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Chapter 14
Tools to help you plan and
support self care
Tool 13
PART/workload assessment
Why you should use this
To help you as a practice prioritise which conditions you will tackle next to provide self care support. To review the frequency with which patients are consulting for specific conditions in your practice or a group of practices if you are thinking of it from a PCT perspective.
When to use this
In a practice planning day or team meeting – working in a group.
What to do
Take some of the conditions listed in Box T13.1. These may be conditions for which
patients might undertake more self care, or conditions where GPs and nurses are
seeing patients who they believe do not need to consult them directly. Place these
selected conditions in the matrix of Box T13.2 according to whether they frequently
occur and, if they do, the workload implications for the GP or (triage) nurse. Either
estimate the frequency and complexity of such consultations as a team, or collect or
collate baseline data first.
1 Take only the conditions you placed in the high demand/low complexity sector
(bottom left quadrant of Box T13.2) and place each one in as many quadrants as
you wish in Box T13.3.
2 Prevention, awaiting resolution, relief and tolerance of symptoms for a particular
condition may all be relevant self care options to guide a patient to or train them
for; if so, write that specific condition in each of the four sectors of Box T13.3. You
might start with the three (or more) health conditions for which there is highest
demand and least complexity.
3 Take each of the conditions you placed in the matrix in Box T13.3 and place them
in a copy of Table T13.1 indicating which members of the practice team are best
placed to provide prevention, await resolution, relieve symptoms or encourage
tolerance. Add extra rows to Table T13.1 to accommodate other health professionals
or patients/carers if they are part of your team too.
How it works (insight)
It allows a practice team to prioritise one or more conditions for which there is potential opportunity to minimise practice team workload, with similar or improved patient health and wellbeing outcomes. Thinking of the four components of self care support brings a wide perspective.
Whom to engage
The exercise is suitable for everyone in the practice team with contact with patients, or who has a role to promote or support self care. Include local community pharmacists and interested staff from the PCT to gain a wider perspective and collaboration.
How much time you should allow
As long as someone has collected baseline data on workload for identified conditions, up to an hour with ensuing discussion. Longer for subsequent action planning.
What a facilitator should do
Urge individual practice team members to subsequent action to promote and support self care as part of a co-ordinated plan.
What to do next
Arrange a review meeting for the first conditions prioritised for report on progress, barriers to action, patients’ responses. If all is going well, include other conditions; if progress is slow, focus on solutions that will re-affirm the culture of promoting and supporting self care.
What makes it work better
Everyone involved should understand the potential benefits to practice workload and patients’ wellbeing when patients undertake more self care. You could use the same template as Table T13.1 for team members to record what they are already doing for that condition prior to the team meeting or discussion, to get individual staff thinking what self care support is already being provided that can be built upon.
What can go wrong
Practice team members may find it difficult to relinquish ‘professional power’ to patients and encourage them to self care. If the self care support is not provided with patient safety as core, there may be risks to patients’ wellbeing if the self care they adopt is not appropriate or in line with conventional health care.
Box T13.1: Examples of conditions for which patients consult a GP or practice team – that might be amenable to elements of supported self care as a starter
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Box T13.2: GP/practice team workload associated with condition Frequency consultations occur
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Box T13.3: Conditions to prioritise for self care support
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Table T13.1: Checklist of practice team members’ roles in supporting self care for each
selected condition
| Role | Prevention | Await resolution | Relieve symptoms | Tolerance |
| GP | ||||
| Nurse | ||||
| Practice manager |
||||
| Health care assistant |
||||
| Receptionist | ||||
| Pharmacist | ||||
| Other |