A Day in the Life of a GP in the @Home Service at GSTT
We spoke to Nichola Starkey about her role at Guy's and St Thomas's Hospital in the @Home Service
Describe the role:
The @home GP provides medical support and clinical leadership to the @home service, working within a multi-disciplinary team to manage the caseload of patients currently 'admitted' to @home.
In practice this involves a daily home visit caseload for each GP, leading or participating in the MDM during which all caseload patients are discussed and case-managed and supervising other healthcare practitioners who are developing advanced clinical or prescribing skills.
What is the first thing you do on arrival at work and what does your typical day look like?
My day starts at 8am, I look up my caseload for the day to determine the urgency of patient visits. I then go through patient notes and check bloods and other results and make any necessary calls to hospital speciality doctors if needed (for example to microbiology if advice on IV antibiotic choice is needed). Before heading out in the car I make sure my bag is packed with fluids, IV antibiotics and cannulation and bloods kits and any other equipment that is needed for a particular patient (i.e. bladder scanner/ECG machine/Neb boxes).
Some days I will meet up with another team member whose development I am supervising and they will join me on visits.
Depending on the day I will dial into the multidisciplinary team meeting to provide feedback on the patients I have seen during the week and/or seek advice from one of the consultant geriatricians who support the service if needed.
At the end of the day I head back to one of the offices to drop off any samples and complete any paperwork.
What is the key objective when you assess someone?
To provide a holistic assessment to allow prevention of admission to hospital if possible.
What has been the feedback from patients and from your GSTT colleagues?
Patients love the service, especially those who have been in and out of hospital repeatedly, much preferring to be treated in the comfort of their home.
Our GSTT colleagues have embraced the service and use it to its full potential to allow them to discharge patients from hospital early knowing that their treatment will be completed with the @home team.
What do you bring to the team that is different from the other members of the team?
Having been with the team from the very beginning when it started as a pilot project, I have seen the service in develop from the ground up. There is very little I don't know or haven't dealt with in this time. I am even the go to person for challenging Penalty charge notices which are not uncommonly given incorrectly when working in the community!
How do you relax after a shift?
Weather permitting I take my 2 young children to the park after school and nursery pick up.
What attracted you to this innovative team?
I was attracted working in such a large and sociable team and also being out and about in the community rather than being glued to my seat in a GP surgery all day.
What would you say to any candidate seeking to work within our GSTT service, recommending what we do?
One of the best aspects of the role is having the time to truly assess the patients and their needs holistically within their homes. It is quite different from a typical GP role and as such would fit very well into a portfolio career.
Thank you for taking a moment to read this information. We hope you found it interesting. We would love to hear from you if you are interested in what we do and would like to find out a little more. With very best wishes from the SELDOC Team
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