Harnessing the expertise of our colleagues in primary care

Sarah, Suzy and Shabnam recently joined the team as our new Primary Care Leads – working with partners to provide vital clinical input and first point of contact expertise. From improving connectivity with our GP and community colleagues, to advising on the implementation of enhanced services, along with supporting new ways of working across the region – their involvement is invaluable. Here we find out a little more about them and what they hope to bring to the partnership.

 

Tell us about your experience in primary care and what gets you up in the morning…

Sarah: I’ve worked in the diverse land of General Practice for over a decade and found this suits me very well, as no day is the same! Providing both acute and ongoing support definitely keeps things interesting, with plenty of opportunities to establish therapeutic relationships along the way. It’s this aspect of the job that keeps me in primary care, along with getting to the heart of what matters to individuals. Whilst we know this is the foundation of good practice and the way to sustain long term changes, there’s always more to learn – which despite the challenges, is ultimately very rewarding.

Suzy: I came to general practice after acute medical specialty training, because I wanted to see the patient journey through from start to finish – and to try to have more of an impact on long term health outcomes. Meeting patients at their level, going upstream and trying to get to the root cause is what motivates me the most; as Michael marmot says ‘why treat your patients and send them back to the conditions that made them sick in the first place?’

Shabnam: I’ve worked as a full time GP at NHS Fife for nine years. I left surgical training to pursue a career in primary care as I find the continuity and supporting patients from ‘cradle to grave’ to be the most rewarding aspect of the job. I work in a big, busy, urban training practice so there is no shortage of experience! I regularly provide out of hours care and enjoy being on the front line. Within my practice, I am the lead for Foundation Year 2 students and enjoy supporting and training colleagues – something I have also extended to both pharmacists and Advanced Nurse Practitioners (ANPs) so that they can achieve their independent prescriber status. A few years ago I took on the lead role at my practice for diabetes management and have enjoyed expanding my knowledge and optimising support for our diabetic patients.

 

What is it that sparked your interest in our programme and encouraged you to join us?

Sarah: I’m acutely aware that we alone in General Practice cannot dedicate the amount of time and resource needed to manage the growing prevalence of Type 2 Diabetes (T2D). And yet with so many people coming through our doors on the cusp of pre-diabetes – it’s clear that we need to work together to ensure change. Having often felt disheartened with prescribing yet more medication, as evidence tells us that tailored lifestyle education or low calorie intervention programmes make all the difference in the long term, I really saw the benefit of the East of Scotland Partnership’s work. Building upon successful strategies which have allowed collaboration to flourish, it’s great to now be part of efforts to enhance existing services and ensure they are accessible to all. The increased media coverage of diabetes, due to growing evidence of the associated Covid-19 complications, also means that we couldn’t be better placed to raise awareness of the core messages of a Healthier Future for Scotland and drive forward implementation of the national Type 2 Diabetes Framework.

Suzy: After completing my lifestyle medicine diploma I was looking for a way to make an impact locally and within the NHS. So much good work was already going on in this sector but it’s hard to keep track. Enter the East of Scotland Partnership which connects many of these dots! Getting involved as a grass roots GP is the perfect next step.

 

How do you feel your involvement in the partnership will help us to achieve our aim of reducing type 2 diabetes across the East of Scotland?

Sarah: Input from primary care stakeholders will be vital in the reframing of expectations and delivery of care to align with government strategies. The term ‘cradle to grave care’ is outdated now, but it still stands true. The need to provide early education to individuals and families for the best start in life and across the lifespan is so apparent; particularly against the obesogenic backdrop of the junk food industry and marketing. General Practice has access to just about the entire population and will be central to starting conversations – capturing those at risk, joining up care and signposting to appropriate local services, including social prescribing and support for health literacy.

Suzy: We are all aware of the growing prevalence of T2D and the potential to prevent its development, but what we’ve been doing to date isn’t working. The programmes offered by the partnership are the support that we need to help our patients recognise and go against societal norms, hopefully starting the process of shifting away from the obesogenic culture in which we live. General practice has a key role in activating and empowering our patients to engage with these evidence based and effective programmes so I’m ready to spread the word to patients and colleagues alike.

Shabnam: Diabetes is common in my family and having struggled with my weight too, I am aware of the importance of lifestyle modification in the management of diabetes. Patients with type 2 diabetes are a mixed group and need individualised treatment goals. Pharmacological management moves forward at a fast pace but we need to ensure lifestyle modification remains the mainstay of treatment. We need to use a joined up approach to educate both current and future generations. Joining this program appealed to me as this allows me to collaborate with other healthcare professionals and be at the forefront of delivering care.

 

What do you see as the biggest a) barrier and b) opportunity to advancing change across the whole system, in the new Covid-19 landscape?

Sarah: Health behaviour change is complex at the best of times, but without a concerted effort to increase access to the social resources that support and sustain change, we will not see the desired outcomes. With leisure facilities and physical education having been closed due to Covid-19, the legacy of the past twelve months is probably yet to rear its head. We have a lot of ground to make up and so continuing to work together to make the best use of funding and produce robust referral pathways is essential. Whilst there have been so many challenges as a result of the pandemic, one huge advantage is the enhanced ability to connect with our colleagues up and down the country using virtual platforms. This will hopefully provide many more opportunities to identify collective actions, act on emerging issues, promote new services, share data and better understand the challenges ahead of us.

Suzy: The coronavirus pandemic has been such a large cog in so many wheels. It’s devastating on many levels, with lockdown increasing some unhealthy behaviours, including inactivity, among local populations. But it has also brought the issue of overweight and obesity into sharp focus. There is political will and a real movement from patients and health care professionals for doing things differently, paving the way for vital, positive conversations and sustainable behaviour change.

Shabnam: I am enthusiastic and passionate about the management of diabetes and keen to bring what I can to the group. I am excited to be a part of a more co-ordinated approach to prevention and remission of this increasingly common condition, whilst empowering people to make behavioural and lifestyle changes that will ultimately reduce its prevalence.

 

Tell us an interesting fact about yourself…

Sarah: I am a serial podcast listener! If I’m running, sorting laundry or just trying to unwind before bed, I am almost certainly listening to something. It is a wonderful way of multitasking when you feel you have no time to read. Lately I have particularly enjoyed The Doctor’s Kitchen Podcast with Dr Rupy Aujla, diabetes core updates from the American Diabetes Association and BBC Radio 4’s Made of Stronger Stuff.

Suzy: I like to practice what I preach, my favourite pillar of health is movement and sitting is the new smoking, so I’m sharing my love of the standing desk. Improvised, adjustable, whatever works for you. Here’s photo evidence of my work and home efforts for inspiration – try it, you won’t look back.

Shabnam: As a full time GP who works out of hours, is a busy mum, looks after a young family and has a husband that runs his own business – time is precious. Over the last year, I’ve enjoyed taking up walking and have tried to take time out to do this during the pandemic. This has been a big challenge for me as exercise and physical activity were not part of my upbringing. Considering my line of work, I have tried hard to embrace lifestyle change and even walked to work on occasion!