After 36 years as a nurse, with 25 years working in general practice nursing, Maggi Bradley has a wealth of experience to share. In the last 5 years she has been the Sefton Training Hub nursing clinical lead, involved in improving student placements, as well as having a clinical role as a general practice nurse. Her work recently came to the attention of The One Show, where she was featured sharing her experiences of organising video group clinics at Aughton Surgery during the first COVID-19 lockdown and beyond.
Group consultations in lockdown
When lockdown hit, the doors of the surgery shut overnight, and it was unclear what would happen next. Maggi said: ‘General practice nurses build up relationships with patients, and that's how we achieve health gains. I wondered, “How can I fill that gap? Is there something we can do in primary care?"’. Maggi quickly got involved in video training with Health Education England and by the end of April 2020 was already running the first group video consultations. The consultations cover anything Quality and Outcomes Framework (QOF)-related, including annual diabetes and asthma reviews, cancer care reviews and postnatal reviews.
Addressing concerns around the technology, Maggi says: ‘It's just like seeing the patient in person, and once you get over seeing yourself on screen it naturally flows. I am not a technical person, but I could do it. I speak about it [the video group consultations] a lot. It is powerful when another normal, everyday nurse shows they can do it.’
There is a maximum of 8 people per video consultation. Everyone gets their individual time with the clinician, but the group learning and allowing other patients to pitch in with their experiences really helps. Highlighting the time saving aspect, Maggi said: ‘It saves time because you don't have to repeat the same advice over and over’. Maggi explained that three student nurses were involved in the initial project to do the group video consultations, as many students found it difficult to find placements during lockdown so the practice offered to host them.
Keeping momentum up
There is now a need to keep the momentum up. Maggi is continuing the video group consultations for all conditions as ‘there is definitely a place for it’. Many patients appreciate having more choice for their appointments. Maggi explains: ‘Long COVID clinics have been very successful and cancer care reviews were really popular – those patients were so isolated during lockdown’. For asthma in particular, many people feel well and healthy and so have been happy to do the review remotely rather than come into the surgery in person. Teenagers have also been keen to get involved; Maggi added, ‘technology is nothing new for them and they are used to being in front of a screen all the time’. Postnatal reviews have also worked well as: ‘it is easier for some mothers to do a review from the sofa, than drag their children into the surgery’.
The COPD consultations were trickier to get off the ground. However, Maggi was keen to point out: ‘The barriers have not been just age, as people might have expected. Older people have been happy to give it a go.’
For nurses unsure whether to get involved, Maggi is encouraging and says ‘It is so worth it’. Maggi was nominated for a Nursing Times award for her work and took the three students with her for the ceremony, ‘I was very proud to have the students with me’.
Starring on The One Show
Maggi was surprised when someone from the BBC contacted her out of the blue via Twitter, wanting to do a piece about access to GPs for The One Show, and initially thought it might be a hoax. After some research, her husband concluded it was real. ‘They then contacted me to say they were definitely going to run the piece and asked if they could film the following week, so it was a mad scramble to get patients’, Maggi said. ‘The patients came across really well’, Maggi added, ‘They demonstrated that they were sceptical about group video consultations but found them useful.’
Encouraging student placements
As well as her work on video group consultations, Maggi is also passionate about getting student nurses into primary care. Maggi recently has had learning disability nurses on placement at the surgery. Many have been finding it hard to get placements in learning disability settings, so they offered a last minute placement in general practice. The first placement went so well, ‘we set about asking for another learning disability nurse’, Maggi explained. Maggi describes having learning disability student nurses as: ‘One of the best experiences I've ever had. They have opened up a whole new way of communicating with our learning disability patients and changed the way we do learning disability reviews.’
舖Students bring different eyes and ways of thinking. It is a bit more work but so worth it. Students can really help us in primary care.舗
Maggi wants learning disability nursing students to see that primary care is a good place to work. By the end of August, they hope to have four learning disability student nurses working across the PCN. ‘Students bring different eyes and ways of thinking. It is a bit more work but so worth it. Students can really help us in primary care.’
The placements have been successful at getting nurses to consider primary care for a career. ‘We have just created a new post across the PCN for one of our learning disability student nurses once she qualifies’, Maggi explained, and going forward, they will have a mental health student nurse coming to do mental health reviews.