A new blueprint for general practice at Robin Lane
“The great story is lives have been transformed. We reach hundreds and hundreds of people every week. People are no longer isolated; they have made new friendships and use services differently. We have increased our patient lists by 4,500 people and seen no increase in demand for either primary or secondary care consultations because we do things differently. ”
Robin Lane Medical Centre has nine doctors, employs 50 people, has 13,000 patients and is growing at about 5% a year.
Managing Partner, Mev Forbes, explains: "We had a growing realisation that general practice was unsustainable in its current format. We can’t just go on employing more and more doctors to meet more and more demands, we had to think quite radically about how to change demand in the first place.”
Robin Lane now works with more than 50 enthusiastic citizens who deliver 19 different kinds of groups and activities. As well as the plethora of champion-led social groups, the practice now runs a Ukulele group, provides 7 day a week breastfeeding support delivered by Champions, keeps a constantly updated dynamic directory of local services and resources and signposts and routes people to activities in the community.
Champions also support service delivery in many different ways including for example increasing the numbers of people attending Saturday flu clinic from 300 to over 800 people.
“When we first put out an invitation to patients to join we had over 100 applicants, it was absolutely astonishing!” said Mev. “Before we started we didn’t know if we would get one champion let alone if one person would use the coffee shop. And now we’ve got a wellbeing centre and groups on every day.”
The Practice has now established a charity run by a board of volunteer champions. Wellbeing Manager Dominique explains: “We’ve got a steering group who run the reception, fundraising, and DIY – Geoff does DIY. We have people on reception 12-2 every day, they give out information and help people.
“We have regulars who come to the café and who might be a bit lonely. So they go into the café and have their breakfast then they come in here and have a chat for an hour, and then they go home. And of course we have our 19 groups run by volunteers.
“The way it works is that it has to be the champions’ thing. We will offer any support they needs, but it’s their idea. If I’d approached them and said ‘We want to start this group, we need somebody to lead it,’ then it would be a lot harder.”
The Ukulele group is one of the groups and is run by Lesley who said: “I wanted to start a group here because I love using this centre, it’s the hub of the community. It’s got so many exciting things happening and it’s all about community and people meeting each other and forming friendships, and learning new skills, enjoying and laughing, and sometimes being sad – but that’s good as well.
“The group is about so much more than ukulele. Of course ukulele is important because it makes you smile – I’ve never known an unhappy ukulele player – but we hope people will step over that threshold and enjoy being part of the group. It’s all about friendship.”
Linda Belderson is the senior GP Partner at Robin Lane and has spent many hours alongside the volunteers – including preparing a Christmas Day lunch for local residents. She said: “The champions really have enabled a lot of things to happen which wouldn’t have been able to happen otherwise so it’s this huge resource of enthusiastic and very committed people.
“It feels like we’re a GP practice within a larger organisation, there’s the general practice primary care bit which is wrapped around with a much bigger range of things going on.”
The Sewing Group is another of the groups run by champions – they meet every Friday for two hours. Noreen from the group said: “It’s 70% about social and 30% sewing, and some days we lay the sewing out and we look as if we know what we’re doing, but then the coffee is out and the chatting starts and before you know it it’s 12 o’clock and we’ve not actually picked up a needle!”
A more sustainable model for general practice has led to improved efficiency and increased productivity:
The practice has increased their patient list by 57% from 8,500 to 13,000 patients without any increase in primary or secondary referrals and a 10% reduction in use of A&E.
There is evidence of increased efficiency by dealing with failure demand
Over 50 volunteer Practice Health Champions work alongside the practice team
The practice have reconfigured their staff team and redesigned their offer to respond to the new challenges, choosing not to appoint to a vacant salaried GP post but instead choosing to invest in a Community Matron and a Wellbeing Coordinator.
The Practice has evolved to do things differently – their identity has changed - they no longer describe themselves as a medical service and are rebranding as the Robin Lane Health and Wellbeing Centre.