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Becoming a WiseGP

 

Wise General Practice (WiseGP) champions a different approach to managing the very real challenges of everyday practice.

 

There are many challenges - from the complex clinical presentations we deal with in daily consultations, to the problems faced by our local community and the dilemmas we face with practice design and service delivery.

 

To meet these challenges, WiseGP champions a distinct vision of general practice built on the wisdom of consultant-led, community based whole person healthcare. In other words, a GP-led multidisciplinary team with the skills, confidence and resources to understand and manage complex problems.

 

WiseGP teams need to have the understanding and confidence to use knowledge work skills. These skills form the foundation of modern general practice and advanced generalist medicine.

 

Many of you have asked us how to develop your skills as a WiseGP - individually and as a team. Here we’ll signpost you to different resources that could support skill development across your team and throughout your own career.

Working at home

Tools for knowledge work

 

You use knowledge work skills every day. It’s how you deal with complex problems. When there isn’t a straightforward answer to the problem in front of us, we have to critically explore the problem, create an explanation that guides the action we take, then evaluate the impact of our actions and revise our plan as required. These are the skills of advanced generalist medicine.1 This process involves us creating new knowledge in practice – so-called practice-based evidence.

We know that many people feel they lack the skills and/or confidence in this knowledge work to generate practice-based evidence, so here are some examples of how WiseGP could support your development of these complex problem-solving skills.

 

  • The WISDOM course - this free to access online course contains practice-based case studies where you can see knowledge work in action and examples of how you could develop your skills through your career.

  • Newsletters - our newsletters contain examples of how a WiseGP would approach current challenges in practice. For example, our newsletter on persistent physical symptoms discusses how a WiseGP could shift the focus of a consultation from diagnosis to explanation, using a patients’ creative capacity.

  • GEM library - our GEMS contain headline messages from recent research with suggested WiseGP actions you could take.

  • WiseGeneralPractice - here you can hear how general practice teams have used WiseGP principles to innovate their practice.

  • Case studies - from managing uncertainty to using gut feelings, these are examples of knowledge work in action from everyday practice.

  • TAILOR - our blog features the TAILOR course, designed to support clinicians when managing complex polypharmacy with tailored deprescribing.

Quality improvement

 

Knowledge work skills don’t just apply to looking after patients. We also use them when we’re running our practices and working with our practice teams.

 

Grass roots changes driven from front-line practice can often be the most impactful, but finding the time and headspace to develop ideas, then gaining momentum to implement and sustain changes can be daunting. Our Lazarus workshops have shown GPs are keen to be involved in shaping the service they deliver if supported with funded time away from seeing patients. Participants felt these workshops could also provide a key space to develop a community of practice and so support retention of GPs in practice. Findings from Lazarus will inform our work to develop and test a new WiseGP model for the delivery of general practice, which we aim to implement from 2025 onwards. In the meantime, there are resources to help you start implementing changes in your own practice that you can explore on WiseGP.

 

  • Our newsletter, “Time for Change”, shares tools to support implementation of changes in practice.

  • Module 4 of the WISDOM course contains some advice on QI activities in practice.

  • WiseGP actions from our GEM library and WiseGeneralPractice stories could inspire your next QI project.

  • Our blog on “tackling health inequalities” explores a really impactful QI project using social prescribers.

  • WiseGP workshops - watch out on X (twitter) @wisegpcouk and sign up to our newsletter for updates on workshops you could participate in!

Image by Christina @ wocintechchat.com
Group Therapy

Sharing your learning and wisdom

 

Much of the knowledge we use and apply in everyday practice isn’t from what we learned at medical school or read in a guideline. Instead, it is wisdom derived from the practice-based evidence we generated through our collective experience working with colleagues. Together we discuss complex problems, develop potential solutions (to apply to individual patients, our practice, or our local population) and learn from the effect of putting them into practice. This is the process of generating practice based evidence – which has also been described as knowledge-in-practice-in-context or mindlines.

 

Creating practice-based evidence is nothing new, but more recently we have recognised the importance of sharing our collective wisdom. This might be in critical discussions within our communities of practice, within formal teaching sessions, the work we do a part of extended roles, or by adding to the professional medical literature. Applying new knowledge can enhance our understanding and application, developing our skills as WiseGPs. Here are some examples about how you could share your learning with the support of WiseGP resources.

 

  • Our WiseGP GEMs and newsletters provide potential inspiration for practice teaching sessions.

  • You could write a blog for WiseGP- have a look at this example on rewilding and health.

  • BJGP life encourages submissions from GPs on research and clinical care for the primary care community. Why not share your opinions and facilitate some interesting discussion? You can find out how to contribute here.

Like all consultant level roles, working as a GP requires us to take on many different roles, including teaching. Explore how different GPs have developed their careers through our WiseGP Stories.

Leadership skills - knowledge is power?

 

The skills to create, use and critique knowledge in practice also help us work as leaders – developing, designing, implementing and evaluating new ways of working. At some point in your career, you will have taken the lead on something, from your first cardiac arrest, to working as duty doctor. Becoming a clinician lead is an extended role, potentially open to all members of the general practice team. As community consultants in General Practice, GPs, whether salaried or a partner, may have formal leadership roles within Primary Care Networks, Local Medical Committees, as Training Programme Directors and within Medical Schools. Beyond this, GPs also have leadership positions within Integrated Care Boards (ICBs), the RCGP, Health Education England, NHS England, the BMA and as government advisors. There are many other examples you could consider to develop your skills as a WiseGP.

 

  • Our WiseGP stories include reflections from GPs with leadership roles, which may inspire your own career pathway.

  • Module 4 on the WISDOM course includes advice on becoming a leader and extending your leadership skills.

  • The RCGP has resources to help GPs to develop their leadership capabilities in a range of GP-specific contexts. 

  • If you want to be part of leading the change needed to reclaim general practice, you could join our WiseGP Action group - updates will be posted on X (twitter) and via our newsletter!

Senior Woman

Consultant level practice and portfolio career planning

 

All consultant level clinicians will have a portfolio of roles within their job plan. In the past, GP job planning often focused on number of clinical sessions worked and our contractual status (partnership/salaried/locum). As we move to consultant level practice (see RCGP), the extended roles we have always done become more visible, explicit and present more opportunities.

 

Health systems depend on the work of consultant level clinicians delivering and leading complex and coordinated care. As GP workloads have increased, the importance and value of the portfolio aspects of our career plans have become ever more important – in particular to avoid burnout. GPs have numerous valuable roles beyond the consulting room – whether teaching, leadership, research, medical writing, extended roles, supporting medical care within the army, at sports events, in prisons, on cruise ships or as expedition medics. Diverse career planning can extend your skills as a WiseGP, providing learning that will complement your everyday work in practice.

 

  • Our WiseGP stories may provide you with a spark of inspiration for a future portfolio career.

  • We’d love to hear from you if you have a career story to share!

 

Dr Annabelle Machin, WiseGP Fellow

Prof Joanne Reeve, Founder WiseGP

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Reference

  1. Reeve J. Medical Generalism, Now! Reclaiming the Knowledge Work of Modern Practice. Boca Raton:CRC Press; 2023.

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