A convert...

The road to Damascus is a dusty tarmac strip.  

It was on this road that Christians believe Saul, on his way to arrest Christians, encountered a vision of Jesus and became Paul, the apostle.    

Actually the scriptures say 'near' to the road and there are contradictory reports.  However, travel west, to Kawkab and you'll find, on a rocky hillside, across a valley, a white painted church.  

Draw nearer, you'll see a sign, in Arabic; Welcome to the Abbey of St Paul the Messenger.  There are twelve arches, one for each disciple.    

It's built on the old road to Jerusalem, which Paul was though to be travelling.  It is here, it is believed, his conversion took place.  

This church was raised on the ruins of a second century Christian church.  Thus, history, belief and a bit of confused geography has entered our language; a Damascus Road conversion.  

My road to Damascus was actually on a miserable, grudging South West train to Gillingham.  Not Jillingham, but Gill, as-in-fish, ingham.  Just in Dorset.  

It was this journey that told me, I've been getting it all wrong.   

I've actually believed we need more GPs.   I've been confusing things.  Society, with its long-term conditions, comorbidities and changing social determinants of health have shifted the fulcrum point of healthcare, yet the NHS is still determined to deliver healthcare using the same old levers.  

More sick people, more demand, more GPs, more of the same.   

In my Damascus moment I realised we probably have enough GPs.  We just don't help them to work efficiently, create the time and space for them to do what they've spent a lifetime training to do.  

If there is a Holy Grail, I think I might have found it.    

It's a GP practice, the Blackmore Vale Partnership, they have changed the way they work.    

They have disciples.  They call them Health Champions, who, through their lived experiences of illness, long-term-conditions, happenstance, pain and even suicide, create groups of the like-minded, fellow travellers and listeners, to help, coax, guide, shepherd and support each other.  

It's simple.  For instance; they've grown walking groups.  Enthusiast for weight-loss, lowering blood pressure, cholesterol, fresh air and each other.  But, that's only part of the story.   

They should take down the sign in the car-park.  This is not a doctors' surgery.  It is a community centre and somewhere, inside, you'll find some doctors... with more time to help the people who are really ill.  

The waiting room is about to become a coffee shop...  

This place and this approach is so totally unique, there is nothing in the management lexicon that helps to describe it.    

Social prescribing doesn't really do it justice.  It's a partnership philosophy.  It's not us and them, it's them with us.  

Fibromyalgia; they have a patient group, sharing experiences, in search of a new wellness and confidence.   

At the heart of it, the understanding; anyone who says 'I know how you feel', doesn't... unless they've been there.  And, if they've been there, they'll know what's next and how to deal with it.  No doctor required.  

Frequent attender's numbers have dropped off the cliff.  

Diabetes, as much as it can be a curse, is simple; blood-tests and prescribing.  So often it can be what happens to the person; loss of control, guilt, regret, becoming a different person, medicalised... is what needs to be sorted and it can be done by fellow travellers.  

This is more than co-production, it's more like syndicated-wellness.  It is the realisation that a long-term condition is so much more than an appointment with a doctor and a prescription... it's a date and a coffee with someone like you, going through what you're going through.    

Free books for the kids, an 'it's good to talk' bench to sit and have a chat and a genuinely welcoming feel.  This practice announces it is different from the moment you walk in.    

The evidence tells us, demand for GP appointments has fallen.  They get home on time.  

This revolution, in collaborative practice, has been lead by Altogether Better, an NHS network organisation, open-minded GPs and staff and the nuclear energy of the practice manager and partner, Jane Dawes.

The results are startling.  Go and take a look you might become a convert. 

Many thanks to Roy Lilley for allowing us to reproduce his blog post here, which was first published on 31 January 2020.  For more of his perspective and insights, follow Roy on Twitter @RoyLilley.