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e21: Understanding the GPA role

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Overview of GPA role

[00:00:06] Munir Adam: Welcome back. It's Munir Adam here, and we have another mini episode, and today we're talking about the GPA or General Practice Assistant role. Now, the thing is this, if we were to be asked an exam question, write an essay about the GPA, how would you fair in that question? And yet the thing is the GPAs can really help in the day-to-day running of a GP practice.

[00:00:27] Now, you will have heard quotes like one person's pain is another person's pleasure, or just beauty is an eye of the beholder. And certainly I got the impression that GPAs were here to deal with the kind of things that we as front line clinicians generally don't want to have to deal with. And so I thought this is great 'cause that would free up time for us to do things that we really do want to do.

[00:00:45] And so the question is, are we benefiting from this opportunity as much as we could? And even if we're not involved with management, could we be having conversations with those who are. 

[00:00:54] In collaboration with Integrated Care Support Services, let's continue season two of Primary Care UK. 

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[00:01:15] Sharon Kelly: Hello, my name is Sharon Kelly. I work in the Workforce Training and Education Directorate at NHS England, and I'd like to speak to you about the general practice assistant role and give you some more information about that and how it came about. To give you a brief overview, as part of the wider team in general practice, General Practice Assistants provide a support role, carry out administrative tasks combined in some areas with some basic clinical duties. Their focus is to support General Practitioners and nurses in their day-to-day management of patients, and what they do is help to free up time by reducing their administrative burden and contributing to the smooth running of appointments, as well as improving patient's experience in the surgery.

[00:02:12] So how did the General Practice Assistant role come about? It was first introduced and developed in the United States, and then introduced to the UK by Health Education England in 2018, which is now part of the new NHS England. The GPA role, as it's known, has been adopted and spread across England now to each of the seven regions, and it enables the development of both the existing and newly recruited non-clinical workforce within primary care.

[00:02:46] The role is also underpinned by a defined job description, competency framework, on the job training, and in some cases associated accreditation and is supported by our training hubs. From September, 2022, the GPA role was also introduced to the additional new role scheme, also known as ARRS, which provides funding for practices to support the role.

[00:03:15] In the next section, you'll hear about the benefits of the role from a real life London general practice assistant, who has recently completed the national GPA program and the opportunities this has led to. 

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Discussion with a GPA

[00:03:32] Munir Adam: And now let's speak to honey who recently qualified as a GPA. 

[00:03:38] It's really great to have you on board to give me an opportunity to learn about a role, and I have to confess, you know, somebody said to me, Hey, you wanna do an episode on the GPA role? My first reaction was, hang on, let me just look at what this is. If that's how I am, there's gotta be other clinicians out there who know very little about it as well.

[00:03:57] So I'm really gonna try and cover the basics here. So let me start by asking you to introduce yourself, and then after that, a dummies' guide to the GPA role.

[00:04:06] Honey Khanna: Yeah. Hi. Thank you for having me here. My name Honey and I've completed a Masters from King's College London and post that I completed my GPA course from the University of Chester. GPA course basically is a General Practice Assistant course. So in the surgeries, like we've all been doing most of the work in the administration is helping out patients, helping them with the queries, signpost them, and helping out the GPs to save their time for the clinical care. So there has actually been a very good help for the entire surgery.

[00:04:40] Munir Adam: Well, that's great to hear and I love it when I hear somebody say, this is here to help the gps, and of course the rest of the clinicians as well, because the one constant in primary care when I speak to different clinicians is I am so busy, I've got so much to do. And indeed, there is so much to do and it's because of the way different systems and different industries work, and this is one in which we can really not limit the demand. So there's always more work to do for everybody. And so it's always great to have more people on board to deal with that work. 

[00:05:06] But let's start with a bit of background. 

[00:05:09] Honey Khanna: I'm a working professional with one of the surgeries. So it's a multidisciplinary role. There's a teamwork. So GPA is basically it's a bridge between the gap between the clinical and the non-clinical work.

