Bodey Medical Centre What is it like to be a patient?

1. BodeyMedical CentreWhat is it like to be a patient?

2. The agenda • Your current status • Data illustrating current situation • Fear about change • The new system and what it means to you • Any questions

3. What do patients think of our service? • Administrative staff views • Patients not happy. Most appts given out by 8.45 am, then patients asked to ring back. Not good. • Patients don’t like being told to ring back. System needs to change • Clinical staff views • We do very well with emergency appts at the expense of routine appts, but not bad service provided • Good. Occasional grumbles about appts but infrequent • Constant complaints about bookings in advance with doctor of choice • Problems getting through phones • Patients would often like to book at specified time with specified doctor which can’t be done at moment

4. My daily work at present • Administrative staff views • Can get stressful when staff ask what to do about appts – don’t have answers! • Multiple complaints from patients about lack of routine appts • Clinical staff views • Open access /emergency appts can be stressful, otherwise ok • Part time GP • Often busy, good work colleagues, sharing of workload between staff • Constant complaints about bookings in advance with doctor of choice • Problems getting through phones • Patients would often like to book at specified time with specified doctor which can’t be done at moment

5. “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

6. Just 47% of patients get what they ask for, and 27% are told to call back. Very high rework and frustrating for all

7. Most people calling the practice want the doctor

8. No of contacts each day that week: • Mon - approx820 (36% of week) • Tues - approx470 (20% of week) • Wed - approx475 (20.9% of week) • Thurs - approx270 (11.8% of week) • Fri - approx235 (10.3% of week)

9. No of consultations per day of data week: • Mon -approx270 • Tues - approx 185 • Wed - approx 190 • Thurs - approx 135 • Fri - approx 115

10. Demand through the day – heavy pressure at 8-9 am.This can change, smooth out with rapid response.

11. Patients requesting appts for same day or 2 days ahead. Very unusual – is this because of when they are released?

12. Of the phone consults, 43% are resolved. We find typically GPs resolve around 60%

13. At present 62% of consults are face to face, but at 38% many already are telephone

14. Already GPs say 10% of consults don’t need to be face to face. This always increases.

15. GPs view on continuity, important at 38% - lower than national average

16. Only 26% of patients ask for a named doctor. This is on the low side, is it due to high proportion of student population?

17. My ideal work • Administrative staff views • Would like to be able to offer appts to patient who are really ill. Lot of NHS wastage on those who don’t need appts • To be able to give patients appts when they want and not to have patients getting angry with staff • Clinical staff views • Did not think that the system needed fixing although accept that it is hard for reception on the front line • An advocate for patients – hence practising medicine! • Calmer at present with structured day and patients less disgruntled as able to get appts with me

18. Fear losses if changes are made? • Administrative staff views • The elderly may suffer as they don’t like change • Some patients may not like the new system as they like to be ale to plan and book ahead • Clinical staff views • Patients may lose choice of doctor as we will need to spread workload evenly • Fear of rise in complaints and increased hassle during consultations – which we don’t have at present • Loss of patient confidence • Currently have safety net with pre-booked follow up appts • Working day may become chaotic with on call/ open access system

19. The new system and whatit will mean

20. 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

21. A Typical Receptionist Day With Patient Access Admin question 20% solve Per Week, Patient List Of 8,000 10-12% of patients call 28% on Monday 220 – 270 calls @ 2 mins 7 to 9 hours of calls Other days 4.5 to 6 hrs Many more calls will come in the morning, but will spread as a result of good service Reception takes call Just 60% list for GP 20% book to see nurse Nurse

22. A Typical GP Day With Patient Access Per Week, Patient List of 8,000 6-8% call for GP Mon - 28% of the week 130 to 180 calls on Mon 80-120 calls on other days Plan for 40 each per GP per day 40 x 5 minsplus 16 x 10 mins Total consulting time 6 hrs/day Availability of nurse consultations can reduce this by ≈ 40 mins/day Mornings more phone calls, becoming more face-to-face late morning &into afternoon. Come and see GP 30% GP phones patient 60% Problem solved 10% Come and see nurse

23. 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.

24. Average wait time to see a GP drops dramatically All data from Clarendon, charts by PA Navigator

25. 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 always offered the same day • 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

26. The Patient Access Launch Programme Eight ways we support you in leading change and avoiding the pitfalls Your personal training partner Key actions checklist week by week Datalog paperless data capture Unique Navigator analysis suite Private online resources portal Easy to use video tutorials & FAQs Patient communication materials customised for you, video & leaflet Expert helpline and rapid response throughout the programme

27. The agenda • Your current status - current model • Data illustrating current situation • Fear about change and your ideal • The new system and what it means to you • Any questions