better demand management in primary care · 2016-11-29 · governance arrangements using vision...
TRANSCRIPT
Introduction: Every poster is different. You may wish to modify elements of the design to suit your needs. Keep the
colour scheme and logos to be consistent with the current WCBPS branding /identity. Keep the word count light.
Methods: Here
Results: Here
Figure 1. Make sure figures are high resolution. Images taken from the internet could print poorly. Check file size. Zoom into the image and look for pixelation.
Acknowledgements:
Replace with figure
Figure 2. Make sure figures are high resolution. Images taken from the internet could print poorly. Check file size. Zoom into the image and look for pixelation.
Replace with figure
Figure 3. Make sure figures are high resolution. Images taken from the internet could print poorly. Check file size. Zoom into the image and look for pixelation.
Replace with figure
Figure 4. Make sure figures are high resolution. Images taken from the internet could print poorly. Check file size. Zoom into the image and look for pixelation.
Replace with figure
Conclusion: Here
Better Demand Management in Primary Care
Kevin Duff - Cluster Development Manager Marie Amanoritsewor – Project Manager
Introduction: GP Practices across Wales have been experiencing an increasing workload, and this was no different in Neath where it was recognised that the traditional method of every patient seeing a GP in every case was proving to be unsustainable. It became apparent to the 8 GP practices which make up the Neath cluster network that better methods of managing patient demand need to be implemented.
Methods: The Cluster set up a project with two key elements: • Channelling patient demand for primary care through
telephone triage • Managing demand more appropriately by deflecting
appropriate cases to a wider range of shared professionals within cluster
The cluster GP practices then: • Commissioned Vision 360 - a shared appointment
and clinical system which would give access to a pool of shared professionals to patient records from a central location (the hub).
• Secured the appointment of 2 physiotherapists, 1 mental health support worker and a cluster pharmacist to work at the hub.
• Commenced the introduction of a triage system and identification of patients who could be better managed by practitioners at the hub
• Signed data sharing agreements and agreed governance arrangements
Using Vision 360, and applying agreed exclusion criteria, practices started booking appointments for their patients to see the appropriate professional.
Figure 1. Neath Pacesetter hub high level process map
Results: The introduction of triage in one of the practices shows a reduction in the number of face to face appointments being booked to see GPs and an increase in the number of patients being managed by telephone advice only. The pool of professionals are also helping to reduce GP workload, freeing them up to deal with more complex cases.
Figure 2a Number of appointments
made for face to face consultations
Figure 2b Number of patients
managed with advice only
0
100
200
300
400
500
600
700
47
161
237 209
654
May - August 2016
0
20
40
60
80
100
120
10
30
23 18
31
112
April - August 2016
Figure 3a Physiotherapist’s activity
(number of patients seen)
Figure 3b Mental Health support worker’s
activity (number of patients seen)
Conclusion: Early indications show that introducing telephone triage has enabled practices to better manage their demand. A shared appointment booking and clinical system is crucial to this model as it enables an efficient and effective service set in a single location into which GP practices can refer.
Settings
• In practice • In Care Homes • Patient’s own home
17%
83%
June 2015 - Aug 2016
Face to Face
(1269)
Non-Face to
Face (6416)
• Polypharmacy reviews • Drug/disease specific
review clinics • Minor ailments (piloted in 1
practice) • Discharge/medicines
reconciliation • Telephone consultations • Liaison with social services
and community pharmacies • Alterations to therapy • Prescribing & repeat
prescribing
Figure 3c Pharmacist's activity
Patients’ views • “Pharmacist made me feel a lot better when I left, very
helpful” • “Didn’t feel the appt was so timed as when seeing GP
He had a better understanding of my medication now” • “Seen quickly, very friendly + helpful” • “I saw Rachel (physiotherapist) and she explained
everything thoroughly to me” • “I don't think this service should be given before you see a
doctor” • “A very good service”