Patient centred care, 12 months a year

After giving my Movember talk last month to a group of GP trainees at West Suffolk NHS Foundation Trust, I wanted to note down a few of my reflections; not just from my own talk, but from the questions and discussions that followed.

The role of the GP

One of the most interesting questions that came up was around the role of the GP during the diagnosis, treatment and discharge. This wasn’t something I’d necessarily thought of before my talk and, to be honest, the answer isn’t necessarily an easy one.

Something we suggested during the course of discussions was that the GP could make sure that some form of counselling or support was offered. This could occur whilst going through the diagnosis and treatment, and perhaps even after discharge from further checkups.

This conversation came about after one of the group asked “What counselling were you offered?”

In truth, I don’t recall there being any offers at the time. This might be me remembering incorrectly, but regardless of this, I more than likely wouldn’t have taken it up; I felt I had the requisite support from family, friends, work and many others.

Honestly, during my cancer journey, I didn’t seriously contemplate the implications of both my diagnoses or treatments. I believe that if someone had sat me down, and fully discussed everything with me thoroughly, then perhaps I would have been a little more prepared for myself and my partner’s recent journey through IVF.

I’d now advocate for an active approach from the GP to ensure that the proper support is offered to the patient at the time, and to make sure the patient really understands the present and future implications of what they were going through. Having these conversations might make all the difference to someone accepting support.

Acknowledge the differences

Finding the time to talk is especially important with men, as there is more than a possibility that they wouldn’t ask for help, clarification on what was happening or what the implications might be.

Many men simply won’t ask questions of a medical professional; they’ll pretend to be okay and want to get back on with everyday life. Men are also much less likely to be aware or participate in patient advocacy groups.

A large number of my fellow Movember ambassadors have told me that unless they had their female partners with them, they wouldn’t have asked any of the questions or got any of the information they did after their diagnoses and onwards.

Educate and inform

Education of the public was also a particularly important part of our discussions.

In 2018 11,882 men died of Prostate cancer in the UK alone. In the case of Testicular Cancer, the number of men diagnosed has more than doubled over the last 50 years. Both are shocking statistics that education can help to change.

I don’t believe it is just the education of men that is needed, but the education of all. Women are far more likely to actively encourage the men in their lives to seek medical support.

The GP waiting area is an easy and efficient place to start this education. Many have boards already in situ and places for flyers and postcards. Organisations such as Macmillan make them easy to order online and deliver to your practice.

Another idea we discussed was patient education talks and days. I’d encourage these to cover not only educating patients around the physical symptoms, but the mental and wellbeing aspect of Men’s Health as well.

Education of the public around prevention and early detection of both testicular and prostate cancer can go some way to help with the reduction in those needing longer treatment, operations or care. It was really encouraging how many of the GP trainees were engaged with these ideas, and I’m looking forward to hearing how some of their education initiatives come along.

A conversation for all seasons

My final reflection is that of patient centred care.

Personally, I believe we first have to acknowledge how differently the sexes interact with their own health. Women are far more likely to speak to a doctor about something, or ask questions to gain a deeper understanding. I’m generalising, of course, but if we build upon this as a foundation, I do believe we can start to tackle the issues surrounding Men’s health.

The recent NHS ‘recovery’ plan, which is rolling out 'patient-initiated follow-up’ rather than admin staff booking follow up contact, completely misses this point. From a Human Factors perspective, this approach centres on “Work as Imagined” not “Work as Done”. In theory this initiative is a great idea, however it completely omits the differences in how the sexes tackle their health.

If we can work on education, then prevention should follow. With that the backlog of patients could decrease.

But for me, as a patient, a trainer and a Human Factors consultant, the biggest single improvement we can make is to make sure that Men’s health isn’t just talked about for one month a year, but all year around.