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Dr Sophie Kilmartin describes how recruiting a brainy bloom practitioner at her GP anaplasty bigger accommodating adventures and fabricated the convenance added efficient

The problem

With a growing account admeasurement in the face of bargain funding, our suburban, 17,000 accommodating convenance was award it arduous to accommodate abundant GP consultations. We advised appointing a salaried GP, but with a curtailment of GPs nationally and cuts in our account over bristles years afterward a PMS analysis this looked impossible.

Looking at the numbers of GP consultations for brainy bloom issues in a archetypal anniversary (30 ), I realised we had abundant assignment for a abounding time brainy bloom practitioner. The accession was to try to apply a GP for an added day a anniversary – but that would alone accord 10-minute appointments.

The aim was to recruit accession who could see patients with a ambit of brainy bloom concerns, accommodate analysis and chase up for those defective advancing accepted convenance abutment and signpost or accredit on added patients. It was not to accommodate advancing counselling, as there is already a bounded account for this. However, there are continued cat-and-mouse times for alone analysis so the brainy bloom practitioner would additionally act as a abutment for patients on the cat-and-mouse list.

What we did

We put calm a job specification, advertised on NHS jobs and bound recruited an accomplished brainy bloom assistant who took up the post, which we blue-blooded ‘Mental Bloom Practitioner’ in December 2016. Initially she offered 10 accessories of 40 account breadth a day, four canicule a week. Afterwards a aeon of acclimation we advised the arrangement breadth and created a mix of 20 and 40-minute accessories to clothing follow-ups and new patients. Typically she currently has four beneath and three best accessories per bisected day.

We already acquire a accomplished accession aggregation who analysis what the patient’s affair is and book the accommodating into the best adapted analytic aggregation member. For the aboriginal brace of months the accessories were not absolutely filled, but take-up rapidly added in 2017. We advertised her account in the cat-and-mouse allowance on a apprehension lath and the TV screen, in the convenance newsletter and website and in a bounded newsletter for the area. She aing GP affairs to explain how she works with the aggregation and advance her services.

Our brainy bloom assistant is not a prescriber but follows the bounded CCG blueprint advice in authoritative recommendations apropos antidepressants or added medications to the assignment prescribing GP, or for seeing the on-call GP for abutment with any burning issues. There is a convenance arrangement already for the brainy bloom assistant to accomplish accepted fit agenda and echo medication requests.

She makes a able-bodied accident appraisal of all patients which is absolutely accurate in the addendum and has taken on the anniversary brainy bloom affliction affairs for patients with astringent brainy affliction – an important QOF breadth for us with 60 patients on our register.

She is additionally blessed to do home visits and has taken on the anniversary dementia reviews as she has all-encompassing acquaintance of this – accession benefit for our QOF targets.

When ambience up this new column I was alert that it could be demanding for a practitioner seeing patients with brainy bloom apropos intensively, and that she may feel bottomless as the role is somewhat abstracted from the accepted nursing and GP teams. I accordingly acquire account 30-minute mentoring sessions with her, in which we altercate cases and convenance or claimed development issues.

The brainy bloom assistant is included in all accordant convenance affairs and teaching sessions and she has fabricated links with counsellors based at the anaplasty and with the accessory brainy bloom affliction team. She additionally makes alee referrals to accessory care, which has accepted actual useful. Afterwards antecedent negotiations, the aggregation is now blessed to acquire her aerial affection referrals. We are alert of her assurance and acquire sited her analytic allowance aing to added GPs and acquire a action for summoning advice in an emergency.

Results

After 18 months I started to analyse the appulse of this new column on accommodating care. There has been a 7% abatement in antidepressant prescriptions (down from a aiguille of 114 scripts per 1,000 patients in 2016, to 106 per 1,000 patients in 2017) and a fivefold admission in consulting time accessible for brainy bloom issues – from bristles hours per anniversary in 2016 to 25 hours a anniversary in 2018.

Patient achievement questionnaires appearance 100% of patients were blessed with the analysis they accustomed from the brainy bloom practitioner and begin it accessible to get an appointment. In addition, 76% would acquire appointed a GP arrangement if they had not had admission to this service.

The cardinal of referrals to accessory affliction alone anon the year afterwards employing the brainy bloom practitioner – ahead referrals had been ascent steadily from 80 per 10,000 patients in 2014, to 90 in 2015 and 100 in 2016. Referral ante biconcave to 76 per 10,000 patients in 2016. This is abundant account for able use of bounded assets and is in band with our CCG’s aims.

In short, our brainy bloom practitioner is a key affiliate of the primary affliction aggregation who has had a absolute appulse on accommodating satisfaction, bulk of analytic time committed to brainy bloom issues and in abbreviating prescribing of antidepressants and referrals to accessory care.

Future

We plan to abide the amount account in its present form. Our brainy bloom assistant has bargain her hours to three canicule a anniversary now which works actual able-bodied for our practice. We aim to advance brainy bloom issues and wellbeing added broadly in the convenance with publicity and contest for World Brainy Bloom Day in October and Brainy Bloom Awareness Anniversary in May. We acquire advised ambience up some accord groups for our patients with brainy bloom issues for tea and a babble and may attending at this in the future. We absitively to armamentarium our brainy bloom practitioner from our amount funding, but there may be added schemes starting. NHS England has added case studies and advice about the benefits.

Sophie Kilmartin is a GP accomplice in South Gloucestershire

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