New method to help GPs manage patients with multiple health conditions

While people are living longer, many develop multimorbidities—that is, multiple health conditions that no single set of guidelines will cover. It's a challenge for the patients themselves, and the GPs trying to support them in living healthy lives.

Now a team of health scientists at the University of Plymouth has developed the SHERPA model for GPs—a new three-step method for evidence-informed and interpretative decision making. And a new paper shows promising signs that it could be an effective tool for GP trainees.

The evaluation led by Dr. Dawn Swancutt, along with colleagues in the Community and Primary Care research group (CPCRG) and the National Institute for Health Research (NIHR) Applied Research Collaboration South West Peninsula (PenARC), showed that SHERPA was viewed as helpful by GP trainees for patients with whom they had established a relationship.

The results demonstrated that all 16 participants engaged well with the teaching sessions, brought observations from their own experience, and reflected on particularly complex consultations.

SHERPA stands for Shared Evidence Routine for a Person-centered Plan for Action, and sees the practitioner acts as a "guide," working with patients to apply evidence and explore solutions in a holistic way. Half of the GP trainees involved in the study feel they applied it successfully with their patients.

Following the paper's publication in the journal Education for Primary Care Dr. Edmund Jack, Visiting Specialist in the CPCRG, and Professor of Primary Care Research at the University, Richard Byng, presented a workshop showcasing the SHERPA approach at the European World Family Doctors conference.

The next step is to "train the trainers"—and ensure that SHERPA is viewed as an integral part of clinicians' communication skills training rather than an "add-on."

Dr Swancutt said: "If SHERPA is viewed as an integral part of clinicians' communication skills training, it could result in a better shared understanding of the biological-psychosocial links in complex health conditions and more appropriate goal setting. Training GP trainers to use SHERPA and to support trainees in their transition from newly qualified to expert clinical communicator is an important next step, and something that we're currently working towards.

"It's early days and it's vital that evidence is used to inform all decision making in implementing this model. But if taken on board successfully, we feel it really could transform primary care and help people to feel more empowered, as well as living longer, healthier lives."