The ELC Programme has been championing group consultations practice in the United Kingdom for nearly 10 years, and developing our support programme since 2015. Over this time, we have gathered an extensive archive of best practice and insights into how to simplify this complex change.
Listen to clinician participants talk about the benefits of attending ELC group consultation learning workshops:
We take a whole team approach to practice development. Our training supports: the clinicians leading the change, clinic and practice managers, administrators, the clinicians who will be consulting with groups and trainee facilitators to understand their unique contributions and to gain the skills they need to succeed. Overtime, we have developed an easy to follow, step by step process, which ensures this change sticks, and builds confidence through knowledge and skills training, whole team coaching and practice development support.
Our programmes are always designed to build on local networks and existing skills and capabilities.
Ongoing evaluation has identified a number of critical success factors that ensure attending group consultations training converts to a change in practice back at the front line.
ELC audits conversion rates annually. Audit in 2018 found that following a one day team learning programme, over 60% of teams progressed to group consultation within eight months. This is an extremely high conversion compared to similarly complex practice development programmes that generally enjoy conversion rates of less than 20%. We are continually improving our programmes and anticipate the conversion rate rising even higher over the coming years as we learn more and simplify the change process even further.
We can help you in a number of different ways:
Getting started with group consultations in primary care: With the right clinical leadership, newbie primary care teams can be realising the benefits of this change within eight weeks. ELC offers a comprehensive package of learning support for primary care teams new to group consultation who want to switch to this way of delivering planned care. ELC has experience working with ‘super practices’ with 25,000 plus patients, delivering onsite workshops for the whole team. We specialise in working with primary care networks (PCNs) and clusters of pioneer general practices within a locality. We help individual teams and collectives prepare for group consultation and continue their learning through peer-led action learning overtime. If you are looking to develop group consultations in primary care, contact us for more details.
Getting started with group consultations in specialist care: With the right clinical leadership, organisations can spread this way of working at scale in 18 months. ELC offers a comprehensive package of learning support for newbie specialist clinical teams who want to switch to this alternative way of delivering planned community or outpatient care. ELC also has experience working with maternity and early years teams and those delivering The NHS Long Term Plan’s commitment to reduce outpatient appointments by 50%. We are also helping specialist teams to cascade their expertise out of hospital through group clinic models. ELC can also help service managers and clinical leads tasked with scaling up this change in practice across whole organisations, including guiding the development quality assurance frameworks for group clinic practice. If you are looking to develop group consultations in early years, maternity, community and specialist care, contact us for more details.
Workforce and spread strategy development: There is no doubt that group consultations realise significant workforce benefits. We are seeing a very clear pattern in evaluation of impact. Evaluation suggests that group consultations:
- Increase clinician efficiency: clinician time efficiencies consistently increase by 50-70%. In other words, clinicians see twice or three times as many patients in the same hour of clinic time
- Reduce ‘Do Not Attend’ (DNA) rates: DNAs fall by between 30-50% compared to equivalent one to one clinics. Furthermore, in specialist care in particular, group consultation eradicate clinician waiting time when people DNA because everyone arrives together
- Support integrated working: clinicians who deliver group consultations together learn from observing each other consult, build relationships and gain respect that fosters closer integrated working
- Support skills acceleration and personal development: group consultations offer a rich learning environment for clinicians and their support teams alike. Whether it is a GP, general practice nurse (GPN) or health care assistant or who wants to build their existing consultation or leadership skills; a trainee clinician; a clinician returning to practice or someone undertaking one of the new additional roles in primary care (social prescribing link worker, physicians associate, clinical pharmacist or first contact physiotherapist), group consultations accelerate consultation skills. Starting out as a facilitator provides clinicians with new skills and builds confidence in their consultation know-how
- Support delegation: because clinicians have the additional support that comes from working together with peers and being involved builds clinical knowledge and confidence, group clinics support delegation of routine assessments and reviews. For instance, in Hertfordshire, community nursery nurses now undertake Group Two and a Half Year Child Development Reviews instead of health visitors. Working together in pairs and with Early Years Support Centre team in a more child friendly, relaxed group environment helps nursery nurses step up and take on this new assessment work that was once the domain of health visitors alone
- Make the most of scarce specialist skills: the more scarce and specialised the clinician resource is, the greater the benefit of switching to group clinics because this care model makes clinician time go further.
The ELC Programme is expert in supporting health and care systems to develop strategies that make the most of group consultation as an enabler of workforce development. Whether primary care or planned care, we can help you maximise impact. We are working on behalf of NHS England at STP/ICS level to support workforce strategy development. Contact us for more details.
Spreading group consultations: ELC knows how to help localities and organisations scale up this change. We have already helped spread group consultations to hundreds of clinical teams across the country. Once a health economy or NHS Trust has a significant community of practice and clinical teams with lots of experience of consulting with groups, ELC works with you to sustain and spread the change. There are a number of approaches to sustainable spread. Some people schedule regular training sessions that we deliver with local expert clinician mentors. Some want to adopt is a ‘Train the Trainer’ cascade model. In response, ELC has developed an accredited Train the Trainer programme that supports local implementation leads or clinicians to train teams, undertake quality assurance and lead spread. The programme ensures that learning support remains quality assured and benefits from continuous updating and improvement as best practice develops nationally. A further benefit of our ‘Train the Trainer’ model is that after intensive classroom learning, local trainers are trained on the job. This means they are supported by ELC Group Consultation Coaches throughout their six to eight months accreditation process. This model works best for organisations and health economies that have set the ambition to make group consultations ‘the way we deliver care around here’. Contact us for more details about our Train the Trainer Programme.
The ELC Programme has also commissioned by NHS England to build a network of expert clinician mentors in each STP/ICS. This group will benefit from training and we will be establishing a virtual community of practice in 2020 to connect mentors at national and regional level. Contact us for more details about our Expert Clinician Mentor Programme.
Learn more about group consultations, listen to patient and clinician stories and download case studies below.