Practice nurse Maggi Bradley pushed her professional boundaries by embracing remote technology for her patients during the Covid-19 pandemic. (Maggi is pictured above receiving her award, with comedian and compere Tom Allen.)
When the Covid pandemic first hit in 2020, general practice nurse Maggi Bradley, from Aughton Surgery in West Lancashire, had been about to embark on a project trialling group appointments for patients with long-term conditions. This was a new approach for the practice, to help patients to learn more about their conditions.
The plans were initially put on hold when lockdown began, when people were not able to come to the practice for routine check-ups. As it became clearer that Covid-19 was going to have a longer-term and unprecedented impact, Ms Bradley decided to approach things a bit differently. The group appointments would go ahead, but they would be held remotely – giving patients the support they needed in an innovative way.
The project went on to earn her national recognition. She won the Nursing Award at the 13th annual General Practice Awards Practice Nursing Award, in 2021. The awards are run by Nursing in Practice publisher Cogora, to recognise the remarkable work carried out by the UK’s primary care professionals.
A Queen’s Nurse with 25 years’ experience of nursing in general practice, and an additional role as a nursing clinical lead at Sefton Training Hub, Ms Bradley was nominated for setting up the video group clinics after noticing patients ‘were beginning to manifest feelings of isolation, fear and anxiety’ during the Covid-19 pandemic.
Seeing patients in groups made good use of the practice’s time, while also giving patients the ongoing support that they needed.
The project not only helped patients access services during the pandemic, it provided useful experience for a group of student nurses on their general practice placements.
Getting the groups up and running
Ms Bradley acknowledges that she was far from a digital expert before starting the sessions and looked to family for advice and support on using remote technology. She reached out to colleagues in the practice while the sessions were being planned, securing their agreement to get the project under way.
She also was able to involve a small group of second-year nursing students, who’d had some placements cancelled due to Covid. The opportunity to provide services remotely was ideal, especially as some of them needed to shield. Ms Bradley says involving three students gave them the chance ‘to see first-hand how primary care can adapt during difficult and unexpected circumstances’.
The video group clinic sessions were offered first to cancer patients, then to others living with long-term conditions. Each session includes six to eight patients, with one or two groups run each week. The session begins with discussion on a useful topic, and then Ms Bradley speaks with each of the attendees, who are invited to share their thoughts and experiences.
‘Groups have been run with newly diagnosed asthma patients, new mums and patients with cancer. They can come for just the one session, or can come back if they wish. Some return in an ‘expert patient’ role, offering useful advice based on their experience,’ she says.
How the sessions are structured
The group is intended to be interactive. Attendees each have a turn to speak if they wish, and can put comments or questions in the on-screen chat window as well. They can share their experiences and perspectives, and sometimes exchange advice between themselves.
Ms Bradley feels the approach was well matched to the challenges patients were feeling during the lockdowns. She says: ‘The peer-group setting enabled patients to talk with, and learn from, others at different stages of the same journey. There was a sense of ‘belonging’; participants made friends and established their own support networks. Despite the stresses of the pandemic, there were smiles, laughs and fun.
‘Feelings of isolation were greatly reduced, particularly when regular sessions were introduced. Additionally, there were opportunities to address anxieties before they could escalate into fears, and feelings of self-worth were much enhanced.’
People are invited to participate in chats while on video but aren’t obliged to do so, Ms Bradley says. ‘If somebody is being quiet then I just check they are alright: are they just listening? Do they want to join in? It can be tricky. In real life if someone in front of you was a little bit subdued, you would pick up on it straight away, wouldn’t you? But some people are happy just listening.’
They often have a lot to learn from each other, as well as from Ms Bradley’s advice. She gives an example of how people involved in the groups were able to support one another. ‘We had a farmer in his 70s join us for a diabetes session. He was experiencing hypos while he was out on his tractor, and he didn’t want to go back home during the working day to do his blood sugars. So, somebody else in the group was just discussing how helpful her Freestyle Libre system is, and she thought he might benefit from that too, because you have more control when you are out and about. He later fed back that he got one, and that it was the best thing in his life. That might not have happened otherwise.’
‘Never in a million years’
The project has propelled Ms Bradley to become something of a local leader: an unexpected outcome, she says. Since starting the scheme, she has been invited to address local meetings, speak on the radio and take part in a webinar. Now she has won a national award. ‘I would never in a million years have thought that I could do all of this,’ she says.
Trying something new has helped develop her professional capabilities, she feels. ‘I’ve talked on Radio Merseyside and BBC Radio Lancashire, and they’ve circulated that all across our ICS in West Lancashire and Sefton, which has been brilliant. I’ve been invited to speak at a workshop, and at a conference in Leeds.
‘I never would have thought I was a leader, but I’ve been putting my head up and talking to people about the project. It develops you in a different way and it’s given me a real sense of leadership.’
She is now involved in supporting others to run remote video sessions in other practices, and takes part in a WhatsApp group for others interested in delivering healthcare through this approach.
The future for the project
Group video sessions will continue to have an important role for the practice in the future, says Ms Bradley. ‘The plan is to carry on. We can address things like the long Covid DES and things like that, that might otherwise be difficult to achieve.’
She will also continue to spread the word about the model, for anyone else who is interested. It helps improve access for patients, among other benefits.
She says: ‘I definitely would recommend this to other practices. It gives patients an extra choice – a different way of seeing you. It’s more efficient for people who don’t have the time to come into the practice, and particularly suits people who may still be anxious about being out.
‘It’s helped the workload. I would have to say that a lot of good has come out of it for me and hopefully for our patients as well.’
General Practice Awards 2022
Organised and supported by the team behind Nursing in Practice, Pulse, Management in Practice, The Pharmacist and Healthcare Leader, the General Practice Awards reaches thousands of healthcare professionals. For details of the 2022 Awards, email [email protected]