Module 4: How to Advocate
Hannah Yu-Pearson
Centric Lab
Featuring:
Dr Joanna Dobbin
NHS England (Camden)
In this lesson GP and academic Dr. Joanna Dobbin shares with us the role of a GP in contributing to your health advocacy journey. She shares the position of GPs, their duty of care in documenting your experience and their role in working with other local authority departments around safeguarding and public health.
Key Learnings: Definitions
-
Determinants of health are the broad conditions that influence health outcomes and are shaped by the forces and systems of daily life, including the social, economic, political and physical environments where people are born, grow, live, work, and age.
-
In the medical context, a duty of care is the legal and ethical obligation for a healthcare professional to take reasonable care to prevent harm to their patients.
-
"Neighbourhood Network" in the context of the NHS refers to the Neighbourhood Health service, an approach that integrates local health and care services to provide more coordinated and holistic support to communities. More information here.
-
A Patient Participation Group (PPG) is a group of volunteer patients, carers, and staff from an NHS GP practice who meet to discuss and improve the services offered to patients. These groups work on non-clinical matters, providing feedback on patient experience, helping to develop new services, and ensuring the practice puts patients at the center of everything it does. All GP practices in England are required to have a PPG, and any registered patient can join.
-
A teaching practice is a GP practice that serves as a hub for healthcare professional teaching and training. They host placements for doctors who are on a training scheme to become a GP, undergraduate medical students and occasionally take on work experience students planning a career in medicine. They are often affiliated with universities, and whilst providing the care of a regular GP, also tend to have resources for GPs to spend more time with patients during their training.
Key Learnings: Our Thoughts
Individual GPs vary quite a lot on the practice level, but they should all share the knowledge that environments do impact a patient's health, this is through the social determinants of health. The extent to which they engage with these broader concerns can vary.
GPs do work with local authorities, for example the public health department - this could be through infectious disease and outbreak, or movement and physical activity. GPs can speak to public health teams and ask for their support on broader issues.
GPs can write letters to housing departments to document and prove the impacts of housing on health, sometimes this will come with an extra charge.
Neighborhood networks have been set up in local areas so that local authority neighbourhood departments, primary care networks and voluntary sectors can meet and know what each other are doing. This may be an area to be influenced.
GPs record everything you are saying, taking down symptoms, measurements and your concerns. This is a form of data collection for the individual, and your medical records can be used as a legal document.
Patient Participation Groups are at all practices, and this is where what is impacting a group can be taken to the GP for response. When you see a GP 1-1 all of that information is confidential, so this is helpful for shared issues.
GPs can send you to social prescribing groups who are based in a community that supports people in their wider lives.
Bearing witness and providing emotional support to someone’s experience is an important part of being a GP, giving the patient space to think about their health more broadly and destigmatise any shame that is often framed as “lifestyle” issues.
Having medical voices alongside campaigns can be more effective, it is worth asking for this support though this is down to the individual practice.
Training and teaching practices have more resourced time to work on these things, and are often linked to universities. Find a local training and teaching practice if your GP is unresponsive to your concerns on these issues.
What in this lesson stood out for you?
Prompts
These questions are framed to help you apply your own experience and perspectives to points raised in this lesson.
To what extent have you considered collaborating with public bodies such as GP practices/practice networks, schools, local leisure facilities and local charities in your campaign coalition?
What has been your experience of taking concerns around structural causes of ill health to your GP?
Is there a collective and localised health concern that you can take to your Patient Participation Group for the engagement of medical professionals?
If you have a health concern that you understand to be a result of pollution in your environment, your housing, or something happening in your local area, have you spoken to a GP to document your symptoms and causes for concern? Have they written a letter to evidence your health concerns?
If your local GP is not responding, seek out a GP practice in your area that are actively engaged in community health and social prescribing, you can ask if they are part of the Royal College of GPs Health Equity Special Interest Group. You may find Training Practices, where there will be medical students and trainee GPs who may have extra time and resources dedicated to their practice.
If your health concerns are more collective and about your community then seek out your local authority public health department to see if it is on their radar. You can find their details through your local council website, or through your GP practice, who will have a relationship with them.
Next Lesson:
Module 4 Lesson 4.1