[00:05:21] So the GPs are actually freed off from the nonclinical part of it. And it's not about just the gps. , like for example, when we talk about some letters which the patients want, or some forms which are to be filled in for the patients, so we just free them out from that time so that they can concentrate more on the clinical care, the timely address of the queries of the patients, which may not require the GP or the other clinical care time, but it involves a lot of things; it's not just filling a form. It requires signposting; it requires helping out patients for their daily queries.

[00:05:58] It could be addressing to their anger as well at times because, you know, if they've been in the queue for long and they've not been addressed , or answering them in a manner which is helpful for them. So that's basically the role is all about.

[00:06:13] Munir Adam: That sounds really welcoming . 'cause there's gonna be some listeners who are gonna be thinking that, with all of these new roles, why do we need yet another new role? And actually, you've said two things which resonate really positively with me as a GP. One is somebody who can deal with the paperwork or the administrative side of it because this is an aspect that we generally don't particularly enjoy doing.

[00:06:33] I hope I'm right in generalizing in that way. May not be true for everybody. Some people might absolutely love it. And then the other thing you said is, Dealing with patient queries and sort of soft level complaints and things and pacifying them in that. Again, that's really helpful. So hopefully that will convince people.

[00:06:51] Can you say a little bit more about what sort of things you've been doing and some of the other things that A GPA specifically can do?

[00:06:57] Honey Khanna: Yeah, so like I said, it's, it involve multitasking. So we can start with, again, calming a stressful situation. So, you know, it could be an aggressive patient, helping them out, calming them, addressing their queries, and to actually signpost them for what, what they've been coming in for. Apart from that, if there are any forms or letters, the referrals being sent, especially, you know, in the hospital side, and they're on a hundreds of them on a daily basis, the first level of it, completing them and then Forwarding forwarding to the GP where they give the final and then sending it, to the hospital and read coding them. So it requires a lot of multitasking, lot of communication. 

[00:07:37] Munir Adam: So you mentioned about dealing with patients. So it actually does involve direct patient contact as well.

[00:07:44] Honey Khanna: Yes.

[00:07:44] Munir Adam: So it's not purely administrative in that sense, but actually involves communication skills and things like that as well.

[00:07:50] Honey Khanna: It does , it's, it's a role on a daily basis and this really works out to help the time, it minimizes the wastage of time is what I would say.

[00:07:57] That's the, that's the most important role of A GPA.

[00:08:00] A. 

[00:08:00] Munir Adam: So if you are dealing with queries with patients who want to discuss maybe their needs, they feel that their needs haven't been addressed. Maybe they can't get an appointment. This is something that receptionists have to deal with all the time. Having to say to patients, I'm sorry, we haven't got any appointments.

[00:08:15] Do you find yourself getting sucked into those discussions as well?

[00:08:18] Honey Khanna: Yes, because I started off as a receptionist and then into administration you know, may not carefully addressed, or patient might be really, really aggressive and want you to speak to GP directly. I want to put forward my complaint to a GP. I don't wanna talk to you, I don't wanna talk to a receptionist. Finally, just forward it to other clinical team member or a nonclinical team member, or to a manager.

[00:08:41] And we all know everybody is actually working on something or the other. So when we intervene, , it's not just about addressing complain, but closing it completely. A patient might have just come in for a simple query of appointments, not being there; but was that appointment actually required at the GP surgery? So what the patient had come in for, signpost them correctly, and then it's all done. So it's basically helping the patients out, and if they are signposted correctly, they know where to go for the further appointments.

[00:09:09] Munir Adam: And you're achieving all of that through a number of things that you mentioned. So communication, that's part of it. And being organized.

[00:09:16] Honey Khanna: Yes. When we talk about the skills which are required, it's not just the communication, but I would say also the ability to to multitask. Because when we talk about it requires to deal with stressful situations at times; you are under a lot of work pressure. You have to complete the deadlines.

[00:09:32] And then obviously we follow confidentiality and maintaining the accuracy. So once under, if you're under too much of pressure, the things might not turn out to be correct, but to follow it within the practice policy to be accurate, these are all the skills apart from the good communication, like what we, what I said earlier. 

