Facilitating Groups in Primary Care

A Manual for Team Members

Marion Duffy, Elaine Griffin

• Publisher: CRC Press
• Year: 2020
• ISBN:
  9781315348285
• Edition: 1
• Topic: Medicine
• Subtopic: Medical Theory, Practice & Reference

Medicine is one of the oldest professions; in common with law, it tends to complicate or mystify its writings by persistent use of obscure jargon. However, an increasing number of lay workers, including administrators, practice managers, medical secretaries, lawyers, social workers and care assistants, are required to be able to interpret medical records, reports and prescriptions. This book unlocks the mystery of medicine for all those whose work involves the use of medical terms, whether in hospital or general practice, or as health authority employees. It will meet the needs of most as a quick, accurate reference source for fundamental anatomical, physiological, clinical and pharmacological terms.

Chapter 1

Introduction

Summary

The introduction describes the focus of the handbook as ‘working in groups’.

It sets the context by helping you to focus on how your practice works together and describes a practice which used a Facilitator to help it establish its goals for development

Please note that, for reasons of convenience, we refer throughout the handbook to the facilitator as of female gender. All references can be assumed to refer to facilitators of either gender.

This handbook looks at facilitating groups in primary care through knowledge and understanding of the context of general practice, and of how groups typically work together. As the need for meetings has increased in the current climate, the handbook focuses on what typically happens when groups work together in a meeting session and suggests an approach which uses facilitative behaviour to make that process of working together easier.

You will be asked to think about how you might act in a more facilitative way, and whether the formal role of Facilitator is one to which you might aspire.

Think now about your own practice:

• are your practice meetings productive?
• is everyone clear about their own and others’ roles?
• are decisions always implemented?
• how do you handle conflicting views?
• do you discuss the potential effect any change might have?
• do you review your group’s functioning from time to time?

Does anyone ask these questions about your practice? Who would answer them?

Here is a real life example from the Yellow Practice, a city centre practice with a team of 28 in total who dealt with some of the questions listed above. They called in an external Facilitator to help them move forward in developing their practice.

Case Study 1
Facilitating development The Yellow Practice

The Yellow Practice was required to produce a Practice Development Plan by its local Health Board. The partners asked the Practice Manager to ‘see to it’ and she decided to get a group together comprising one representative from each of the main staff groups in the practice – GPs, practice nurses, district nurses, health visitors, reception staff and herself.

Twelve meetings took place over a six month period but attendance was patchy. The GP was usually ‘too busy’ to attend and there was always at least one member on holiday at any one time. However, the group had lots of ideas for developing the practice and spent many hours discussing them. Nevertheless, after six months there was still nothing in writing and the group was struggling to find a direction. The members of the group didn’t know if all the practice members would like their plan and they were not sure whether they were supposed to be implementing as well as planning the development of the practice. Who would write the plan? Whose job was it really? Which decisions could they make and which ones would have to be referred back to the partners?

The Health Board had sent round a reminder that plans should be submitted within the next six months. The Practice Manager asked a local Primary Care Facilitator to attend a practice development meeting and offer some advice. The Facilitator suggested that she would facilitate a meeting where the whole practice would get together to establish its goals for development (to include writing the development plan itself) based on a clear vision presented by the partners. They would then be in a position to devise a system whereby goals could be pursued in a way that had the commitment and support of the whole group. At that meeting the practice decided to form small working groups containing representatives from key staff groups to address a set of agreed goals. The Facilitator helped the first working group establish itself – and its way of working – and left some guidance which other groups could follow.

The critical help that the Facilitator gave was in helping the practice establish how it would achieve its own goals. She encouraged the practice team, through discussion, to be quite explicit about what was to be done, who would do it, what authority they would have and how the whole group would be kept informed.

Although the practice possessed lots of ideas and had set up a forum for discussing them, it had not devised a suitable mechanism whereby group ideas could be converted into action in a way that was designed by, and acceptable to, the whole practice.

The Facilitator’s guidance came from her knowledge of how groups work and the particular context of general practice. Her skill was to run an effective meeting, help the group reach consensus on the next step, and offer some structure which would allow the small working groups to plan and reflect on their own operating procedures.

With training, guidance, experience and reflection, you, or someone in your practice, can develop facilitation skills which might help your practice in similar ways. These skills can also be transferred to other settings where you are part of a group – perhaps you run a carers’ group or are a member of a local committee, or participate in a professional working group.

Chapter 2

How to use this handbook

Summary

This chapter gives a guide to the content and structure of the handbook, explaining the role of:

• theory
• reference to general practice
• case studies from local projects
• suggestions for facilitating your own practice
• tips and tools to help you facilitate.

The handbook is divided into three main sections:

1   A general introduction to facilitation skills

2   How groups work

3   Making meetings more effective.

There is also a summary chapter entitled Qualities, skills and opportunities. You may want to read this chapter first to gain an overview of the content of the handbook.

In each of the three main sections you will find:

Theory	A brief overview of some of the relevant body of knowledge.
General Practice	How theory translates to real life in general practice.
Case Study	An example from general practice.
Tips and Tools	For diagnosing difficulties, suggesting alternative ways of working and encouraging a more reflective approach to working together – all tried and tested in the context of general practice.
Facilitate Your Own Practice	How you can help smooth the process of managing in this climate of change in general practice.

For easy access descriptions of specific facilitation tools and techniques referred to in the text, are marked with the symbol:

Other aids to facilitation appear in the body of the chapter and are surrounded by a border like this:

Chapter 3

A general introduction to facilitation skills

Summary

In this chapter, we develop your understanding of the skills and personal qualities required of a Facilitator.

Reference is made to several key writers on facilitation who help us describe the role of the Facilitator – John Heron, Trevor ...

Table of contents

• Cover
• Title Page
• Copyright Page
• Table of Contents
• Preface
• List of tools
• List of case studies
• Acknowledgements
• 1 Introduction
• 2 How to use this handbook
• 3 A general introduction to facilitation skills
• 4 How groups work
• 5 Making meetings more effective
• 6 Qualities, skills and opportunities
• References