Primary care team of the yearBMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h1951 (Published 22 April 2015) Cite this as: BMJ 2015;350:h1951
- Nigel Hawkes, freelance journalist, London, UK
Marginal gains, scalable impact
At Sycamore House Medical Centre in Walsall, patients were happy with their care but frustrated by accessing it—an issue common to many practices. Previous attempts to improve matters had achieved only patchy success. The answer, says Jagdeesh Singh Dhaliwal, a GP at the practice, was not a single blinding idea, but a range of “little things” that added up to something big.
“Our inspiration was Sir Dave Brailsford’s British Cycling Team ‘marginal gains’ concept,” he says. “He showed that many small improvements across the board make a difference.” At the heart was a new web portal, www.sycamorehousesurgery.co.uk, which can be used by patients to book appointments, access their own records, or search for reliable information on symptoms without the distractions and potential misinformation of a Google search.
“Patients with a headache will read it and decide either ‘I’m fine, I don’t need to see the doctor,’ or if they do want an appointment, they will already have done a bit of the work before they arrive,” Dhaliwal says. “That shaves time off appointments, and changes the nature of the conversation. We’ve had a really good response from older patients. They get an iPad and they think it’s great. They say ‘I can see my records now and I don’t feel left out’.”
Appointments are saved by enabling patients to cancel by text, and the capacity released has enabled appointment times to increase from 10 …