[00:09:50] Munir Adam: And you mentioned a few minutes ago about the paperwork side of things as well, hospital letters and so on. So does that require some sort of training managing data?

[00:09:58] Honey Khanna: . Yes, it does require formal training, and with the formal training, you get that confidence. You get that strong organizational and the interpersonal skills you are confident about doing it.

[00:10:09] Formal training is definitely required.

[00:10:11] Munir Adam: Now, do GPA generally all do the same things? Do they all have similar skillset sets and do the same roles?

[00:10:18] Honey Khanna: Yes. So basically when we talk about the complete framework, yes, there are five modules which are basic modules, which includes the care, the administration part, the clinical part, the communication part, which also includes the managing health records. So there are different modules , but minimum of three, yes, it's important if you need the certification.

[00:10:38] Munir Adam: So you start off with three and then you can develop more as you go along.

[00:10:41] Honey Khanna: Yes. This is a new role. This has been recently started in 2019, and it has been successfully launched in the northwest of the uk. So once it was done there, it was a success there. It was realized that yes, a lot of times for the GP and the primary care practitioners are saved.

[00:10:59] It was taken further, if I'm not wrong, roughly around more, more than 300 GPAs have already been trained in the same program.

[00:11:06] Munir Adam: Right. Okay, great. So it's taking off then. 

[00:11:09] What I wanna ask you is for you, what would you say is the part of your job that you like the most or find the most rewarding perhaps I should say. Work, is work really isn't it?.

[00:11:19] Honey Khanna: . I really like communicating it with the patients. I, I really like to bridge that gap between the patients and the primary care team members. That's what we are here for. You know, patients come in for their clinical problems. So if you're resolving it out with the clinical team, with helping them on a timely manner. The, the best person can be a GPA at times more than where the patient wants to see. I have those cases wherein a patient may want to come back to see me, rather than...

[00:11:49] Yeah, I want to talk to Honey. This is something which I need to speak to her. This is related to my letter. I wanna speak to her. So I think that's very important. That's the kind, you know, rapport you build it with your patients.

[00:12:02] Munir Adam: Yeah, I can certainly understand that being a rewarding aspect of it. Conversely then, are there times when you find it really stressful? I.

[00:12:10] Honey Khanna: Yes. It's when you have those deadlines, when there are times , you've committed to one of the patients that this is a deadline. You'll be, you know, delivering it to them, but you couldn't make a contact yourself with the, team member or maybe they're on leave, so even you are stuck at that time.

[00:12:24] How to resolve it, how to go to, you have to be quick thinker, how to get it resolved immediately. So yes, I, I do have gone through those stages wherein even I got frustrated, like why it is not being done on the timely frame, why it's not being done the way patient had asked me to do it.

[00:12:40] Like when we talk about the theoretical part of it, and when we talk about the practical part of it, Theory, we do learn it. It's like boosting up on, you know, confidence. It is getting the certification, but we, when you're actually dealing with the patients in the primary care setup, you'll evolve more you, your interpersonal skills buildup. So the communication examples during your lectures they're way different like from and way about and loads more than what it was being just talked to you. So that's, I think, the beauty of it.

[00:13:12] And when you are dealing it on a daily basis, you pick up, you learn more, and that's very enjoyable.

[00:13:18] Munir Adam: Ongoing learning.

[00:13:20] Honey Khanna: Every day is a different day, every day.

[00:13:23] Munir Adam: Do you feel that when things are a little bit difficult then they could have been improved? If other people, whether it's patients, whether it's clinicians, managers, if other people understood what you need to do, if they understood it better.

[00:13:38] Honey Khanna: I would say yes at times, but like, because now this GPA role has been evolving, people are understanding. I think , you have to create your importance. You have to explain it to them. Okay. You know, this is a workload. I know it might be a little more tasking for you, but if that can be shifted to us, let us do it and let us do it together.

[00:13:57] Like I'll talk about referrals. Referrals is something which is, which consumes time. It has to be done hundreds on a daily basis. But yes, if the GPA is a bit, you know, aware about how it has to be done correctly, being sent to the correct place, it saves a lot of time for the gp. But yes, it has to be done with the involvement of a clinical team member.

