Dr Nitin Gambhir - GP - NHS Greater Glasgow & Clyde
Inter-professional Practice Based Small Group Learning (PBSGL)
In 2003, the pilot study for PBSGL in Scotland involved only general practitioners. When the programme expanded to involve all of NHSScotland it became open to all professions within primary health care. A small number of practice nurses joined existing GP groups and one ‘practice nurse only group was started. In the ten years following the pilot, the programme expanded steadily throughout Scotland and grew from the 45 GPs in the pilot to over 1700 GPs by 2012. This growth was mostly within the confines of general practice rather than primary healthcare.
I facilitate our PBSGL group which has been running for three years now. Our group consists of six GPs, two of whom are from neighbouring practices, two sessional GPs, two GP trainees and one practice nurse. We meet once a month within our practice which is located near the West End of Glasgow.
We complete at least 10 PBSGL modules each year. Group learning through PBSGL has been extremely useful because it combines the acquisition of knowledge with development of skills such as team working, sharing information and learning from colleagues. Earlier this year, Fiona, our practice pharmacist, invited us to be part of an inter professional PBSGL group, an idea which was being piloted by NES. We embraced this opportunity with open arms and the initial experience has been nothing but excellent.
Most GP modules contain prescribing issues which we now discuss more comprehensively since a pharmacist is able to contribute. Lately there have also been modules dedicated to prescribing such as Drugs and the Elderly, Vitamin D prescribing and High Risk Medications.
Fiona Swinnerton’s presence in our group has led to an increased awareness of cost effective, formulary compliant prescribing. We have lately had some interesting discussions on prescribing with Fiona. These conversations have enhanced our understanding of dilemmas faced in clinical practice when drug choices are made.
Her contributions have extended to conducting audits for the practice e.g. Lithium prescribing from the High risk Medicines module, creating Polypharmacy review templates for practice patients as learnt from the Drugs and the Elderly module, fact finding on drugs choices, formulary compliance, cost implications and current guidelines.
Surprisingly she had a lot to contribute to topics unrelated to prescribing such as ‘Adults with Incapacity’ and ‘Abnormal Uterine bleeding’ as well. We now strongly support Inter professional PBSGL and hope to expand our group even further by inviting other disciplines as well.