4.1. The NHS – The People Who Care
This week, here at Self Care, we begin to untangle the roles and the responsibilities of the people who work within our wonderful NHS. Over the past year we have all learnt so much about how important the NHS staff are. They have put their lives on the line for us all. It is the fortitude, passion and forward-thinking mind-set of NHS workers that has given us all hope during this dreadful pandemic.
We’ve decided to split this session into three different articles and spread them out over the next few weeks:
- Understanding your GP surgery staff
- Who works in Community Services?
- What do those Hospital job titles actually mean?
Understanding your GP surgery staff
Your GP surgeries have been changing. You will have noticed that many have changed their names over the years from ‘Dr. Smith & Partners’ to ‘West Highdown Health Centre’ for example. This is mainly due to the increased scope of health support that a surgery now offers. We’ll cover most of this in the ‘community services’ article, but many GP surgeries have evolved into facilities that provide more care than just from a GP and Practice Nurse Team.
You may now find multiple surgeries within the same building; podiatry services, pharmacies, respiratory clinics, child health clinics, tissue viability (wound care) clinics… the list can go on and can be remarkably diverse. What is happening is that health centres are now health care hubs. This also means that you’ll possibly find a large variety of health care professionals (HCP’s) working in the same building. And just to note, Health Care Professionals is the current term used by the NHS for our clinical heroes.
At my surgery, all the GP’s and Nurses have their rooms downstairs. Then there is a team of District Nurses based upstairs who use the health centre as their base. Alongside them are based a few Specialist Nurses who are classed as community services. Built onto the side of the health centre is a Rowlands Pharmacy. So, it’s really a one-stop shop for health support! Has your surgery evolved like this?
Those wonderful people – the NHS workers
The Reception Team:
Ok, so we’ve all had a run in with a difficult receptionist at some point. And unfortunately, that negative experience can stay in our minds for a long time. But let’s take a step back – the role of the reception team is varied, significant and ever-changing. 99% of reception staff are incredible at their jobs. Their main role is to make sure you get the correct support that you need. They deal with patients, the vital admin – plus all the clinical staff on the other side of the counter. It’s a mega task that requires super organisational and people skills.
The receptionist will usually be deeply knowledgeable about local health services and can make decisions about who you are best to see within the Practice. They will know the responsibilities and specialities of the clinical team and will have been trained to book you in with the appropriate team member.
All practice staff are bound by strict codes of confidentiality. Therefore, you can discuss high level matters with the receptionist, but if that makes you feel uncomfortable, you can ask to speak to a Practice Nurse.
There’s lots of affection for our Practice Nurses across our nation – and rightly so. First of all, they have to deal with all those GP’s!!!
A Practice Nurse will manage a wide variety of treatment room activities such as changing dressings, ear syringing, smears, basic contraception, injections – the list goes on.
You may have also heard the term, Nurse Practitioner. A Nurse Practitioner can also take responsibility for some chronic illnesses such as diabetes and respiratory diseases like asthma and COPD. They may run clinics for these diseases and take over the general care ahead of your GP.
There are also Prescribing Nurses. As the name suggests, these are nurses who have taken an extra qualification which allows them to prescribe medication.
So, if you have a long-term (chronic) condition, you will probably get to know your Nurse team very well. They are also usually a good person to talk to if you have been confused or left uncertain by a conversation with your GP.
Most of us know that GP stands for General Practitioner – and therefore, we would assume that they have a wide knowledge across the sphere of ailments and diseases.
A GP will treat all common medical conditions and can refer a patient onwards to other medical services (such as the hospital) for urgent or specialist treatment. A GP focuses on the patient holistically, combining physical, psychological, and social aspects of a patient’s care.
A GP surgery may have multiple GP’s working within it. GP’s can specialise in specific disease areas, so if you have a specific problem, for example a respiratory disease, you can ask to be seen by the GP who specialises in respiratory medicine for that surgery.
So, if you go to a large surgery with 15 GP’s, then there’s a good chance that one specialises in your problem. However, a downside of a large surgery is that they can sometimes be less comforting to visit and feel more like a small hospital – so there are aspects to consider if you are choosing a surgery to sign up to.
Here’s a great video from the NHS England and NHS Improvement YouTube Channel, which talks through (in 3 mins) the day in the life of a GP on The Wirral:
Pharmacists within practices are growing in numbers. That’s all part of the NHS Long Term Plan. They play a vital role in a GP practice in two dimensions: 1). To ensure the practice is using the right medicines efficiently and aligned to guidelines and 2). To advise patients on correct usage of medications.
As we get older, the number of medications that we take invariably increases. Have you ever felt that some of your medications are making you feel ill in some way? It is very possible. Some medicines don’t belong together. Every single person is unique and drug interactions can be different for each person. So, if you think a combination of medications that you are taking are making you feel unwell, then you can speak to your GP Pharmacist who can book you in for a medications review.
I had a friend once who was extremely ill. However, the 28 daily medications he was taking seemed bewildering to me. So, he asked for a medication review and managed to get it down to less than 10 a day and some of the effects he was feeling went away. I bet we all know a similar story. Don’t feel that you have to suffer in silence.
“Clinical pharmacists work as part of the general practice team to improve value and outcomes from medicines and consult with and treat patients directly. This includes providing extra help to manage long-term conditions, advice for those on multiple medicines and better access to health checks. The role is pivotal to improving the quality of care and ensuring patient safety.” (NHS Website, Link to source: CLICK HERE).
The Practice Manager:
“Practice managers are vital to the successful running of GP surgeries. You'll manage the business aspect of the surgery, making sure that patients are at the centre of the surgery's operations.” NHS Website, ‘Roles in Management,’ (Link to source: CLICK HERE).
So a Practice Manager is the main business-focused member of the GP surgery. Imagine the scope that can include:
- Business planning
- The main business contact between the local Clinical Commissioning Group and the practice
- Management of patient and practice records and performance against set-targets
- Management and responsibility of the appointment system
- Managing the financial systems for the practice, including payroll
- Recruiting, training, and managing non-clinical staff
It’s a huge job, especially for the larger practices. Many Practice Managers will look after practices spread over multiple sites, covering 10’s of thousands of patients, with multiple GPs to work with and many staff to personally manage. When you consider the responsibility of a role like this, it is no walk in the park.
As a patient, you will possibly never see your Practice Manager. However, if you need to raise an issue or question a process, then writing to your Practice Manager is probably a good first step.
Ok, that’s enough for today!
We’ve highlighted the key roles that you may have interaction with at your GP surgery. As we have said in previous articles, it is always a good idea to get to know your clinical teams well. They will have a section on your GP Practice website that invites you to ‘Meet the Team’. The full team are there for you to use and benefit from, so don’t be afraid to ask for specific help from a specific Health Care Professional when you need it.
See you next time when we talk through Community Services.
Founder of Health Control