eltham palace surgery what is it like to be a patient? thoreya swage...
TRANSCRIPT
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
Why do patients call? 63% GP, many for nurse, admin, repeat prescription, test results
Requests for GP by day, Monday much higher demand
Requests: a problem: huge rush at 8am
Outcome of requests – 41% not offered what they want, of whom 8% told to call back, making rework
Vast majority of requests are for same day.
49% specified a named doctor, GPs say continuity important in 37%, though achieved only 28%.
Volume of consults per day, as submitted, very different from pattern of patient demand per day.
35% of cases acute, unusually low. Any reason for this?
At present, very few consults are by phone
Sample very small, but 5/7 resolved over the phone. We typically see 60% resolved.
Your view is only 20% more consults could have been by phone – though this often changes!
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.
What do patients think of our service?
• Administrative staff views– No one answers the phones, never no appointments for
about 2 weeks.– Not able to get through on the phones. Complaints that
they are too few appointments available. Problems with scripts.
– Patients complaint that they cannot get an appointment with a GP for over 2 weeks,
– Patients can wait for up to 10 minutes to be answered by telephone even though we have appointed extra staff to answer these calls.
• Clinical staff views– Long waiting times, frustration with this– Good , helpful but has trouble getting through on the
phone at busy times. waiting times, frustration with this
My daily work at present
• Administrative staff views– Answering the phone, dealing with patients. Get very
stressed as no appointments and gets upset that I’ve got nothing to offer them. Embarrassment too with it.
– I have experienced very upset patients that have had difficulty getting through on the telephone lines which we fully understand must be very frustrating.
– It's hard talking to patients on the appointments line when you can't offer any appointments.
• Clinical staff views– Extremely busy regularly working over 12 hours a day– QOF, Results, Workflow, Docman, Prescriptions, helping with
Reception. Feel stressed most days with the workload & the backlog of work that i cannot catch up with, angry patients who are rude when you try to help them.
My ideal work
• Administrative staff views– Be able to offer a more better service – Time to do daily work without having a backlog of
paperwork. A system that allows the surgery to run efficiently with the patients feeling that they don't need to complain.
– Content and happy patients with lots of appointments– It would be great to have two spaces on the front desk of
reception so at busy times we can get through patients quicker. It would great to have more phones upstairs for our appointment line.
• Clinical staff views– More structured working day with time to go through
letters/results within the working day rather than coming in on days off or staying v late at night
– To have enough time to do my daily work. Less/No home visits
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