction has continued at the same high level - 4.7 out of five - since 2008.”
Dr Mackay added that up to 18 people with a new diagnosis of rheumatoid arthritis or psoriatic arthritis are invited for a monthly group question and answer session led by a rheumatology consultant, specialist nurse, podiatrist, physiotherapist and occupational therapist.
“Tea and coffee are available, with time for patients to interact with each other, encouraging peer-to-peer support,” she said. “Average attendance per clinic was 12 patients, with the addition of some relatives and carers. As a consequence of this approach, 11 clinics per month have been released for other work for the physiotherapists, OTs and podiatrists. Anecdotal reports suggest patients have been better educated about their treatment plans and their underlying disease when seen in follow up clinics.”
SMAs are expected to be included in the NHS 10-year funding plan, which is due to be published later this year. If you’re worried about waiting lists and would like to find out more about private health care benefits such as access to a private consultation, you can compare health insurance quotes online or speak to one of our team on 0800 862 0373.
