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Blackheath PMS Woodland Surgery What is it like to be a patient?. Outside a traditional surgery. People waiting on the phone, the same, unseen. “All gone, c all back t omorrow”. 3 week wait H igh DNAs R epeat booking. Reception takes call. GP sees patient 10-min slot. 70% “routine”.
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Blackheath PMS Woodland SurgeryWhat is it like to be a patient?
Outside a traditional surgery People waiting on the phone, the same, unseen
“All gone, call back tomorrow” 3 week wait High DNAs Repeat booking Reception takes call GP sees patient 10-min slot 70% “routine” Problem solved Patient pressure 30% “urgent” See any GP/locum Poor continuity Repeat booking
Why do patients call? 65% for a GP, many for nurse, admin, repeat prescription
39% specified a named doctor, interestingly more often important to GPs at 52%.
GP consultations by day – compare fairly flat line with much higher demand on Mondays
50% of cases acute, clinically best dealt with today. This usually rises to around 60%
Your view is only 21% more consults could have been by phone – though this often changes!
What do patients think of our service? • Administrative staff views • On the whole, pretty good • normally excellent with us able to give same day appointments or telephone triage calls with GP • normally always good • Clinical staff views • we provide enough same day appointments telephone advise & triage • very good service, able to get appointment or speak to doctor with in a day
My ideal work • Administrative staff views • I would like the time to be able to finish one task before being several others. I like interacting with the patients on a friendly basis. I think this helps patients to feel more relaxed as they wait to see the Doctor • being able to be of help to all patients and clinicians when called upon. Improving my IT skills. • Clinical staff views • need more time for face to face consultation & telephone triage • more time to have face to face and paper work
Key points • Demand variable by day, supply volume match looks OK with Mondays much higher. • Patients ring the day they want to be seen, but most have to wait. • Continuity (choice of doctor) appears more valued by GPs than patients – this can be improved with better access • Currently some consults by phone, but resolve rate is on the low side at 45% which will mean a higher workload. The average is around 60%, saving time and increasing capacity.
A Practice In The Patient Access Community Looks, Sounds, Feels Different Dr Chris Barlow of Quorn, one of the earliest pioneers in 2000 Monday morning 8.30, busy day, going full tilt. All carefully worked out.
The Relief of Working Efficiently • Evidence from practices in the Patient Access movement • 60% of calls don’t typically need an appointment • A rapid and safe system, where patients that need to be seen are • 7% list increase with no extra GP sessions needed at Oak Tree Health Centre We’re now saving20% of GP working hoursand A&E attends are 50% below Liverpool average- DrChris Peterson, GP at The Elms & Liverpool CCG Urgent Care Lead
How Patient Access Works Come and see GP Admin question 30% 20% Reception takes call GP phones patient 60% 60% Problem solved 10% 20% Come andsee nurse
Golden Rules • If telephone lines open 9am, so do Dr callbacks • All patients are called back – no Doctors appointments made by receptionists • Call back within the hour • All Drs on telephone call backs (exception Duty Dr or locum/trainee) • Call patients in for face to face from mid morning (and mid/late afternoon)
Launch programme - just 12 weeksto a happier, less stressful practice Detailed planning Staff survey Patient comms Whole team meeting New deal for patients Predicting demand & matching capacity. Patient & staff feedback Review Launch day Preparation Routine New measures help tuning. Build confidence Affirmation Consensus Yes. Pledge to each other and to patients
What happens next? • All to agree to a change • Change leader • Decide on a launch date • Do not book any appointments from launch date onwards • Workforce planning (GPs and reception staff)
What happens next? • Inform the patients • e.g. flyer, PPG, website, media, answerphone message etc • Train staff • Procedure for reception staff to follow • Support provided by Patient Access training partner – before, at launch and afterwards
Which is the best pancake? Hot, fresh and crispy Cold and soggy