wallington medical centre what is it like to be a patient? thoreya swage...

Wallington Medical CentreWhat is it like to be a patient?

Thoreya Swagethoreya.swage@patient-access.org.uk

07946 559132

Outside a traditional surgery

People waiting on the phone, the same, unseen

Receptio

n takes

call

GP sees patient10-min

slot

Problem solved

70% “routine”

30% “urgent”

“All gone,call backtomorrow”

3 week waitHigh DNAsRepeat booking

See any GP/locumPoor continuityRepeat booking

Patientpressure

Face-to face vs telephone consultations

Already 24% of consultations are by phone

Sample is small at 17, but of these 88% were resolved on the phone.

Requests for appointments are reasonably well spread

Confirmed by datalog collection - a good sign

But outcome of requests – 17% told to call back – generating more work

You are seeing about 100/wk and 40 phone/wk, total of about 6% of your list, well within expectations.

Average no of days wait to see a GP is 3.5 days

Some appointments are up to 2 weeks ahead

Vast majority of requests are for same day.

Continuity is about 75%

32% specified a named doctor, interestingly more often important to GPs at 43%, about average.

What do patients think of our service?

• Administrative staff views– Some complain about lack of appointments but the

majority seem ok.– They want more appointments with Dr.– generally patient's are happy. Minority of rude,

demanding patients complaining they are unable to make an appointment to see the GP.

• Clinical staff views– Overall good but can be long wait for routine

appointment which can lead to higher DNA rate. Sometimes inconsistent some patients are offered telephone appointments if they can't get a routine appointment but some are not.

– Patients complain that it is difficult to get an appointment with a doctor.......... However having seen a clinician they are usually positive about their experience.

My daily work at present

• Administrative staff views– Spend most of my time on reception whilst juggling

paperwork between callers. Difficult to finish anything.– Mainly administration work; Audits, QOF, etc. Can become

stressful when interrupted with patient queries/ reaching QOF targets.

• Clinical staff views– Generally manageable as we operate 15min appointments

and patients are usually seen on time. – I feel my surgeries are not too stressful, they can be if there

are many extras or I will get stressed if the surgery is over-running. Patients do complain about access and it can be stressful to explain to them that we are trying our best.

My ideal work

• Administrative staff views– I would prefer to be on reception all the time and the

patients then get to know you and its easier to explain a difficult situation to them.

– Ideal day! Having more time - not feeling rushed to get work done.

• Clinical staff views– More structure to the course of my day with greater

flexibility. Would like to do more proactive management of LTC patients

– Patients arriving on time, surgery running on time, no extras, no interruptions, patients with single problems in each consultation!

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.

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 saving

20% of GP working hours and A&E attends are

50% below Liverpool average - Dr Chris

Peterson,

GP at The Elms & Liverpool CCG

Urgent Care Lead

The Relief of Working Efficiently

Reception takes call

GP phones patient

Problem solved

Come and see GP

Admin question

Come and see nurse

20%

20% 10%

30%

60%

60%

How Patient Access Works

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)

Consensus

Preparation

Detailed planningStaff surveyPatient commsWhole team meeting

New deal for patientsPredicting demand & matching capacity.Patient & staff feedback

Launch day

Routine

Review

New measures help tuning.Build confidenceAffirmation

Yes.Pledge toeach otherand to patients

Launch programme - just 12 weeksto a happier, less stressful practice

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?

Cold and soggy

Hot, fresh and crispy