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Gallions Reach Health Centre What is it like to be a patient?

Gallions Reach Health Centre What is it like to be a patient?. Outside a traditional surgery. People waiting on the phone, the same, unseen. The traditional model. “All gone. Call back tomorrow”. Rework. 3 week wait, high DNAs, repeat booking. Reception takes call. GP sees patient

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Gallions Reach Health Centre What is it like to be a patient?

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  1. GallionsReach Health CentreWhat is it like to be a patient?

  2. Outside a traditional surgery People waiting on the phone, the same, unseen

  3. The traditional model “All gone. Call back tomorrow” Rework 3 week wait, high DNAs, repeat booking Reception takes call GP sees patient 10 min slot 70% “routine” Problem solved Patient pressure 60% 30% “urgent” See any GP/locum Poor continuity, repeat booking

  4. Face-to-face consultations vs telephone consultations

  5. Appointment bookings by time of day

  6. No of days wait to see a GP

  7. Some appointments are up to two weeks ahead (or more)

  8. About 28% are telephone consultations

  9. 75% of telephone consultations resolved there and then

  10. Appropriateness of consultations – about 15% face-to-face not needed

  11. Length of time for telvs face-to-face consultations

  12. GP continuity

  13. What do patients think of our service? • Administrative staff views • not enough appointments, difficult to get through on the phone and difficult to get appointments with specific doctors • lack of appointments, unable to get through on phones • Patients get frustrated when they are unable to get an appointment for 2 weeks • Often patients have to wait for a long time for a call to be answered in order to make an appointment, • They have to wait too long for an appointment • Clinical staff views • Difficult to make appointment or get through to reception. • Receptionists obstructive (though clearly just trying to cope with demand) • No continuity with the same doctor, difficult to get appointment on the day or when they want to be seen. • not seeing the doctor they wanted to. • difficult to get nurse appointment

  14. My daily work at present • Administrative staff views • it is very busy working on the reception and can be difficult not being able to offer patients what they are asking for • stresses are caused by arguments with patients because of lack of appointments • unable to offer appointments and dealing with upset patients due to frustration. • Clinical staff views • DNAs, inappropriate use of appointments • Having to follow up other Doctor's patients where I am not happy to issue sick notes etc or have to catch up on long history in short period. • can be very difficult, often older patients need more than 10 mins appointments. Also some patients don’t turn up often and clump problems together hence you over run, become stressed, more likely to miss things. • People who book on the day appointments and don't turn up for them

  15. My ideal work • Administrative staff views • in an ideal world it would be good if every patient could be offered what they ask for • I would like to offer patients appointments rather than having daily arguments about lack of them. • I would like to help patients in every way, elderly patients come in for prescriptions I would like to do it there and then not ask them to come back the next day. • Clinical staff views • More appropriate use of appointments. More control over my work load and continuity with patients. • for patient to get more flexibility when booking their appointments . • Ideally i would like greater continuity with the patients • I want to manage my workload, I want to be able to know what is going to be discussed in the appointment before the consultation

  16. A practice in the Patient Access community looks a little 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.

  17. The traditional view of general practice, every problem requires 10 minutes face to face with the GP One tiny problem Perfect service

  18. A new principle is at work • We help all our patients, all day, every day • The Patient Access method makes this a daily reality.

  19. Simple, but the whole system changes Come and see GP Admin question 30% 10% Reception takes call GP phones patient 70% 60% Problem solved 10% 20% Come and see nurse PA Navigator measures the flows, which vary by GP & practice.

  20. “How are we going to help all our patients, all day, every day?”You answer, over five stages of the programme. Consensus Yes. Pledge to each other and to patients Preparation Launch day Staff survey Patient survey Data capture Training System setup Whole team Routine New deal for patients Feedback wall Test & learn Build confidence Review Evidence: New measures New staff survey New patient survey Your decision

  21. 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)

  22. 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

  23. Which is the best pancake? Hot, fresh and crispy Cold and soggy

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