wallington medical centre 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
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