City & Hackney CCG and the Confederation are supporting GP practices to implement Group Consultations as part of their LTC strategy. With the Covid-19 pandemic, the focus has now shifted on to Virtual Group Consultations (VGCs) in order to help practices to continue to provide patient-centred, effective and efficient care, remotely. We want practices to get involved in delivering VGCs to provide routine care for long-term conditions, such as Diabetes, Hypertension, Asthma and COPD.

Please see our videos at the bottom of this page on why City & Hackney feel that Group Consultations/VGCs can help to solve some of the challenges that we currently face in Primary Care.  

What are Group Consultations?

Group Consultations are an evidence-based intervention that have been tried and tested in UK Primary, Secondary, and Tertiary care. They deliver high quality person-centred care, with patients reporting improved experiences of care and evidence showing improved clinical outcomes over a wide range of long-term conditions. For more information on established best practice, see Virtual group consultations offer continuity of care globally during Covid‐19. Group Consultations are a great way to deliver routine care and kick start patient reviews and health checks as we navigate our way through the Covid -19 pandemic.

Group Consultations involve a 1:1 appointment between a clinician and a patient, in a supportive setting with a group of 10-15 other patients, lasting around 90 minutes. VGCs follow the same framework as Group Consultations, but are held over a software platform. In City & Hackney, we are using Microsoft Teams, which has been approved in terms of security features by NHS England. 

How can Group Consultations/VGCs benefit delivery of patient care?

Compared to 1:1 consultations, Group Consultations have been shown to improve patient satisfaction and clinical outcomes, as well as offering clinicians the benefits of increased clinical efficiency and development of new skills. See below what patients in City & Hackney told us about their experiences of Group Consultations:

In a time when there is increased demand and pressure on resources, this model can help change the dynamic with patients and give clinicians ‘more time to care’. Practices can benefit from improved team working and staff morale, as well as efficiency savings and the opportunity to use this consultation model to maximise on Key Performance Indicators, including completion of Care Plans, Time to Talk consultations and Structured Medication Reviews.

As a relatively new consultation model, there is currently a paucity of data in the UK to support VGCs. However, we can extrapolate many of the likely benefits of VGCs from the evidence that already supports use of Group Consultations. Globally, many services are switching to virtual group models in order to sustain routine care during the pandemic. Have a look at the British Society of Lifestyle Medicine (BSLM) webinars (Virtual Group Consultations Webinars) which share examples and learning from the use of VGCs around the world. 

What have City & Hackney done so far?

We have applied a phased approach to training and practice engagement, offering regular training workshops and resources to practice teams. We have partnered with the Group Consultations Training Team, www.groupconsultations.com, who have supported local practice teams to introduce this way of delivering care for their patients. This support is based on best practice gathered over 7 years of experience in this field, working with hundreds of organisations up and down the country to ensure success in implementing and scaling up this model of care. To date, over 75% of City & Hackney practices have taken part in training or have started to implement Group Consultations in their practice. A video is linked below where you can hear from colleagues who have already tried out Group Consultations.  

Why should my practice invest in implementing VGCs now?

We know that practices are currently very busy, with many of the teams feeling burnt out or exhausted as we navigate our way through Covid-19 and beyond. Resources are tight and many of us are wondering how we can kick-start delivery of routine care reviews and health checks. Above and beyond the benefits of Group Consultations for patients, VGCs will also provide many benefits for practices at this time:

• We need to continue to provide effective, patient-centred, and routine care remotely in order to prevent a backlog of patients, reduce acute admissions to hospital, and reduce risk in patients who are at high-risk of developing complications following Covid-19 infection. VGCs can help us to do this, whilst still delivering high quality personalised care.
• Group Consultations increase clinical efficiency, including allowing practices to efficiently and effectively complete routine Care Planning, Time to Talk consultations and Structured Medication Reviews.
• For patients, a Group Consultation model can help them to face the problems and challenges of loneliness and social isolation by encouraging them to share their experiences with each other. VGCs provide a great opportunity to work with your Social Prescriber, Health & Wellbeing Coach or link worker to deliver a more supportive, holistic approach to care for your patients.
• For clinicians, a VGC offers an opportunity to reconnect ‘face-to-face’ with patients and provide patients with support and reassurance about Covid-19 in a relaxed and informal way. Many patients and clinicians tell us that connecting through telephone consultations can prove challenging.
• For smaller practices, VGCs allow a clinician to see a group of patients, without using up a clinical room.
• This is a flexible model, which can be adapted to meet an individual practice’s areas of needs, and maximise the potential of a range of different Healthcare Professionals – this model can be used for LTC reviews, Covid-19 triage, review of symptoms post-Covid, review of vulnerable/shielded patients by a Social Prescriber, etc.

Please see our video on how adapting to VGCs can help you to refocus on providing routine care and reconnecting with your patients.  

Addressing ‘The Digital Divide’

Some clinicians have expressed concern that this consultation model may lead to greater inequalities by promoting the ‘Digital Divide’. It is important to point out that VGCs are not a one-size-fits-all model, and so will not be suitable for all patients. However, patients are currently more motivated than ever to get online, and this model has been used in vulnerable and socially-deprived groups with great success in the USA (Virtual Group Consultations Webinars). Additionally, as clinicians will be seeing 8-15 patients at one time in a VGC, this model has the potential to free up more 

time for us to concentrate on the more complex patients who need 1:1 or face-to-face consultations. 

The Hackney Digital Skills team have kindly created a ‘How To’ video for patients to use to help and guide them on how to sign on to a VGC - https://hackney.gov.uk/digital-skills/#Teams. We hope that this will make VGCs accessible to a wider range of patients. 

The current VGC Pilot and recent feedback

Two practices in C&H have begun running a GP- and Pharmacist-Led pilot, with VGCs being used by Practice Pharmacists and Practice Nurses to conduct LTC reviews. This has been a useful learning experience and helped us to develop resources for other practices taking part. Feedback surveys from one practice have shown high patient satisfaction rates, with over 85% of patients taking part saying that they would recommend VGCs to friends and family, 86% saying that they feel more able to manage their condition, and 86% say that they feel more able to understand their condition after a VGC. Individual feedback in the practice’s survey included patients saying it is ‘great to hear from other people with same issues, and that they ‘feel better knowing I’m not alone with this, especially...when I am shielding’. Staff members have also said that ‘this works even better than the face-to-face session did’ and ‘it’s the most honest conversation I’ve ever had with patients’. See our video for information about feedback from both patients and practices who have taken part.  

How can I get involved?

Interested practices are able to access online training and resources, as well as after-training implementation support from the Group Consultation training team (www.groupconsultations.com). Please contact katharinetowers@nhs.net to express interest, or to ask about upcoming training dates and other events. 

Our advice is for you to give Group Consultations a go - use the resources on the City & Hackney website and adapt them to your individual practice and to meet your patients’ needs. See this video for advice on getting started. 

To see what resources are available to help you set up Group Consultations or Virtual Group Consultations in your practice, please visit our Resources page 

Password: CHGC 

For any queries, or to share ideas, contact:

katharinetowers@nhs.net (CCG Clinical Lead)

alison@groupconsultations.com (Group Consultations Training Team)