First Contact Practice Lessons learnt one year on

First Contact Practice. Lessons learnt one year on… Peter Harris. VISION OPENNESS INTEGRITY COMPASSION EXCELLENCE

Who we are… • Bolton FT – MSK Physio in FCP. – Mental Health Practitioners. – HIP. – Pharmacy • 10 MSK FCP – 10 Neighbourhoods of 30, 000 patients. – Various GP surgeries. VISION OPENNESS INTEGRITY COMPASSION EXCELLENCE

Lesson One…. . “Where the fog is thickest……. …… Begin. ” Marty Rubin VISION OPENNESS INTEGRITY COMPASSION EXCELLENCE

Dealing with Uncertainty. • • • Uncertainty is a core element. Nothing is straight forward. Patients often don’t have the answer. Powerful source of stress Its okay to not know but protect your patient. Must be included in education programmes. VISION OPENNESS INTEGRITY COMPASSION EXCELLENCE

Lesson Two…. . “Coming together is a beginning…. . Staying together is progress…… …. Working together is success. ” Henry Ford. VISION OPENNESS INTEGRITY COMPASSION EXCELLENCE

Teamwork. • Recrutment. • Various backgrounds, post graduate qualifications. • All have different LNA MSK frameworks. • We all have different experiences. • Avoid the feeling of isolation. • Your team is bigger than you think VISION OPENNESS INTEGRITY COMPASSION EXCELLENCE

Lesson Three…. “Give me 6 hours to chop down a tree…. …. I will spend 4 hours sharpening my axe. ” Abraham Lincoln VISION OPENNESS INTEGRITY COMPASSION EXCELLENCE

Be Prepared. • • Know your IT systems. Know the referral pathways Know your population & local services. To be flexible. To overcome barriers. Good housekeeping. Don’t go to battle without a gun… Assertive. – Time managment. – Sen, spec +LR Tests. VISION OPENNESS INTEGRITY COMPASSION EXCELLENCE

Lesson Four…. “If you feel like the dumbest person in the room… …. then you are in the right room. ” VISION OPENNESS INTEGRITY COMPASSION EXCELLENCE

Expand your knowledge. • Know and recognise your limitations. • MSK Frameworks. – Injection? – NMP? • PUNs / Patient reflection. • Organise your CPD. – Mentorship / supervision is varied. • Start to work within 4 pillars AP. – FCP more than clinical – Lots to develop. VISION OPENNESS INTEGRITY COMPASSION EXCELLENCE

Lesson five…. “Always trust your instinct…. …. it knows what your head hasn’t figured out yet. ” VISION OPENNESS INTEGRITY COMPASSION EXCELLENCE

Trust Your Gut. • • Discitis. Myelopathy. Bowel cancer. Prostate cancer. Pancoast tumour. Lymphoma. Unexpected osteoporotic fractures. • Bronchial carcinoma. • Pathological hip fractures. • Pathological spine fractures. • Multiple sclerosis. • CVA. • DVT. • Sarcoidosis VISION OPENNESS INTEGRITY COMPASSION EXCELLENCE

Lesson six…. “Respect is the result of right actions. ” Amit Kalantri VISION OPENNESS INTEGRITY COMPASSION EXCELLENCE

We are appreciated and respected. • “I found (name) to be very thorough and informative. ” • “The best examination I have had in 3 years – extremely empathic concerning nature. ” • “Excellent service. ” • “Eased my concerns, very kind and informative. ” • “Gave me useful info. ” • “Fantastic service. ” • “Advice was excellent. I left feeling a lot better. ” VISION OPENNESS INTEGRITY COMPASSION EXCELLENCE

We are appreciated and respected • “Training was excellent thanks. ” • “I now have much more knowledge on the shoulder and learnt new assessment skills”. • “I didn’t realise how little I knew about MSK” • “Very informative lecture on Red Flags, Thanks” VISION OPENNESS INTEGRITY COMPASSION EXCELLENCE

Thank you. VISION OPENNESS INTEGRITY COMPASSION EXCELLENCE

• Broekhuizen, H. , Groothuis-Oudshoorn, C. G. M. , van Til, J. A. et al. (2015). “Review and Classification of Approaches for Dealing with Uncertainty in Multi-Criteria Decision Analysis for Healthcare Decisions”. Pharmaco. Economics. 33: 445 • Moskowitz, A. J. , Kuipers, B. J. and Kassirer, J. P. , 1988. “Dealing with uncertainty, risks, and tradeoffs in clinical decisions: a cognitive science approach. ” Annals of Internal Medicine, 108(3), pp. 435 -449. • O'Riordan, M. , Aktürk, Z. , Ortiz, J. M. B. , Dağdeviren, N. , Elwyn, G. , Micallef, A. , Murtonen, M. , Samuelson, M. , Struk, P. , Tayar, D. and Thesen, J. , (2011). Dealing with uncertainty in general practice: an essential skill for the general practitioner. Quality in Primary Care, 19(3). • Schneider, A. , Wübken, M. , Linde, K. and Bühner, M. , 2014. Communicating and dealing with uncertainty in general practice: the association with neuroticism. Plo. S one, 9(7), p. e 102780. VISION OPENNESS INTEGRITY COMPASSION EXCELLENCE

VISION OPENNESS INTEGRITY COMPASSION EXCELLENCE

VISION OPENNESS INTEGRITY COMPASSION EXCELLENCE