p84012 northenden group practice what is it like to be a patient? meena modi...
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P84012 Northenden Group Practice
What is it like to be a patient?Meena Modi
“How To Get Your Life Back,
Save More Money
and Have Happier Patients
Within The Next 12 Weeks”
Familiar?
Familiar?
Before Patient Access GPs, PMs and receptionists said…I’m
embarrassed when I see
rows of patients waiting
We’re going to have to get
another GP in at a cost of
£100,000.00
We all feel
totally drained
& I know that
patients aren’t
happy either
I’m annoyed by the huge number of
DNAsI dread the inevitable
phone blitz at 8 every
morning
I can’t take the
aggression from
frustrated patients
anymore. I can’t magic
up an appointment
Not To Mention The Patients…
I’m frustrated that I
can’t speak to my GP
when I need to. I’m
very tempted to
change surgeries
A lot of the time I
don’t even need to
see the GP, so why
can’t I just phone,
save the travel cost,
hassle & my GP’s
time?
We’re told to ring at
8 but can never get
through because
they’ve told
everyone to call at
8.
It’s a joke!
Why do I have a 3-
week wait at my
surgery & yet I hear
of others who see
their doctor the
same day?
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
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
A Typical Receptionist Day With Patient Access
Reception takes call
Admin question
20% solve
20% bookto see nurse
Just 60% list
for GP
Nurse
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
GP phones patient
Problem solved
Come and see GP
Come and see nurse
10%
30%
60%
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 mins plus 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.
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.
Average wait time to see a GP drops dramatically
All data from Clarendon, charts by PA Navigator
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
What do patients think of our service?
• Administrative staff views– Not happy with current appointment system– Not happy with patient queues outside in mornings– Lack of appts– Difficult for patients to get appts if they don’t call in for
one– Patients not happy having to book appts a week ahead– Reception staff at brunt end of disgruntled patients– Struggle for appts thus poor feedback on NHS website– Most patients happy at Gatley
What do patients think of our service?
• Clinical staff views– Avoid wasting time– Patients want appts and better continuity – Current system offers appt with Dr in the morning (open
surgery)– But bookable appts nearly 7 days in advance– Difficulty getting thro on phones– Difficult getting appts when at work– Often long wait on ‘extras’ list
My daily work at present
• Administrative staff views– Front reception ; copy / summarising notes– Scanning; insurance work
• Clinical staff views– Patient access too easy– Inadequate appt times– Working life in surgery has become horrendous over last
6 mths– Patient expectations and demand out of control– Increased chances of patient complaints as patients feel
they can get financial compensation– Increased paperwork – never enough time to get done
during the day– Afternoon clinics run late due to complex probs and
elderly patients
My daily work at present
• Clinical staff views (cont)– Increased paperwork – never enough time to get done
during the day– Afternoon clinics run late due to complex probs and
elderly patients– Phone too many people back– Sometimes phones not answered / ansaphones– Too many trivial problems– Overbooked clinics with inapprop appt times– Overbooked clinics with inapprop appt times– Patients struggle for appts– Poor feedback on NHS wesbite
My ideal work
• Administrative staff views– Being able to get job in hand done
– Less chasing up / querying meds
– Most admin / reception staff happy with current roles
• Clinical staff views– see as many patients as possible
– Also safe and effective consultations
– fewer FTF appts; more using technology
– shorter surgeries; fewer visits; longer appt times for better consults
– booked appts only – no extras or unnecessary visits
– patients taking more responsibility for their health
My ideal work
• Clinical staff views (cont)– Have a lunch break and time to do paperwork– More telephone triage – opportunity to educate patients– Reduce home visits - mostly not necessary (93% of
time)– Seamless and instant flow of information from hospital
to GP via computer links– Enough time to see patients – flexible appt times– Good mix of population (young / old/ easy / complex)
problems
Fear losses if changes are made?
• Administrative staff views– How would patients request urgent prescriptions?– Loss of jobs?– Elderly moving away unless change is for the better– Not being ale to physically book appt for patients– Job satisfaction?– Appt bookings left to the Drs
• Clinical staff views– Safer prescribing, less overload– Difficulty with covering triage when drs away– Lack of freedom to do other activities due to time on
phones– More litigation as fewer FTF consults– More pressure on our time – new system hopefully more
effective– A system that no-one understands with patients
complaining– Unhappy admin staff
Why do patients call? Nearly 60% for GP.
How do patients request help? Very surprising large proportion are walk ins at 43%
When do they call? A strange double peak at 10am and 3pm – may be delayed submissions?
Do they get what they want? Appears that 93% do, but with only 124 responses, may not be all
When do they want the GP? Vast majority today, with some for a week ahead.
Consultations by day: Monday is a little higher
So far 82% of consults are face to face and only 16% by phone
Already you see 19% of consultations as “face to face not needed” – this always goes up lots.
Already you are resolving 63% of calls over the phone – though many others become visits?
Continuity seen as important in quite few consultations, only 30%. Patient requests 37%.