Ivy Grove Surgery in Derbyshire made the headlines in April with an extensive and honest open letter to their patients. But for the practice partners, it’s only one part of their wider strategy on communicating with patients. Gareth Gillespie, Editor of Practice Matters, spoke to the surgery about what drives their approach.

Communication between healthcare professionals and their patients has long been held up as a fundamental aspect of modern-day care, particularly where the dynamic between doctors and patients has shifted away from one of paternalism to something based more on a partnership. Good communication is the basis for patients to be fully informed about all aspects of their care – from diagnoses and treatment plans to a practice’s opening hours and range of services. It’s no surprise, then, that during the COVID-19 pandemic, many practices have boosted their communication offerings – in an attempt to keep reaching out to those many patients now restricted to remote consultations.

An engagement masterclass?

In April 2021, Derbyshire practice Ivy Grove Surgery made some headlines when the partners issued an open letter to patients about their increasingly intense caseload. The letter, issued via their main communication channels – website (ivygrove.org.uk) and social media – spoke in often striking honesty about the growing pressures on appointments and consulting times, as many patients ventured back to the practice after the various COVID-19 lockdowns. 

Judging by the response – trade press such as Pulse and GP covered the news in depth, with their readers, who are clinicians, generally supportive in the website comments sections – many in the NHS felt the letter was a refreshingly frank account of the realities of working in general practice during the pandemic. The latest challenge being the result of the backlog of unaddressed (and potentially undiagnosed) health conditions that were now coming to the fore as the various lockdowns receded.

But for Ivy Grove’s partners Dr Michael Wong and Dr Riva Greer, it was just another in a long line of engagement pieces that the surgery has issued to its patients over the years. According to Dr Wong, the practice is built on good communication both inside and out, and their open letter showed they were not afraid to tackle sensitive issues head-on – even at the risk of upsetting the authorities.

Education, education, education

Dr Wong says that the practice approach to communication has enabled them to educate patients, which has had a positive impact – at least before COVID-19 – on practice workload.

“When I first joined the practice 25 years ago, we were quite paternalistic,” says Dr Wong. “But we also operated ‘on-demand’ when it came to things like home visits – if a patient demanded one, we generally did it, which obviously has a significant effect on resourcing and workload.

“So we began to educate patients about why home visits are not always necessary and in fact might not even be the best thing for them. We explained that a home visit takes a GP away from seeing patients in the surgery, but it also means we are denied access to suitable facilities, such as the couch. We explained and justified our changes fully through videos in the waiting room and posters on the noticeboards, and I’m happy to say we never received any backlash from patients at all.

“What we did instead is develop a specific policy for conducting home visits. This freed up time so we were able to use Wednesday afternoons for team meetings.”

Internal communication is equally important in Ivy Grove Surgery. “It’s absolutely essential we communicate with each other,” adds Dr Wong, “so we have regular coffee mornings, case discussions, social gatherings and times when we just get together to reassure each other. As GPs, we don’t work in isolation from each other.”

Different channels of communication

In today’s platform-diverse world, we all have a wider range of choice in how we access information than ever before. Ivy Grove Surgery utilises many different channels of communication to ensure the public has every chance to stay informed – whether it be via the website, video or traditional print newsletters and waiting room posters.

Dr Wong generally puts the regular newsletter together, with frequent contributions from his colleagues. He says the newsletter is a good way of keeping patients in the loop – making them feel part of the practice, rather than being spoken down to. Dr Wong also develops the practice’s video content himself using the presentation software Keynote.

“Our approach really helps to moderate expectations for the public,” says Dr Wong. “Where policy-makers and politicians are going around promising everything to everyone, we are honest about what we can and can’t do.

“Sometimes it feels like there’s a climate of fear among GPs that we can’t say anything without being criticised by the authorities. But one of our previous videos, ‘State of GP’, was really well-received and was actually defended by our LMC and GPC rep after a local MP criticised it.”

The doctor-patient partnership

Overall, Dr Greer strongly believes healthcare needs to be a co-operative approach between doctors and patients, and the regular practice communication is really a way of underpinning this.

“When appropriate, patients need to help themselves too,” says Dr Greer, “and a key enabler in this is to educate them. This needs to be a national approach, starting with children at school – how to self-manage minor conditions and take more responsibility.

“This also feeds into the current mental health burden faced by many – people have lost their emotional resilience, which is why more needs to be done to educate people and empower them.”

Dr Greer adds that other practices have been in touch for the template of their recent open letter, which could bode well for a better informed and educated public.