CASE Study: Alexandra McGarvey

CASE Study: Alexandra McGarvey

Alexandra McGarvey, Nursing Services Manager

Leighton Road Surgery, Bedfordshire, Luton and Milton Keynes (BLMK) ICS

I started my nursing career in acute care and have held senior roles in paediatric wards and A&E. I took a career break to have my children and returned to nursing at a GP practice. I am lead nurse at my surgery which has a patient population of 20,000. I’m also lead nurse for Leighton Buzzard Primary Care Network. Although I’ve held senior roles for a number of years, I’ve never had any formal leadership training. It’s often difficult to access learning that really targets the needs of nurses in primary care, so I was very pleased when the opportunity to take part in the CARE programme came along.

As nurses we aim to be the best we can be – and I saw taking part in the CARE programme as an opportunity to discover a little more about myself and to delve more deeply into what makes a good leader. I also wanted to network, develop relationships and share ideas with other clinicians in my health system. I liked the idea of working towards similar goals in a supportive environment.

The programme has opened up new ways of thinking about care delivery and improving patient outcomes. For example, we have explored population health management and the use of data to make improvements to services. We also worked through useful and practical concepts and tools such as Six Thinking Hats and Nancy Kline’s Thinking Environment.

All of the facilitators in the CARE webinars are really knowledgeable and learning is tailored to our needs. The webinars offer an opportunity to connect with primary care professionals in my health system and to make friendships. The webinars have made me reflect on my own leadership and how I can better influence people around me when it comes to implementing new ideas and ways of working.

The ShinyMind app is a great tool for managing my wellbeing. Nurses lead very busy lives juggling demanding roles and a home life. The app gives you the headspace to reflect, empathise and to think about what makes a good team.

Being able to lead a project with support from the CARE programme has been really valuable. My CARE project involves looking at the needs of housebound patients – particularly those who are requesting visits from the GP practice. At the moment, home visits are done by minor illness nurses or practice paramedics. In the winter of 2019 we were getting an average of 13 home visit requests a day – often from the same people. I wanted to explore the motivation for the requests and whether we were meeting the health and care needs of these patients as effectively as possible.

My aim is to look at different aspects of the patients’ lives – including finance, health and relationships – and to establish how we can meet these needs in a more holistic way. I have access to a tool to help me to get this insight from patients and I’m liaising with our patient participation group to make sure that patients would feel comfortable providing this information. My hope is that we can use information around the wider needs of these patients to support our workforce and resource planning in the future.
Although the project is still in development there has been some early outcomes. Being able to break down the data around home visit has been very valuable and has given us the confidence to pursue this area of service improvement.

CARE has really benefitted me. The programme’s focus on population health management, its high quality content and opportunities to network and learn from others has been invaluable. The programme is tailored to primary care yet is easily adaptable to any primary care system in the country.

Through analysis of the data, we found that 73% of the patients had an unmet need and required additional support. Many of these needs were social and emotional, which could be supported through social prescribing and signposting to appropriate services in the community.

The CARE programme really taps into the person-centred approach of general practice nurses. We see our patients regularly on a one-to-one basis and they will often open up to us more than they do with other health professionals. We understand their needs and can often pick up on any unmet needs. CARE has helped us to bring our ideas for improvement to life and influence colleagues around us. It’s given us a voice in shaping services and supported us to improve patient outcomes.

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