[00:14:17] Munir Adam: Right. Well, some people might be thinking about training up for this or there may be GP partners and managers who are thinking we could actually do with somebody just like that in our practice. If they wanted to train people up what you've said is this is sometimes for somebody who might already have been doing the role in some capacity, and this is a case of formalizing it, getting that accreditation and so on.

[00:14:37] What's the course like? And who do you think it would be suitable for?

[00:14:42] Honey Khanna: It is suitable anyone who wants to take up the GPA role. Yes.

[00:14:45] When a clinical team member is stuck, you can take up a role. I would cope with an example for those who have done the clinical part of it or the care module of a GPA. They also help their healthcare assistants, you know, when they're suddenly they've been a dropout, they couldn't come there, patients lined up so they can take upthe blood samples for them.

[00:15:05] Munir Adam: So that's quite flexible. But what about the course itself? How long is that?

[00:15:09] Honey Khanna: So course starts from a minimum of six months to a period of one year. And it's an online module, but for those taking up the course with the clinical part of it has to go for formal trainings. It could be like once in a month or so, but that is only after a period of six months. 

[00:15:26] Munir Adam: And that would be organized by the university

[00:15:28] Honey Khanna: That, that is organized by the university. Yeah. The modules are quite flexible. The timings are because like when we talk about the GPA course you with, with the current work which you're going on, where you are already working, you're already a professional, and along with that, getting into an educational university, it's not easy.

[00:15:46] You know, you have to take out time to study for those modules, obviously. And in a, in a primary care practice, you know, it's, it's like a complete dedicated work. So those ways the modules have been flexible. You can do it at your own timings.

[00:15:59] There are assignments which you have to do, and alongside with that, there is a lot of practical learning. It's basically the same learning, which you are doing it, but you're doing it more formally. You are understanding the in depth of why you are doing it. 

[00:16:13] Why is it important? Even my thinking has been changed a lot from what I started off. And then when I took over the professional training for it, it, it really changed.

[00:16:22] Munir Adam: Right.

[00:16:23] Honey Khanna: I could understand the role more better. I could understand the clinical side of it much better. I could understand the nonclinical side of it much better.

[00:16:32] Munir Adam: I was thinking in addition it might also be beneficial for practices in terms of protecting them if they have somebody who they can demonstrate has the accreditation and training in place. I. And you also mentioned earlier in the episode about the confidence that it gives you as

[00:16:48] Honey Khanna: yes.

[00:16:48] Munir Adam: And everything comes at a price. So is this something that normally gets funded by the practice or do GPAs normally have to just do this in their own time, in their own expense? How's it for you?

[00:16:59] Honey Khanna: Yeah, it could be both ways as I was already associated with one of the practice surgeries, it was funded by my surgery and then, I completed the entire six months coarse within the timeframe. And I plan to take another module as well next year. 

[00:17:14] Munir Adam: Right there we are. That's fantastic. It's, it's really nice to hear about this. I'm now thinking a time might come where we're gonna be thinking how on earth did we ever survive without the GPAs? Because it really is an opportunity to share some of the work in a more effective way.

[00:17:30] And it can be rewarding, as you mentioned. It's nice to hear that you enjoy those things as well. Great. Thanks for joining.

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[00:17:39] Sharon Kelly: 

Final comments

[00:17:39] Sharon Kelly: So how can you get involved in the general practice assistant national program? There are a few routes to becoming a general practice assistant, which are open to your existing or newly recruited non-clinical workforce, and a range of provider models on offer within the different regions. 

[00:17:59] Your locality training hub should be able to help signpost you to your key General Practice Assistant program contacts who can help support you with implementing the role within your practice. So how can practices and learners get involved in the program? If you are interested in finding out more information on the General Practice Assistant role and how your GP practice and learners can take part, do contact your local training hub lead.

[00:18:27] Munir Adam: You can find out more by checking the links in the show notes. But that's it for today. Do continue to give us your feedback and ratings and until next time, keep well and keep safe.

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Disclaimer

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